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Article ; Online: Secondary hemophagocytic lymphohistiocytosis versus cytokine release syndrome in severe COVID-19 patients.

Hakim, Nausheen N / Chi, Jeffrey / Olazagasti, Coral / Liu, Johnson M

Experimental biology and medicine (Maywood, N.J.)

2020 Volume 246, Issue 1, Page(s) 5–9

Abstract: Impact statement: Severe COVID-19 associated pneumonia and acute respiratory distress syndrome has recently been described with life-threatening features of cytokine storm and loosely referred to as hemophagocytic lymphohistiocytosis (HLH) or macrophage ...

Abstract	Impact statement: Severe COVID-19 associated pneumonia and acute respiratory distress syndrome has recently been described with life-threatening features of cytokine storm and loosely referred to as hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS). Although a recent report indicated favorable responses to the interleukin-1 receptor antagonist, anakinra in eight patients with COVID-19 secondary HLH diagnosed using the HScore calculation, others have suggested that the diagnosis of secondary HLH is uncommon and that the use of the HScore has limited value in guiding immunomodulatory therapy for COVID-19. Here, we provide additional perspective on this important controversy based upon comparisons between 14 COVID-19 cytokine storm patients and 10 secondary HLH patients seen immediately prior to the pandemic. We hypothesize that identification of HLH may relate to the severity or timing of cytokine release and suggest distinguishing between cytokine release syndrome and secondary HLH, reserving the latter term for cases fulfilling diagnostic criteria.
MeSH term(s)	Adult ; Aged ; Aged, 80 and over ; COVID-19/complications ; Cytokine Release Syndrome/etiology ; Female ; Humans ; Lymphohistiocytosis, Hemophagocytic/etiology ; Lymphohistiocytosis, Hemophagocytic/virology ; Male ; Middle Aged ; Splenomegaly/etiology
Keywords	covid19
Language	English
Publishing date	2020-09-24
Publishing country	England
Document type	Journal Article
ZDB-ID	4015-0
ISSN	1535-3699 ; 1525-1373 ; 0037-9727
ISSN (online)	1535-3699 ; 1525-1373
ISSN	0037-9727
DOI	10.1177/1535370220962043
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Article: Secondary hemophagocytic lymphohistiocytosis versus cytokine release syndrome in severe COVID-19 patients

Hakim, Nausheen N / Chi, Jeffrey / Olazagasti, Coral / Liu, Johnson M

Exp Biol Med (Maywood)

Abstract: IMPACT STATEMENT: Severe COVID-19 associated pneumonia and acute respiratory distress syndrome has recently been described with life-threatening features of cytokine storm and loosely referred to as hemophagocytic lymphohistiocytosis (HLH) or macrophage ... ...

Abstract	IMPACT STATEMENT: Severe COVID-19 associated pneumonia and acute respiratory distress syndrome has recently been described with life-threatening features of cytokine storm and loosely referred to as hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS). Although a recent report indicated favorable responses to the interleukin-1 receptor antagonist, anakinra in eight patients with COVID-19 secondary HLH diagnosed using the HScore calculation, others have suggested that the diagnosis of secondary HLH is uncommon and that the use of the HScore has limited value in guiding immunomodulatory therapy for COVID-19. Here, we provide additional perspective on this important controversy based upon comparisons between 14 COVID-19 cytokine storm patients and 10 secondary HLH patients seen immediately prior to the pandemic. We hypothesize that identification of HLH may relate to the severity or timing of cytokine release and suggest distinguishing between cytokine release syndrome and secondary HLH, reserving the latter term for cases fulfilling diagnostic criteria.
Keywords	covid19
Publisher	WHO
Document type	Article
Note	WHO #Covidence: #796862
Database	COVID19

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Book ; Online: Secondary hemophagocytic lymphohistiocytosis versus cytokine release syndrome in severe COVID-19 patients.

