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pancytopenia guidelines

Moris Sangineto, Antonio Perrone, Pasquale Agosti, Viera Boccuti, Anna Campobasso, Carlo Sabbà
Here we present the case of a 57-years old patient affected by hemophagocytic lymphohistiocytosis (HLH), a rare disease characterized by an uncontrolled immune activation, resulting in clinical and biochemical manifestations of extreme inflammation. In a previous hospitalization, the patient showed fever, hepato-splenomegaly, pancytopenia, hyperferrtitinemia, lymphadenopathy and cholestasis. No diagnosis was done, however, he totally recovered after splenectomy. Eight months later, he relapsed, showing also hypofibrinogenemia, hypertriglyceridemia, hemophagocytic signs in bone marrow, cholestatic jaundice, high LDH and high PT-INR...
February 23, 2017: Hematology Reports
Sajal Ajmani, Yogesh Preet Singh, Shiva Prasad, Abhra Chowdhury, Amita Aggarwal, Able Lawrence, Ramnath Misra, Richa Mishra, Vikas Agarwal
AIM: Methotrexate (MTX) has the potential to cause serious adverse reactions and even mortality. We analyzed the predisposing factors and outcome in patients with MTX-induced pancytopenia admitted into our unit from 1996 to 2015. METHODS: Patients were identified by departmental database search. Pancytopenia was defined as white blood cell count (WBC) < 3500 cells/mm(3) , hemoglobin (Hb) < 11 g/dL and platelet count < 150 000 cells/mm(3) . Severe pancytopenia was defined as WBC < 2000 cells/mm(3) , Hb < 10 g/dL and platelet count < 50 000 cells/mm(3) ...
March 5, 2017: International Journal of Rheumatic Diseases
Pari Zarrini, Ziba Mosayebi, Asghar Ramyar, Hosein Dalili
 Hemophagocytic lymphohistiocytosis (HLH) is a syndrome of pathologic immune activation, occurring as either a familial disorder or a sporadic condition, in association with a variety of triggers. This article will introduce a neonate with HLH in Iran. We report a case of HLH presenting with respiratory distress and fever, hepatosplenomegaly, jaundice and pancytopenia on the second day of life. Typical clinical and laboratory findings were detected in the neonate. HLH was diagnosed according to HLH-2004 guidelines...
January 2017: Acta Medica Iranica
Pasquale Pagliano, Tiziana Ascione, Giusy Di Flumeri, Giovanni Boccia, Francesco De Caro
Visceral Leishmaniasis (VL) is a chronic infectious disease endemic in tropical and sub-tropical areas including the Mediterranean basin, caused by a group of protozoan parasites of the genus Leishmania and transmitted by phlebotomine sandflies. Typically, VL is classified as a zoonotic infection when Leishmania infantum is the causative agent and as an anthroponotic one when L. donovani is the causative agent. Immunocompromised patients, in particular HIV positive, are considered at risk of VL. They may present atypical signs and poor response to the treatment due to a compromission of T-helper and regulatory cells activity...
December 1, 2016: Le Infezioni in Medicina
Michael R Grever, Omar Abdel-Wahab, Leslie A Andritsos, Versha Banerji, Jacqueline Barrientos, James S Blachly, Timothy G Call, Daniel Catovsky, Claire Dearden, Judit Demeter, Monica Else, Francesco Forconi, Alessandro Gozzetti, Anthony D Ho, James B Johnston, Jeffrey Jones, Gunnar Juliusson, Eric Kraut, Robert J Kreitman, Loree Larratt, Francesco Lauria, Gerard Lozanski, Emili Montserrat, Sameer A Parikh, Jae H Park, Aaron Polliack, Graeme R Quest, Kanti R Rai, Farhad Ravandi, Tadeusz Robak, Alan Saven, John F Seymour, Tamar Tadmor, Martin S Tallman, Constantine Tam, Enrico Tiacci, Xavier Troussard, Clive S Zent, Thorsten Zenz, Pier Luigi Zinzani, Brunangelo Falini
Hairy cell leukemia is an uncommon hematologic malignancy characterized by pancytopenia and marked susceptibility to infection. Tremendous progress in the management of patients with this disease has resulted in high response rates and improved survival, yet relapse and an appropriate approach to re-treatment present continuing areas for research. The disease and its effective treatment are associated with immunosuppression. Because more patients are being treated with alternative programs, comparison of results will require general agreement on definitions of response, relapse, and methods of determining minimal residual disease...
February 2, 2017: Blood
Gregory Plotnikoff, Melissa Barber
INTRODUCTION: Single-disorder or single-organ-system clinical practice guidelines are often of limited usefulness in guiding effective management of patients with chronic multidimensional signs and symptoms. The presence of multiple long-standing medical problems in a given patient despite intensive medical effort suggests that addressing systemic core imbalances could complement more narrowly focused approaches. CASE PRESENTATION: A 72-year-old man experiencing longstanding depression, fatigue, irritable bowel syndrome, and chronic pain in the context of additional refractory illnesses was assessed and treated, guided by a system-oriented approach to underlying core imbalances termed functional medicine...
