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Expert Review of Hematology

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https://www.readbyqxmd.com/read/28162019/interleukin-7-signaling-as-a-therapeutic-target-in-acute-lymphoblastic-leukemia
#1
Angela Maria Savino, Shai Izraeli
No abstract text is available yet for this article.
February 6, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28164722/when-to-treat-patients-with-relapsed-follicular-lymphoma
#2
Chan Yoon Cheah, John F Seymour
Follicular lymphoma is the most common indolent lymphoma and remains incurable for the majority of patients despite recent major advances. The disease is typically initially chemosensitive, however relapse is inevitable. In contrast to the frontline setting, studies addressing the optimal timing of initiating second line therapy have not been performed and subsequently practice varies considerably. Areas covered: In the review, we consider the available literature regarding timing of therapy in patients with follicular lymphoma and consider key insights from FL biology to provide guidance on when to treat patients with relapsed disease...
February 4, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28076695/deacetylase-inhibitors-an-advance-in-myeloma-therapy
#3
Jacob P Laubach, Jesus F San-Miguel, Vania Hungria, Jian Hou, Philippe Moreau, Sagar Lonial, Jae Hoon Lee, Hermann Einsele, Melissa Alsina, Paul G Richardson
A significant unmet need exists in patients with relapsed or refractory multiple myeloma (MM), which remains an incurable disease despite recent advances in the field. One such development was the use of deacetylase inhibitors (DACi), which exert unique antimyeloma effects through targeting of epigenetic and protein metabolism pathways. The pan-DACi panobinostat was recently approved in combination with bortezomib and dexamethasone for use in patients with relapsed or relapsed and refractory MM. Results of a phase 3 trial showed that the panobinostat-containing regimen improved the overall response rate and progression-free survival...
February 1, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28136133/the-gastrointestinal-tract-properties-and-role-in-allogeneic-hematopoietic-stem-cell-transplantation
#4
Ilias Pessach, Panagiotis D Tsirigotis, Arnon Nagler
The GI-tract is a major target for both the intensive chemo and/or radiotherapy conditioning as well as for GVHD and therefore is closely associated with transplant outcome. Apart from being a target, the GI-tract is also a mediator and therefore is also a key player of the pathogenetic process following allogeneic transplantation. Areas covered: The intestinal homeostasis is regulated through complicated interactions between the key players of this process which are the intestinal epithelium, the intestinal immune system, and the intestinal microbiota...
January 30, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28133975/lymphoma-classification-update-t-cell-lymphomas-hodgkin-lymphomas-and-histiocytic-dendritic-cell-neoplasms
#5
Manli Jiang, N Nora Bennani, Andrew L Feldman
Lymphomas are classified based on the normal counterpart, or cell of origin, from which they arise. Because lymphocytes have physiologic immune functions that vary both by lineage and by stage of differentiation, the classification of lymphomas arising from these normal lymphoid populations is complex. Recent genomic data have contributed additional depth to this complexity. Areas covered: Lymphoma classification follows the World Health Organization (WHO) system, which reflects international consensus and is based on pathological, genetic, and clinical factors...
January 29, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28128670/large-granular-lymphocytic-leukemia-current-diagnostic-and-therapeutic-approaches-and-novel-treatment-options
#6
Estella Matutes
Large granular lymphocytic leukemia (LGLL) is a low grade lymphoproliferative disorder characterized by the clonal proliferation of large granular lymphocytes (LGL) and recognised by the WHO. The diagnosis and management of these patients is challenging due to the limited information from prospective studies. Guidelines for front-line therapy have not been established. The prognosis is favourable with median overall survivals greater than 10 years. Areas covered: This manuscript is a review of the clinical features, diagnosis, pathogenesis and, in particular, the various available therapeutic options for this rare lymphoid leukemia...
January 29, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28116920/safety-issues-and-management-of-toxicities-associated-with-new-treatments-for-multiple-myeloma
#7
Annamaria Brioli, Lars-Olof Mügge, Andreas Hochhaus, Marie Von Lilienfeld-Toal
In the last decade, the availability of new drugs for the treatment of Multiple Myeloma (MM) significantly improved patients' outcomes, but also raised attention towards a new spectrum of adverse events. Recently, four novel agents with different mechanisms of action (carfilzomib, elotuzumab, daratumumab and panobinostat) have been approved for the treatment of MM. This review aims at providing physicians with the tools to recognize and handle toxicity issues related with these new treatments. Areas covered: This review focuses on the management of drug related adverse events of the latest approved drug combinations...
