Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARSCoV-2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixtynine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality.

Introduction: Fludarabine, a purine analog, is getting more attention with the increasing use of reduced intensive conditioning regimens in allogeneic hematopoietic stem cell transplantation (allo-HSCT). The side effect of bradycardia was observed in only a few cases reported in the literature. In clinical practice, bradycardia can be asymptomatic or cause syncope and cardiac arrest. This study aimed to evaluate the bradycardia side effect of fludarabine used in the conditioning regimen in allo-HSCT recipients and to increase awareness of this issue. Methods: This retrospective study included 73 patients who received fludarabine in the allo-HSCT conditioning regimen between January 2015 and January 2021. Patients with and without bradycardia were compared regarding demographic data, allo-HSCT characteristics, electrolyte values, fludarabine administration dose and duration, and survival. Univariate and multivariate analyzes were performed to evaluate independent predictors for fludarabine-induced bradycardia. Results: Fludarabine administration doses and days were higher in the bradycardia group, but no statistically significant difference was observed. In the multivariate analysis, age was the only independent predictor of fludarabine-induced bradycardia (odds ratio (OR) 0.93, 95% confidence interval (CI): 0.89–0.98, p = 0.007). The median age in the group with bradycardia was 19 years younger than those without bradycardia (34 (19–49) vs 53 (19–69), p = 0.005). In 11 (84.6%) of the patients who had bradycardia, bradycardia improved with the discontinuation of fludarabine alone, but atropine was administered in 2 (15.4%) patients. Conclusion: Age was the only independent predictor of fludarabine-induced bradycardia; therefore, close heart rate monitoring is recommended during fludarabine administration, especially in younger patients.

Primary immune thrombocytopenia (pITP) is an acquired bleeding disorder related with mainly decreased number of platelets due to destruction or impaired production of platelets. Clinical presentation of pITP can be multifaceted, and thrombotic events may rarely manifest. Thrombosis can develop with treatment or during the untreated period. The primary objective of the study was to examine the frequency of arterial thromboembolism (ATE) in patients with pITP. We also aimed to evaluate the risk factors in these patients and the effect of ITP treatments on ATE. The study was designed as a retrospective, multicenter, conducted under the Turkish Society of Hematology's Scientific Subcommittee on Hemostasis-Thrombosis. Patients over the age of 18 with pITP and who subsequently developed ATE while undergoing follow-up for pITP were evaluated. A total of 2,178 patients with pITP were screened, and 37 patients (1.7%) were observed to have ATE. The mean age was 62 years. Fifteen (40.5%) of the patients who developed ATE were not receiving pITP treatment at the time of thromboembolism. The patients receiving pITP treatment at the time of ATE, 9 patients (24.3%) were receiving eltrombopag and 10 patients (27%) were receiving corticosteroids. Compared to patients who did not develop ATE, multivariate analysis revealed that presence of hypertension, comorbidity, and the history of venous thromboembolism statistically significantly increased the risk of developing ATE (p: 0.008, 0.018, 0.038). It should be noted that the risk of ATE may increase in pITP patients both during and without treatment. It is important to inquire thoroughly about the presence of comorbidities, atherosclerotic risk factors, hypertension and history of thrombosis in patients at the initiation of treatment. Correctable risk factors should be addressed to minimize the number of risk factors present. The treatment of pITP shall be individualized and incorporate age-related disorders.

Introduction: The COVID-19 vaccine is the most essential tool for altering the pandemic's trajectory. The pandemic's control is complicated by society's unwillingness to vaccinate. The aim of this cross-sectional study was to assess patients with hematological malignancies and their attitudes regarding COVID-19 immunization and to investigate COVID-19 anxiety in this susceptible population. Methods: In this cross-sectional study, 165 patients with hematological malignancies were included. COVID-19 anxiety was evaluated with the coronavirus anxiety scale (CAS), and COVID-19 vaccine attitude was evaluated with the Vaccine Attitudes Review (VAX) scale. Results: The mean CAS score was 2.42 (0-17). There were 22 (13%) participants with a mean CAS score of ≥ 9. Half of the participants had a CAS score of 0. The CAS score was higher in females (p = 0.023). Similarly, it was significantly higher in patients who were not in remission for hematological malignancy and who received active chemotherapy (p = 0.010). The mean VAX score was 49.07 ± 8.76 (27-72). Most of the participants (64%) had a neutral attitude toward the COVID-19 vaccination. In a survey of 165 patients, 55% said that they were skeptical about vaccination safety, and 58% said that they were concerned about unintended side effects. In addition, 90% expressed moderate concerns about commercial profiteering. Natural immunity was preferred by 30% of the participants. There was no statistically significant correlation between CAS scores and the Vaccine Attitudes Review (VAX) scale. Conclusion: This study draws attention to the level of anxiety in patients with hematological malignancies during the COVID-19 pandemic. Negative attitudes toward the COVID-19 vaccine are worrisome for at-risk patient groups. We think that patients with hematological malignancies should be informed to eliminate their hesitations about COVID-19 vaccines.