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Interventional Cardio-Oncology: Adding a New Dimension to the Cardio-Oncology Field.

The management of cardiovascular disease in patients with active cancer presents a unique challenge in interventional cardiology. Cancer patients often suffer from significant comorbidities such as thrombocytopenia and coagulopathic and/or hypercoagulable states, which complicates invasive evaluation and can specifically be associated with an increased risk for vascular access complications. Furthermore, anticancer therapies cause injury to the vascular endothelium as well as the myocardium. Meanwhile, improvements in diagnosis and treatment of various cancers have contributed to an increase i

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… Prophylactic platelet transfusion is not recommended in the general adult inpatient population for platelet counts over 10,000/μl ( 38 ). … Platelet transfusion: a clinical practice guideline from the AABB. Ann Intern Med (2015) 162(3):205–13. 10.7326/M14-1589 39. Iliescu CA, Grines CL, Herrmann J, Yang EH, Cilingiroglu M, Charitakis K, et al. …

Bidireкционная связь между системным иммунно-воспалительным индексом и анемией после аутологичной трансплантации стволовых клеток у пациентов с мультиплексной миеломой: ретроспективное когорта исследование.

БАКGROUND: Автологическая трансплантация стволовых клеток (АСК) является ключевой терапией для консолидации при множественной миеломе (ММ). Однако анемия после трансплантации является распространенной осложнением, которое нарушает восстановление и прогноз. Системный иммунно-воспалительный индекс (СИИ), удобный показатель системного воспалительного бремени, связан с прогнозом в различных опухолях. Настоящее исследование направлено на изучение двунаправленной связи между СИИ до АСК и анемией после АСК у пациентов с ММ, определение прогнозной ценности СИИ для анемии и исследование влияния базовой

Missed Until Critical: Unravelling the Mystery of Persistent Hemolysis With a Definitive Diagnosis of Babesiosis.

Babesiosis is a parasitic protozoan infection caused primarily by Babesia microti in the United States. Its presentation can imitate that of malaria, which often leads to misdiagnosis. We present here a case of a 54-year-old female with multiple comorbidities, such as hypertension and hyperlipidemia, who was initially diagnosed with malaria but, with further investigation, was found to have babesiosis. The patient initially presented with anemia and thrombocytopenia, prompting an extensive and meticulous workup including a peripheral blood smear and autoimmune studies. From these tests, we wer

Ренальные результаты после автономной трансплантации стволовых клеток у пациентов, страдающих диализом-депендентом с множественными миеломами: одноцентральное исследование из страны с низким и средним уровнем дохода.

Множественная миелома (ММ) часто вызывает почечные расстройства, и подгруппа пациентов переходит к конечной стадии почечной болезни (ESRD), требующей диализа. Зависимость от диабета традиционно считалась относительным противопоставлением к кондиционирования при высоких дозах и автоматической трансплантации стволовых клеток (ASCT). Появляющиеся данные свидетельствуют о том, что ACCT может обеспечивать эффективный гематологический контроль, а в отдельных пациентах - почечную реабилитацию. Мы провели серию ретроспективных дел five Зависящие от диализа пациенты с MM, которые прошли ACCT в больнице

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… Irradiated packed red blood cells and platelet transfusions were administered according to clinical indications and institutional thresholds. … Platelet engraftment was defined as the first of three consecutive days with a platelet count ≥ 20 × 109/L without platelet transfusion. Neutrophil engraftment was defined as the first of three consecutive days with an absolute neutrophil count ≥ 0.5 × 109/L. 2.5. …

Practical recommendations on the use of lenalidomide in the management of myelodysplastic syndromes.

Lenalidomide, an oral immunomodulatory agent, has received approval in the USA from the Food and Drug Administration (FDA) for the management of myelodysplastic syndromes (MDS) classified by the International Prognostic Scoring System (IPSS) as low risk or intermediate-1 risk and with a deletion 5q (del(5q)) cytogenetic abnormality. Although some patients with del(5q) have a relatively good prognosis, all del(5q) patients will become transfusion-dependent at some point during the course of their disease. The results of two clinical trials in more than 160 patients with MDS have demonstrated cl

Clinical Practice Guideline: Nosebleed (Epistaxis) Executive Summary.

OBJECTIVE: Nosebleed, also known as epistaxis, is a common problem that occurs at some point in at least 60% of people in the United States. While the great majority of nosebleeds are limited in severity and duration, about 6% of people who experience nosebleeds will seek medical attention. For the purposes of this guideline, we define the target patient with a nosebleed as a patient with bleeding from the nostril, nasal cavity, or nasopharynx that is sufficient to warrant medical advice or care. This includes bleeding that is severe, persistent, and/or recurrent, as well as bleeding that impa

Clinical and Molecular Insights in Erythropoiesis Regulation of Signal Transduction Pathways in Myelodysplastic Syndromes and β-Thalassemia.