January 27, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28110585/anemia-in-the-elderly-a-consequence-of-aging
#8
Racha Halawi, Hassan Moukhadder, Ali Taher
Anemia in the elderly is a common finding that is associated with a poorer quality of life, worse outcomes, and increased mortality. While this entity is frequently overlooked, there is often an underlying cause that is correctable. Areas covered: In this review, we shed light on the prevalence of anemia in the elderly population, review the most common causes, particularly iron deficiency anemia and anemia of chronic disease, and describe the available treatment modalities. When a clear etiology for the anemia is ruled-out, the term unexplained anemia may be utilized; while still an under-explored field, one of the underlying pathophysiological mechanisms appears to be associated with an age-related inflammatory process...
January 21, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28110581/triplet-combinations-in-relapsed-refractory-myeloma-update-on-recent-phase-3-trials
#9
Jean-Samuel Boudreault, Cyrille Touzeau, Philippe Moreau
Multiple myeloma (MM) is a rare hematologic disease of antibody-secreting plasma cells. Our understanding of the pathogenesis of this malignancy has improved greatly, and at the same time, we have access to new and more effective treatments options. Over the last 5 years, a spectrum of novel therapies with different mechanisms of action, including third-generation immunomodulatory drugs (pomalidomide), second generation proteasome inhibitors (carfilzomib and ixazomib), a histone deacetylase inhibitor (panobinostat) and monoclonal antibodies (mAbs) (elotuzumab and daratumumab) has transformed our approach to the treatment of patients with relapsed/refractory MM (RRMM)...
January 21, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28094575/treatment-approaches-of-hard-to-treat-non-hodgkin-lymphomas
#10
Lakshminarayanan Nandagopal, Amitkumar Mehta
Even after recent advancements with monoclonal antibodies, antibody drug conjugates and immune therapies, relapsed and refractory lymphomas remain challenging to treat; and the definition and treatment approaches of hard-to-treat lymphomas (HTL) continue to evolve. Areas covered: In this review, we will address HTL encompassing diffuse large B cell lymphoma (DLBCL), follicular lymphoma (FL) and peripheral T cell lymphomas (PTCL). DLBCL, which comprises 30-40% of non-Hodgkin lymphomas is a highly aggressive and heterogeneous malignancy, with primary refractory or relapsed disease remaining a therapeutic challenge...
January 17, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28092987/emerging-treatment-approaches-for-myeloma-related-bone-disease
#11
Maria Gavriatopoulou, Meletios A Dimopoulos, Efstathios Kastritis, Evangelos Terpos
Multiple myeloma is characterized by the presence of osteolytic lesions that leads to devastating skeletal-related events in the majority of patients. Myeloma bone disease is attributed to increased osteoclastic and suppressed osteoblastic activity. Areas covered: Bisphosphonates remain the main treatment option, however they have limitations on their own. Understanding the pathogenesis of myeloma bone disease may provide a roadmap for new therapeutic approaches. The pathway of RANKRANKLOPG pathway has revealed denosumab, a monoclonal antibody targeting RANKL as a novel emerging therapy for myeloma-related bone disease...
January 17, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28075196/typhlitis-neutropenic-enterocolitis-in-patients-with-acute-leukemia-a-review
#12
Rodrigo Portugal, Marcio Nucci
Typhlitis is an abdominal complication of cancer chemotherapy, affecting mostly patients receiving intensive chemotherapeutic regimens with high potential to induce mucosal damage, such as patients with acute leukemia. Despite being relatively frequent, there are no randomized trials or high-quality cohort studies addressing important aspects of the diagnosis and management of the disease. Areas covered: In this review we discuss the gaps in the literature, acknowledging that the evidences for recommendations regarding the management of typhlitis are mostly expert opinion...
February 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28013565/the-current-state-of-adverse-event-reporting-in-hemophilia
#13
Lize F D van Vulpen, Giorgia Saccullo, Alfonso Iorio, Michael Makris
Replacement of the missing clotting factor is the mainstay of hemophilia treatment. Whilst historically many hemophilia patients were infected with blood-borne viruses transmitted via plasma-derived products, nowadays the formation of alloantibodies against the missing clotting factor is the main adverse event of treatment. Areas covered: This paper provides an overview of the current national and international adverse event reporting systems, what these surveillance schemes taught us about side effects of the products presently in use, and elaborates on how to adapt these systems to the challenges we face with the changing treatment landscape...
