Background/Objectives: The modified Endothelial Activation and Stress Index (mEASIX), derived from routinely available laboratory parameters, has emerged as a potential biomarker reflecting systemic inflammatory and endothelial stress. However, its prognostic value in myelodysplastic syndromes (MDS) remains incompletely defined. This study evaluated the association between the mEASIX and overall survival and explored its time-dependent prognostic pattern. Methods: This retrospective study included 151 patients with MDS. The mEASIX score was calculated using C-reactive protein, lactate dehydrogenase, and platelet count and was log-transformed for regression analyses. Overall survival was estimated using the Kaplan–Meier method. Univariable and multivariable Cox proportional hazards models were used to evaluate prognostic factors, including age, IPSS-R risk group, hypomethylating agent (HMA) exposure, and venetoclax exposure. The proportional hazards assumption was assessed, and landmark analyses were performed at the median follow-up time (29 months). Receiver operating characteristic analysis was used to determine the optimal mEASIX cut-off value for mortality prediction. Model comparison, internal validation, and sensitivity analyses were also performed. Results: During a median follow-up of 29 months, 85 deaths occurred. The mEASIX yielded an AUC of 0.767 for mortality prediction (95% CI 0.691–0.844; p < 0.001). Patients with a high mEASIX had inferior overall survival (log-rank p < 0.001). In multivariable Cox regression analysis including age, IPSS-R risk group, HMA exposure, and venetoclax exposure, log(mEASIX) remained independently associated with inferior overall survival (HR 1.325, 95% CI 1.166–1.506; p < 0.001). In landmark analyses, this association persisted during the early follow-up period (≤29 months; HR 1.347, 95% CI 1.172–1.548; p < 0.001) but was attenuated during the late period (>29 months; HR 1.287, 95% CI 0.930–1.782; p = 0.128). Conclusions: The baseline mEASIX was independently associated with overall survival in patients with MDS and appeared most prognostically relevant during early follow-up. These findings suggest that the mEASIX may complement established risk models, although further validation is needed before broader clinical use.

Background: Autologous stem cell transplantation (ASCT) remains a cornerstone in the management of multiple myeloma (MM). However, the optimal timing of ASCT and the factors determining whether patients ultimately undergo transplantation remain unclear in real-world practice. The Revised Myeloma Comorbidity Index (R-MCI) was developed to quantify patient fitness but its influence on transplant eligibility and timing has not been fully characterized. Methods: We conducted a retrospective single-center study including 137 patients with newly diagnosed MM between 2015 and 2025. Clinical parameters recorded at diagnosis included age, sex, performance status, renal and pulmonary function, cytogenetic risk, International Staging System (ISS) stage, and bone marrow plasma cell infiltration. The R-MCI was calculated for all patients. Transplant timing was categorized as early (≤12 months) or delayed (>12 months) after diagnosis. Logistic regression analysis was performed, and variables with p < 0.10 in univariate analyses were included in the multivariate model. Early versus delayed ASCT was defined as ≤12 months or >12 months from diagnosis, respectively. Results: ASCT was performed in 61/137 patients (44.5%), while 42.6% of these underwent early transplantation. Transplanted patients were significantly younger (<65 years: 82.0% vs. 25.0%, p < 0.001) and had lower R-MCI scores (median 0 vs. 1, p < 0.001) compared with non-transplanted patients, while plasma cell infiltration and ISS stage did not differ. In multivariate analysis, R-MCI was the only variable showing a trend toward predicting early transplantation (OR 0.27, 95% CI 0.07–1.06, p = 0.06). Conclusions: In real-world MM management, patients quantified by R-MCI appear to play a more prominent role than disease burden in determining both eligibility for and timing of ASCT. Incorporating comorbidity indices alongside ISS may enhance individualized transplant decision-making and optimize treatment outcomes.

Background/Objectives: Early death (ED) remains the primary barrier to long-term survival in acute promyelocytic leukemia (APL). Since current risk stratification models rely solely on static baseline parameters, they fail to capture the high biological volatility during the induction phase. We aimed to evaluate the prognostic value of the dynamic evolution of the endothelial activation and stress index (EASIX). Materials and Methods: This multicenter, retrospective study analyzed 131 newly diagnosed adult APL patients treated with the AIDA protocol. EASIX scores were calculated at admission (D0) and day 7 (D7). ROC, landmark, multivariable logistic and Cox regression analyses were performed to assess the impact of dynamic endothelial changes (ΔEASIX) on mortality and survival. Results: The ED rate was 25.2%. While baseline EASIX successfully predicted very early death ( 0.35) was an independent predictor of early mortality (OR: 12.41, p = 0.007), inferior EFS (HR: 5.70, p = 0.004), and poor OS (HR: 3.69, p = 0.023). Landmark analysis stratified by the kinetic trajectory of ∆EASIX confirmed that patients above the optimal cut-off had significantly inferior 3-year EFS (56.3% vs. 77.8%, p = 0.041) and OS (59.5% vs. 78.0%, p = 0.026). Conclusions: To our knowledge, this is the first study to establish EASIX as a dynamic prognostic marker in APL. Our findings indicate that the “kinetic trajectory” of endothelial stress is a more accurate predictor of survival than static baseline assessment alone. While dynamic EASIX monitoring offers a valuable tool for real-time risk reclassification, these results require validation through prospective studies.

