Clinical Medicine Insights-Blood Disorders最新文献_第4页

Chronic Myeloid Leukemia in Nigerian Patients: Anemia is an Independent Predictor of Overall Survival. 尼日利亚患者的慢性髓性白血病:贫血是总体生存的独立预测因子。

IF 3

Clinical Medicine Insights-Blood Disorders Pub Date : 2016-06-20 eCollection Date: 2016-01-01 DOI: 10.4137/CMBD.S31562

Anthony A Oyekunle, Muheez A Durosinmi, Ramoni A Bolarinwa, Temilola Owojuyigbe, Lateef Salawu, Norah O Akinola

{"title":"Chronic Myeloid Leukemia in Nigerian Patients: Anemia is an Independent Predictor of Overall Survival.","authors":"Anthony A Oyekunle, Muheez A Durosinmi, Ramoni A Bolarinwa, Temilola Owojuyigbe, Lateef Salawu, Norah O Akinola","doi":"10.4137/CMBD.S31562","DOIUrl":"https://doi.org/10.4137/CMBD.S31562","url":null,"abstract":"Objectives: The advent of the tyrosine kinase inhibitors has markedly changed the prognostic outlook for patients with Ph(+) and/or BCR-ABL1 (+) chronic myeloid leukemia (CML). This study was designed to assess the overall survival (OS) of Nigerian patients with CML receiving imatinib therapy and to identify the significant predictors of OS.Methods: All patients with CML receiving imatinib from July 2003 to June 2013 were studied. The clinical and hematological parameters were studied. The Kaplan-Meier technique was used to estimate the OS and median survival. P-value of <0.05 was considered as statistically significant.Results: The median age of all 527 patients (male/female = 320/207) was 37 (range 10-87) years. There were 472, 47, and 7 in chronic phase (CP), accelerated phase, and blastic phase, respectively. As at June 2013, 442 patients are alive. The median survival was 105.7 months (95% confidence interval [CI], 91.5-119.9); while OS at one, two, and five years were 95%, 90%, and 75%, respectively. Multivariate Cox regression analysis revealed that OS was significantly better in patients diagnosed with CP (P = 0.001, odds ratio = 1.576, 95% CI = 1.205-2.061) or not in patients with anemia (P = 0.031, odds ratio = 1.666, 95% CI = 1.047-2.649). Combining these variables yielded three prognostic groups: CP without anemia, CP with anemia, and non-CP, with significantly different median OS of 123.3, 92.0, and 74.7 months, respectively (χ (2) = 22.042, P = 0.000016).Conclusion: This study has clearly shown that for Nigerian patients with CML, the clinical phase of the disease at diagnosis and the hematocrit can be used to stratify patients into low, intermediate, and high risk groups.","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2016-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMBD.S31562","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34698137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Pediatric Blood Pressure and Adult Preclinical Markers of Cardiovascular Disease. 儿童血压和成人心血管疾病的临床前标志物。

IF 3

Clinical Medicine Insights-Blood Disorders Pub Date : 2016-05-04 eCollection Date: 2016-01-01 DOI: 10.4137/CMBD.S18887

Costan G Magnussen, Kylie J Smith

引用次数: 31

Artificial Blood Substitutes: First Steps on the Long Route to Clinical Utility 人造血液代用品:漫漫临床应用之路的第一步

IF 3

Clinical Medicine Insights-Blood Disorders Pub Date : 2016-01-01 DOI: 10.4137/CMBD.S38461

S. Moradi, A. Jahanian-Najafabadi, Mehryar Habibi Roudkenar

引用次数: 49

Mixed Phenotype Acute Leukemia with Two Immunophenotypically Distinct B and T Blasts Populations, Double Ph (+) Chromosome and Complex Karyotype: Report of an Unusual Case. 具有两种免疫表型不同的B细胞和T细胞群，双Ph(+)染色体和复杂核型的混合表型急性白血病:一个罕见病例的报告。

IF 3

Clinical Medicine Insights-Blood Disorders Pub Date : 2015-09-21 eCollection Date: 2015-01-01 DOI: 10.4137/CMBD.S24631

Samah A Kohla, Ahmad Al Sabbagh, Halima El Omri, Firyal A Ibrahim, Ivone B Otazu, Hessa Alhajri, Mohamed A Yassin

