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Expert Review of Hematology

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https://www.readbyqxmd.com/read/28712322/is-now-the-time-for-molecular-driven-therapy-for-diffuse-large-b-cell-lymphoma
#1
Alice Di Rocco, Federico De Angelis, Michela Ansuinelli, Robin Foà, Maurizio Martelli
Recent genetic and molecular discoveries regarding alterations in diffuse large B-cell lymphoma (DLBCL) deeply changed the approach to this lymphoproliferative disorder. Novel additional predictors of outcomes and new therapeutic strategies are being introduced to improve outcomes. Areas covered: This review aims to analyse the recent molecular discoveries in DLBCL, the rationale of novel molecular driven treatments and their impact on DLBCL prognosis, especially in ABC-DLBCL and High Grade B Cell Lymphoma...
July 17, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28701106/insights-into-the-diagnosis-and-management-of-iron-deficiency-in-inflammatory-bowel-disease
#2
Rayan Bou-Fakhredin, Racha Halawi, Joseph Roumi, Ali Taher
Iron deficiency is a frequent comorbidity of chronic diseases such as inflammatory bowel disease that can severely impact the health and quality of life of affected individuals. It can exist as a silent condition and manifest in non-specific symptoms even in the absence of anemia. Even though iron deficiency anemia is the most common complication and extra-intestinal manifestation of inflammatory bowel disease, the majority of inflammatory bowel disease patients who are diagnosed with iron deficiency anemia are not treated...
July 13, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28693343/the-potential-role-of-endothelial-dysfunction-and-platelet-activation-in-the-development-of-thrombotic-risk-in-copd-patients
#3
Mario Malerba, Matteo Nardin, Alessandro Radaeli, Paolo Montuschi, Giovanna E Carpagnano, Enrico Clini
Despite lack of knowledge in the field, several studies have underlined the role of endothelium dysfunction and platelet activation as significant players in the development and progression of chronic obstructive pulmonary disease (COPD). Indeed, endothelium plays a crucial role in vascular homeostasis and impairment, due to the inflammation process enhanced by smoking. Chronic inflammation and endothelial dysfunction have been proved to drive platelet activity. Consequently, thrombotic risk is enhanced in COPD, and might explain the higher percentage of cardiovascular death in such patients...
July 12, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28665214/the-evolving-role-of-targeted-drugs-in-the-treatment-of-hodgkin-lymphoma
#4
Dennis A Eichenauer, Andreas Engert
Hodgkin lymphoma (HL) is a B-cell-derived malignancy mostly affecting young adults. More than 80% of patients are cured after stage-adapted first-line treatment with chemotherapy and/or radiotherapy. About 50% of patients with disease recurrence achieve long-term remission with second-line treatment consisting of high-dose chemotherapy and autologous stem cell transplantation. However, HL treatment is often associated with acute toxicity and in part life-threatening late effects. Implementing targeted drugs may reduce toxicity and potentially further optimize efficacy...
July 10, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28664772/bendamustine-hydrochloride-in-patients-with-b-cell-malignancies-who-have-comorbidities-is-there-an-optimal-dose
#5
Max J Gordon, Lionel D Lewis, Jennifer R Brown, Alexey V Danilov
The majority of patients with non-Hodgkin lymphoma (NHL) and chronic lymphocytic leukemia (CLL) present with comorbidities. Many of them are poor candidates for intensive chemo-immunotherapy regimens, such as FCR (fludarabine, cyclophosphamide, rituximab). Still, most clinical trials aim to enroll 'fit' patients, who poorly represent the community oncology population. Areas covered: In the past decade, bendamustine hydrochloride, a cytotoxic agent with structural similarities to both alkylating agents and purine analogs, has received widespread use in therapy of NHL and CLL, and has demonstrated a relatively favorable toxicity profile...
July 10, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28675317/emerging-applications-of-gene-edited-t-cells-for-the-treatment-of-leukemia
#6
Christos Georgiadis, Waseem Qasim
The first applications of gene-edited T cells are reaching clinical phase testing as new reagents including TALENs and CRISPR/Cas9 nucleases have emerged to allow efficient and highly specific cell engineering. The transplant setting is an ideal testing ground for these new therapies, given the established infrastructure for cell based interventions. Powerful new immunotherapies are anticipated, which will need to be evaluated in carefully monitored studies, designed to capture both molecular and immunological events over an extended period of time...
