Anticoagulants are recommended for the prevention and treatment of venous thromboembolism (VTE). The new anticoagulants which target specific factors in the coagulation cascade offer the advantage that they can be administered orally. These drugs seek to offer safe anticoagulation without the need for regular monitoring and frequent dose adjustment. Some of these newer drugs are in the advanced stages of clinical trials or have already completed them and thereby aim to provide more options in the management of thromboembolism. In the present review we discuss the currently available evidence supporting the use of these new anticoagulants, in particular rivaroxaban.
{"title":"Update on Rivaroxaban","authors":"O. Moussa, D. Chattopadhyay, V. Bhattacharya","doi":"10.4137/CMBD.S5101","DOIUrl":"https://doi.org/10.4137/CMBD.S5101","url":null,"abstract":"Anticoagulants are recommended for the prevention and treatment of venous thromboembolism (VTE). The new anticoagulants which target specific factors in the coagulation cascade offer the advantage that they can be administered orally. These drugs seek to offer safe anticoagulation without the need for regular monitoring and frequent dose adjustment. Some of these newer drugs are in the advanced stages of clinical trials or have already completed them and thereby aim to provide more options in the management of thromboembolism. In the present review we discuss the currently available evidence supporting the use of these new anticoagulants, in particular rivaroxaban.","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":"50 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2010-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73026832","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Altaee Akram, Abu Saud Khalida, S. Sawsan, L. Charles
To assess some simple blood parameters at birth that can be used as a basis to suspect α-thalassemia minor (ATM), a prospective study involving 202 consecutive neonates with MCV of less than 95 fl or less were checked for Hb Barts by HPLC. The group was divided into two, one with an MCV of 90-95 (89 cases) and the other with an MCV below 90 (113 cases). For control, 104 consecutive neonates with an MCV ≥ 95 fl were similarly checked. It has been confirmed that an MCV that is below 90 fl, especially with and MCH of ≤30 pg is a strong indicator of the presence of ATM (109/113). On the other hand, MCV of 90 or more, especially with an MCH of 30 or more is a strong negative indicator for ATM (70/89). Firm diagnosis of ATM at birth can thus be secured in majority of neonates.
{"title":"Birth MCV and MCH are Quite Reliable Parameters for the Prediction of Alpha Thalassemia Trait","authors":"Altaee Akram, Abu Saud Khalida, S. Sawsan, L. Charles","doi":"10.4137/CMBD.S1927","DOIUrl":"https://doi.org/10.4137/CMBD.S1927","url":null,"abstract":"To assess some simple blood parameters at birth that can be used as a basis to suspect α-thalassemia minor (ATM), a prospective study involving 202 consecutive neonates with MCV of less than 95 fl or less were checked for Hb Barts by HPLC. The group was divided into two, one with an MCV of 90-95 (89 cases) and the other with an MCV below 90 (113 cases). For control, 104 consecutive neonates with an MCV ≥ 95 fl were similarly checked. It has been confirmed that an MCV that is below 90 fl, especially with and MCH of ≤30 pg is a strong indicator of the presence of ATM (109/113). On the other hand, MCV of 90 or more, especially with an MCH of 30 or more is a strong negative indicator for ATM (70/89). Firm diagnosis of ATM at birth can thus be secured in majority of neonates.","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":"30 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2009-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74179061","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
J. Menezes, M. Emerenciano, F. Pimenta, Gilson Guedes Filho, I. Magalhães, M. Sant'ana, Marina Lipkin Vasquez, Llana Zalcberg Renault, M. Pombo-de-Oliveira
Although acute leukaemia is rare in pregnancy its importance lies in its life-threatening potential, both to the child and the mother. The possibility of vertical transmission of leukemic cells increases the attention devoted to these patients and their offspring. Three cases of pregnant young women (15-17 years of age) with AML are presented. This series of cases is the first report where gene abnormalities such as ITD mutations of the FLT3 gene and AML1/ETO fusion genes were screened in pregnant AML patients and their babies, so far. Unfortunately, very poor outcomes have been associated to similar cases described in literature, and the same was true to the patients described herein. Although very speculative, we think that the timing and possible similar exposures would be involved in all cases.