{"title":"Mixed Phenotype Acute Leukemia with Two Immunophenotypically Distinct B and T Blasts Populations, Double Ph (+) Chromosome and Complex Karyotype: Report of an Unusual Case.","authors":"Samah A Kohla, Ahmad Al Sabbagh, Halima El Omri, Firyal A Ibrahim, Ivone B Otazu, Hessa Alhajri, Mohamed A Yassin","doi":"10.4137/CMBD.S24631","DOIUrl":"https://doi.org/10.4137/CMBD.S24631","url":null,"abstract":"Mixed phenotype acute leukemia (MPAL) is considered as a rare type of leukemia with an incidence of less than 4% of all acute leukemia based on the most recent 2008 WHO classification. Common subtypes are the B/myeloid and T/myeloid; B/T and trilineage MPAL being extremely rare. We present a case of a male in his 20s, whose peripheral blood smears showed 34% blast cells and bone marrow with 70% blasts. Immunophenotyping by multiparametric flow cytometry showed two populations of blasts, the major one with B-lineage and the minor one with T-lineage. Conventional karyotyping revealed complex karyotype with the presence of double Philadelphia chromosome (Ph (+)). BCR/ABL1 rearrangement was confirmed by fluorescent in situ hybridization (FISH) analysis. The BCR/ABL1 ES probe on interphase cells indicated p190 minor m-BCR/ABL fusion in 46% and a second abnormal clone with double Ph (+) in 16% of the cells analyzed confirmed by reverse transcription-PCR (RT-PCR). The case was diagnosed as MPAL with double Philadelphia chromosome Ph (+). The patient was treated with dasatinib, four cycle hyper CVAD/methotrexate cytarabin protocol, and allogeneic transplant. He is still alive in complete hematological, cytogenetic, and molecular remission. Mixed phenotype B/T acute leukemia is an extremely rare disease, particularly those with double Philadelphia chromosomes and clinically presents challenges in diagnosis and treatment. ","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2015-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMBD.S24631","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"34138881","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 12

Dasatinib Induced Avascular Necrosis of Femoral Head in Adult Patient with Chronic Myeloid Leukemia. 慢性髓性白血病成人患者达沙替尼诱发的股骨头血管性坏死

IF 3

Clinical Medicine Insights-Blood Disorders Pub Date : 2015-07-23 eCollection Date: 2015-01-01 DOI: 10.4137/CMBD.S24628

Mohamed A Yassin, Abbas H Moustafa, Abdulqadir J Nashwan, Ashraf T Soliman, Hatim El Derhoubi, Shehab F Mohamed, Deena S Mudawi, Sarah ELkourashy, Deena-Raiza Asaari, Hope-Love G Gutierrez, Radwa M Hussein, Mohamed Al Musharraf, Samah Kohla, Ahmed Elsayed, Nader Al-Dewik

{"title":"Dasatinib Induced Avascular Necrosis of Femoral Head in Adult Patient with Chronic Myeloid Leukemia.","authors":"Mohamed A Yassin, Abbas H Moustafa, Abdulqadir J Nashwan, Ashraf T Soliman, Hatim El Derhoubi, Shehab F Mohamed, Deena S Mudawi, Sarah ELkourashy, Deena-Raiza Asaari, Hope-Love G Gutierrez, Radwa M Hussein, Mohamed Al Musharraf, Samah Kohla, Ahmed Elsayed, Nader Al-Dewik","doi":"10.4137/CMBD.S24628","DOIUrl":"10.4137/CMBD.S24628","url":null,"abstract":"Chronic myeloid leukemia (CML) is a myeloproliferative neoplasm characterized by the presence of the Philadelphia (Ph) chromosome resulting from the reciprocal translocation t(9;22)(q34;q11). The molecular consequence of this translocation is the generation of the BCR-ABL fusion gene, which encodes a constitutively active protein tyrosine kinase. The oncogenic protein tyrosine kinase, which is located in the cytoplasm, is responsible for the leukemia phenotype through the constitutive activation of multiple signaling pathways involved in the cell cycle and in adhesion and apoptosis. Avascular necrosis of the femoral head (AVNFH) is not a specific disease. It occurs as a complication or secondary to various causes. These conditions probably lead to impaired blood supply to the femoral head. The diagnosis of AVNFH is based on clinical findings and is supported by specific radiological manifestations. We reported a case of a 34-year-old Sudanese female with CML who developed AVNFH after receiving dasatinib as a second-line therapy. Though the mechanism by which dasatinib can cause avascular necrosis (AVN) is not clear, it can be postulated because of microcirculatory obstruction of the femoral head. To the best of our knowledge and after extensive literature search, this is the first reported case of AVNFH induced by dasatinib in a patient with CML. ","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2015-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4514172/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33994414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Anemia and the Need for Intravenous Iron Infusion after Roux-en-Y Gastric Bypass. Roux-en-Y胃旁路术后贫血和静脉输铁的需要。

IF 3

Clinical Medicine Insights-Blood Disorders Pub Date : 2015-06-04 eCollection Date: 2015-01-01 DOI: 10.4137/CMBD.S21825

Adam Kotkiewicz, Keri Donaldson, Charles Dye, Ann M Rogers, David Mauger, Lan Kong, M Elaine Eyster

