Hematology. American Society of Hematology. Education Program最新文献_第4页

Managing patients with a history of arterial disease and new venous thromboembolism. 管理有动脉疾病史和新发静脉血栓栓塞的患者。

IF 3.7 3区教育学

Hematology. American Society of Hematology. Education Program Pub Date : 2025-12-05 DOI: 10.1182/hematology.2025000683

Echo Deng, Freda H Passam

引用次数: 0

Buckle up! Managing surgery in patients with bleeding disorder of unknown cause. 系好安全带!不明原因出血性疾病患者的手术处理。

IF 3.7 3区教育学

Hematology. American Society of Hematology. Education Program Pub Date : 2025-12-05 DOI: 10.1182/hematology.2025000694

Callie Berkowitz

{"title":"Buckle up! Managing surgery in patients with bleeding disorder of unknown cause.","authors":"Callie Berkowitz","doi":"10.1182/hematology.2025000694","DOIUrl":"10.1182/hematology.2025000694","url":null,"abstract":"Bleeding disorder of unknown cause (BDUC) is a diagnosis of exclusion encompassing patients who have objective clinical symptoms of a mild bleeding disorder, yet negative hemostatic evaluations. Patients with BDUC may have a history of significant postoperative bleeding, and management of subsequent procedures poses a distinct challenge. After reviewing both patient and procedural bleeding risk factors, empiric hemostatic therapies can be considered. Extrapolating from the management of phenotypically similar bleeding disorders, a therapeutic approach may include antifibrinolytic agents (tranexamic acid), desmopressin, and/or platelet transfusion. Patients should be medically optimized prior to procedures and monitored closely for excess bleeding. Education of both patients and providers is central throughout the hemostatic planning process. Primary research in BDUC remains limited; future multisite observational and therapeutic clinical trials in BDUC may help us better understand multifactorial bleeding risk and further define the role of hemostatic therapies.","PeriodicalId":12973,"journal":{"name":"Hematology. American Society of Hematology. Education Program","volume":"2025 1","pages":"111-115"},"PeriodicalIF":3.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891361/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Molecular subtypes of DLBCL: are we ready to translate our knowledge into the change of treatment paradigms? DLBCL的分子亚型：我们准备好将我们的知识转化为治疗范式的改变了吗？

IF 3.7 3区教育学

Hematology. American Society of Hematology. Education Program Pub Date : 2025-12-05 DOI: 10.1182/hematology.2025000741

Sarah C Rutherford

{"title":"Molecular subtypes of DLBCL: are we ready to translate our knowledge into the change of treatment paradigms?","authors":"Sarah C Rutherford","doi":"10.1182/hematology.2025000741","DOIUrl":"10.1182/hematology.2025000741","url":null,"abstract":"Diffuse large B-cell lymphoma (DLBCL) is a heterogeneous disease with disparate outcomes. While about two-thirds of patients have historically been cured with standard frontline chemoimmunotherapy, those who relapse or are refractory have typically had poor outcomes. Early efforts to tailor treatment based on molecular subtypes categorized by gene expression profiling (germinal center-like and activated B-cell-like) or approximation by immunochemistry algorithms did not substantially impact therapy in DLBCL. Genomic profiling led to the discovery of up to 7 subtypes with shared genetic alterations. The LymphGen and DLBclass are classifiers that assign patients to these subtypes. A clinical trial is under design to specifically treat subtypes of DLBCL in the frontline setting with targeted therapies in combination with standard treatment. Importantly, some of the most efficacious therapeutic approaches in relapsed/refractory DLBCL (chimeric antigen-receptor T cells and bispecific antibodies) appear to work independently of molecular subtype, although these agents' effectiveness may be impacted by the tumor microenvironment. Bispecific antibodies are being studied in newly diagnosed patients in combination with standard chemoimmunotherapy regimens. While future treatment may incorporate drugs with novel mechanisms and/or immunotherapies in the frontline setting, targeting by molecular subtype continues to hold promise as our treatment regimens evolve. Potential strategies could include escalation with specific therapies when response is inadequate, de-escalation of chemotherapy with continuation or addition of targeted agents in those with early complete responses, and refined algorithms to select appropriate treatment in high-risk or relapsed/refractory disease.","PeriodicalId":12973,"journal":{"name":"Hematology. American Society of Hematology. Education Program","volume":"2025 1","pages":"489-495"},"PeriodicalIF":3.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891366/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anticoagulation in malignancy: the patient who bleeds and clots simultaneously. 恶性肿瘤抗凝：同时出血和凝血的病人。

IF 3.7 3区教育学

Hematology. American Society of Hematology. Education Program Pub Date : 2025-12-05 DOI: 10.1182/hematology.2025000703

