Pub Date : 1986-02-01DOI: 10.1016/S0308-2261(86)80013-3
Robert Souhami, William Peters
The available evidence suggests that if benefit is to be obtained from high dose chemotherapy regimens, it will be in patients whose tumours are either untreated or still responding to conventional therapy. In each of the diseases discussed in this chapter the optimum timing of the treatment regimen has still to be determined. Effective regimens have been found but it is probable that further improvements can be made. In small cell lung cancer initial high dose therapy followed by non-cross-resistant regimens may prove effective. In glioma studies with high dose therapy before irradiation are awaited and may offer the best means of exploiting this approach to treatment. In breast cancer some impressive responses have occurred but the category of patient likely to benefit has not yet been defined. In melanoma high dose treatment is likely to benefit only those patients with probable minimal disease after surgery.
{"title":"High dose chemotherapy in solid tumours in adults","authors":"Robert Souhami, William Peters","doi":"10.1016/S0308-2261(86)80013-3","DOIUrl":"10.1016/S0308-2261(86)80013-3","url":null,"abstract":"<div><p>The available evidence suggests that if benefit is to be obtained from high dose chemotherapy regimens, it will be in patients whose tumours are either untreated or still responding to conventional therapy. In each of the diseases discussed in this chapter the optimum timing of the treatment regimen has still to be determined. Effective regimens have been found but it is probable that further improvements can be made. In small cell lung cancer initial high dose therapy followed by non-cross-resistant regimens may prove effective. In glioma studies with high dose therapy before irradiation are awaited and may offer the best means of exploiting this approach to treatment. In breast cancer some impressive responses have occurred but the category of patient likely to benefit has not yet been defined. In melanoma high dose treatment is likely to benefit only those patients with probable minimal disease after surgery.</p></div>","PeriodicalId":75718,"journal":{"name":"Clinics in haematology","volume":"15 1","pages":"Pages 219-234"},"PeriodicalIF":0.0,"publicationDate":"1986-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14142044","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}
{"title":"Autologous bone marrow transplantation.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75718,"journal":{"name":"Clinics in haematology","volume":"15 1","pages":"1-272"},"PeriodicalIF":0.0,"publicationDate":"1986-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"14638917","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}
Pub Date : 1985-10-01DOI: 10.1016/S0308-2261(21)00502-6
Samuel Charache, Jennifer R. Niebyl
{"title":"Pregnancy in Sickle Cell Disease","authors":"Samuel Charache, Jennifer R. Niebyl","doi":"10.1016/S0308-2261(21)00502-6","DOIUrl":"https://doi.org/10.1016/S0308-2261(21)00502-6","url":null,"abstract":"","PeriodicalId":75718,"journal":{"name":"Clinics in haematology","volume":"14 3","pages":"Pages 729-746"},"PeriodicalIF":0.0,"publicationDate":"1985-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92120809","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}
{"title":"Haematological disorders in pregnancy.","authors":"","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75718,"journal":{"name":"Clinics in haematology","volume":"14 3","pages":"601-810"},"PeriodicalIF":0.0,"publicationDate":"1985-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15187395","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 mechanism by which anaemia develops in pregnancy is well understood: haemodilution causes a fall in the haemoglobin concentration during the first and second trimesters of normal pregnancies. Negative iron balance throughout pregnancy, particularly in the latter half, may lead to iron deficiency anaemia during the third trimester. The increase in iron demand is required to meet the expansion in maternal haemoglobin mass and to meet the needs of fetal growth. Fetal demand for iron results in a unidirectional flow of iron to the fetus against a concentration gradient regulated by fetal requirements for iron; this iron transfer occurs almost entirely irrespective of maternal iron status. The development of maternal iron deficiency during pregnancy may be detected by monitoring the haemoglobin concentration frequently; values falling to less than 11 g/dl should be regarded as abnormal, but specific red cell changes, such as microcytosis, may be lacking. A diagnosis of iron deficiency can be most conveniently confirmed by the serum ferritin concentration falling to less than 12 micrograms/l. Women at risk from iron deficiency anaemia can therefore be readily identified and corrective treatment instituted prior to the development of severe anaemia. A serum ferritin concentration of less than 50 micrograms/l in early pregnancy is an indication for iron supplements. Women in whom the serum ferritin concentration is greater than 80 micrograms/l at booking are unlikely to require iron supplements during pregnancy. This approach would eliminate the need for routine prophylactic iron therapy, which, in populations enjoying a good nutritional status, can no longer be justified in early pregnancy. Furthermore, any risk to the fetus from severe maternal anaemia would be avoided by prophylaxis and prompt treatment.