{"title":"Occurrence of Acute Myeloid Leukemia in Young Pregnant Women","authors":"J. Menezes, M. Emerenciano, F. Pimenta, Gilson Guedes Filho, I. Magalhães, M. Sant'ana, Marina Lipkin Vasquez, Llana Zalcberg Renault, M. Pombo-de-Oliveira","doi":"10.4137/CMBD.S823","DOIUrl":"https://doi.org/10.4137/CMBD.S823","url":null,"abstract":"Although acute leukaemia is rare in pregnancy its importance lies in its life-threatening potential, both to the child and the mother. The possibility of vertical transmission of leukemic cells increases the attention devoted to these patients and their offspring. Three cases of pregnant young women (15-17 years of age) with AML are presented. This series of cases is the first report where gene abnormalities such as ITD mutations of the FLT3 gene and AML1/ETO fusion genes were screened in pregnant AML patients and their babies, so far. Unfortunately, very poor outcomes have been associated to similar cases described in literature, and the same was true to the patients described herein. Although very speculative, we think that the timing and possible similar exposures would be involved in all cases.","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":"17 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81803490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Brice, M. André, P. Franchi-Rezgui, I. Biasoli, C. Hennequin
In patients with Hodgkin lymphoma (HL) a continued improvement in outcome with a high cure rate is observed but with an increased treatment-induced late effects. We report the long-term results from 188 (stage I to IIIA) patients treated during the period 1985-94 with 3 courses of ABVD-like chemotherapy and subtotal nodal radiotherapy. 10 year overall survival is of 88% and no secondary leukaemia was observed. The main long term toxicity was cardiac, mainly related to a mediastinal dose of 45 Grays in patients with partial remission. New strategies are aiming to reduce the mediastinal dose at 30 Grays after chemotherapy-induced complete remission.
{"title":"Long Term Results after 3 Courses of ABVD plus Subtotal Nodal Radiotherapy in 188 Adult Patients with Stage I, II and IIIA Hodgin Lymphoma","authors":"P. Brice, M. André, P. Franchi-Rezgui, I. Biasoli, C. Hennequin","doi":"10.4137/CMBD.S357","DOIUrl":"https://doi.org/10.4137/CMBD.S357","url":null,"abstract":"In patients with Hodgkin lymphoma (HL) a continued improvement in outcome with a high cure rate is observed but with an increased treatment-induced late effects. We report the long-term results from 188 (stage I to IIIA) patients treated during the period 1985-94 with 3 courses of ABVD-like chemotherapy and subtotal nodal radiotherapy. 10 year overall survival is of 88% and no secondary leukaemia was observed. The main long term toxicity was cardiac, mainly related to a mediastinal dose of 45 Grays in patients with partial remission. New strategies are aiming to reduce the mediastinal dose at 30 Grays after chemotherapy-induced complete remission.","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":"1 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89278329","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Mitsuhashi, K. Endo, Kazuhiko Obara, H. Izutsu, T. Ishida, Norio Chikatsu, A. Shinagawa
Apoptosis was induced in heparinized human whole blood by 3 different ways (radiation, bleomycin, or etoposide), and various mRNA were quantified using the method we reported (Clin. Chem. 2006; 52:634-642). We found that cyclin-dependent kinase inhibitor 1A (p21) and p53 upregulated modulator of apoptosis (PUMA) were the most sensitive and universal mRNA markers of apoptosis in leukocytes. In order to define positive and negative responses, a synthetic RNA was spiked into the lysis buffer and the fold increase was calculated. As a result, 837/880 (95.1%) of data points stayed between 0.75 and 1.5 fold increase, and 874/880 (99.3%) were within 0.5-2.0 fold increase. When blood samples from 40 healthy adults were stimulated with 22 different drugs, more than 75% of the samples responded to bleomycin (1 μM), idarubicin (2 μM), vincristine (1 μM), daunorubicin (2 μM), cytarabine (10 μM), to induce p21 and/or PUMA mRNA, and approximately 25% showed no induction. Significant correlation was found between p21 and PUMA mRNA responses, and between daunorubicin and cytarabine, idarubicin, and vincristine for both p21 and PUMA. The quantification of drug-induced mRNA in whole blood will be considered as ex vivo, and is a suitable platform for biomarker screening as well as a model system for drug sensitivity tests in future.
