Myelodysplastic syndromes (MDS) are rare in women of reproductive age, and evidence regarding pregnancy outcomes remains limited. A systematic literature search identified 21 publications reporting MDS recognized before or during pregnancy, encompassing 69 pregnancies. The data were descriptively analyzed and stratified by timing of MDS diagnosis. Of the 69 pregnancies, 52% involved women diagnosed with MDS before conception, while 48% were diagnosed during pregnancy. Leukemic transformation occurred exclusively among cases diagnosed during pregnancy. The majority of pregnancies resulted in live births, with rates exceeding 93% in both groups, and neonatal complications being uncommon. MDS diagnosed during pregnancy appears to confer higher maternal risk, underscoring the need for early recognition and multidisciplinary management. This scoping review suggests that pregnancy can be successfully carried to term in selected women with MDS, particularly when disease stability is established prior to conception.

Glyphosate herbicide has been linked with airway diseases in adults. Evidence remains inconsistent, without investigations conducted in youthful populations. This study aims to examine the association between glyphosate and obstructive airway diseases in adult and youth samples in the National Health and Nutrition Examination Survey. Glyphosate exposure was categorized into tertiles. Separate multiple logistic regressions were conducted for adults and youths, adjusting for relevant covariates. Analyses were stratified by age. Sensitivity analyses explored associations with past-year asthma-related events. In total, 4031 adults and 1692 youths were included. There was a significant dose–response relationship between glyphosate and airway diseases in adults (tertile 2: aOR = 1.17, 95% UI: 0.94, 1.46, p = 0.15; tertile 3: aOR = 1.29, 95% UI: 1.02, 1.62, p = 0.03). Weak associations were shown between glyphosate and asthma in the youth sample (aOR = 1.08, 95% UI: 0.74, 1.58, p = 0.69); however, the relationship was more pronounced in adolescents (aOR = 1.33, 95% UI: 0.82, 2.15, p = 0.24). A dose–response pattern was observed between recent exposure and temporal outcomes in adults, reaching up to 75% higher odds of past-year asthma attacks among participants with glyphosate levels at the third tertile (tertile 3: aOR = 1.75, 95% UI: 0.92, 3.36, p = 0.09). These warrant timely monitoring and prevention strategies, with future research focusing on investigating longitudinal associations.

Background: Thrombosis remains a clinically important complication of acute promyelocytic leukemia (APL), coexisting with the prototypical hemorrhagic diathesis. Data from Gulf Cooperation Council (GCC) populations are limited in addition to data specifically about thrombosis, which is heterogenous in general. Objectives: To describe the incidence, clinical characteristics, treatment, and outcomes of thrombotic events in patients with APL treated at a tertiary center in the GCC. Methods: We conducted a retrospective cohort study of 75 consecutive patients with newly diagnosed APL managed at a single tertiary center. Baseline demographic variables (age, sex, regional background), hematologic parameters (hemoglobin, leukocyte, platelet counts), and coagulation indices (fibrinogen, activated partial thromboplastin time, prothrombin time, international normalized ratio, and D-dimer) were compared between patients with and without thrombosis. Thrombotic event type, timing, antithrombotic management, bleeding complications, and mortality (including early mortality within 30 days) were recorded. Results: Eleven of 75 patients (14.7%) developed thrombosis. Baseline demographic characteristics, hemoglobin level, leukocyte count, platelet count, fibrinogen, and activated partial thromboplastin time were comparable between patients with and without thrombosis, whereas prothrombin time, international normalized ratio, and D-dimer levels were numerically higher in patients who developed thrombosis. Most thrombotic events (73%) occurred during active therapy, and the majority were venous (55%). Pulmonary embolism accounted for 36% of all thrombotic episodes, and catheter-associated thromboses represented a clinically relevant subset. Anticoagulation was initiated in 45% of patients with thrombosis and antiplatelet therapy in 18%. Bleeding episodes occurred in 36% of patients who experienced thrombosis. Thrombosis was associated with a 27% all-cause mortality. Conclusions: In this GCC APL cohort, thrombosis, though less frequent than bleeding, emerged as a serious and clinically significant manifestation associated with substantial morbidity and mortality. These findings underscore the need for vigilant thrombo-hemorrhagic assessment and individualized antithrombotic strategies, particularly during induction and early consolidation therapy.