Hakim, Nausheen N / Chi, Jeffrey / Olazagasti, Coral / Liu, Johnson M

Maine Medical Center

2020

Abstract	IMPACT STATEMENT: Severe COVID-19 associated pneumonia and acute respiratory distress syndrome has recently been described with life-threatening features of cytokine storm and loosely referred to as hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS). Although a recent report indicated favorable responses to the interleukin-1 receptor antagonist, anakinra in eight patients with COVID-19 secondary HLH diagnosed using the HScore calculation, others have suggested that the diagnosis of secondary HLH is uncommon and that the use of the HScore has limited value in guiding immunomodulatory therapy for COVID-19. Here, we provide additional perspective on this important controversy based upon comparisons between 14 COVID-19 cytokine storm patients and 10 secondary HLH patients seen immediately prior to the pandemic. We hypothesize that identification of HLH may relate to the severity or timing of cytokine release and suggest distinguishing between cytokine release syndrome and secondary HLH, reserving the latter term for cases fulfilling diagnostic criteria.
Keywords	COVID-19 ; Cytokines ; immunology ; microbiology ; virology ; inflammation ; Humans ; Lymphohistiocytosis ; Hemophagocytic ; Cytokine Release Syndrome ; severe acute respiratory syndrome coronavirus 2 ; Hematology ; Pathology ; covid19
Subject code	610
Publishing date	2020-09-24T07:00:00Z
Publisher	MaineHealth Knowledge Connection
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Secondary hemophagocytic lymphohistiocytosis versus cytokine release syndrome in severe COVID-19 patients

Hakim, Nausheen N / Chi, Jeffrey / Olazagasti, Coral / Liu, Johnson M

Experimental Biology and Medicine

2020 , Page(s) 153537022096204

Abstract: COVID-19 or SARS-CoV-2 infection can lead to severe acute respiratory distress syndrome/pneumonia with features of cytokine storm reminiscent of secondary hemophagocytic lymphohistiocytosis (HLH), which can be diagnosed by the calculated HScore. Recent ... ...

Abstract	COVID-19 or SARS-CoV-2 infection can lead to severe acute respiratory distress syndrome/pneumonia with features of cytokine storm reminiscent of secondary hemophagocytic lymphohistiocytosis (HLH), which can be diagnosed by the calculated HScore. Recent reports have suggested favorable responses to the interleukin-1 receptor antagonist, anakinra in patients with COVID-19 associated secondary HLH. In our single institution study, we compared 14 COVID-19 cytokine storm patients with 10 secondary HLH patients seen immediately prior to the pandemic (non-COVID-19), to determine whether diagnostic features of secondary HLH were typically seen in COVID-19 patients presenting with cytokine storm. Although most of our COVID-19 patients did not fulfill diagnostic criteria for HLH, we hypothesize that identification of HLH may relate to the severity or timing of cytokine release. Based on our observations, we would suggest distinguishing between cytokine release syndrome and secondary HLH, reserving the latter term for cases fulfilling diagnostic criteria. Impact statement Severe COVID-19 associated pneumonia and acute respiratory distress syndrome has recently been described with life-threatening features of cytokine storm and loosely referred to as hemophagocytic lymphohistiocytosis (HLH) or macrophage activation syndrome (MAS). Although a recent report indicated favorable responses to the interleukin-1 receptor antagonist, anakinra in eight patients with COVID-19 secondary HLH diagnosed using the HScore calculation, others have suggested that the diagnosis of secondary HLH is uncommon and that the use of the HScore has limited value in guiding immunomodulatory therapy for COVID-19. Here, we provide additional perspective on this important controversy based upon comparisons between 14 COVID-19 cytokine storm patients and 10 secondary HLH patients seen immediately prior to the pandemic. We hypothesize that identification of HLH may relate to the severity or timing of cytokine release and suggest distinguishing between cytokine release syndrome and secondary HLH, reserving the latter term for cases fulfilling diagnostic criteria.
Keywords	General Biochemistry, Genetics and Molecular Biology ; covid19
Language	English
Publisher	SAGE Publications
Publishing country	us
Document type	Article ; Online
ISSN	1535-3702
DOI	10.1177/1535370220962043
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article: COVID-19 infection presenting as paroxysmal nocturnal hemoglobinuria.

