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Hematopoietic neoplasm

Last edited: 4/13/2026

Overview

Hematopoietic neoplasms encompass a range of malignancies affecting blood-forming tissues, including leukemia, lymphoma, and myeloma. These conditions often require hematopoietic stem cell transplantation (HSCT) for curative treatment.

Diagnosis

  • Clinical Presentation: Symptoms vary but often include cytopenias, recurrent infections, and organ dysfunction 123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869.
  • Laboratory Tests: Complete blood count (CBC), bone marrow biopsy, flow cytometry, cytogenetic analysis, and molecular profiling 123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869.
  • Imaging: Chest X-ray, CT scans, MRI for organ involvement 123456789101112131415161718192021222324252627282930313233343536373839404142434445464748495051525354555657585960616263646566676869.
  • Management

  • Conditioning Regimens: Chemotherapy (e.g., busulfan) and/or radiation therapy 316214149.
  • Prophylaxis: Antifungal prophylaxis (ciprofloxacin vs levofloxacin) 422.
  • Infection Control: Management of viral infections (e.g., CMV, HHV-6B) with antiviral therapy 21622.
  • Supportive Care: Transfusion support, management of organ dysfunction, pain control 727405053.
  • Nutritional Support: Vitamin D supplementation to address insufficiency 101318.
  • Special Populations

  • Pediatrics: Consider procedural sedation safely, manage pain syndromes effectively 192750.
  • Elderly: Evaluate impact of polypharmacy on outcomes 15.
  • Comorbidities: Pre-transplant comorbidities impact ICU admission and survival 8.
  • Key Recommendations

  • Use of Antifungal Prophylaxis: Ciprofloxacin or levofloxacin can be used for prophylaxis in HSCT patients, with no significant difference noted between them (Evidence: Moderate) 422.
  • Vitamin D Supplementation: Administer
  • References

