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Документ JAK2-positive acute myeloid leukemia de novo or secondary transformed from myeloproliferative neoplasm? Case report(Lithuanian Society of Hematology, 2024-05-24) Skrypnyk, Igor; Maslova, Ganna; Lymanets, Tetiana; Gusachenko, Iuliia; Скрипник, Ігор Миколайович; Маслова, Ганна Сергіївна; Лиманець, Тетяна Володимирівна; Гусаченко, Юлія ОлександрівнаIntroduction and Aim. JAK2 V617F mutation is typically found in Ph-negative myeloproliferative neoplasms. This molecular abnormality very rarely occurs in de novo acute myeloid leukemia (AML). Data on the effective treatment of AML with JAK 2 mutation are limited. Our case report presents the results of successful patient’s management with JAK2-positive AML, treated by azacitidine and ruxolitinib combination. Case Report A 65-year-old man presented to the hematology department in October 2021 with complains of discomfort in the right half of the body, the presence of a dense formation (intermuscular hemorrhage) on the back on the right, general weakness, shortness of breath, fatigue. From anamnesis it is known that symptoms developed rapidly during the previous week. Anamnesis vitae: in 2012 patient underwent complex treatment of Ca pulm. sinistra T2aN0M0, gr. IB, clinical group ІІ. Physical examination revealed large intermuscular hematoma of the back on the right, blood imbibition of soft tissues from the neck to the lower back. The computed tomography showed massive hemorrhagic infiltration of the trunk muscles on the right, infiltration of the upper mediastinum, mediastinum shifted to the left (after operative treatment in 2012), splenomegaly 74×125×155 mm. In hemogram: erythrocytes (RBC) 5.1×1012/L, hemoglobin (HGB) 89 g/L, platelets (PLT) 999×109/L, leukocytes (WBC) 32.2×109/L, blast cells 5%, monocytes 39%. In myelogram: bone marrow hypercellular, polymorphic, infiltrated with blast cells 36.8%, some of which contained Auer's rods; the erythron was hyperplastic, without rejuvenation, with signs of dyserythropoiesis; the granulocytic line narrowed, with a predominance of mature forms of granulocytes; the megakaryocytic line with reactive changes. Bone marrow flow cytometry revealed signs of pronounced clonal proliferation of blast cells of myeloid origin (makes up to 34% of all nuclear cells in the sample): 1st clone up to 18%, with phenotype: CD34+19- 117+38(dim)+10-36-14-HLA-DR-; 2nd clone up to 16%, with the phenotype: CD34- 19-117-38+10-36+14+HLA-DR(dim)+/-11c+11b+3-4+/-56-. Molecular-genetic tests: FISH BCR/ABL1; FLT3 ITD; Inv(16)(p13q22) were not detected. Karyotyping: cytogenetically normal male karyotype was revealed 46,XY [20]. These changes corresponded with AML (М4).Документ Quality of life impairment in patients with newly diagnosed multiple myeloma who suffered from russian military aggression in ukraine: a single center experience(EHA. HemaSphere, 2023) Lymanets, Tetiana; Skrypnyk, Igor; Maslova, Anna; Gusachenko, Iuliia; Лиманець, Тетяна Володимирівна; Скрипник, Ігор Миколайович; Маслова, Ганна СергіївнаBackground: A number of factors influence the quality of life (QoL) of patients with multiple myeloma (MM). First of all, the fact of hemato-oncological diagnosis itself and the prognosis for life and work capacity. From February 24, 2022, all patients in Ukraine have an additional factor of negative impact on their QoL: military hostilities, lack of opportunity to live in their own houses and be treated in hospitals in their Region. This fact requires a detailed study in order to timely identify and prevent severe cases of anxiety and depression. Aims: to assess QoL in patients with newly diagnosed MM, who were internally displaced to more safe central region of Ukraine due to russian military aggression from the territories of active hostilities. Methods: The study involved 42 patients with newly diagnosed MM. All patients were treated in Hematology department of Poltava Regional Clinical Hospital n.a.M.V.Sklifosovsky during 2022 year. The cohort consisted of 24 (57%) males and 18 (43%) females, mean age 64.2±9.6 years, ECOG I-III. The patients were divided into two groups: I (n=31) – MM pts, who were native citizens of Poltava region; II (n=11) – MM pts, internally displaced persons from the regions of active hostilities: 9 were from Kharkiv Region, 1 patient from Sumy region and 1 – Luhansk region. The compared groups did not significantly differ by age, gender, ECOG score and ISS staging. QoL of patients was assessed using EQ-5D-5L questionnaire, which included descriptive data and visual analog score (EQ-VAS) data. The study was approved by the local ethic committee and all patients gave a written consent before they were included. Results: Patients of groups reported violations of mobility, self-care, usual activities and pain/discomfort data, that were not significantly different between groups. The anxiety/depression EQ-5D-5L component in patients of group I showed the presence of this violation in 14 (45.2%) cases: 6 (19.4%) patients had slight problems, 4 (12.9%) pts – moderate and 4 (12.9%) pts –severe. Meanwhile, 9 (81.9%) patients of group II, who have suffered from russian military aggression reported the presence of anxiety/depression: 3 (27.3%) pts had slight problems, 3 (27.3%) pts – moderate, 2 (18.2%) pts – severe and 1 (9.1%) patient had extreme problems. Thus, the need to move to another region due to hostilities definitely leads to increase in anxiety and depression, X2 (1, N=42) = 4.4, p < .05. The mean self-rated health score (EQ-VAS) for pts of group I was 57.42 (SD 3.32), which was significantly higher in comparison with the results of group II responders 45.45 (SD 4.64), which is 1.3-fold lower than the indicators of group I, t(42)= 2.4, p = .01.