Hines, Adam / Hakim, Nausheen / Barrientos, Jacqueline

Clinical case reports

2021 Volume 9, Issue 8, Page(s) e04636

Abstract: A diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) was elicited during acute COVID-19 infection. COVID-19 spike proteins trigger the alternative pathway of complement. Acute SARS-CoV-2 infection possibly expanded an existing PIG-A mutation. ...

Abstract	A diagnosis of paroxysmal nocturnal hemoglobinuria (PNH) was elicited during acute COVID-19 infection. COVID-19 spike proteins trigger the alternative pathway of complement. Acute SARS-CoV-2 infection possibly expanded an existing PIG-A mutation.
Language	English
Publishing date	2021-08-21
Publishing country	England
Document type	Case Reports
ZDB-ID	2740234-4
ISSN	2050-0904
ISSN	2050-0904
DOI	10.1002/ccr3.4636
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Why HALO 301 Failed and Implications for Treatment of Pancreatic Cancer.

Hakim, Nausheen / Patel, Rajvi / Devoe, Craig / Saif, Muhammad W

Pancreas (Fairfax, Va.)

2019 Volume 3, Issue 1, Page(s) e1–e4

Abstract: Survival rates for pancreatic cancer (PC) remain dismal. Current standard of care treatment regimens provide transient clinical benefit but eventually chemoresistance develops leading to poor outcomes. PC is a relatively chemoresistant tumor and one of ... ...

Abstract	Survival rates for pancreatic cancer (PC) remain dismal. Current standard of care treatment regimens provide transient clinical benefit but eventually chemoresistance develops leading to poor outcomes. PC is a relatively chemoresistant tumor and one of the explanations for this is attributed to desmoplasia that impedes drug delivery. Based on this, stromal modifying agent such as Pegvorhyaluronidase alfa (PEGPH20) was developed and investigated in phase I-III studies. Although phase I-II studies showed promising results in patients with high hyaluronic acid (HA) expressing tumors, the phase III HALO 301 study failed to miss it's primary endpoint and further development of PEHPH20 is halted. This failure implies that targeting desmoplasia alone is not sufficient and other intrinsic factors such as lack of significant neoantigens, low tumor mutational burden, and epithelial to mesenchymal transition may be at play. It is also important to consider that although the tumor stroma may be a physical barrier hampering drug delivery, it may also have protective effects in restraining tumor growth and progression. Further studies in molecular biology to better characterize the complex interaction between the microenvironment and cancer cells are warranted.
Language	English
Publishing date	2019-12-20
Publishing country	United States
Document type	Journal Article
ISSN	2471-142X
ISSN (online)	2471-142X
DOI	10.17140/POJ-3-e010
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Hyperpigmentation due to imatinib: A rare case of cutaneous involvement.

Rehman, Hasan / Hakim, Nausheen / Sugarman, Ryan / Seetharamu, Nagashree / Saif, Muhammad W

Journal of oncology pharmacy practice : official publication of the International Society of Oncology Pharmacy Practitioners

2020 Volume 26, Issue 6, Page(s) 1511–1515

Abstract: Case report: Imatinib mesylate is a well-known tyrosine kinase inhibitor used to treat chronic myeloid leukemia, gastrointestinal stromal tumor, as well as a variety of other malignancies.: Discussion: Although there have been several case reports ... ...

Abstract	Case report: Imatinib mesylate is a well-known tyrosine kinase inhibitor used to treat chronic myeloid leukemia, gastrointestinal stromal tumor, as well as a variety of other malignancies. Discussion: Although there have been several case reports describing hyperpigmentation of the oral mucosa or nails, very few have described skin hyperpigmentation. We previously reported the first two cases of imatinib-related squamous cell carcinoma in patients undergoing treatment for gastrointestinal stromal tumors. In this paper, we present a case of a patient on imatinib for management of gastrointestinal stromal tumor who experienced extensive skin hyperpigmentation and review the literature.
MeSH term(s)	Aged ; Antineoplastic Agents/administration & dosage ; Antineoplastic Agents/adverse effects ; Female ; Gastrointestinal Neoplasms/drug therapy ; Gastrointestinal Stromal Tumors/drug therapy ; Humans ; Hyperpigmentation/chemically induced ; Imatinib Mesylate/adverse effects ; Imatinib Mesylate/therapeutic use ; Protein Kinase Inhibitors/adverse effects ; Protein Kinase Inhibitors/therapeutic use
Chemical Substances	Antineoplastic Agents ; Protein Kinase Inhibitors ; Imatinib Mesylate (8A1O1M485B)
Language	English
Publishing date	2020-02-18
Publishing country	England
Document type	Case Reports ; Journal Article
ZDB-ID	1330764-2
ISSN	1477-092X ; 1078-1552
ISSN (online)	1477-092X
ISSN	1078-1552
DOI	10.1177/1078155220903364
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Article: "Waitlist mortality" is high for myeloma patients with limited access to BCMA therapy.

