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Hematology Reports
Volume 6
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Hematology Reports is published by MDPI from Volume 14 Issue 1 (2022). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by MDPI on mdpi.com as a courtesy and upon agreement with PAGEPress.

Hematol. Rep., Volume 6, Issue 3 (August 2014) – 6 articles

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2 pages, 600 KiB  
Case Report
Posterior Reversible Encephalopathy Syndrome in a B-Cell Acute Lymphoblastic Leukemia Young Adult Patient Treated with a Pediatric-like Chemotherapeutic Schedule
by Cristina Papayannidis, Francesca Volpato, Ilaria Iacobucci, Maria Chiara Abbenante, Chiara Sartor and Giovanni Martinelli
Hematol. Rep. 2014, 6(3), 5565; https://doi.org/10.4081/hr.2014.5565 - 30 Sep 2014
Cited by 3 | Viewed by 242
Abstract
We report here the case of a young adult affected by pre B-cell acute lymphoblastic leukemia (ALL), who developed, during a pediatric-like chemotherapy consolidation schedule with high dosage of Methotrexate, a severe neurological toxicity. Clinical presentation and neuroimaging data were diagnostic for posterior [...] Read more.
We report here the case of a young adult affected by pre B-cell acute lymphoblastic leukemia (ALL), who developed, during a pediatric-like chemotherapy consolidation schedule with high dosage of Methotrexate, a severe neurological toxicity. Clinical presentation and neuroimaging data were diagnostic for posterior reversible encephalopathy syndrome (PRES). A complete resolution was quickly obtained with medical blood pressure control and anticonvulsants administration. To the best of our knowledge, this is the first case of PRES described in the adult ALL setting. Currently, the clinical management of this aggressive disease is moving towards a pediatric-like approach also in adult patients, due to the better outcome reached with intensive chemotherapeutic regimens in children population. However, therapy-related toxicities have to be taken into account, since their onset may adversely affect patients’ clinical outcome. Full article
7 pages, 679 KiB  
Review
Rationale for a Pediatric-Inspired Approach in the Adolescent and Young Adult Population with Acute Lymphoblastic Leukemia, with a Focus on Asparaginase Treatment
by Carmelo Rizzari, Maria Caterina Putti, Antonella Colombini, Sara Casagranda, Giulia Maria Ferrari, Cristina Papayannidis, Ilaria Iacobucci, Maria Chiara Abbenante, Chiara Sartor and Giovanni Martinelli
Hematol. Rep. 2014, 6(3), 5554; https://doi.org/10.4081/hr.2014.5554 - 30 Sep 2014
Cited by 12 | Viewed by 323
Abstract
In the last two decades great improvements have been made in the treatment of childhood acute lymphoblastic leukemia, with 5-year overall survival rates currently approaching almost 90%. In comparison, results reported in adolescents and young adults (AYAs) are relatively poor. In adults, results [...] Read more.
In the last two decades great improvements have been made in the treatment of childhood acute lymphoblastic leukemia, with 5-year overall survival rates currently approaching almost 90%. In comparison, results reported in adolescents and young adults (AYAs) are relatively poor. In adults, results have improved, but are still lagging behind those obtained in children. Possible reasons for this different pattern of results include an increased incidence of unfavorable and a decreased incidence of favorable cytogenetic abnormalities in AYAs compared with children. Furthermore, in AYAs less intensive treatments (especially lower cumulative doses of drugs such as asparaginase, corticosteroids and methotrexate) and longer gaps between courses of chemotherapy are planned compared to those in children. However, although favorable results obtained in AYAs receiving pediatric protocols have been consistently reported in several international collaborative trials, physicians must also be aware of the specific toxicity pattern associated with increased success in AYAs, since an excess of toxicity may compromise overall treatment schedule intensity. Cooperative efforts between pediatric and adult hematologists in designing specific protocols for AYAs are warranted. Full article
3 pages, 579 KiB  
Case Report
Azacitidine as Salvage Therapy for Acute Myeloid Leukemia in a Severely Ill Patient
by Harry Ross Powers, Moshe Bachar, Natasha Savage, Michael Toscano and Paul M. Dainer
Hematol. Rep. 2014, 6(3), 5516; https://doi.org/10.4081/hr.2014.5516 - 30 Sep 2014
Cited by 5 | Viewed by 270
Abstract
Acute myeloid leukemia (AML) is a hematological malignancy of myeloid progenitor cells that disrupt normal hematopoiesis. Current chemotherapy regimens result in complete remission in many cases; however, there exists no standard efficacious therapy for refractory acute myeloid leukemia. The hypomethylating agent, azacitidine, is [...] Read more.
Acute myeloid leukemia (AML) is a hematological malignancy of myeloid progenitor cells that disrupt normal hematopoiesis. Current chemotherapy regimens result in complete remission in many cases; however, there exists no standard efficacious therapy for refractory acute myeloid leukemia. The hypomethylating agent, azacitidine, is effective in a limited number of such cases. We present a 57-year-old Filipino male with acute myeloid leukemia who was refractory to two induction chemotherapy regimens; however, he achieved complete remission after palliative therapy with azacitidine. We report this case to demonstrate the efficacy of azacitidine in refractory acute myeloid leukemia. Although the effectiveness of azacitidine in improving overall survival has been shown, this case demonstrates the effect on remission induction in high risk AML. Further studies are needed to delineate subsets of acute myeloid leukemia in which azacitidine will serve as effective therapy and to identify other targeted agents that may potentiate its effects. Full article
5 pages, 729 KiB  
Case Report
Hypotension associated with Advanced Hodgkin Lymphoma
by Ankit Mangla, Geetanjali Dang, Hussein Hamad, Roozbeh Mohajer, Rosalind Catchatourian and Paula Kovarik
Hematol. Rep. 2014, 6(3), 5572; https://doi.org/10.4081/hr.2014.5572 - 29 Sep 2014
Cited by 2 | Viewed by 825
Abstract
Hypotension is an extremely rare manifestation of Hodgkin lymphoma. We report the case of a patient who presented with new onset hypotension and was diagnosed with urosepsis and septic shock requiring pressor support for maintaining his blood pressure. computed tomography (CT) scan of [...] Read more.
