Background and Objective: Perianal pathologies are the most common cause of perianal infections in patients with hematological malignancies. Perianal infection diagnosis in this group of patients is difficult, thus careful anorectal examination is necessary, with imaging modalities. The literature revealed a knowledge gap on the approach of anal pathologies in patients with neutropenia during diagnosis or chemotherapy. This study aimed to examine our institutional data of perianal complications and investigate the relationship among the white blood cell-neutrophil count, perianal lesion, and the type of treatment in patients with hematologic malignancies during the neutropenic period. Methods: Patients with a hematologic malignancy, hospitalized for cytotoxic chemotherapy, complicated by perianal pathology, and documented by at least one imaging method were included in the study. Results: A total of 42 patients were included in the study. The comparison between the groups revealed no statistical significance between the anal abscess formation and the neutrophil count and previous perianal pathology. A statistical significance in favor of acute myeloid leukemia was found between patient diagnosis and anal abscess development. An inverse relationship was found between the number of white blood cells at hospitalization and having an anal pathology operation. It was observed that patients with high white blood cell count were less operated on due to anal pathology. Conclusions: In conclusion, this article has shown that white blood cell count at the time of hospitalization in patients with hematological malignancy, can affect the operation status of patients due to anal pathologies that may occur in the neutropenic period.

The impact of inflammatory markers such as systemic immune-inflammation (SII) index and systemic inflammation response index (SIRI) on myelofibrosis (MF) prognosis was evaluated for the first time in this study. Data from 60 patients diagnosed with MF between March 2011 and September 2022 were retrospectively analyzed. In addition to disease-related markers, the impact of SII and SIRI on prognosis was evaluated. In our study, the overall median survival (OS) was 64 months. OS was significantly shorter in patients older than 65 years, with high ferritin and lymphocyte levels, transfusion dependence at diagnosis, platelet count below 100 × 10⁹/L, Hb level below 8 g/dl, and high risk according to the dynamic international prognostic scoring system (DIPSS)-Plus score. When these variables were included in the multivariate Cox regression model, it was found that being older than 65 years, having a high ferritin value, being at high risk according to the DIPSS-plus score and Hb values below 8 increased the risk of death. Platelet-to-lymphocyte ratio (PLR) and SII index were lower in patients with a fatal outcome. No statistically significant relationship was found between SIRI and mortality. The findings of this study showed that low PLR and high ferritin were associated with poor prognosis in MF. Elevated SII and SIRI, evaluated for the first time in patients with myelofibrosis, did not predict prognosis. Since non-inflammatory variables play a role in the pathogenesis of MF, bone marrow indicators and systemic inflammation indicators derived from hematologic parameters may not be accurate.

Kaposi sarcoma is a rare disease and there is a gap in the literature about which chemotherapeutics should be applied, especially for the classical type. We aimed to present our institutional data on the demographic characteristics, treatment, and treatment efficacy in 16 Kaposi sarcoma (KS) patients treated with chemotherapy. We retrospectively analyzed the demographic and clinical characteristics, and the chemotherapeutic agents administered to the 16 KS patients diagnosed in our center and treated with chemotherapy, based on the medical records obtained. The median age, gender, type of KS, site of involvement, cytotoxic agents administered, progression-free survival (PFS), overall survival (OS), objective response rate (ORR), disease control rate (DCR), and safety profiles of the patients were evaluated. The median age at disease onset was 61.07 years (range, 39.4–85.8 years). Among the patients, 1 had immunosuppression-related KS, 4 had AIDS-related KS, and 11 had classical KS. In the first-line cytotoxic therapy, 7 patients received pegylated-liposomal doxorubicin (PLD), 6 patients received paclitaxel, 2 patients received oral etoposide, and 1 patient received the adriamycin, bleomycin, and vincristine regimen. In the Kaplan–Meier analysis, the PFS was 39.9 months (95% CI, 7.7–72.0). In the first-line setting, a significant difference in terms of PFS was observed between the PLD- and paclitaxel-treated groups (not reached vs. 12.8 months, p = 0.033). The OS was 66.1 months (95% CI, 30.2–102.0). The ORR of the 16 patients was 43.8%, and their DCR was 81.3%. No grade 3 or 4 toxicity was observed. This retrospective study showed that PLD seems better than paclitaxel in terms of PFS and response rates and it has shown to have a good safety profile in KS patients.

Background and Objectives: Bleeding is a major cause of mortality in cases of acute myeloid leukemia (AML)-associated disseminated intravascular coagulation (DIC). The predictive power of the standard International Society on Thrombosis and Hemostasis (ISTH) score for bleeding in patients diagnosed with AML is limited. This study aimed to evaluate the performance of the standard ISTH score and modified versions in predicting bleeding among acute promyelocytic leukemia (APL, M3) and non-APL AML subgroups. Methods: This single-center, retrospective study included 190 AML patients (61 APL, 129 non-APL). The predictive power of the original ISTH score and eight different modified scores—incorporating parameters such as lactate dehydrogenase (LDH) and genetic positivity—for DIC-related bleeding was assessed using receiver operating characteristic (ROC) analysis. Results: In the APL group, the original ISTH score was statistically significant in predicting DIC-related bleeding (AUC = 0.727), but the modifications did not improve performance. In the non-APL AML group, the original score did not predict bleeding (AUC = 0.632, p = 0.079). However, a modified ISTH score excluding D-dimer and including LDH (≥800 mg/dL) and genetic positivity significantly improved prediction (AUC = 0.710, p = 0.005). This modification increased specificity from 48.2% to 60.7% and sensitivity from 76.5% to 82.4%. Conclusions: A subtype-specific approach is required to predict bleeding risk in AML-associated DIC. Modified ISTH scores remain suboptimal for APL; however, a modified score incorporating LDH and genetic status represents a promising tool to identify non-APL AML patients at risk of bleeding and warrants prospective validation.

Background and Objectives: Advanced solid organ tumors, particularly breast, lung, and prostate cancers, frequently metastasize to bone, leading to debilitating skeletal-related events (SREs). Denosumab, a RANKL inhibitor, is crucial in preventing SREs. This study aimed to comparatively evaluate the efficacy and adverse effect profiles of denosumab in patients with bone metastases originating from these three common cancer types. Materials and Methods: This retrospective study included 146 patients treated with denosumab for bone metastases. Data on demographics, SREs before and during denosumab treatment, serum creatinine, calcium, and magnesium levels (at baseline, 3, and 6 months), other adverse effects, and survival were analyzed. Results: Before denosumab, SREs were present in 36.3% of patients (breast: 43.4%, prostate: 28%, lung: 33.8%). During denosumab treatment, SRE rates markedly decreased across all groups (breast: 9.4%, prostate: 16.0%, lung: 8.8%), with no significant intergroup difference in on-treatment SREs. Significant decreases in serum calcium levels were observed at 3 and 6 months post-denosumab initiation in breast (p < 0.0001) and lung cancer patients (p = 0.001). Mean creatinine levels significantly decreased in lung (p < 0.0001) and prostate (p = 0.020) cancer patients at 3 and 6 months. Overall survival significantly differed, with lung cancer patients having the shortest median survival (p < 0.005). Conclusions: Denosumab effectively reduces the incidence of SREs in patients with bone metastases from breast, lung, and prostate cancer. However, clinicians must diligently monitor for hypocalcemia, a notable adverse effect, particularly at 3 and 6 months after starting denosumab, with specific caution warranted in patients with lung cancer.