Background: Outcomes in chronic myeloid leukemia (CML) remain heterogeneous despite effective BCR::ABL1 tyrosine kinase inhibitors (TKIs). Somatic mutations in epigenetic regulators, particularly additional sex combs-like 1 (ASXL1), have been implicated in adverse prognosis, but their clinical impact in CML has not been systematically defined. Methods: A systematic review was conducted using CINAHL, EMBASE, MEDLINE Ultimate, and PubMed from inception through August 2025. A total of 1339 records were identified; the eligible studies included adult and pediatric patients with chronic and advanced-phase (accelerated or blast) CML. After duplicate removal and screening, 11 studies met the inclusion criteria; these included adult patients only and were included in a qualitative synthesis and meta-analysis. ASXL1 mutation status was assessed using validated molecular methods. The outcomes included the molecular response, cytogenetic response, survival, and treatment resistance. Random-effects models were used to calculate the pooled odds ratios (ORs) with 95% confidence intervals (CIs). Statistical heterogeneity was assessed using the I² statistic. Results: Across the included studies, ASXL1 mutations were detected in approximately 15% of patients. At 12 months, patients with ASXL1 mutations had significantly lower odds of achieving a major molecular response (MMR) compared with ASXL1-wildtype patients (OR 0.29; 95% CI 0.16–0.51; p < 0.0001; I² = 30%). No statistically significant difference was observed in the complete cytogenetic response (CCyR) (OR 0.30; 95% CI 0.02–5.31; p = 0.41; I² = 68%). Compared with patients harboring other non-ASXL1 somatic mutations, an ASXL1 mutation was not associated with a significant difference in MMR (OR 0.49; 95% CI 0.23–1.05; p = 0.067; I² = 0%). Conclusions: ASXL1 mutations may be associated with an inferior molecular response to TKI therapy in CML, supporting their role as an adverse prognostic biomarker. These findings highlight the potential value of incorporating myeloid mutation profiling into future CML risk-stratification strategies.

Background: Outcomes in chronic myeloid leukemia (CML) remain heterogeneous despite effective BCR::ABL1 tyrosine kinase inhibitors (TKIs). Somatic mutations in epigenetic regulators, particularly additional sex combs like 1 (ASXL1), have been implicated in adverse prognosis, but their clinical impact in CML has not been systematically defined. Methods: A systematic review was conducted using CINAHL, EMBASE, MEDLINE Ultimate, and PubMed from inception through August 2025. A total of 1,339 records were identified; after duplicate removal and screening, 11 studies met inclusion criteria and were included in qualitative synthesis and meta-analysis. Eligible studies included adult and pediatric patients with chronic and advanced phase (accelerated or blast) CML with ASXL1 mutation status assessed using validated molecular methods. Outcomes included molecular response, cytogenetic response, survival, and treatment resistance. Random-effects models were used to calculate pooled odds ratios (ORs) with 95% confidence intervals (CI). Statistical heterogeneity was assessed using the I² statistic. Results: Across included studies, ASXL1 mutations were detected in approximately 16% of patients. At 12 months, ASXL1-mutated patients had significantly lower odds of achieving major molecular response (MMR) compared with ASXL1–wildtype patients (OR 0.29; 95% CI 0.16–0.51; p< 0.0001; I²=30%). No statistically significant difference was observed in complete cytogenetic response (CCyR) (OR 0.30; 95% CI 0.02–5.31; p=0.41; I²=68%). Compared with patients harbouring other non-ASXL1 somatic mutations, ASXL1 mutation was not associated with a significant difference in MMR (OR 0.49; 95% CI 0.23–1.05; p=0.067; I²=0%). Conclusions: ASXL1 mutations are associated with inferior molecular response to TKI therapy in CML, supporting their role as an adverse prognostic biomarker. These findings highlight the potential value of incorporating myeloid mutation profiling into future CML risk-stratification strategies.

Background: Sodium-glucose cotransporter 2 (SGLT2) inhibitors are widely used in the management of type 2 diabetes mellitus (T2DM) due to their survival benefits. However, these agents are associated with increases in hemoglobin (Hgb) and hematocrit (Hct), raising concern for secondary polycythemia or erythrocytosis and potential thrombotic risk. The clinical significance of these hematologic changes remains unclear. Methods: We conducted a systematic review and meta-analysis in accordance with PRISMA guidelines. PubMed, Scopus, and Embase were searched up to February 2026 for studies evaluating the effect of SGLT2 inhibitors on hematologic parameters in adults with T2DM. Patients with primary polycythemia, end-stage renal disease (ESRD), or heart failure were excluded. Primary outcomes were changes in Hgb and Hct. Secondary outcomes included the incidence of erythrocytosis/polycythemia and thrombotic events. Results: A total of 10 studies met inclusion criteria, comprising randomized and observational studies, with follow-up ranging from 8 weeks to 24 months. SGLT2 inhibitors, including empagliflozin, dapagliflozin, and canagliflozin, were consistently associated with increases in Hgb and Hct. Across three randomized controlled trials, SGLT2 inhibitors significantly increased hematocrit (3 studies, 171 patients, pooled mean difference + 2.29%, 95% CI 1.48 to 3.09) and hemoglobin (3 studies, 171 patients, pooled mean difference + 0.51 g/dL, 95% CI 0.28 to 0.74) compared with placebo. Real-world data (9,646 patients) reported an increase in polycythemia prevalence from 2.4% to 9.7%, with severe cases in 1.4% of patients. Limited data suggested a potential association with thrombotic events, with one observational study of 100 patients with JAK2-unmutated erythrocytosis reporting a 10% event rate. Hematologic changes were observed early after treatment initiation and appeared reversible following drug discontinuation. Conclusions: In patients with type 2 diabetes, ESRD, or heart failure, SGLT2 inhibitor use is associated with consistent increases in hemoglobin and hematocrit. Although these effects may contribute to cardiovascular benefit, a subset of patients may develop clinically significant erythrocytosis. Clinicians should be aware of this potential effect and monitor high-risk individuals. Larger prospective studies are needed to better define the clinical significance of these findings.