Erythropoiesis regulation is essential in normal physiology and pathology, particularly in myelodysplastic syndromes (MDS) and β-thalassemia. Several signaling transduction processes, including those regulated by inositides, are implicated in erythropoiesis, and the latest MDS or β-thalassemia preclinical and clinical studies are now based on their regulation. Among others, the main pathways involved are those regulated by transforming growth factor (TGF)-β, which negatively regulates erythrocyte differentiation and maturation, and erythropoietin (EPO), which acts on the early-stage erythropoi

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Hematopoietic stem and progenitor cell harvesting: technical advances and clinical utility.

Hematopoietic stem and progenitor cell (HSPC) transplantations require prior harvesting of allogeneic or autologous HSPCs. HSPCs are usually present in bone marrow (BM) during the entire life, in cord blood (CB) at birth, or in peripheral blood (PB) under particular circumstances. HSPCs were first harvested in BM and later in CB and PB, as studies showed interesting features of such grafts. All harvesting methods were in use throughout the years, except BM harvesting for HSPC autologous transplantation, which was replaced by PB harvesting. BM, CB, and PB harvesting methods have been developed,

Postoperative Natural Killer Cell Dysfunction: The Prime Suspect in the Case of Metastasis Following Curative Cancer Surgery.

Surgical resection is the foundation for the curative treatment of solid tumors. However, metastatic recurrence due to the difficulty in eradicating micrometastases remain a feared outcome. Paradoxically, despite the beneficial effects of surgical removal of the primary tumor, the physiological stress resulting from surgical trauma serves to promote cancer recurrence and metastasis. The postoperative environment suppresses critical anti-tumor immune effector cells, including Natural Killer (NK) cells. The literature suggests that NK cells are critical mediators in the formation of metastases i

How to Use a Prioritised Approach for Treating Hematological Disorders During the COVID-19 Pandemic in India?

The current pandemic coronavirus, SARS-CoV-2, is known to cause severe infection (COVID-19) in patients with comorbidities, particularly cancer or an immunosuppressed state. Most healthcare systems in the country are likely to be overwhelmed soon if the pandemic moves to a stage of community transmission. Currently, limited evidence is available for managing patients with hematological disorders during the COVID-19 pandemic. The current review summarises the possible challenges clinicians are likely to face, key considerations to guide decision making, and possible solutions to the anticipated

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… transfusions. … For e.g. a “no prophylactic platelet transfusion” strategy may be adopted for asymptomatic patients with chronic bone marrow failure (including during low dose oral chemotherapy or azacitidine) and to consider no prophylactic platelet transfusions for well patients without bleeding after autologous stem …

Rapid progression of gastric cancer with liver metastasis after discontinuation of lenalidomide in a patient with concurrent multiple myeloma: A case report.

INTRODUCTION: The synchronous incidence of multiple myeloma (MM) and other primary malignant solid tumor is rare. No detailed studies have been published regarding the perioperative management of patients with concurrent MM and malignant solid tumor. We report a patient with concurrent MM and gastric cancer who experienced rapid progression of liver metastasis after lenalidomide was discontinued. PRESENTATION OF CASE: An 82-year-old woman with MM was diagnosed with clinical T3N2M0 gastric cancer, and MM had been maintained in remission with lenalidomide. Preoperatively, pancytopenia was found

Scheduled removal of central venous catheters (CVC) to prevent CVC-related bloodstream infections in patients with hematological disease or autologous stem cell transplantation: a registry-based randomized simulation-study.

Although not generally recommended, scheduled central venous catheter (CVC) removal is sometimes carried out in order to reduce the CVC-related bloodstream infection (CRBSI) incidence. We conducted a simulation for scheduled CVC removal within the multicenter CRBSI registry (SECRECY). Non-tunneled jugular and subclavian CVC in patients with hematological disease or with germ cell tumors (including patients receiving autologous stem cell transplantation [SCT]) were included. Cases were randomized in a 1:1:1:1 ratio to either a simulated, scheduled CVC removal after 7, 14, and 21 days, or to non

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… While neutropenia at the time-point of CVC insertion does not pose a clinically relevant problem [ 30 ], thrombocytopenia < 20,000/µL requires prophylactic platelet transfusions [ 31 , 32 ]. … Optimal preprocedural platelet transfusion threshold for central venous catheter insertions in patients with thrombocytopenia. Transfusion. 2011;51:2269–2276. doi: 10.1111/j.1537-2995.2011.03147.x. 32. …

GroβT rapidly and reliably mobilizes primitive hematopoietic stem and progenitor cells in nonhuman primates.