Calcineurin inhibitors,clinical nephrology,immunosuppressive therapy,membranous nephropathy,Rituximab

Background and Objectives: Familial Mediterranean Fever (MEFV) gene variants exhibit a high carrier frequency in the Turkish population and modulate clinical phenotypes through persistent low-grade innate immune activation. However, their role in myeloid malignancies—where aberrant inflammasome signaling contributes to immunopathogenesis—remains poorly defined. We aimed to investigate the carrier frequency and potential disease-modifying role of common MEFV variants in patients with acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). Materials and Methods: In this retrospective case–control study, 80 clinical evaluations from 75 unique patients with myeloid malignancies (53 AML and 27 MDS, including 5 patients evaluated in both cohorts before and after leukemic transformation) and 186 healthy controls from the Turkish population were analyzed. Four established pathogenic exon 10 variants (M694V, V726A, M680I, and M694I) and two variants of uncertain significance (VUS; K695R and E148Q) were genotyped using rhAmp™ SNP Genotyping and polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) assays. Clinical characteristics, blastic progression, and survival outcomes were evaluated. Results: Overall MEFV variant carriage did not differ significantly between the unique patient cohort and healthy controls (24.0% [18/75] vs. 19.9% [37/186], p = 0.462; or 23.8% [19/80] across all disease evaluations, p = 0.479). In the MDS cohort (n = 27), 10 mutant alleles were detected in 9 unique patients (variant frequency: 37.0% vs. 19.9% in controls, p = 0.045; unique carrier frequency: 33.3% vs. 19.9%, p = 0.113), as one female MDS patient was a compound heterozygote (M694V/V726A). Stratified analysis revealed that this enrichment in MDS was driven by established pathogenic exon 10 variants (22.2% [6/27] vs. 9.1% [17/186], p = 0.041; allele frequency: 11.1% [6/54] vs. 4.6% [17/372], p = 0.047), whereas VUS frequencies were comparable (14.8% vs. 10.8%, p = 0.533). Within the MDS group, male patients showed an exploratory trend toward a higher carrier rate than females (60.0% [6/10] vs. 17.6% [3/17], Fisher’s exact p = 0.039). Conversely, MEFV variant frequency in AML mirrored that of controls (20.8% [11/53] vs. 19.9%, p = 0.890). Baseline clinical parameters and overall survival did not differ significantly by genotype, although MEFV-positive MDS patients exhibited a non-significant numerical trend toward a shorter interval to blast progression (12.7 vs. 36.2 months). Conclusions: Our findings provide exploratory, hypothesis-generating evidence suggesting a potential enrichment of pathogenic exon 10 MEFV variants in MDS—particularly among male patients—but not in AML. Given the small sample size and retrospective design, these observations require validation in larger multi-center cohorts, and future studies may explore whether MEFV genotyping offers clinical or prognostic utility in high-prevalence populations.

Background: Infections are a leading cause of morbidity and mortality in multiple myeloma (MM), particularly during the induction phase. Identifying real-world infection patterns and predictors is crucial for guiding preventive strategies. Methods: This retrospective cohort study included 161 newly diagnosed MM patients who received standard induction therapy at a single tertiary center between 2016 and 2024. Clinical, laboratory, and infection-related parameters were analyzed over the first 12 months. Results: Infections occurred in 50.9% of patients, with the highest incidence within the first 3 months (27.3%, p = 0.004). Pneumonia was the most common type (34.1%), and gram-negative bacteria, particularly Escherichia coli , Klebsiella spp. , and Pseudomonas aeruginosa , were predominant. Antibiotic resistance to TMP-SMX and levofloxacin was observed in E. coli isolates. Multivariate analysis identified advanced ISS stage (OR: 3.83), diabetes mellitus (OR: 3.64), and chronic kidney disease (OR: 6.01) as independent predictors of infection ( p < 0.05). Lymphocyte counts were significantly lower in febrile episodes ( p = 0.040), highlighting a possible early immune marker. Hospitalization was more common in patients with advanced ISS and kidney disease. No significant differences were found between induction regimens. Conclusion: Infections pose a significant burden during the first year of MM treatment, particularly in high-risk patients during early induction. Readily available clinical parameters can aid in early risk stratification. These findings support a risk-adapted approach to prophylaxis, including the selective use of levofloxacin in patients with diabetes or kidney disease during the first 3 months of therapy.