{"title":"Quantification of Drug-Induced mRNA in Human Whole Blood ex vivo","authors":"M. Mitsuhashi, K. Endo, Kazuhiko Obara, H. Izutsu, T. Ishida, Norio Chikatsu, A. Shinagawa","doi":"10.4137/CMBD.S507","DOIUrl":"https://doi.org/10.4137/CMBD.S507","url":null,"abstract":"Apoptosis was induced in heparinized human whole blood by 3 different ways (radiation, bleomycin, or etoposide), and various mRNA were quantified using the method we reported (Clin. Chem. 2006; 52:634-642). We found that cyclin-dependent kinase inhibitor 1A (p21) and p53 upregulated modulator of apoptosis (PUMA) were the most sensitive and universal mRNA markers of apoptosis in leukocytes. In order to define positive and negative responses, a synthetic RNA was spiked into the lysis buffer and the fold increase was calculated. As a result, 837/880 (95.1%) of data points stayed between 0.75 and 1.5 fold increase, and 874/880 (99.3%) were within 0.5-2.0 fold increase. When blood samples from 40 healthy adults were stimulated with 22 different drugs, more than 75% of the samples responded to bleomycin (1 μM), idarubicin (2 μM), vincristine (1 μM), daunorubicin (2 μM), cytarabine (10 μM), to induce p21 and/or PUMA mRNA, and approximately 25% showed no induction. Significant correlation was found between p21 and PUMA mRNA responses, and between daunorubicin and cytarabine, idarubicin, and vincristine for both p21 and PUMA. The quantification of drug-induced mRNA in whole blood will be considered as ex vivo, and is a suitable platform for biomarker screening as well as a model system for drug sensitivity tests in future.","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":"7 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"88112170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Wiskott-Aldrich Syndrome (WAS) is an × chromosome-linked immunodeficiency disorder. The most common symptom in WAS is bleeding. Several clinical investigations indicate that low platelet counts and defective platelet aggregation are the major causes of bleeding in WAS patients. However, the molecular bases underlying these defects are unclear. This study focuses on the molecular mechanism of defective platelet aggregation of WAS patients. The gene responsible for WAS encodes WAS protein (WASP). The mutations or deletion of WASP causes various functional defects in hematopoietic cells. We previously showed that binding of WASP to calcium- and integrin-binding protein (CIB) is required for activation of platelet integrin, αIIbβ3. I here demonstrate that blocking WASP binding to CIB reduces binding of talin to the β3 cytoplasmic tail, resulting in impaired activation of αIIbβ3. Impaired αIIbβ3 activation causes defective platelet aggregation, resulting in bleeding. This finding suggests a potential disease mechanism underlying bleeding seen in WAS patients.
{"title":"A Disease Mechanism Underlying Bleeding in Wiskott-Aldrich Syndrome","authors":"S. Tsuboi","doi":"10.4137/CMBD.S536","DOIUrl":"https://doi.org/10.4137/CMBD.S536","url":null,"abstract":"The Wiskott-Aldrich Syndrome (WAS) is an × chromosome-linked immunodeficiency disorder. The most common symptom in WAS is bleeding. Several clinical investigations indicate that low platelet counts and defective platelet aggregation are the major causes of bleeding in WAS patients. However, the molecular bases underlying these defects are unclear. This study focuses on the molecular mechanism of defective platelet aggregation of WAS patients. The gene responsible for WAS encodes WAS protein (WASP). The mutations or deletion of WASP causes various functional defects in hematopoietic cells. We previously showed that binding of WASP to calcium- and integrin-binding protein (CIB) is required for activation of platelet integrin, αIIbβ3. I here demonstrate that blocking WASP binding to CIB reduces binding of talin to the β3 cytoplasmic tail, resulting in impaired activation of αIIbβ3. Impaired αIIbβ3 activation causes defective platelet aggregation, resulting in bleeding. This finding suggests a potential disease mechanism underlying bleeding seen in WAS patients.","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":"1 1","pages":""},"PeriodicalIF":3.0,"publicationDate":"2008-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86736336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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