Approach to the Older Patient with Acute Myeloid Leukemia.

Purpose Of Review: This study aims to review the challenges of treating AML in older patients, the spectrum of genomic aberrancies in this cohort, and discuss treatment options for newly diagnosed AML in this patient population.

Recent Findings: Greater understanding of biological underpinnings of AML and availability of newer, effective, targeted therapies have allowed us to move away from intensification of chemotherapy, to prioritize better tolerability while still maintaining efficacy. Increasing knowledge of the genomic complexity and adverse karyotypes in older AML patients drives the need for ongoing investigations of targeted and lower-intensity therapies in the frontline, relapsed/refractory setting, and post-remission.

Suspected COVID-19 Immunization-Induced Probable Catastrophic Antiphospholipid Syndrome.

In this report, we describe the case of a woman with suspected COVID-19 immunization-induced probable catastrophic antiphospholipid syndrome. The patient is a 35-year-old female with a past medical history significant for antiphospholipid syndrome, not on anticoagulation, who presented with a 5-day history of abdominal pain and distention, nausea, vomiting, and shortness of breath. She had received her first dose of the Pfizer COVID-19 vaccine one day prior to the onset of symptoms.

Severe Thrombocytopenia Two Weeks Following Immunization with the Janssen Ad26.CoV2.S Vaccine.

Immune thrombocytopenia (ITP) has been associated with immunizations with various proposed mechanisms, including overactivation of the immune system and production of antibodies against circulating platelets. ITP has also been associated with several viral infections, including HCV, HIV, and most recently, active SARS-CoV-2 infection. Here, we present a case of a 52-year-old male with no past medical history who sought evaluation with his primary care physician for upper and lower extremity ecchymosis of one week duration.

Venous thromboembolism prophylaxis in hospitalized sickle cell disease and sickle cell trait patients.

Introduction: Sickle trait (Hb SA) or sickle disease (Hb SS) carries increased risk of venous thromboembolism (VTE). Hb SS patients are young and lack common comorbid conditions that qualify them for VTE prophylaxis (VTEP).

Methods: Retrospective, multicenter analysis of Hb SS/Hb SA adult patients between January 2013 and December 2018.

Confusion, Hallucinations, and Primary Polydipsia: A Rare Presentation of Neurosarcoidosis.

Neurosarcoidosis is a rare manifestation of sarcoidosis that can exhibit a variety of neuropsychiatric symptoms and can present independently of pulmonary or other systemic symptoms. This is the case of a 51-year-old African American male who presented with recurrent episodes of auditory and visual hallucinations, confusion, seizures that did not respond to antiepileptics, and recent-onset primary polydipsia. In the emergency department, he did not have meningeal signs, focal neurologic deficits, or a fever.

Extubation Failure in Critically Ill COVID-19 Patients: Risk Factors and Impact on In-Hospital Mortality.

Purpose: We sought to identify clinical factors that predict extubation failure (reintubation) and its prognostic implications in critically ill COVID-19 patients.

Materials And Methods: Retrospective, multi-center cohort study of hospitalized COVID-19 patients. Multivariate competing risk models were employed to explore the rate of reintubation and its determining factors.

Epstein-Barr virus induced haemophagocytic lymphohistiocytosis.

Haemophagocytic lymphohistiocytosis (HLH) is a rare condition of uncontrolled immune activation as a result of an inherited genetic defect or in response to malignancy, autoimmune disease, rheumatological disease, AIDS infection or post-transplant immunosuppression. Described here is the case of a 19-year-old Caucasian man who presented with complaints of worsening fever, new-onset jaundice and lethargy after failing treatment for suspected infectious mononucleosis. Physical examination was significant for fever and splenomegaly while laboratory results revealed transaminitis, cytopaenia, indirect hyperbilirubinaemia and elevated ferritin, raising the likelihood of both autoimmune haemolytic anaemia and HLH.