Autologous hematopoietic stem cell (HSC) gene therapy has gone through remarkable advancements in recent years, especially for the treatment of sickle cell disease (SCD). However, the collection of HSCs from SCD patients requires unique considerations, as granulocyte colony-stimulating factor (G-CSF)-mediated mobilization is contraindicated, and plerixafor-only mobilization is highly variable. Consequently, alternative mobilization regimens that are safe for SCD patients and generate better cell yields are desirable for SCD HSC gene therapy. Here, we evaluated a combination of plerixafor (AMD3

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… Recovery of neutrophils, platelets, and the need for platelet transfusions was compared side by side with our historic controls. Animals receiving G-CSF-mobilized CD34 + cells recovered neutrophils after 9 ± 1.41 days and platelets after 13.5 ± 3.54 days ( Figures 4 A, 4B, and S1 ). … (C) Number of platelet transfusions given until platelet recovery (Mean, SD, one-sided t test). (D) White blood cells (WBCs), platelet (Plt), neutrophil (Neu), and lymphocyte (Lym) counts over time, measured with a hemocytometer. …

Recommendations for the management of the haematological and onco-haematological aspects of Gaucher disease.

Current knowledge of the haematological and onco-haematological complications of type 1 Gaucher disease has been reviewed with the aim of identifying best clinical practice for treatment and disease management. It was concluded that: (i) Awareness of typical patterns of cytopenia can help clinicians distinguish haematological co-morbidities. (ii) Red blood cell studies and complete iron metabolism evaluation at baseline are recommended. (iii) Haemoglobin levels defining anaemia should be raised and used in Gaucher disease treatment and monitoring. (iv) Surgeons should be aware of potential ble

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… Platelet transfusion before surgery should be carried out in cases where platelet counts are <50 × 10 9 /l, with monitoring during the operation and repetition if necessary. … Kelsey) Guidelines for the use of platelet transfusions British Journal of Haematology 2003 122 10 23 Burstein Y Zakuth V Rechavi G Spirer Z Abnormalities of cellular immunity and natural killer cells in Gaucher's disease Journal of Clinical & Laboratory Immunology 1987 23 149 151 2959782 Charrow J …

Optimal chemo-mobilization for the collection of peripheral blood stem cells in patients with multiple myeloma.

BackgroundFor successful autologous stem cell transplantation, the collection of a sufficient number of hematopoietic stem cells after induction therapy is essential for transplant candidates with multiple myeloma (MM).MethodsIn this study, we compared the efficacy and safety of stem cell mobilization using cyclophosphamide (CY; 3.0 g/m2 on day 1) or etoposide (VP-16; 375 mg/m2 on days 1 and 2) in patients with MM. Granulocyte-colony stimulating factor (G-CSF, 10 μg/kg/day, subcutaneously) was administered from the onset of neutropenia to the final day of collection.ResultsSixty-five patients

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… Platelet engraftment after transplant was defined as the first of 7 consecutive days where the platelet count was > 20 × 10 9 /L without platelet transfusion. … In addition, 47 (72.3%) patients in the CY group and 24 (38.1%) in the VP-16 group required platelet transfusions ( P < 0.001). Non-hematological toxicities occurred in 35.4% of the CY group and 22.2% of the VP-16 group. …

Abstract

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Успешное уничтожение антител de novo HLA с помощью Daratumumumab в иммунопосредованных цитопенциях после пересадки аллогенетических стволовых клеток: отчет по делу.

Рефракторные иммуномедиаментированные цитопенции (КМК) после трансплантации стволовых клеток с аллогенетической гематопоиетической гематозностью (аллоХСТ) представляют собой сложное осложнение с ограниченными терапевтическими возможностями. Несмотря на то, что ранее существовавшие антитела лейкоцитов человека (ХЛА), в частности конкретные для доноров антитела (АДС), являются хорошо зарекомендовавшими себя факторами риска в случае отказа от трансплантации, клиническая значимость и механистическая роль антител de novo HLA, появившихся после трансплантации, по-прежнему плохо определены. Не провод

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Криопрезентация против пересадки свежих стволовых клеток в автоматической трансплантации для множественной миеломы: воздействие на раннюю токсичность и пересадку.

ВВЕДЕНИЕ: Аутологическая трансплантация стволовых клеток (ASCT) по-прежнему является краеугольным камнем терапии для имеющих на это право пациентов с множественной миеломой. Криопирование гематополиетических трансплантаций обеспечивает логистическую гибкость, но может способствовать повышению токсичности, связанной с процедурой, и использованию ресурсов. Мы провели two- Фаза, неслучайное двухнациональное исследование в высших центрах Сантьяго, Чили, и Севилье, Испания, сравнивая криопрезентированные и некриопретрофированные трансплантаты у пациентов, проходящих ACCT. На ретроспективном этапе20