July 4, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28675071/from-the-pathogenesis-to-the-cure-of-indolent-b-cell-lymphoproliferative-disorders-associated-with-hepatitis-c-virus-infection-which-role-for-direct-acting-antivirals
#7
Marcella Visentini, Massimo Fiorilli, Milvia Casato
Hepatitis C virus (HCV) causes monoclonal B cell lymphoproliferative disorders ranging from benign, such as in mixed cryoglobulinemia (MC), to indolent or aggressive lymphomas. MC and indolent lymphomas commonly regress when HCV is eradicated with interferon (IFN) therapy; however, sustained virologic response (SVR) to IFN is achieved only in ~50% of patients. The new all oral direct-acting antivirals (DAA), yielding nearly 100% SVR, promise a breakthrough in the treatment of HCV-associated lymphoproliferative disorders, but experience is still scanty...
July 4, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28666090/emerging-role-of-immunotherapy-in-precursor-b-cell-lymphoblastic-leukemia
#8
Gautam Kishore Valecha, Uroosa Ibrahim, Sassine Ghanem, Divya Asti, Jean-Paul Atallah, Terenig Terjanian
Acute lymphoblastic leukemia (ALL) is an aggressive type of leukemia that carries poor prognosis in adults especially in the setting of high risk cytogenetics and relapsed/refractory (R/R) disease. Advancements in immunotherapy have led to the development of several monoclonal antibodies (MoAbs) and chimeric antigen receptor (CAR) T cells that are capable of targeting certain surface antigens on leukemic cells, resulting in their destruction. Areas covered: This article reviews the mechanism of action, outcomes of various trials, and adverse effects of MoAbs and CAR-T cells used in the treatment of precursor B-cell ALL...
June 30, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28665232/integrating-novel-drugs-to-chemoimmunotherapy-in-diffuse-large-b-cell-lymphoma
#9
Annalisa Chiappella, Elisa Santambrogio, Alessia Castellino, Maura Nicolosi, Umberto Vitolo
Diffuse Large B-cell Lymphoma (DLBCL) is the most common aggressive non-Hodgkin lymphoma (NHL), with an incidence in Europe of 3.8/100.000/year. A multi-drugs chemoimmunotherapy regimen, containing rituximab, cyclophosphamide, vincristine, doxorubicin and prednisone (R-CHOP) administrated every 21 days, is the standard therapy for DLBCL patients. The discovery of several biological features of DLBCL has encouraged the introduction of novel drugs in the treatment. Areas covered: In this article, the use of standard therapies will be reviewed and will be investigated adoption of novel drugs such as Bortezomib, Bruton's tyrosine kinase, IMiDs, Venetoclax, mTOR inhibitors and other biological agents...
June 30, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28665231/erythropoietin-in-umbilical-cord-blood-transplantation-defining-the-role-and-implications
#10
Omar S Aljitawi, Mary Laughlin, Hal Broxmeyer
No abstract text is available yet for this article.
June 30, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28644735/fetal-and-neonatal-alloimmune-thrombocytopenia-evidence-based-antenatal-and-postnatal-management-strategies
#11
Dian Winkelhorst, Dick Oepkes, Enrico Lopriore
Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is a relatively rare but potentially lethal disease, leading to severe bleeding complications in 1 in 11.000 newborns. It is the leading cause of thrombocytopenia in healthy term-born neonates. Areas covered: This review summarizes the antenatal as well as postnatal treatment, thus creating a complete overview of all possible management strategies for FNAIT. Expert commentary: The optimal antenatal therapy in order to prevent bleeding complications in pregnancies complicated by FNAIT is non-invasive treatment with weekly intravenous immunoglobulin (IVIG)...
June 29, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28656800/position-paper-on-management-of-iron-deficiency-in-adult-cancer-patients
#12
Sandro Barni, Pere Gascòn, Fausto Petrelli, José Antonio García-Erce, Paolo Pedrazzoli, Giovanni Rosti, Giulio Giordano, Antonio Mafodda, Manuel Múñoz
Disorders of iron metabolism are commonly seen in onco-hematological clinical practice. Iron-deficiency anemia and cancer-associated anemia are usually treated with supportive therapies. Optimal management of these conditions are discussed in this perspective paper. Areas covered: A position paper discussing a number of hot topics on anemia in cancer patients is presented. The main areas covered by experts in the field are: definitions, prevalence and consequences of anemia and iron deficiency, incidence of anemia resulting from targeted therapies, importance of anemia diagnosis and monitoring, evaluation of iron status before and during treatment, role of transfusions and erythropoiesis-stimulating agents, management of iron deficiency with or without anemia, parenteral iron supplementation, role of new oral iron formulations, safety and cost issues regarding different iron compounds and administration routes...
June 28, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28644756/immunological-effects-of-hypomethylating-agents
#13
Katherine E Lindblad, Meghali Goswami, Christopher S Hourigan, Karolyn A Oetjen
Epigenetic changes resulting from aberrant methylation patterns are a recurrent observation in hematologic malignancies. Hypomethylating agents have a well-established role in the management of patients with high-risk myelodysplastic syndrome or acute myeloid leukemia. In addition to the direct effects of hypomethylating agents on cancer cells, there are several lines of evidence indicating a role for immune-mediated anti-tumor benefits from hypomethylating therapy. Areas Covered: We reviewed the clinical and basic science literature for the effects of hypomethylating agents, including the most commonly utilized therapeutics azacitidine and decitabine, on immune cell subsets...