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Ciprofloxacin versus levofloxacin prophylaxis in hematopoietic stem cell transplantation: A randomized trial. International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases 2024. link 5 Schoettler ML, Carreras E, Cho B, Dandoy CE, Ho VT, Jodele S et al.. Harmonizing Definitions for Diagnostic Criteria and Prognostic Assessment of Transplantation-Associated Thrombotic Microangiopathy: A Report on Behalf of the European Society for Blood and Marrow Transplantation, American Society for Transplantation and Cellular Therapy, Asia-Pacific Blood and Marrow Transplantation Group, and Center for International Blood and Marrow Transplant Research. Transplantation and cellular therapy 2023. link 6 Arsenault V, Yan MTS, Tait G, Lewin A, Pendergrast J. An online immunohematology educational resource for post-graduate hematology trainees: LearnSerology.ca. Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis 2023. link 7 Holloway MR, Fountaine T, Henrichs K, Feeney T, Andolina J, O'Dwyer K et al.. Association of crystalloid fluid infusion with intravascular hemolysis and organ dysfunction in hematopoietic stem cell transplant patients. Transfusion and apheresis science : official journal of the World Apheresis Association : official journal of the European Society for Haemapheresis 2023. link 8 Jamy O, Dasher J, Chen A, Salzman D, Bhatia R, Bhatia S. Impact of pre-transplant individual comorbidities on risk of ICU admission and survival outcomes following allogeneic hematopoietic stem cell transplantation. Bone marrow transplantation 2023. link 9 Bettini E, Idiokitas R, Mahmood L, Jacobs S, Steinhorn D. Safety and Acceptance of Acupuncture and Acupressure in Children, Adolescents, and Young Adults Undergoing Hematopoietic Stem Cell Transplant. Cancer nursing 2023. link 10 Bai N, Lee K, Limvorapitak W, Liu E, Kendler D, Broady R et al.. Loading dose vitamin D3 improves vitamin D insufficiency in adults undergoing hematopoietic stem cell transplantation: A randomized controlled trial. PloS one 2023. link 11 Qutob H. Effect of flipped classroom approach in the teaching of a hematology course. PloS one 2022. link 12 Michallet M, El Cheikh J, Herbrecht R, Yakoub-Agha I, Caillot D, Gangneux JP. Systemic antifungal strategies in allogeneic hematopoietic stem cell recipients hospitalized in french hematology units: a post-hoc analysis of the cross-sectional observational AFHEM study. BMC infectious diseases 2022. link 13 Bodea J, Beebe K, Campbell C, Salzberg D, Schwalbach C, Miller H et al.. Impact of Adequate Day 30 Post-Pediatric Hematopoietic Stem Cell Transplantation Vitamin D Level on Clinical Outcome: An Observational Cohort Study. Transplantation and cellular therapy 2022. link 14 Yuan T, Han X, Liu H, Zhang J, Fan S. Mouse parabiosis model promotes recovery of lymphocytes in irradiated mice. International journal of radiation biology 2021. link 15 Sugidono M, Lo M, Young R, Rosario K, Jung Y, Huang CY et al.. Impact of Polypharmacy Prior to Allogeneic Hematopoietic Stem Cell Transplantation in Older Adults. Transplantation and cellular therapy 2021. link 16 Stern A, Su Y, Dumke H, Fang J, Tamari R, Jakubowski A et al.. Cytomegalovirus Viral Load Kinetics Predict Cytomegalovirus End-Organ Disease and Mortality After Hematopoietic Cell Transplant. The Journal of infectious diseases 2021. link 17 Holland EM, Gonzalez C, Levy E, Valera VA, Chalfin H, Klicka-Skeels J et al.. Case Report: Fatal Complications of BK Virus-Hemorrhagic Cystitis and Severe Cytokine Release Syndrome Following BK Virus-Specific T-Cells. Frontiers in immunology 2021. link 18 Bhandari R, Aguayo-Hiraldo P, Malvar J, Cheng K, Sacapano A, Abdel-Azim H et al.. Ultra-High Dose Vitamin D in Pediatric Hematopoietic Stem Cell Transplantation: A Nonrandomized Controlled Trial. Transplantation and cellular therapy 2021. link 19 Bain BJ. Historical review: a history of the British Journal of Haematology. British journal of haematology 2020. link 20 D S, A T. Student perceptions of "doing" hematology physiology practicals. Advances in physiology education 2020. link 21 El Hussein S, Lyapichev KA, Crane GM, Mirza KM, Pemmaraju N, Medeiros LJ et al.. Social Media for Hematopathologists: Medical Practice Reinvented-#Hemepath. Current hematologic malignancy reports 2020. link 22 Swerdlow SH, Monaghan SA, Douglas AR, Johnson K, Johnson RL. Harmonization of Training, Training Requirements, Board Certification, and Practice of Hematopathology. American journal of clinical pathology 2019. link 23 Yan MTS, Arsenault V, Pendergrast J. Evaluation of immunohematology knowledge in hematology trainees. Transfusion 2019. link 24 Kesselheim JC, Clayton CP, Fritz J, Smith RE, Gitlin SD, Reid E et al.. The American Society of Hematology (ASH) Medical Educators Institute: a Pilot Faculty Development Project for Hematology Educators. Journal of cancer education : the official journal of the American Association for Cancer Education 2019. link 25 Taghavi S, Castillo-Angeles M, Uribe-Leitz T, Hirji S, Armand P, Nehra D et al.. Emergency general surgery procedures in hematopoietic stem cell transplant recipients. American journal of surgery 2019. link 26 Wang WS, Ma JD, Nelson SH, Revta C, Buckholz GT, Mulroney C et al.. Transfusion practices at end of life for hematopoietic stem cell transplant patients. