The treatment of local recurrence after radical prostatectomy and salvage pelvic irradiation, has no consensus in the literature. A surgical approach is possible, main benefit which delaying an androgen blockade. We present a patient who evolved with this scenario. He underwent robotic surgery. planning included anatomical reconstruction virtual three-dimensional model. There standard therapeutic modality. Few studies have looked at stereotactic radiotherapy surgery, whose benefits been need...

Vitamin B12 deficiency can cause extensive hematologic alterations such as pancytopenia, macrocytosis, hypersegmentation of neutrophils, and hypercellular bone marrow with blastic differentiation. These dysplastic changes sometimes be so profound that they mimic myelodysplastic syndromes or even acute leukemia, leading to workup aggressive treatment measures. We present a patient who was referred our tertiary care medical center for suspected myeloid leukemia on the basis peripheral smear...

Abstract Chronic lymphocytic leukemia/small lymphoma (CLL/SLL) is a B-cell neoplasm with indolent clinical course. If identified early, observation opted. Many variables lead to the initiation of treatment. Authors describe 62-year-old male presenting shortness breath and found have white cell count 1360 × 109/L subsequently was diagnosed CLL/SLL. The patient received leukapheresis along tumor lysis treatment systemic chemotherapy fludarabine, cyclophosphamide, rituximab regimen. His course...

Acquired idiopathic thrombotic thrombocytopenic purpura is a life-threatening disease with mortality of up to 90%, if not promptly recognized and treated. We report 64-year-old woman this condition who presented left-sided weakness seizure-like activity preceded by headache easy bruising. She did achieve optimal response plasma exchange, corticosteroids, rituximab, vincristine. initiated treatment eculizumab, following which she had durable remission that continued for 30 months after...

Hemophagocytic lymphohistiocytosis (HLH) is an underrecognized disorder due to the variability of its presentation and fact that in adults, diagnosis based on cumbersome, pediatric-based criteria. Data regarding demographics, underlying causes, clinical features, laboratory results, complications, treatments received, outcomes were collected analyzed 41 patients who diagnosed treated at University Arkansas for Medical Sciences between 2007 2019. In this group, 51% male, median age was 47...

Using the Quality Oncology Practice Initiative, an affiliate program of ASCO, we outlined opioid-associated constipation (OAC) as a subject in need quality improvement (QI) our fellowship at University Arkansas for Medical Sciences and Central Veterans Healthcare System. We initiated fellow-led QI project to advance patient care provide valuable avenue training young physicians. Fellows organized meetings with all stakeholders, addressed scope problem, devised strategies OAC management....

We present the case of a young man with acute lymphoblastic leukemia who developed cytomegalovirus (CMV) appendicitis after receiving alemtuzumab for refractory graft-versus-host disease allogeneic hematopoietic stem cell transplantation (HSCT). CMV is rare complication; and we are reporting first to our knowledge following HSCT. Our highlights importance recognition viral reactivation use alemtuzumab. Using preemptive strategy checking PCR, initiation early effective treatment on detection...

Acquired inhibitors of coagulation are a group rare but potentially life-threatening blood disorders characterized by the presence autoantibodies directed against clotting factor. Autoantibody factor VIII is most common form inhibitor, condition also known as acquired hemophilia A. We present clinical series nine patients diagnosed and treated for A at our institution. Among these patients, there were five men four women with median age 64 years. All presented bleeding diathesis. Factor...

Intravascular large B-cell lymphoma is a rare malignancy characterized by the presence of cells within lumen blood vessels. The annual incidence cases fewer than 0.5 per 1,000,000. It usually affects elderly with an average age diagnosis around 70 years. Due to absence in peripheral smear and lymphadenopathy, it difficult diagnose these cases. Although central nervous system skin are commonly involved organs, they can involve any organ system. Prompt initiation treatment very crucial as...

Hemolytic uremic syndrome (HUS) is a type of thrombotic microangiopathy (TMA) defined as triad non-immune microangiopathic hemolytic anemia, thrombocytopenia, and acute kidney injury. Shiga toxin (Stx) or diarrhea-associated HUS one the major categories secondary HUS, which seen predominantly in children regarded rare entity adult population. We present two cases sporadic Stx females. Our first case 74-year-old Caucasian woman who presented to emergency department with nausea, vomiting,...

Anaplastic lymphoma kinase (ALK) with positive Large Cell Lymphoma (ALCL) is has a distinct entity among the peripheral T-cell lymphomas.With 5-year survival rate of 70%, it carries one best prognoses T cell lymphomas.In rare instances, ALK ALCL presents in leukemic phase and very poor prognosis negligible number cases reporting beyond year.Following Case study as research technique, researchers tried to discuss about patient affected by phase, associated t (2;5)(p23;q35).The reported clinic...

42 Background: Advance Directive (AD) completion is particularly more important in patients with cancer given the higher mortality associated diagnoses as well treatments that receive. In reality AD discussion and rate influenced by patient characteristics disease status. We undertook a Quality improvement project to improve inpatient hematology unit at our institution. Methods: Plan-Do-Study-Act (PDSA) methodology was used team consisted of residents case managers. Each morning electronic...

We report the case of a young African American male with no significant past medical history presenting low back and bilateral leg pain; CBC chemistries revealed elevated white blood cell count 250,000, anemia (Hb 6.8 g/dL) thrombocytopenia (platelets 9 K/μL), LDH, 1008. Physical examination findings were notable for diffuse lymphadenopathy lower extremity skin nodules. Interestingly bone marrow biopsy involvement by CLL/SLL translocation (2;14)(p16;q32) trisomy 12. The patient was treated...

Treatment of refractory/relapsing diffuse large B cell (R/R DLBCL) lymphoma remains a challenge. Radiation therapy (RT) has versatile roles in R/R DLBCL treatment: it can be used the peri-transplant setting for transplant-eligible candidates, or as salvage palliation depending on extent disease transplant-ineligible patients. The introduction chimeric antigen receptor (CAR) T-cell changed landscape DLBCL. RT been bridging to CAR order control progression during its manufacturing period....

Nivolumab, a monoclonal antibody against programmed cell death-1 used to treat multiple cancers, has fewer side effects than traditional chemotherapy but displayed propensity cause host of immune-related adverse events. We describe case nivolumab immune-mediated neurotoxicity in 42-year-old Hispanic man with relapsed Hodgkin lymphoma who presented unilateral facial droop, dysarthria, and dysphagia 1 week after receiving nivolumab. His symptoms rapidly improved steroids, intravenous...

Acquired hemophilia A (AHA) is a rare bleeding disorder caused by autoantibodies against clotting factor VIII. It occurs most commonly in the elderly population. AHA associated with malignancy, autoimmune diseases, pregnancy, and drugs. However, up to 50% of reported cases remain idiopathic. very rarely multiple sclerosis.