Sargam Kapoor, Andrew M Peseski, Thomas L Ortel

{"title":"Anticoagulation in malignancy: the patient who bleeds and clots simultaneously.","authors":"Sargam Kapoor, Andrew M Peseski, Thomas L Ortel","doi":"10.1182/hematology.2025000703","DOIUrl":"10.1182/hematology.2025000703","url":null,"abstract":"Patients with active malignancy frequently require anticoagulation for a variety of indications, including thrombosis, atrial fibrillation, or mechanical heart valves. Cancer-associated thrombosis is associated with significant morbidity and mortality and necessitates extended anticoagulation for the duration of active cancer. However, the bleeding risk in this population is heightened due to tumor-related factors such as cancer site (eg, primary or secondary brain tumors), invasive procedures (surgeries, biopsies, etc), and side effects of cancer-directed therapies such as thrombocytopenia. Moreover, there are specific bleeding risk factors unique to individual patients, including medications and preexisting bleeding disorders. Together, these factors substantially increase the likelihood of bleeding events in patients receiving anticoagulation for cancer-associated thrombosis. In this review, we outline the various risk factors contributing to increased bleeding risk in patients with cancer and thrombosis and describe management strategies to ensure safe anticoagulation aimed at minimizing thrombotic complications and hemorrhagic risk.","PeriodicalId":12973,"journal":{"name":"Hematology. American Society of Hematology. Education Program","volume":"2025 1","pages":"176-182"},"PeriodicalIF":3.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891530/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Diagnosis of bleeding disorder of unknown cause: how many tests are enough to diagnose BDUC? 不明原因出血性疾病的诊断：多少次检查足以诊断BDUC？

IF 3.7 3区教育学

Hematology. American Society of Hematology. Education Program Pub Date : 2025-12-05 DOI: 10.1182/hematology.2025000695

Maria N Avgeropoulos, Paula D James

{"title":"Diagnosis of bleeding disorder of unknown cause: how many tests are enough to diagnose BDUC?","authors":"Maria N Avgeropoulos, Paula D James","doi":"10.1182/hematology.2025000695","DOIUrl":"10.1182/hematology.2025000695","url":null,"abstract":"The challenges associated with achieving a clear diagnosis in patients with a suspected bleeding disorder are evident in those who end up categorized as bleeding disorder of unknown cause (BDUC), which can contribute to uncertainty in management and suboptimal care. BDUC is a diagnosis of exclusion, with nondiagnostic first-line hemostatic laboratory testing not meeting the criteria of an inherited mild bleeding disorder, despite the patient having a positive bleeding phenotype and/or positive family history. An abnormal bleeding phenotype, an important diagnostic criterion for BDUC, should be assessed through the use of standardized bleeding assessment tools, allowing for the quantification of bleeding symptoms as well as through clinical gestalt and judgment. The first-line laboratory workup must include a minimum set of hemostasis assays with normal results, including complete blood count, prothrombin time, activated partial thromboplastin time, thrombin time, fibrinogen, von Willebrand disease testing, factor VIII, platelet aggregation testing, and, if available, platelet-dense granule assessment. Following normal results of initial laboratory testing, specialized tests may be ordered based on examination in addition to the patient's clinical history, including measurement of individual clotting factor assays to identify other rare bleeding causes, and in rarer cases, additional platelet assays and fibrinolysis assays may be performed. Genetic testing involving targeted genomic sequencing of known genes associated with bleeding and platelet dysfunction is not currently part of the standard line of care, primarily due to the cost and low diagnostic yield.","PeriodicalId":12973,"journal":{"name":"Hematology. American Society of Hematology. Education Program","volume":"2025 1","pages":"116-119"},"PeriodicalIF":3.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891331/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677607","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Nze C, Flowers CR. Barriers to accessing cellular therapy for patients receiving care in community practices. Hematology Am Soc Hematol Educ Program. 2023;2023(1):382-385. 李建平，李建平。社区护理中细胞治疗的障碍。中华血液学杂志；2009;23(1):382-385。

IF 3.2 3区教育学

Hematology. American Society of Hematology. Education Program Pub Date : 2025-12-05 DOI: 10.1182/hematology.2025E01

C Nze, C R Flowers

引用次数: 0

What's new in hereditary hemorrhagic telangiectasia? 遗传性出血性毛细血管扩张有什么新进展？

IF 3.7 3区教育学

Hematology. American Society of Hematology. Education Program Pub Date : 2025-12-05 DOI: 10.1182/hematology.2025000698