{"title":"Anemia and the Need for Intravenous Iron Infusion after Roux-en-Y Gastric Bypass.","authors":"Adam Kotkiewicz, Keri Donaldson, Charles Dye, Ann M Rogers, David Mauger, Lan Kong, M Elaine Eyster","doi":"10.4137/CMBD.S21825","DOIUrl":"https://doi.org/10.4137/CMBD.S21825","url":null,"abstract":"The frequency of anemia, iron deficiency, and the long-term need for IV iron following Roux-en-y gastric bypass (RYGB) surgery has not been well characterized. Three-hundred and nineteen out of 904 consecutive subjects who underwent RYGB at Penn State Hershey Medical Center from 1999 to 2006 met the inclusion criteria for a preoperative complete blood count (CBC) and at least one CBC >6 months following surgery. Cumulative incidence of anemia 7 years post procedure was 58%. Menstruation status and presence of preoperative anemia were predictive of anemia by univariate analysis and multivariable Cox regression (P = 0.0014 and 0.044, respectively). Twenty-seven subjects, primarily premenopausal women, representing 8.5% of the cohort and 22% of the 122 anemic subjects, needed intravenous (IV) iron a mean of 51 months postoperatively for anemia unresponsive or refractory to oral iron. The risk for development of anemia necessitating IV iron therapy following RYGB is highest in menstruating women and continues to increase for many years, even in post-menopausal women. Well-designed prospective studies are needed to identify the incidence of iron deficiency anemia and the patient populations at increased risk for requiring IV iron replacement after RYGB surgery. ","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2015-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMBD.S21825","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33391950","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 31

Efficacy and Safety of Rituximab for Refractory and Relapsing Thrombotic Thrombocytopenic Purpura: A Cohort of 10 Cases. 利妥昔单抗治疗难治性和复发性血栓性血小板减少性紫癜的疗效和安全性:10例队列研究。

IF 3

Clinical Medicine Insights-Blood Disorders Pub Date : 2015-05-24 eCollection Date: 2015-01-01 DOI: 10.4137/CMBD.S25326

Halima El Omri, Ruba Y Taha, Amna Gamil, Firyal Ibrahim, Hisham Al Sabah, Zeinab O Mahmoud, Gianfranco Pittari, Ibrahim Al HIjji, Mohamed A Yassin

{"title":"Efficacy and Safety of Rituximab for Refractory and Relapsing Thrombotic Thrombocytopenic Purpura: A Cohort of 10 Cases.","authors":"Halima El Omri, Ruba Y Taha, Amna Gamil, Firyal Ibrahim, Hisham Al Sabah, Zeinab O Mahmoud, Gianfranco Pittari, Ibrahim Al HIjji, Mohamed A Yassin","doi":"10.4137/CMBD.S25326","DOIUrl":"https://doi.org/10.4137/CMBD.S25326","url":null,"abstract":"Objective: Idiopathic thrombotic thrombocytopenic purpura (TTP) is a life-threatening disorder mediated by autoantibodies directed against ADAMTS13. This provides a rationale for the use of rituximab in this disorder. We report our experience and the outcome of 10 cases of TTP (9 refractory and 1 relapsing) successfully treated with rituximab in combination with plasma exchange (PE) and other immunosuppressive treatments.Methods: The diagnosis of TTP was based on clinical criteria and supported by severe deficiency of ADAMTS13 activity and presence of inhibitors in seven cases. Rituximab was started after a median of 18.6 sessions of PE (range: 5-35) at the dose of 375 mg/m(2)/week for 4-8 weeks.Results: Complete remission was achieved in all patients after a median time of 14.4 days of the first dose (range: 6-30). After a median follow-up of 30 months (range: 8-78), eight patients were still in remission and two developed multiple relapses, treated again with the same therapy, and achieved complete responses; they are alive, and in complete remission after a follow-up of 12 and 16 months.Conclusion: Rituximab appears to be a safe and effective therapy for refractory and relapsing TTP. However, longer follow-up is recommended to assess relapse and detect possible long-term side effects of this therapy.","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2015-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMBD.S25326","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33243654","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 13

Ribosomopathies: mechanisms of disease. 核糖体病:疾病机制。

IF 3

Clinical Medicine Insights-Blood Disorders Pub Date : 2014-08-14 eCollection Date: 2014-01-01 DOI: 10.4137/CMBD.S16952

Hani Nakhoul, Jiangwei Ke, Xiang Zhou, Wenjuan Liao, Shelya X Zeng, Hua Lu

引用次数: 75

Risk factors for thrombosis in an african population. 非洲人群血栓形成的危险因素。

IF 3

Clinical Medicine Insights-Blood Disorders Pub Date : 2014-04-10 eCollection Date: 2014-01-01 DOI: 10.4137/CMBD.S13401