2016: Permanente Journal
Jonathan S Auerbach, Christopher K Schott
Solid-organ transplant graft-versus-host disease (SOT-GVHD) is a rare complication of organ transplant that is associated with high mortality. The initial signs and symptoms are vague, so this disease is easily confused with other posttransplant complications. A case of SOT-GVHD occurred after orthotopic liver transplant for liver failure due to hepatitis C in a patient in a Veterans Affairs intensive care unit. The patient had dehydration, acute kidney injuries, rashes, diarrhea, and pancytopenia. Results of skin biopsy, bone marrow biopsy, and cytogenetic studies were consistent with SOT-GVHD...
June 2016: Critical Care Nurse
A Porwit, A Rajab
Acute leukemia, myelodysplastic syndromes (MDS), myeloproliferative neoplasms and lymphomas are the most prevalent diagnoses in adults presenting with new onset cytopenia. Here, we describe two 10-color panels of surface markers (screening and comprehensive panel) applied at the Flow Cytometry Laboratory, University Health Network, Toronto, ON, Canada. A 10-color flow cytometry is applied using the stain-lyse-wash sample preparation method. In patients with <10% blasts and no clear involvement by hematological malignancy based on cytomorphological evaluation of bone marrow (BM) smear, the recently published one-tube 10-color 14-antibody screening panel is applied...
May 2015: International Journal of Laboratory Hematology
Angelica Barone, Annunziata Lucarelli, Daniela Onofrillo, Federico Verzegnassi, Sonia Bonanomi, Simone Cesaro, Francesca Fioredda, Anna Paola Iori, Saverio Ladogana, Anna Locasciulli, Daniela Longoni, Marina Lanciotti, Alessandra Macaluso, Rosalba Mandaglio, Nicoletta Marra, Baldo Martire, Matteo Maruzzi, Giuseppe Menna, Lucia Dora Notarangelo, Giovanni Palazzi, Marta Pillon, Ugo Ramenghi, Giovanna Russo, Johanna Svahn, Fabio Timeus, Fabio Tucci, Chiara Cugno, Marco Zecca, Piero Farruggia, Carlo Dufour, Paola Saracco
Acquired aplastic anemia (AA) is a rare heterogeneous disease characterized by pancytopenia and hypoplastic bone marrow. The incidence is 2-3/million inhabitants/year, in Europe, but higher in East Asia. Survival in severe aplastic anemia (SAA) has markedly improved in the past 2 decades because of advances in hematopoietic stem cell transplantation, immunosuppressive and biologic drugs, and supportive care. In SAA hematopoietic stem cell transplant (HSCT) from a matched sibling donor (MSD) is the treatment of choice...
June 2015: Blood Cells, Molecules & Diseases
Lisa Zimmer, Julia Vaubel, Peter Mohr, Axel Hauschild, Jochen Utikal, Jan Simon, Claus Garbe, Rudolf Herbst, Alexander Enk, Eckhart Kämpgen, Elisabeth Livingstone, Leonie Bluhm, Rainer Rompel, Klaus G Griewank, Michael Fluck, Bastian Schilling, Dirk Schadendorf
PURPOSE: Up to 50% of patients with uveal melanoma (UM) develop metastatic disease with limited treatment options. The immunomodulating agent ipilimumab has shown an overall survival (OS) benefit in patients with cutaneous metastatic melanoma in two phase III trials. As patients with UM were excluded in these studies, the Dermatologic Cooperative Oncology Group (DeCOG) conducted a phase II to assess the efficacy and safety of ipilimumab in patients with metastatic UM. PATIENTS AND METHODS: We undertook a multicenter phase II study in patients with different subtypes of metastatic melanoma...
2015: PloS One
Yurika Kawaguchi, Atsushi Inagaki, Yumiko Sato, Hiroka Ogura, Atsushi Wakita
Currently, there is no consensus to determine whether the therapeutic doses of anticancer drugs should be based on the actual or the ideal body weight of obese cancer patients. We performed induction and consolidation chemotherapy at doses calculated by using the actual body weight of an obese patient with acute myeloid leukemia (AML). A 47-year-old Japanese man presented with pancytopenia at our hospital, and he was diagnosed with AML (FAB classification M0). At the initial diagnosis, the patient was 170 cm tall and weighed 132 kg; therefore, his body surface area was 2...
December 2014: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Rachel Kyeyune, Elmar Saathoff, Amara E Ezeamama, Thomas Löscher, Wafaie Fawzi, David Guwatudde
BACKGROUND: Cytopenias are the most common HIV-associated hematological abnormality. Cytopenias have been associated with several factors including sex, race/ethnicity, geographical location and comorbidities such as tuberculosis, hepatitis B infection, fever and oral candidiasis. Cytopenias become more prevalent as HIV progresses and are often fatal. Data from resource-limited settings about the prevalence and correlates of cytopenia are limited. Therefore we conducted this cross-sectional study to assess the prevalence and correlates of cytopenia among adult AIDS patients at initiation of HAART in Uganda...