Raj S Kasthuri

{"title":"What's new in hereditary hemorrhagic telangiectasia?","authors":"Raj S Kasthuri","doi":"10.1182/hematology.2025000698","DOIUrl":"10.1182/hematology.2025000698","url":null,"abstract":"Hereditary hemorrhagic telangiectasia (HHT) is an inherited vasculopathy that results in dysregulated angiogenesis leading to the development of mucocutaneous telangiectasias and visceral organ arteriovenous malformations. HHT is the second most common inherited bleeding disorder. Recurrent, spontaneous epistaxis occurs in over 90% of affected individuals and is the hallmark of this disorder. Epistaxis and gastrointestinal bleeding result in the development of iron deficiency anemia in nearly half of all affected individuals. Considerable advances have been made in the understanding of the pathobiology, manifestations, and treatment of HHT in the last decade. International consensus treatment guidelines have been developed. Medical therapeutics have become the primary approach for treating HHT-related bleeding. The initial clinical studies evaluating medications for the treatment of HHT have involved repurposing drugs that were previously approved for other indications. In the wake of these efforts, several therapies specifically for HHT are currently being developed and are in preclinical studies and early phase human trials or may soon start pivotal phase III trials. The landscape of HHT is changing fast with increased awareness and diagnosis and the development of new and novel therapies, all of which will decrease morbidity and improve the quality of life of affected individuals.","PeriodicalId":12973,"journal":{"name":"Hematology. American Society of Hematology. Education Program","volume":"2025 1","pages":"131-136"},"PeriodicalIF":3.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891444/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677387","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Selecting the best treatment approach and optimizing sequencing strategies in large B-cell lymphoma. 选择大b细胞淋巴瘤的最佳治疗方法和优化测序策略。

IF 3.7 3区教育学

Hematology. American Society of Hematology. Education Program Pub Date : 2025-12-05 DOI: 10.1182/hematology.2025000740

Gloria Iacoboni, Franck Morschhauser

引用次数: 0

Thalassemia and hypercoagulability. 地中海贫血和高凝性。

IF 3.7 3区教育学

Hematology. American Society of Hematology. Education Program Pub Date : 2025-12-05 DOI: 10.1182/hematology.2025000716

Maria Domenica Cappellini, Ali T Taher, Irene Motta

{"title":"Thalassemia and hypercoagulability.","authors":"Maria Domenica Cappellini, Ali T Taher, Irene Motta","doi":"10.1182/hematology.2025000716","DOIUrl":"10.1182/hematology.2025000716","url":null,"abstract":"Although the management of β-thalassemia has improved significantly, patients still suffer from many complications, including thrombotic events. A hypercoagulable state has been demonstrated in these conditions, particularly in non-transfusion-dependent β-thalassemia, because of disease-specific contributors that play a role in the pathogenesis, including reactive oxygen species, pathological erythroid cells, circulating microparticles, free heme, and endothelial activation. Splenectomy further contributes to the complexity of thrombotic risk in such patients, together with emerging complications related to increased survival, such as atrial fibrillation. Moreover, in recent years the role of new drugs in further modifying the thrombotic risk of these patients has been demonstrated, as in the case of luspatercept. However, its role still needs to be elucidated. The currently available prevention and clinical management of thrombosis in thalassemia patients mainly relies on the international guidelines for the general population, although, given the peculiar pathophysiology and the disease-related risk factors, robust data and evidence are necessary to develop dedicated guidelines.","PeriodicalId":12973,"journal":{"name":"Hematology. American Society of Hematology. Education Program","volume":"2025 1","pages":"285-290"},"PeriodicalIF":3.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891362/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677531","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The aging hemophilia patient. 老年血友病患者。

IF 3.7 3区教育学

Hematology. American Society of Hematology. Education Program Pub Date : 2025-12-05 DOI: 10.1182/hematology.2025000773

Magdalena Lewandowska, Ming Y Lim

{"title":"The aging hemophilia patient.","authors":"Magdalena Lewandowska, Ming Y Lim","doi":"10.1182/hematology.2025000773","DOIUrl":"10.1182/hematology.2025000773","url":null,"abstract":"Advances in the development of safe and effective treatments for hemophilia over the past century have significantly increased the life expectancy of persons with hemophilia (PwH). As a result, clinicians are now encountering age-related comorbidities that were previously uncommon in hemophilia care, including cardiovascular disease, malignancy, and renal disease. Managing this aging population of PwH requires addressing both the complications of hemophilia and the multifaceted effects of aging. Their care needs have become increasingly complex, requiring attention to broader aspects of health, such as liver and bone health, fall and fracture risk, and frailty. However, preventive care, including routine monitoring and treatment of these conditions, is a gap in the current care model for this population. Inadequate access to primary care physicians negatively impacts the management and prevention of chronic diseases in PwH, resulting in medical vulnerability. The focus of this review is to examine prevalent complications in the aging PwH. Case studies presented focus on identifying and reducing cardiovascular disease risk, weighing bleeding risk with stroke risk in the management of atrial fibrillation, and ensuring a multidisciplinary approach to address frailty, bone health, and orthopedic surgery in the aging PwH. As we enter a new era of therapeutics, hemophilia treatment centers will play an integral role in closing care gaps in helping PwH achieve optimal outcomes.","PeriodicalId":12973,"journal":{"name":"Hematology. American Society of Hematology. Education Program","volume":"2025 1","pages":"674-681"},"PeriodicalIF":3.7,"publicationDate":"2025-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12891591/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145677500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0