February 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/27998188/can-the-surgical-tourniquet-be-used-in-patients-with-sickle-cell-disease-or-trait-a-review-of-the-literature
#14
Marco Pignatti, Sara Zanella, Caterina Borgna-Pignatti
In patients with sickle cell disease, circulatory stasis, acidosis, and hypoxemia induce red cell deoxygenation and consequent sickling. Tourniquets are an important adjunct in limb surgery to obtain a bloodless field. Many local and systemic effects, due to the inflation and deflation of the tourniquet, can develop. These effects may have severe consequences if comorbidities are present. The use of a tourniquet in sickle cell patients is controversial because it may provoke vaso-occlusive complications. Areas covered:We reviewed the literature to detect reports of the use of tourniquet in sickle cell disease or sickle trait...
February 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/27998183/systemic-therapy-for-cutaneous-t-cell-lymphoma-who-when-what-and-why
#15
Pooja Virmani, Susan H Hwang, Justin G Hastings, Bradley M Haverkos, Becca Kohnken, Alejandro A Gru, Anjali Mishra, Stephanie K Fabbro, Steve M Horwitz, Pierluigi Porcu
CTCL are rare neoplasms. Optimal care requires integrated use of diagnostic and treatment modalities spanning multiple specialties. Current instruments for patient risk stratification and disease measurement across all anatomical compartments are suboptimal. A common treatment dichotomy between early (Dermatology) and advanced stage (Hematology-Oncology) has hindered accrual of long term outcome data. Thus, important facts about natural history, such as frequency and determinants of stage progression, and the impact of specific treatment modalities on these endpoints, are not known...
February 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/27983880/how-ruxolitinib-modified-the-outcome-in-myelofibrosis-focus-on-overall-survival-allele-burden-reduction-and-fibrosis-changes
#16
Fulvio Massaro, Matteo Molica, Massimo Breccia
Ruxolitinib is a potent and selective JAK1/JAK2 inhibitor that has shown superiority as compared to available conventional chemotherapies, in terms of reduction in splenomegaly and improvement of symptoms and quality of life. Areas covered: Data published about overall survival in the major randomized sponsored trials and in independent series of patients were detailed. Indeed, data regarding action of ruxolitinib on allele burden reduction and potential activity of the drug on pathogenetic mechanisms involved in increased fibrosis has been reviewed...
February 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/27967256/direct-lineage-reprogramming-a-useful-addition-to-the-blood-cell-research-toolbox
#17
Sandra Capellera-Garcia, Johan Flygare
No abstract text is available yet for this article.
February 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/27967252/hyperleukocytosis-and-leukostasis-management-of-a-medical-emergency
#18
Sabrina Giammarco, Patrizia Chiusolo, Nicola Piccirillo, Alessia Di Giovanni, Elisabetta Metafuni, Luca Laurenti, Simona Sica, Livio Pagano
Hyperleukocytosis is defined as a white blood cell count greater than 100,000/mL in patients affected by acute leukemia and often it is associated with increased morbidity and mortality, that can be up to 40% if unrecognized. Areas covered: Risk factors include younger age, myelomonocytic or monocytic/monoblastic morphology, microgranular variant of acute promyelocitic leukemia and T-cell ALL, and some cytogenetic abnormalities. Poor prognosis due to high early death rate secondary to leukostasis. The mechanisms at the origin of leukostasis are still poorly understood...
February 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/27936980/chronic-lymphocytic-leukemia-and-small-lymphocytic-lymphoma-two-faces-of-the-same-disease
#19
Michael T Tees, Ian W Flinn
Chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) are considered indolent lymphocytic malignancies, more often requiring active surveillance rather than intervention. Despite the indolent nature of CLL/SLL, treatment is likely indicated in a patients' lifetime. Recent changes in the therapeutic landscape have created more options to the clinician. Areas covered: The authors provide a broad assessment of the current state of disease, including the work-up, prognostic features, and mutational aspects of the disease that should be acknowledged when developing a rational treatment plan...
February 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/27936978/mature-aggressive-b-cell-lymphoma-across-age-groups-molecular-advances-and-therapeutic-implications
#20
Jonas Lange, Georg Lenz, Birgit Burkhardt
Mature B-cell lymphoma represents the most common type of Non-Hodgkin lymphoma, and different subtypes prevail at different patient ages. Areas covered: We review recent data on differences and commonalities in mature B-cell lymphoma occurring in adult and pediatric patients, with a special emphasis on molecular advances and therapeutic implications. To this end, we will discuss knowledge on diffuse large B-cell lymphoma and Burkitt lymphoma/leukemia, which are the most frequent subtypes in adult and pediatric patients, respectively, and on primary mediastinal B-cell lymphoma, which is a subtype of mature B-cell lymphoma occurring mainly in adolescents and young adults with a female predominance...
February 2017: Expert Review of Hematology
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