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 2018. link 27 Ma JD, El-Jawahri AR, LeBlanc TW, Roeland EJ. Pain Syndromes and Management in Adult Hematopoietic Stem Cell Transplantation. Hematology/oncology clinics of North America 2018. link 28 Chen X, Chen B, Li X, Song Q, Chen Y. Mutual benefit for foreign medical students and Chinese postgraduates: A mixed team-based learning method overcomes communication problems in hematology clerkship. Biochemistry and molecular biology education : a bimonthly publication of the International Union of Biochemistry and Molecular Biology 2017. link 29 Pillon M, Amigoni A, Contin A, Cattelan M, Carraro E, Campagnano E et al.. Risk Factors and Outcomes Related to Pediatric Intensive Care Unit Admission after Hematopoietic Stem Cell Transplantation: A Single-Center Experience. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation 2017. link 30 Kanbayashi Y, Matsumoto Y, Kuroda J, Kobayashi T, Horiike S, Hosokawa T et al.. Predicting risk factors for varicella zoster virus infection and postherpetic neuralgia after hematopoietic cell transplantation using ordered logistic regression analysis. Annals of hematology 2017. link 31 Webb J, Abraham A. Complex Transfusion Issues in Pediatric Hematopoietic Stem Cell Transplantation. Transfusion medicine reviews 2016. link 32 Stahl ED, Mahomed F, Hans AK, Dalal JD. Transplant related ocular surface disorders: Advanced techniques for ocular surface rehabilitation after ocular complications secondary to hematopoietic stem cell transplantation. Pediatric transplantation 2016. link 33 Reichard KK, Wood AJ. Laboratory Test Utilization Management: General Principles and Applications in Hematopathology. Surgical pathology clinics 2016. link 34 Saillard C, Blaise D, Mokart D. Critically ill allogeneic hematopoietic stem cell transplantation patients in the intensive care unit: reappraisal of actual prognosis. Bone marrow transplantation 2016. link 35 Johnson S. It takes a team: creating a hematology/hematopoietic cell therapy day hospital. Nursing administration quarterly 2014. link 36 Wahla AS, Chatterjee A, Khan II, Conforti JF, Haponik E. Survey of academic pulmonologists, oncologists, and infectious disease physicians on the role of bronchoscopy in managing hematopoietic stem cell transplantation patients with pulmonary infiltrates. Journal of bronchology & interventional pulmonology 2014. link 37 Carlson AM, McPhail ED, Rodriguez V, Schroeder G, Wolanskyj AP. A prospective, randomized crossover study comparing direct inspection by light microscopy versus projected images for teaching of hematopathology to medical students. Anatomical sciences education 2014. link 38 Sano H, Kobayashi R, Iguchi A, Suzuki D, Kishimoto K, Yasuda K et al.. Risk factor analysis of idiopathic pneumonia syndrome after allogeneic hematopoietic SCT in children. Bone marrow transplantation 2014. link 39 Aspesberro F, Guthrie KA, Woolfrey AE, Brogan TV, Roberts JS. Outcome of pediatric hematopoietic stem cell transplant recipients requiring mechanical ventilation. Journal of intensive care medicine 2014. link 40 Zhang T, Osborn S, Brandow C, Dwyre D, Green R, Lane S et al.. Structured illumination-based super-resolution optical microscopy for hemato- and cyto-pathology applications. Analytical cellular pathology (Amsterdam) 2013. link 41 Sivgin S, Eser B. The management of iron overload in allogeneic hematopoietic stem cell transplant (alloHSCT) recipients: where do we stand?. Annals of hematology 2013. link 42 Brueggeman MS, Swinehart C, Yue MJ, Conway-Klaassen JM, Wiesner SM. Implementing virtual microscopy improves outcomes in a hematology morphology course. Clinical laboratory science : journal of the American Society for Medical Technology 2012. link 43 Marr KA. Delayed opportunistic infections in hematopoietic stem cell transplantation patients: a surmountable challenge. Hematology. American Society of Hematology. Education Program 2012. link 44 Emura I, Usuda H. Apoptotic cells in peripheral blood and multiple organ injury. Pathology international 2012. link 45 Ferkowicz MJ, Yoder MC. Whole embryo imaging of hematopoietic cell emergence and migration. Methods in molecular biology (Clifton, N.J.) 2011. link 46 le Douarin N. Developmental hematopoiesis: historical background and perspectives. An interview with Nicole le Douarin. Interview by Charles Durand and Thierry Jaffredo. The International journal of developmental biology 2010. link 47 