Introduction: The outbreak of novel coronavirus (severe acute respiratory syndrome coronavirus 2), which causes the coronavirus disease 2019 (COVID-19), is the most important current health problem. The number of patients is increasing worldwide. Pneumonia is the most life-threatening complication of the disease. Prolonged viral shedding in hematological patients with COVID-19 has been demonstrated; however, data on COVID-19 patients receiving anti-CD20 monoclonal antibody therapy are limited. Accordingly, focusing on humoral immunity, herein, we present 4 COVID-19 patients who were on anti-CD20 monoclonal antibody treatment and had prolonged pneumonia. Patient concerns: Two of 4 patients were on rituximab and the other 2 were on obinutuzumab therapy. Diagnosis: The polymerase chain reaction test results for severe acute respiratory syndrome coronavirus 2 were positive for all 4 patients and their COVID pneumonia lasted for >50 days. Interventions: Although all patients were treated with an adequate amount of convalescent plasma, prolonged polymerase chain reaction positivity and prolonged pneumonia were possibly due to the lack of ability of the immune system to initiate its antibody response. Outcomes: Despite the administration of standard therapies, recurrent pneumonia observed in the present case series of non-neutropenic patients, in whom primary malignancies were under control. Conclusions: It is suggested that further investigations should be performed to understand the underlying pathophysiology.

Nicotine is associated with increased incidence of periodontal disease and poor response to therapy. This article aimed at identifying the expression of Matrix metalloproteinases-2 (MMP2) and Vascular endothelial growth factor (VEGF) proteins on extracellular matrix, fibrous distribution and angiogenetic development in periodontitis caused by nicotine effects on periodontal membrane. In this experimental study, the groups were divided into nicotine and control groups. While the nicotine groups in rats (n=6) were administered 2mg/kg Nicotine sulphate for 28 days, the control group in rats (n=6) were only administered 1,5 ml physiologic saline solution subcutaneously for 28 days. Histological sections were prepared and immunohistochemically stained for MMP2 and VEGF. The sections were stained with Trichrome-Masson were observed under light microscope. VEGF and MMP2 immunoreactivity of periodontal gingiva and dentin was assessed by immunohistochemical staining. In conclusion, nicotine effect reduces Matrix metalloproteinases production and disrupt collagen synthesis and causes periodontitis. We observed that nicotine increases periodontitis by disrupting periodontal membrane and prevent tooth to anchor in dental alveoli by disrupting epithelial structure. Nicotine is associated with increased incidence of periodontal disease and poor response to therapy. This article aimed at identifying the expression of Matrix metalloproteinases-2 (MMP2) and Vascular endothelial growth factor (VEGF) proteins on extracellular matrix, fibrous distribution and angiogenetic development in periodontitis caused by nicotine effects on periodontal membrane. In this experimental study, the groups were divided into nicotine and control groups. While the nicotine groups in rats (n=6) were administered 2mg/kg Nicotine sulphate for 28 days, the control group in rats (n=6) were only administered 1,5 ml physiologic saline solution subcutaneously for 28 days. Histological sections were prepared and immunohistochemically stained for MMP2 and VEGF. The sections were stained with Trichrome-Masson were observed under light microscope. VEGF and MMP2 immunoreactivity of periodontal gingiva and dentin was assessed by immunohistochemical staining. In conclusion, nicotine effect reduces Matrix metalloproteinases production and disrupt collagen synthesis and causes periodontitis. We observed that nicotine increases periodontitis by disrupting periodontal membrane and prevent tooth to anchor in dental alveoli by disrupting epithelial structure.

Introduction: Acute hemolytic transfusion reaction is a rare but extremely mortal condition. Even small quantities of ABO-incompatible erythrocytes, as much as 50 mL, can lead to fatality. Since there is no successful standard therapy, preventive measures are very important. In this case report, we presented a 29-year-old woman who was transfused with 2 units of AB Rh-positive instead of 0 Rh-positive red blood cells following a cesarean section. As far as we know, this is the first patient in the literature for whom ruxolitinib was used as a part of therapy. Case Report: The patient was referred to our center 22 h after the ABO-mismatched transfusion. On admission, she had severe hemolysis, acute renal failure, and disseminated intravascular coagulation. Massive plasma exchange, hemodialysis, and pulse steroid therapy were commenced. The patient was refractory to first-line therapies. She was intubated on day 2 due to hypoxia, respiratory failure and changes in consciousness. Ruxolitinib, 2 × 10 mg/day, was started on day 3. The patient’s clinical status improved on day 6. Ruxolitinib was withdrawn on day 15, and the patient was discharged without any complications or sequels on day 26. Conclusion: Ruxolitinib may be life-saving in patients with ABO-incompatible transfusion reaction which follows a severe and catastrophic course.

Although inhibition of complement system at different steps is a promising therapy modality in PNH (paroxysmal paroxysmal nocturnal hemoglobinuria) patients, allogeneic hematopoetic stem cell transplantation (HCT) is still the only curative therapy especially for patients with intractable hemolysis or bone marrow failure. The aim of this study is to evaluate the outcomes of allogeneic HCT in PNH patients with or without aplastic anemia ( PNH-AA). 35 PNH / PNH-AA patients who were treated with allegeneic HCT in ten transplantation centers in Turkey were retrospectively analyzed. 16 (45.7 %) and 19 (54.3 %) patients were diagnosed as classical PNH and PNH / AA respectively. The median age of the patients was 32 ( 18-51) 2-year overall survival (OS) and GVHD-free, failure-free survival (GFFS) was 81.2 % and 78.1 % , respectively. 2 year OS in classical PNH and PNH /AA was 81.3 % and % 79.9 (p =0,87), respectively and 2 year GFFS in PNH and PNH/AA was 79% and 76% (0,977) without statistical significance. OS and GFFS rates did not differ between transplantations with matched sibling donor (MSD) and matched unrelated donor (MUD), neither. Allo HCT with MSD or MUD is a good option in selected patients with classical PNH and PNH / AA. Especially, patients with debilitating and refractory hemolysis and patients with bone marrow failure might form the excellent group for allo - HCT.