Objective:This study retrospectively analyzed the clinical characteristics of patients newly diagnosed with acute myeloid leukemia (AML) who were admitted to the hematology intensive care unit (HCU) with critical illness. It also examined factors associated with critical illness and early mortality in these patients.Methods:Clinical data were collected from 91 newly diagnosed AML patients admitted to the HCU of the Department of Hematology, First Affiliated Hospital of Soochow University, from October 2020 to 2024. Reasons for HCU admission, major therapeutic interventions, and risk factors for critical illness and early mortality were analyzed.Results:The median time from diagnosis to HCU admission was 3 days ( IQR: 3–9 days), and the median HCU stay was 10 days ( IQR: 3–23 days). Of the 91 patients, 71 were admitted to the HCU before induction chemotherapy, while 20 were transferred to the HCU after its initiation. The leading causes of HCU admission were pulmonary infection (78.0% ), respiratory failure (44.0% ), hepatic insufficiency (28.6% ), renal insufficiency (27.5% ), disseminated intravascular coagulation (DIC; 25.3% ), and sepsis (23.1% ). Median Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and SOFA scores at HCU admission were 14 ( IQR: 11–18) and the median Sepsis Related Organ Failure Assessment (SOFA) score was 7 ( IQR: 4, 10). Major HCU interventions included vasoactive drugs, noninvasive and invasive mechanical ventilation, continuous renal replacement therapy, therapeutic leukocyte clearance, and cardiopulmonary resuscitation. Among patients receiving induction chemotherapy, the composite complete remission rate was 65.4%, and the overall remission rate was 88.5%. Thirty-five (38.5% ) patients died within 28 days of HCU admission. Independent risk factors for 28-day mortality were DIC ( OR=9.350, 95% CI 1.999–43.745, P=0.005), sepsis ( OR=6.817, 95% CI 1.571–29.582, P=0.010), and cardiac insufficiency ( OR=12.281, 95% CI 2.385–63.254, P=0.003) . Conclusion:The main reason for HCU admission in newly diagnosed critically ill AML patients was pulmonary infection. Nearly 40% of patients experisenced early death, and DIC, sepsis, and heart failure were factors influencing early mortatlity.

This report presents the management of a critically ill 36-year-old woman diagnosed with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph +ALL) at 28 weeks of gestation. The patient rapidly deteriorated, developing disseminated intravascular coagulation (DIC) , diffuse alveolar hemorrhage (DAH) , septic shock, and multi-organ dysfunction, necessitating admission to the hematological intensive care unit. Given her critical condition and advanced pregnancy, a chemotherapy-free induction regimen comprising imatinib and dexamethasone was initiated, alongside comprehensive supportive measures, including mechanical ventilation, continuous renal replacement therapy (CRRT) , broad-spectrum antibiotics, and high-dose corticosteroids. During treatment, intrauterine fetal demise occurred, and a stillborn was delivered following obstetric intervention. With aggressive treatment, the patient's respiratory failure, DIC, and DAH gradually resolved, and she achieved complete remission. She subsequently received consolidation chemotherapy, CAR-T cell therapy, and allogeneic hematopoietic stem cell transplantation, achieving sustained complete molecular remission on long-term follow-up. This case demonstrates that for critically ill pregnant patients with Ph + ALL, a chemotherapy-free regimen of targeted therapy and corticosteroids, when combined with intensive supportive care, is a safe and effective approach that may offer a therapeutic option for similar cases.

Objective To explore the relationship between atherosclerosis(AS)and bone mineral density(BMD)as well as frac-ture risk in patients with type 2diabetes mellitus(T2DM).Methods A total of 380 T2DM patients aged 50-80 years were included and divided into AS group and non-AS group based on carotid intima-media thickness.Clinical indicators were compared between the two groups,and the relationship between AS and BMD as well as fracture risk was analyzed.Results The AS group had higher age,diabetes duration,incidence of osteopenia,10-year probability of major osteoporotic fracture(PMOF),and 10-year probability of hip fracture(PHF),while having lower femoral neck BMD than the non-AS group.In male T2DM patients,PMOF and PHF were positively correla-ted with age,diabetes duration,and AS lesions,and negatively correlated with total cholesterol,triglycerides,low-density lipoprotein,25-hydroxyvitamin D,type Ⅰ procollagen amino-terminal peptide,and BMD.In female T2DM patients,PMOF and PHF were posi-tively correlated with menopause duration,fasting insulin,and AS lesions,and negatively correlated with blood phosphorus and BMD.Regression analysis showed that osteopenia was an independent risk factor for AS lesions in male T2DM patients,AS lesions were an inde-pendent risk factor for BMD levels,and body mass index was an independent protective factor for BMD levels.In female T2DM patients,age,fasting insulin,and high-density lipoprotein were independent risk factors for BMD levels,and parathyroid hormone was an inde-pendent protective factor for BMD levels.Conclusion When T2DM patients have AS lesions,the incidence of low bone mass and osteo-porosis is higher,with decreased femoral neck BMD and increased PMOF and PHF.In male subjects,low bone mass and osteoporosis are independent risk factors for AS lesions,and AS lesions are also independent risk factors for BMD levels.