Hypotension is an extremely rare manifestation of Hodgkin lymphoma. We report the case of a patient who presented with new onset hypotension and was diagnosed with urosepsis and septic shock requiring pressor support for maintaining his blood pressure. computed tomography (CT) scan of abdomen showed liver lesions, which were new on comparison with a CT abdomen done 3 weeks back. Biopsy of the liver lesions and subsequently a bone marrow biopsy showed large atypical Reed-Sternberg cells, positive for CD15 and CD 30 and negative for CD45, CD3 and CD20 on immunohistochemical staining, hence establishing the diagnosis of Hodgkin lymphoma. The mechanism involved in Hodgkin lymphoma causing hypotension remains anecdotal, but since it is mostly seen in patients with advanced Hodgkin lymphoma, it is hypothetically related to a complex interaction between cytokines and mediators of vasodilatation. Here we review relevant literature pertaining to presentation and pathogenesis of this elusive and rare association. Full article
5 pages, 161 KiB  
Article
Safety and Efficacy of PDpoetin for Management of Anemia in Patients with End Stage Renal Disease on Maintenance Hemodialysis: Results from a Phase IV Clinical Trial
by Abbas Norouzi Javidan, Heshmatollah Shahbazian, Amirhossein Emami, Mir Saeed Yekaninejad, Hassan Emami-Razavi, Masoumeh Farhadkhani, Ahmad Ahmadzadeh and Fazel Gorjipour
Hematol. Rep. 2014, 6(3), 5195; https://doi.org/10.4081/hr.2014.5195 - 10 Sep 2014
Cited by 5 | Viewed by 537
Abstract
Recombinant human erythropoietin (rHuEPO) is available for correcting anemia. PDpoetin, a new brand of rHuEPO, has been certified by Food and Drug Department of Ministry of Health and Medical Education of Iran for clinical use in patients with chronic kidney disease. We conducted [...] Read more.
Recombinant human erythropoietin (rHuEPO) is available for correcting anemia. PDpoetin, a new brand of rHuEPO, has been certified by Food and Drug Department of Ministry of Health and Medical Education of Iran for clinical use in patients with chronic kidney disease. We conducted this post-marketing survey to further evaluate the safety and efficacy of PDpoetin for management of anemia in patients on maintenance hemodialysis. Patients from 4 centers in Iran were enrolled for this multicenter, open-label, uncontrolled phase IV clinical trial. Changes in blood chemistry, hemoglobin and hematocrit levels, renal function, and other characteristics of the patients were recorded for 4 months; 501 of the patients recruited, completed this study. Mean age of the patients was 50.9 (±16.2) years. 48.7% of patients were female. Mean of the hemoglobin value in all of the 4 centers was 9.29 (±1.43) g/dL at beginning of the study and reached 10.96 (±2.23) g/dL after 4 months and showed significant increase overall (p < 0.001). PDpoetin dose was stable at 50-100 U/kg thrice weekly. Hemorheologic disturbancesand changes in blood electrolytes was not observed. No case of immunological reactions to PDpoetin was observed. Our study, therefore, showed that PDpoetin has significantly raised the level of hemoglobin in the hemodialysis patients (about 1.7 ± 0.6 g/dL). Anemia were successfully corrected in 49% of patients under study. Use of this biosimilar was shown to be safe and effective for the maintenance of hemoglobin in patients on maintenance hemodialysis. Full article
6 pages, 757 KiB  
Article
Decreased Threshold of Aggregation to Low-Dose Epinephrine is Evidence of Platelet Hyperaggregability in Patients with Thrombosis
by Chelsea Hayes, Sumire Kitahara and Oxana Tcherniantchouk
Hematol. Rep. 2014, 6(3), 5326; https://doi.org/10.4081/hr.2014.5326 - 26 Aug 2014
Cited by 14 | Viewed by 344
Abstract
Sticky platelet syndrome has been described as a hereditary thrombophilic condition. The aim of this study is to identify the presence of platelet hyperaggregability in patients who have experienced thrombosis. Light-transmittance platelet aggregometry was used to assess for spontaneous platelet aggregation, aggregation in [...] Read more.
Sticky platelet syndrome has been described as a hereditary thrombophilic condition. The aim of this study is to identify the presence of platelet hyperaggregability in patients who have experienced thrombosis. Light-transmittance platelet aggregometry was used to assess for spontaneous platelet aggregation, aggregation in response to full and low-dose (LD) epinephrine (Epi) and adenosine diphosphate, as well as arachidonic acid, and identify a distinct pattern of platelet hyperaggregability. Light-transmittance platelet aggregometry results were correlated with PFA-100® (Dade-Behring, Marburg, Germany) results, when available. An exaggerated response to LD Epi was found in 68% of patients with thrombosis compared to only 36% of healthy controls (p = 0.034). Patients with thrombosis, either arterial or venous, demonstrated an exaggerated response to LD Epi nearly twice as frequently as healthy controls, even without significant family history of thrombophilia or other known risk factors for thrombosis. This suggests that platelet hyperaggregability may be multifactorial in nature and not necessarily hereditary. Full article
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