Ahmed, Nausheen / Wesson, William / Mushtaq, Muhammad Umair / Bansal, Rajat / AbdelHakim, Haitham / Bromert, Sarah / Appenfeller, Allison / Ghazal, Batool Abu / Singh, Anurag / Abhyankar, Sunil / Ganguly, Siddhartha / McGuirk, Joseph / Abdallah, Al-Ola / Shune, Leyla

Frontiers in oncology

2023 Volume 13, Page(s) 1206715

Abstract: Background: The first-in-class approved BCMA CAR-T therapy was idecabtagene vicleucel (ide-cel), approved in March 2021, for RRMM patients who progressed after 4 or more lines of therapy. Despite the promising outcomes, there were limited apheresis/ ... ...

Abstract	Background: The first-in-class approved BCMA CAR-T therapy was idecabtagene vicleucel (ide-cel), approved in March 2021, for RRMM patients who progressed after 4 or more lines of therapy. Despite the promising outcomes, there were limited apheresis/production slots for ide-cel. We report outcomes of patients at our institution who were on the "waitlist" to receive ide-cel in 2021 and who could not secure a slot. Methods: We conducted a retrospective review of RRMM patients evaluated at the University of Kansas Cancer Center for ide-cel from 3/2021-7/2021. A retrospective chart review was performed to determine patient and disease characteristics. Descriptive statistics were reported using medians for continuous variables. Survival analysis from initial consult was performed using Kaplan-Meier Survival estimator. Results: Forty patients were eligible and were on the "waitlist" for CAR-T. The median follow-up was 14 months (2-25mo). Twenty-four patients (60%) secured a production slot and 16 (40%) did not. The median time from consult to collection was 38 days (8-703). The median time from collection to infusion was 42 days (34-132 days). The median overall survival was higher in the CAR-T group (NR vs 9 mo, p<0.001). Conclusions: Many patients who were eligible for ide-cel were not able to secure a timely slot in 2021. Mortality was higher in this group, due to a lack of comparable alternatives. Increasing alternate options as well as improvement in manufacturing and access is an area of high importance to improve RRMM outcomes.
Language	English
Publishing date	2023-08-03
Publishing country	Switzerland
Document type	Journal Article
ZDB-ID	2649216-7
ISSN	2234-943X
ISSN	2234-943X
DOI	10.3389/fonc.2023.1206715
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Article ; Online: Forming the Hematology-Oncology Collaborative Videoconferencing (CO-VID) Learning Initiative: Experiential Lessons Learned From a Novel Trainee-Led Multidisciplinary Virtual Learning Platform.

Martin, Richard L / Grant, Michael J / Kimani, Stephen / Midha, Shonali / May, Jori / Patell, Rushad / Collier, Emily / Furfaro, David / Bodine, Charles / Reap, Leo / Shah, Nikesh / DeLaune, Jess / Brusca, Samuel / Olazagasti, Coral / Goyal, Shreya / Rubinstein, Samuel / Hakim, Nausheen / Qin, Shuai / Browning, Sabrina L /

Sena, Laura / Gilbert, Jill / Davidson, Mario / Lovly, Christine M / Seetharamu, Nagashree / Rangachari, Deepa / Murphy, Martina / Chatwal, Monica / Paschal, Rita / Henry, Elizabeth / Collichio, Frances / Green, Jennifer R

JCO oncology practice

2021 Volume 18, Issue 1, Page(s) e36–e46

Abstract: ... n = 46) pre-/postcorrect 82.6%/97.8% and incorrect 10.9%/2.2%, anticoagulation (n = 60) pre ... postcorrect 75%/93.3% and incorrect 15%/6.7%, and pulmonary (n = 21) pre-/postcorrect 66.7%/95.2% and ...