Objective To explore the relationship between atherosclerosis(AS)and bone mineral density(BMD)as well as frac-ture risk in patients with type 2diabetes mellitus(T2DM).Methods A total of 380 T2DM patients aged 50-80 years were included and divided into AS group and non-AS group based on carotid intima-media thickness.Clinical indicators were compared between the two groups,and the relationship between AS and BMD as well as fracture risk was analyzed.Results The AS group had higher age,diabetes duration,incidence of osteopenia,10-year probability of major osteoporotic fracture(PMOF),and 10-year probability of hip fracture(PHF),while having lower femoral neck BMD than the non-AS group.In male T2DM patients,PMOF and PHF were positively correla-ted with age,diabetes duration,and AS lesions,and negatively correlated with total cholesterol,triglycerides,low-density lipoprotein,25-hydroxyvitamin D,type Ⅰ procollagen amino-terminal peptide,and BMD.In female T2DM patients,PMOF and PHF were posi-tively correlated with menopause duration,fasting insulin,and AS lesions,and negatively correlated with blood phosphorus and BMD.Regression analysis showed that osteopenia was an independent risk factor for AS lesions in male T2DM patients,AS lesions were an inde-pendent risk factor for BMD levels,and body mass index was an independent protective factor for BMD levels.In female T2DM patients,age,fasting insulin,and high-density lipoprotein were independent risk factors for BMD levels,and parathyroid hormone was an inde-pendent protective factor for BMD levels.Conclusion When T2DM patients have AS lesions,the incidence of low bone mass and osteo-porosis is higher,with decreased femoral neck BMD and increased PMOF and PHF.In male subjects,low bone mass and osteoporosis are independent risk factors for AS lesions,and AS lesions are also independent risk factors for BMD levels.

Objective:This study retrospectively analyzed the clinical characteristics of patients newly diagnosed with acute myeloid leukemia (AML) who were admitted to the hematology intensive care unit (HCU) with critical illness. It also examined factors associated with critical illness and early mortality in these patients.Methods:Clinical data were collected from 91 newly diagnosed AML patients admitted to the HCU of the Department of Hematology, First Affiliated Hospital of Soochow University, from October 2020 to 2024. Reasons for HCU admission, major therapeutic interventions, and risk factors for critical illness and early mortality were analyzed.Results:The median time from diagnosis to HCU admission was 3 days ( IQR: 3–9 days), and the median HCU stay was 10 days ( IQR: 3–23 days). Of the 91 patients, 71 were admitted to the HCU before induction chemotherapy, while 20 were transferred to the HCU after its initiation. The leading causes of HCU admission were pulmonary infection (78.0% ), respiratory failure (44.0% ), hepatic insufficiency (28.6% ), renal insufficiency (27.5% ), disseminated intravascular coagulation (DIC; 25.3% ), and sepsis (23.1% ). Median Acute Physiology and Chronic Health Evaluation Ⅱ (APACHE Ⅱ) and SOFA scores at HCU admission were 14 ( IQR: 11–18) and the median Sepsis Related Organ Failure Assessment (SOFA) score was 7 ( IQR: 4, 10). Major HCU interventions included vasoactive drugs, noninvasive and invasive mechanical ventilation, continuous renal replacement therapy, therapeutic leukocyte clearance, and cardiopulmonary resuscitation. Among patients receiving induction chemotherapy, the composite complete remission rate was 65.4%, and the overall remission rate was 88.5%. Thirty-five (38.5% ) patients died within 28 days of HCU admission. Independent risk factors for 28-day mortality were DIC ( OR=9.350, 95% CI 1.999–43.745, P=0.005), sepsis ( OR=6.817, 95% CI 1.571–29.582, P=0.010), and cardiac insufficiency ( OR=12.281, 95% CI 2.385–63.254, P=0.003) . Conclusion:The main reason for HCU admission in newly diagnosed critically ill AML patients was pulmonary infection. Nearly 40% of patients experisenced early death, and DIC, sepsis, and heart failure were factors influencing early mortatlity.

This report presents the management of a critically ill 36-year-old woman diagnosed with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph +ALL) at 28 weeks of gestation. The patient rapidly deteriorated, developing disseminated intravascular coagulation (DIC) , diffuse alveolar hemorrhage (DAH) , septic shock, and multi-organ dysfunction, necessitating admission to the hematological intensive care unit. Given her critical condition and advanced pregnancy, a chemotherapy-free induction regimen comprising imatinib and dexamethasone was initiated, alongside comprehensive supportive measures, including mechanical ventilation, continuous renal replacement therapy (CRRT) , broad-spectrum antibiotics, and high-dose corticosteroids. During treatment, intrauterine fetal demise occurred, and a stillborn was delivered following obstetric intervention. With aggressive treatment, the patient's respiratory failure, DIC, and DAH gradually resolved, and she achieved complete remission. She subsequently received consolidation chemotherapy, CAR-T cell therapy, and allogeneic hematopoietic stem cell transplantation, achieving sustained complete molecular remission on long-term follow-up. This case demonstrates that for critically ill pregnant patients with Ph + ALL, a chemotherapy-free regimen of targeted therapy and corticosteroids, when combined with intensive supportive care, is a safe and effective approach that may offer a therapeutic option for similar cases.

Objective To explore the diagnostic value of digital breast tomosynthesis technique (DBT) in breast suspicious calcified lesions.Methods Clinical data of 135 patients using DBT and FFDM (Full field digital mammography) was respectively analyzed.Results Of the 135 cases,43 cases were malignant,and 92 cases were benign.The diagnostic sensitivity DBT and FFDM were 93.0％ (40/43)and 88.4％ (38/43),specificity were 88.0％ (81/92) and 75.0％ (69/92),accuracy were 89.6％ (121/135) and 79.3％ (107/135),the differences were statistically significant (P ＜0.05).The ROC curve area (AUC) of DBT and FFDM were 0.905 ± 0.026 and 0.817 ± 0.034 (P =0.000 2).In premenopausal,postmenopausal and breast density ACR3-4 cases,DBT accuracy is higher than FFDM (P ＜ 0.05).The BI-RADS classification difference of the benign calcified lesions was statistically significant (x2 =11.740,P =0.038 5).Conclusions Compared with the traditional FFDM,DBT has a higher value in the diagnosis of breast suspicious calcified lesions,especially for benign calcified lesions.