Background: Limited real-world data (RWD) may provide important information regarding diagnostic and treatment patterns in patients (pts) with AL Amyloidosis. The aim was to analyze the characteristics, treatment approach and clinical outcome of patients in the real-world settings. Materials and Methods: RWD of 60 pts diagnosed with AL amyloidosis were analyzed. Advanced cardiac involvement, Mayo Clinical Stage (CS) IIIa and IIIb, and Revised-Mayo CS III and IV, has been found in 26.7%, and 16.7%, or 33.3% and 16.7%, respectively. Bortezomib (Bz)-based regimens were applied in 36 pts (60%), and alkylating-based regimens in 24 pts (40%). In 8 pts (13.3%) treated initially with CyBorD induction, high-dose therapy with Melphalan and autologous stem cell transplantation (HDT + ASCT) was applied as the first line of treatment. Results: The overall response rate (ORR, ≥partial response) was achieved in 40 pts (70%). Patients treated with Bz-based induction followed by HDT + ASCT achieved significantly better hematologic (p = 0.001), cardiac (p = 0.004) and renal response rates (p = 0.002) in comparison to CyBorD or Alk-based regimens alone. There was no difference in PFS between those groups (p = 0.733), but patients treated with CyBorD + HDT + ASCT had significantly durable OS (p = 0.039). Univariate analysis pointed out the predictive influence of cardiac involvement (Mayo CS and Revised Mayo CS), ASCT eligibility, and hematologic, cardiac, renal and composite response rates. Conclusions: Advanced cardiac involvement and cardiac and hematologic response still retain adverse prognostic impact on the clinical outcome. Bz-based combinations significantly improved the survival of patients with AL amyloidosis, regardless of HDT + ASCT treatment.

Introduction: Chemotherapy-induced neutropenia is often complicated by the development of febrile neutropenia (FN) which is associated with infections, dose reductions/delay of chemotherapy, quality of life deterioration, and increased treatment costs. Study aim: The study aims to research the association between risk factors for FN and the significance of applying G-CSF in patients with hematological malignancies. Materials and methods: We evaluated 90 patients with lymphoma, multiple myeloma (MM), and myelodysplastic syndrome (MDS) treated at the Day-care Unit of the University Clinical Center of Serbia (UCCS) Clinic for Hematology, between January and June 2024. Results: The study included 90 patients with the following diagnoses: 70 (77.8%) patients with lymphomas, 12 (13.3%) patients with MM, and 8 (8.9%) patients with MDS, of whom 42.2% (38/90) male and 57.8% (52/90) female. FN was observed in 22 (24.4%) patients, while 68 (75.6%) patients did not develop FN. The distribution of FN by lymphoma type was as follows: 57.9% in aggressive lymphomas, 31.6% in indolent lymphomas, and 10.5% in Hodgkin's lymphoma. FN was associated with a higher incidence of advanced clinical stages of disease, with 70% in stages III and IV. Patients with FN had significantly higher rates of bulky tumor mass (54.5% vs. 25%; p = 0.010), more lines of chemotherapy (p = 0.020), more cycles of chemotherapy (p = 0.027), more immunotherapy cycles (p = 0.025), as well as more infections (59.1% vs. 27.9%; p = 0.008), antibiotic use (95.5% vs. 33.8%; p = 0.004), and G-CSF administration (54.5% vs. 11.8%; p < 0.001), with more G-CSF ampoules used (5.0 vs. 1.0; p < 0.001). Higher CRP levels were also significantly associated with FN (7.2% vs. 3.3%; p = 0.012). Conclusion: Our study has shown that the number of lines of therapy, the number of immunochemotherapy cycles, the clinical stage, the presence of bulky tumor mass, and the aggressiveness of the lymphoma affected FN development.

Circulating tumor DNA (ctDNA) has emerged as a promising minimally invasive biomarker in multiple myeloma (MM), providing dynamic insight into tumor burden, clonal evolution and molecular heterogeneity. Unlike conventional bone marrow-based diagnostics, ctDNA analysis offers a systemic approach to disease assessment and may better reflect spatially heterogeneous and extramedullary disease. Recent advances in highly sensitive molecular techniques, including digital droplet polymerase chain reaction and next-generation sequencing, have improved the feasibility of ctDNA detection and longitudinal disease monitoring in MM. Increasing evidence demonstrates substantial concordance between ctDNA and bone marrow genomic profiles, while also highlighting the ability of ctDNA to identify resistant subclones, molecular relapse and genomic evolution during therapy. ctDNA has shown potential clinical utility in molecular profiling, therapeutic monitoring and minimal residual disease assessment. ctDNA may become increasingly relevant in the era of novel immunotherapies, including chimeric antigen receptor T-cell therapy and bispecific antibodies. Despite these promising applications, several biological and technical limitations still restrict routine clinical implementation, including low ctDNA concentration in patients with minimal disease burden and lack of methodological standardization. Overall, ctDNA represents a rapidly evolving tool with significant potential to improve personalized disease monitoring and therapeutic strategies in MM.

Introduction: Gastroschisis is a congenital paraumbilical defect of the anterior abdominal wall with evisceration of the abdominal organs. A modern approach to treating gastroschisis has contributed to better results, as evidenced by the 5%-10% mortality rate. Aim: The study aims to evaluate the frequency of complications and death in the population due to gastroschisis, as well as the connection between the surgical techniques used in the treatment and the outcome of the treatment. Material and methods: The retrospective cohort study included 75 patients diagnosed with gastroschisis, treated from 2000 to 2020 at the Mother and Child Health Institute of Serbia Dr Vukan Čupić. By applying the exclusion criteria, a sample of 61 patients was obtained. Two cohorts of subjects were formed based on the applied surgical method, namely: primary repositioning and fascial closure of the defect (gastroschisis surgical cohort-GSC), i.e. delayed primary repositioning of the defect using a silastic bag (silastic gastroschisis cohort-SGC). Results: The gastroschisis surgical cohort comprised 38 patients, while the silastic gastroschisis cohort comprised 23 subjects. It was found that necrotizing enterocolitis (NEC) was a statistically significantly more frequent complication in subjects from the silastic gastroschisis cohort (5/23, i.e. 21.7% in SGC and 0/38 in GSC; RR 0.32, 95% CI: 0.22-0.47; p = 0.003). The statistical significance of the difference in relation to the frequency of other complications was not proven: ileus (0/23 in SGC and 5/38, i.e. 13.2% in GSC; RR 0.59, 95% CI: 0.47-0.73, p = 0.069), compartment syndrome (0/23 in SGC and 2/38, i.e. 5.3% in GSC; RR 0.61, 95% CI: 0.50-0.75, p = 0.263) and death (2/23, i.e. 8.7% in SGC and 2/38, i.e. 5.3% in GSC; RR 1.26, 95% CI: 0.46-3.43, p = 0.600). Conclusion: There is no distinctive proof of the superiority of one method over another. The risks of ileus and compartment syndrome are higher when applying primary fascial closure of the defect, while the risks of NEC and fatal outcome are higher when the silo method (use of a silastic bag, i.e., silo bag) is applied. The choice of method in treating gastroschisis depends on the abdominovisceral disproportion and the physical appearance of the eviscerated intestines, assessed with the Gastroschisis Prognostic Score (GPS).