{"title":"Iron metabolism and anaemia in pregnancy.","authors":"D P Bentley","doi":"","DOIUrl":"","url":null,"abstract":"<p><p>The mechanism by which anaemia develops in pregnancy is well understood: haemodilution causes a fall in the haemoglobin concentration during the first and second trimesters of normal pregnancies. Negative iron balance throughout pregnancy, particularly in the latter half, may lead to iron deficiency anaemia during the third trimester. The increase in iron demand is required to meet the expansion in maternal haemoglobin mass and to meet the needs of fetal growth. Fetal demand for iron results in a unidirectional flow of iron to the fetus against a concentration gradient regulated by fetal requirements for iron; this iron transfer occurs almost entirely irrespective of maternal iron status. The development of maternal iron deficiency during pregnancy may be detected by monitoring the haemoglobin concentration frequently; values falling to less than 11 g/dl should be regarded as abnormal, but specific red cell changes, such as microcytosis, may be lacking. A diagnosis of iron deficiency can be most conveniently confirmed by the serum ferritin concentration falling to less than 12 micrograms/l. Women at risk from iron deficiency anaemia can therefore be readily identified and corrective treatment instituted prior to the development of severe anaemia. A serum ferritin concentration of less than 50 micrograms/l in early pregnancy is an indication for iron supplements. Women in whom the serum ferritin concentration is greater than 80 micrograms/l at booking are unlikely to require iron supplements during pregnancy. This approach would eliminate the need for routine prophylactic iron therapy, which, in populations enjoying a good nutritional status, can no longer be justified in early pregnancy. Furthermore, any risk to the fetus from severe maternal anaemia would be avoided by prophylaxis and prompt treatment.</p>","PeriodicalId":75718,"journal":{"name":"Clinics in haematology","volume":"14 3","pages":"613-28"},"PeriodicalIF":0.0,"publicationDate":"1985-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15022496","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}
{"title":"Obstetric haemorrhage: causes and management.","authors":"F E Boulton, E Letsky","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75718,"journal":{"name":"Clinics in haematology","volume":"14 3","pages":"683-728"},"PeriodicalIF":0.0,"publicationDate":"1985-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15049904","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}
Pub Date : 1985-10-01DOI: 10.1016/S0308-2261(21)00503-8
D.J. Weatherall
Many common genetic disorders of the blood can be identified in utero, either by fetal blood sampling, biochemical analysis of amniotic fluid cells or directly by studying DNA obtained from amniotic fluid cells or chorion biopsy. With the development of gene probes for most of the important genetic disorders of the blood there will be a gradual transition from fetal blood sampling and amniocentesis to chorion biopsy as the major approach to prenatal diagnosis of haematological disorders. Since the carrier states for many of these conditions can be identified at the antenatal clinic by a careful family history and a few relatively simple blood tests the outlook for prevention of many of the important genetic disorders of the blood is extremely promising.
{"title":"Prenatal Diagnosis of Inherited Blood Diseases","authors":"D.J. Weatherall","doi":"10.1016/S0308-2261(21)00503-8","DOIUrl":"https://doi.org/10.1016/S0308-2261(21)00503-8","url":null,"abstract":"<div><p>Many common genetic disorders of the blood can be identified in utero, either by fetal blood sampling, biochemical analysis of amniotic fluid cells or directly by studying DNA obtained from amniotic fluid cells or chorion biopsy. With the development of gene probes for most of the important genetic disorders of the blood there will be a gradual transition from fetal blood sampling and amniocentesis to chorion biopsy as the major approach to prenatal diagnosis of haematological disorders. Since the carrier states for many of these conditions can be identified at the antenatal clinic by a careful family history and a few relatively simple blood tests the outlook for prevention of many of the important genetic disorders of the blood is extremely promising.</p></div>","PeriodicalId":75718,"journal":{"name":"Clinics in haematology","volume":"14 3","pages":"Pages 747-774"},"PeriodicalIF":0.0,"publicationDate":"1985-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92120810","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}
{"title":"Obstetric management and diagnosis of haematological disease in the fetus.","authors":"K H Nicolaides, C H Rodeck, R S Mibashan","doi":"","DOIUrl":"","url":null,"abstract":"","PeriodicalId":75718,"journal":{"name":"Clinics in haematology","volume":"14 3","pages":"775-805"},"PeriodicalIF":0.0,"publicationDate":"1985-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"15049906","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}
Pub Date : 1985-10-01DOI: 10.1016/S0308-2261(21)00504-X
K.H. Nicolaides, C.H. Rodeck, R.S. Mibashan
{"title":"Obstetric Management and Diagnosis of Haematological Disease in the Fetus","authors":"K.H. Nicolaides, C.H. Rodeck, R.S. Mibashan","doi":"10.1016/S0308-2261(21)00504-X","DOIUrl":"https://doi.org/10.1016/S0308-2261(21)00504-X","url":null,"abstract":"","PeriodicalId":75718,"journal":{"name":"Clinics in haematology","volume":"14 3","pages":"Pages 775-805"},"PeriodicalIF":0.0,"publicationDate":"1985-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92060662","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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