To evaluate the incidence, clinical features, risk factors, and prognosis of central nervous system (CNS) involvement in patients with acute myeloid leukemia (AML). All AML patients who were admitted to Hacettepe University hospital between 2000 and 2021 were evaluated. The medical records of 548 AML cases were retrospectively analyzed. The frequency of CNS involvement was 2.4% (n=13) at diagnosis and 4.6% (n= 25) at diagnosis or during follow-up. Parenchymal involvement was seen in 5 patients, leptomeningeal involvement was seen in 11 patients. Three patients had both leptomeningeal and parenchymal involvements and 6 patients had optic nerve or ocular involvement. In univariate analysis; younger age and extramedullary involvement at diagnosis were associated with CNS disease at diagnosis and extramedullary involvement at diagnosis was associated with CNS disease during follow-up. In multivariate analysis; younger age and extramedullary involvement at diagnosis were associated with CNS disease at diagnosis and during follow-up respectively. Median overall survival was 5.4 months in patients with CNS disease at diagnosis and 16.9 months in patients with CNS disease during follow-up and 16.2 months in patients with no CNS disease. CNS disease is a rare complication of AML. Younger age and extramedullary involvement at diagnosis are risk factors for CNS involvement.

Background: Several studies have suggested that the serum albumin–creatinine ratio (sACR) is a useful marker for the early risk stratification of patients with cardiomyocyte injury. This study aims to evaluate the relationship between sACR and anthracycline-related cardiotoxicity. Methods: This study included patients who had received anthracycline-based chemotherapy between 2014 and 2023 and had undergone baseline and follow-up echocardiography after the treatment. The level of sACR was calculated using serum albumin and creatinine values obtained before the chemotherapy. The definition of cardiotoxicity was based on the criteria of the European Society of Cardiology (ESC) for ejection fraction and the American Society of Echocardiography (ASE) for diastolic dysfunction. The patients were categorized into either the high or low sACR group based on the cut-off value obtained from the receiver operating characteristic (ROC) curve analysis. Results: In total, 525 patients (159 males, 366 females) were included. Multivariate analysis after adjustment for age, body mass index (BMI), cardiovascular disease, hemoglobin, anthracycline dose, and gender showed that sACR (HR = 1.85% 95 CI 1.12 to 3.06 p = 0.016), cardiovascular disease (HR = 1.97% 95 CI 1.08 to 3.61 p = 0.027), BMI (HR = 1.86% 95 CI 1.12 to 3.10 p = 0.017), and age (HR = 1.02% 95 CI 1.001 to 1.04 p = 0.036) were significantly associated with an increased risk of cardiotoxicity. Conclusions: This study is the first to show a significant relationship between sACR and cardiotoxicity related to anthracycline use. Routine laboratory tests that are conducted before anthracycline therapy can aid clinicians in identifying high-risk patients who may require closer follow-up or cardioprotective measures.

Background: Delays in treatments are frequent in real-world lymphoma management. This study evaluates the impact of diagnosis-to-treatment intervals (DTIs) and first inter-cycle delay (IcD) on outcomes in patients with Hodgkin lymphoma (HL) receiving ABVD chemotherapy. Methods: We retrospectively analyzed 137 patients with classical HL treated with ABVD at a single institution between 2015 and 2022. Results: The median age was 34 years (range: 18–73), and 62% were male. The median DTI was 14 days, with 24.1% of patients experiencing a delay of >7 days between the first and second chemotherapy cycles. The most frequent reason for delay was neutropenia, observed in 69% of delayed cases. Neither DTI nor IcD was significantly associated with PFS or OS. Multivariate analysis identified elevated beta-2 microglobulin as an independent predictor of both inferior PFS and OS. Conclusions: This is the first study to evaluate both DTI and first IcD as independent prognostic factors in HL. Modest delays in treatment initiation or early cycle administration did not negatively affect survival. Timely but flexible scheduling of ABVD may be appropriate in HL. Prospective studies are warranted in the era of novel therapeutic agents.