2014: BMC Infectious Diseases
Soumyajit Roy, Supriya Mallick, Md Waseem Raza, Kunhi Parambath Haresh, Subhash Gupta, Daya Nand Sharma, Pramod Kumar Julka, Goura Kisore Rath
Burden of cancer is progressively increasing in developing countries like India which has also led to a steep rise in toxicity due to anti-cancer therapy. A cross-sectional analysis was here conducted for patients with different malignancies (except leukaemia) who while undergoing radical anti-cancer therapy were admitted to our oncology ward from January-July 2013. In a total of 280 patients, the total number of toxicity events was 473. Nine patients expired over this time period. Among the events, grade 2 anaemia the most common (n=189) while the most common grades of neutropenia and thrombocytopenia were grade 4 (n=114) and grade 2 (n=48), respectively...
2014: Asian Pacific Journal of Cancer Prevention: APJCP
Dana L Casey, Leonard H Wexler, Michael P LaQuaglia, Paul A Meyers, Suzanne L Wolden
BACKGROUND: Current Children's Oncology Group (COG) guidelines recommend 24 Gy whole abdominopelvic radiation therapy (WAP-RT) for pediatric patients with sarcoma with peritoneal dissemination and/or malignant ascites. However, WAP-RT has never been described for pediatric sarcoma excluding desmoplastic small round-cell tumor (DSRCT). The objective of this study was to evaluate feasibility, outcomes, and toxicity of WAP-RT in children with sarcoma and peritoneal dissemination. PROCEDURE: Detailed records of all 10 pediatric patients with sarcoma (excluding DSRCT) treated with WAP-RT from 2001 to 2013 were reviewed...
September 2014: Pediatric Blood & Cancer
Gilles Hejblum, Olivier Lambotte, Lionel Galicier, Paul Coppo, Christophe Marzac, Cédric Aumont, Laurence Fardet
The diagnosis of the reactive form of hemophagocytic syndrome in adults remains particularly difficult since none of the clinical or laboratory manifestations are specific. We undertook a study in order to elicit which features constitute helpful criteria for a positive diagnosis. In this Delphi study, the features investigated in the questionnaire and the experts invited to participate in the survey were issued from a bibliographic search. The questionnaire was iteratively proposed to experts via a web-based application with a feedback of the results observed at the preceding Delphi round...
2014: PloS One
Ulrich Germing, Guido Kobbe, Rainer Haas, Norbert Gattermann
BACKGROUND: Myelodysplastic syndromes (MDS) are malignant stem-cell diseases that are usually diagnosed in elderly patients who present with anemia or, less commonly, bi- or pancytopenia. Their incidence in persons over age 80 is above 50 new cases per 100,000 persons per year. Their clinical course is highly variable. About one-quarter of all patients with MDS develop acute leukemia. The median survival time from the moment of diagnosis is about 30 months. METHOD: We selectively searched the PubMed database for pertinent articles and guidelines from the years 2000-2013...
November 15, 2013: Deutsches Ärzteblatt International
Nadav Willner, Shimon Storch, Tamar Tadmor, Elad Schiff
BACKGROUND: Methotrexate (MTX), an antimetabolite of folic acid, is the drug of choice for the nonsurgical management of ectopic pregnancy. MTX-related toxicity may include leukopenia, thrombocytopenia, pancytopenia, nausea, vomiting, stomatitis, mucositis, and liver and lung toxicity, depending primarily on the dosage of the drug and patients' renal function. Currently, the use of MTX in hemodialysis patients, even at a low dosage, is controversial, and no clear-cut guidelines are available...
March 2014: European Journal of Clinical Pharmacology
Makoto Hirokawa
No abstract text is available yet for this article.
October 2013: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Sujata E Mathews, Dinesh Srivastava, Raj Balayadav, Anjali Sharma
AIM: This work was carried out to study the hematologic profile of human immunodeficiency virus (HIV)-positive patients and its association with the clinicoimmunologic stage of the disease. MATERIALS AND METHODS: A total of 187 patients with HIV, whether symptomatic or asymptomatic, diagnosed by enzyme-linked immunosorbent assay (ELISA) method according to the National AIDS Control Organization (NACO) guidelines were included in this study. Patients in the study population were divided into two groups: (1) Group A (antiretroviral therapy (ART) included patients receiving ART [ART-Y]) and (2) Group B included treatment naïve patients (ART-N)...
January 2013: Journal of Laboratory Physicians
Eisuke Adachi, Takeshi Fujii
No abstract text is available yet for this article.
March 2013: Kansenshōgaku Zasshi. the Journal of the Japanese Association for Infectious Diseases
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