Abstract	Purpose: COVID-19 challenged medical practice and graduate medical education. Building on previous initiatives, we describe and reflect on the formative process and goals of the Hematology-Oncology Collaborative Videoconferencing Learning Initiative, a trainee-led multi-institutional virtual COVID-19 learning model. Methods: Clinical fellows and faculty from 13 US training institutions developed consensus needs, goals, and objectives, recruited presenters, and generated a multidisciplinary COVID-19 curriculum. Weekly Zoom conferences consisted of two trainee-led instructional segments and a trainee-moderated faculty Q&A panel. Hematology-oncology training program faculty and trainees were the targeted audience. Leadership evaluations consisted of anonymized baseline and concluding mixed methods surveys. Presenter evaluations consisted of session debriefs and two structured focus groups. Conference evaluations consisted of attendance, demographics, and pre- or postmultiple-choice questions on topic learning objectives. Results: In 6 weeks, the initiative produced five conferences: antivirals, anticoagulation, pulmonology, provider resilience, and resource scarcity ethics. The average attendance was 100 (range 57-185). Among attendees providing both pre- and postconference data, group-level knowledge appeared to increase: antiviral (n = 46) pre-/postcorrect 82.6%/97.8% and incorrect 10.9%/2.2%, anticoagulation (n = 60) pre-/postcorrect 75%/93.3% and incorrect 15%/6.7%, and pulmonary (n = 21) pre-/postcorrect 66.7%/95.2% and incorrect 33.3%/4.8%. Although pulmonary management comfort appeared to increase, comfort managing of antivirals and anticoagulation was unchanged. At the conclusion of the pilot, leadership trainees reported improved self-confidence organizing multi-institutional collaborations, median (interquartile range) 58.5 (50-64) compared with baseline 34 (26-39), but did not report improved confidence in other educational or leadership skills. Conclusion: During crisis, trainees built a multi-institutional virtual education platform for the purposes of sharing pandemic experiences and knowledge. Accomplishment of initiative goals was mixed. Lessons learned from the process and goals may improve future disaster educational initiatives.
MeSH term(s)	COVID-19 ; Education, Distance ; Hematology/education ; Humans ; SARS-CoV-2 ; Videoconferencing
Language	English
Publishing date	2021-07-09
Publishing country	United States
Document type	Journal Article
ZDB-ID	3028198-2
ISSN	2688-1535 ; 2688-1527
ISSN (online)	2688-1535
ISSN	2688-1527
DOI	10.1200/OP.20.00960
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Article: A Case of Invasive Pneumococcal Infection with Septic Shock and Rare Complications.

Woytanowski, John R / Hakim, Nausheen / Deering, Caytlin / Schultz, Sara

Case reports in critical care

2017 Volume 2017, Page(s) 9503654

Abstract: Invasive pneumococcus is a serious illness with potentially devastating outcomes. A 64-year-old female with a medical history of psoriatic arthritis and diabetes was transferred from an outside hospital for ventilator dependent respiratory failure and ... ...

Abstract	Invasive pneumococcus is a serious illness with potentially devastating outcomes. A 64-year-old female with a medical history of psoriatic arthritis and diabetes was transferred from an outside hospital for ventilator dependent respiratory failure and altered mental status. She initially presented with worsening back pain and was found to have leukocytosis with bandemia and acute renal failure but she was in septic shock upon arrival to our tertiary care center. Her blood cultures grew
Language	English
Publishing date	2017-10-18
Publishing country	United States
Document type	Case Reports
ZDB-ID	2927720-6
ISSN	2090-6439 ; 2090-6420
ISSN (online)	2090-6439
ISSN	2090-6420
DOI	10.1155/2017/9503654
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