Awa Ot Fall, Valérie Proulle, Abibatou Sall, Alassane Mbaye, Pape Samba Ba, Maboury Diao, Moussa Seck, Macoura Gadji, Sara B Gning, Saliou Diop, Tandakha Nd Dièye, Blaise Félix Faye, Doudou Thiam, Marie Dreyfus

{"title":"Risk factors for thrombosis in an african population.","authors":"Awa Ot Fall, Valérie Proulle, Abibatou Sall, Alassane Mbaye, Pape Samba Ba, Maboury Diao, Moussa Seck, Macoura Gadji, Sara B Gning, Saliou Diop, Tandakha Nd Dièye, Blaise Félix Faye, Doudou Thiam, Marie Dreyfus","doi":"10.4137/CMBD.S13401","DOIUrl":"https://doi.org/10.4137/CMBD.S13401","url":null,"abstract":"Summary: Little is known about the biological, epidemiological, and clinical risk factors for thrombosis and venous thromboembolism (VTE) among Black Africans. We undertook a study of the prevalence of VTE risk factors for thrombosis in a Senegalese population. A three-year cross-sectional and case-control study involving 105 cases and 200 controls was conducted in various hospitals in Dakar (Senegal). Our results demonstrate that oral contraception, immobilization by casts, surgery, and blood group were significantly associated with VTE occurrence. Additionally, 16 cases and 2 controls had protein S (PS) values of less than 48.4% (M-2SD), exhibiting a highly significant difference (P < 1 × 10(-4)). The number of cases with a low protein C (PC) level was significantly higher than the respective number of controls. Using logistic regression methods, we established a correlation between significantly associated variables and deep venous thrombosis (DVT) occurrence. Age, obesity, sickle cell disease, and PC deficiency were not significantly associated with thrombosis. In contrast, gender, PS deficiency, varicose veins, surgery, non-O blood type, and the presence of antiphospholipid antibodies were significantly and independently associated with DVT. These findings are extremely useful for clinical management of patients suffering from DVT and can help to reduce the high recurrence rate observed in our study.","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2014-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMBD.S13401","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32910788","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 17

Clinical Characteristics and Risk of Relapse for Patients with Stage I-II Diffuse Large B-cell Lymphoma Treated in First Line with Immunochemotherapy. 一线免疫化疗治疗I-II期弥漫性大b细胞淋巴瘤患者的临床特征和复发风险

IF 3

Clinical Medicine Insights-Blood Disorders Pub Date : 2013-11-14 eCollection Date: 2013-01-01 DOI: 10.4137/CMBD.S12713

S Mercadal, F Climent, E Domingo-Doménech, A Oliveira, V Romagosa, A Fernández de Sevilla, E González-Barca

{"title":"Clinical Characteristics and Risk of Relapse for Patients with Stage I-II Diffuse Large B-cell Lymphoma Treated in First Line with Immunochemotherapy.","authors":"S Mercadal, F Climent, E Domingo-Doménech, A Oliveira, V Romagosa, A Fernández de Sevilla, E González-Barca","doi":"10.4137/CMBD.S12713","DOIUrl":"https://doi.org/10.4137/CMBD.S12713","url":null,"abstract":"Diffuse large b-cell lymphoma (DLBCL) is an aggressive and potentially curable lymphoma that presents itself as stage I-II in 30% of all cases. It is known that in these localized stages, 15-20% of patients treated without rituximab eventually relapse, but less data exist regarding rituximab era. We have analyzed clinico-pathological features and risk of relapse in 98 patients with I-II stage DLBCL in complete response (CR) or unconfirmed CR (CRu) after first-line treatment consisting of immunochemotherapy. Twelve patients (12.2%) eventually relapsed. Late relapse, more than two years after diagnosis, occurred in three patients, and early relapse, less than two years after diagnosis, was documented in nine patients. Median time from diagnosis to relapse was 0.61 years for patients with early relapse and 3.66 years for patients with late relapse. The second CR rate obtained was similar in the late and in early relapsing patients, being 33% versus 44% (p = 0.072), respectively. Three-year overall survival (OS) was 22% for early relapsing patients and 33% for late relapsing patients (p = 0.65). In conclusion, patients who are diagnosed with stage I-II DLBCL and achieve a CR/CRu with first line immunochemotherapy have a good prognosis. However, a proportion of patients relapse, and this is less frequent in patients treated with first line with immunochemotherapy. These patients have a poor prognosis. ","PeriodicalId":43083,"journal":{"name":"Clinical Medicine Insights-Blood Disorders","volume":null,"pages":null},"PeriodicalIF":3.0,"publicationDate":"2013-11-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.4137/CMBD.S12713","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"32910859","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0