June 23, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28617144/the-risk-of-stroke-among-acutely-ill-hospitalized-medical-patients-lessons-from-recent-trials-on-extended-duration-thromboprophylaxis
#14
Jolanta Marszalek, Sara Mehrsefat, Gerald Chi
Data from recent randomized controlled trials indicate that the incidence of stroke among acutely ill medical patients is unexpectedly high and approximates 1% at 90 days. Preliminary data suggest that betrixaban may reduce ischemic stroke in patients without atrial fibrillation. There is an unmet demand for stroke risk stratification schemes targeting hospitalized medical patients. The prognostic value of biomarkers such as natriuretic peptides and D-dimer in predicting short-term stroke remains uncertain...
June 21, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28592170/current-options-to-manage-waldenstr%C3%A3-m-s-macroglobulinemia
#15
Giulia Benevolo, Maura Nicolosi, Elisa Santambrogio, Umberto Vitolo
Waldenström's macroglobulinemia (WM) is a rare, incurable B-cell lymphoma, with a median survival of 5-10 years in symptomatic patients. There is no consensus on the standard of care and several agents are currently used in these patients. Areas covered: In this article, we will review the use of standard therapies and new drugs investigated such as monoclonal antibodies, proteasome inhibitors, immunomodulatory agents, Bruton's tyrosine kinase inhibitors and novel agents in early-stage development. Expert commentary: RCD (Rituximab/Cyclophosphamide/Dexamethasone) is an effective and safe treatment in first line in WM...
June 19, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28586248/side-effects-and-potential-risk-factors-of-botulinum-toxin-type-a-intramuscular-injections-in-knee-flexion-contractures-of-hemophiliacs
#16
E Carlos Rodriguez-Merchan, Hortensia De la Corte-Rodriguez
Knee flexion contracture (KFC) is a common complication of recurrent hemarthrosis in children and young adults with hemophilia. If the KFC is not prevented (by means of primary prophylaxis) and treated properly and early (be means of physical medicine and rehabilitation), it will become fixed. Areas covered: The aim of this article is to review the potential role of botulinum toxin type A (BTX-A) intramuscular injections for the treatment of KFC in people with hemophilia (PWH). Expert commentary: Although two recent reports have mentioned the benefits of intramuscular injections of BTX-A in PWH with KFC, the data are still scant and too preliminary...
June 19, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28571503/managing-side-effects-of-jak-inhibitors-for-myelofibrosis-in-clinical-practice
#17
Iram Saeed, Donal McLornan, Claire N Harrison
Myelofibrosis (MF) is characterized by bone marrow fibrosis, abnormalities in peripheral counts, extramedullary hematopoiesis, splenomegaly and an increased risk of transformation to acute myeloid leukaemia. The disease course is often heterogeneous and management can range from observation alone through to allogeneic stem cell transplantation. As of 2017, the only approved medication for MF remains the JAK Inhibitor (JAKi), ruxolitinib (Novartis Pharmaceuticals, Basel, Switzerland; Incyte, Wilmington, Detroit, USA) although several others have reached advanced stages of clinical trials...
June 19, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28617062/novel-approaches-to-targeting-myd88-in-waldenstr%C3%A3-m-macroglobulinemia
#18
Jorge J Castillo, Zachary R Hunter, Guang Yang, Steven P Treon
Waldenström macroglobulinemia (WM) is an incurable lymphoma characterized by the accumulation of IgM-producing lymphoplasmacytic cells in the bone marrow and other organs. Although WM patients can experience prolonged remissions, the disease invariably recurs advocating for the need of novel treatments in order to achieve higher response and survival rates. The discovery of a recurrent mutation in the MYD88 gene and an increased understanding behind the biology of MYD88 signaling have provided the opportunity to developing novel agents targeting the MYD88 pathway...
June 15, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28598700/comment-and-response-to-the-significance-of-early-warning-in-chronic-myeloid-leukemia
#19
Ahmet Emre Eskazan, Muhlis Cem Ar, Teoman Soysal
No abstract text is available yet for this article.
June 15, 2017: Expert Review of Hematology
https://www.readbyqxmd.com/read/28598209/the-significance-of-early-warning-in-chronic-myeloid-leukemia
#20
Mario Tiribelli, Gianni Binotto, Massimiliano Bonifacio
No abstract text is available yet for this article.
June 15, 2017: Expert Review of Hematology
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