Weissinger EM, Mischak H, Kontsendorn J, Hahn A, Hahn N, Morgan M et al.. Proteome analysis in hematology using capillary electrophoresis coupled on-line to mass spectrometry. Mini reviews in medicinal chemistry 2009. link 48 Brand A, Eichler H, Szczepiorkowski ZM, Hess JR, Kekomaki R, McKenna DH et al.. Viability does not necessarily reflect the hematopoietic progenitor cell potency of a cord blood unit: results of an interlaboratory exercise. Transfusion 2008. link 49 Gajewski JL, Johnson VV, Sandler SG, Sayegh A, Klumpp TR. A review of transfusion practice before, during, and after hematopoietic progenitor cell transplantation. Blood 2008. link 50 van Gestel JP, Bollen CW, Bierings MB, Boelens JJ, Wulffraat NM, van Vught AJ. Survival in a recent cohort of mechanically ventilated pediatric allogeneic hematopoietic stem cell transplantation recipients. Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation 2008. link 51 Au WY, Leung WC. Challenges and pitfalls in prenatal screening in pregnancies involving allogeneic stem cell transplantation recipients. Bone marrow transplantation 2007. link 52 Pène F, Aubron C, Azoulay E, Blot F, Thiéry G, Raynard B et al.. Outcome of critically ill allogeneic hematopoietic stem-cell transplantation recipients: a reappraisal of indications for organ failure supports. Journal of clinical oncology : official journal of the American Society of Clinical Oncology 2006. link 53 Gooley TA, Rajvanshi P, Schoch HG, McDonald GB. Serum bilirubin levels and mortality after myeloablative allogeneic hematopoietic cell transplantation. Hepatology (Baltimore, Md.) 2005. link 54 Chiang KY, Lazarus HM. Should we be performing more combined hematopoietic stem cell plus solid organ transplants?. Bone marrow transplantation 2003. link 55 Haire WD. Multiple organ dysfunction syndrome in hematopoietic stem cell transplantation. Critical care medicine 2002. link 56 Kraai R, Reymer AG, Brouwer-Mandema GG, van Beckhoven JM, Hoogeboom M, le Cessie S et al.. Hemopoietic stem and precursor cell analysis in umbilical cord blood using the Sysmex SE-9000 IMI channel. Cytometry 2001. link 57 Fallows G, Rubinger M, Bernstein CN. Does gastroenterology consultation change management of patients receiving hematopoietic stem cell transplantation?. Bone marrow transplantation 2001. link 58 Nguyen A, Wu S, Jalali M, Uthman M, Johnson K, Banez E. A web-based database for diagnosis of haematologic neoplasms using immunophenotyping by flow cytometry. Medical informatics and the Internet in medicine 2001. link 59 Owens MA, Vall HG, Hurley AA, Wormsley SB. Validation and quality control of immunophenotyping in clinical flow cytometry. Journal of immunological methods 2000. link00226-x) 60 Bönig H, Schneider DT, Sprock I, Lemburg P, Göbel U, Nürnberger W. 'Sepsis' and multi-organ failure: predictors of poor outcome after hematopoietic stem cell transplantation in children. Bone marrow transplantation 2000. link 61 Gordon B, Tarantolo S, Ruby E, Stephens L, Lynch J, Kessinger A et al.. Increased platelet transfusion requirement is associated with multiple organ dysfunctions in patients undergoing hematopoietic stem cell transplantation. Bone marrow transplantation 1998. link 62 Wall DA, Noffsinger JM, Mueckl KA, Alonso JM, Regan DM, Johnson CE et al.. Feasibility of an obstetrician-based cord blood collection network for unrelated donor umbilical cord blood banking. The Journal of maternal-fetal medicine 1997. link1520-6661(199711/12)6:6<320::AID-MFM4>3.0.CO;2-Q) 63 Haire WD. Antithrombin III in hematopoietic stem cell transplantation. Seminars in thrombosis and hemostasis 1997. link 64 Gordon B, Haire W, Ruby E, Kotulak G, Stephens L, Kessinger A et al.. Factors predicting morbidity following hematopoietic stem cell transplantation. Bone marrow transplantation 1997. link 65 Brecher ME, Sims L, Schmitz J, Shea T, Bentley SA. North American Multicenter Study on flow cytometric enumeration of CD34+ hematopoietic stem cells. Journal of hematotherapy 1996. link 66 Cetrulo CL, Sbarra AJ, Cetrulo CL. Collection and cryopreservation of cord blood for the treatment of hematopoietic disorders: the obstetrician's overview. Journal of hematotherapy 1996. link 67 Jeglum KA. Immunomodulation of hematopoietic tumors. The Veterinary clinics of North America. Small animal practice 1985. link50038-8) 68 Freedman MH. Congenital failure of hematopoiesis in the newborn infant. Clinics in perinatology 1984. link 69 Little HK, Crawford DB, Meister K. Hematocolpos: diagnosis made by ultrasound. Journal of clinical ultrasound : JCU 1978. link

    Original source

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      Transfusion practices at end of life for hematopoietic stem cell transplant patients.Wang WS, Ma JD, Nelson SH, Revta C, Buckholz GT, Mulroney C et al. Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer (2018)
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