Acta HaematologicaPub Date : 2025-01-01Epub Date: 2025-08-14DOI: 10.1159/000547973
Ine Schmale
{"title":"Highlights from the European Hematology Association Congress 2025.","authors":"Ine Schmale","doi":"10.1159/000547973","DOIUrl":"10.1159/000547973","url":null,"abstract":"","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"600-601"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144854203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta HaematologicaPub Date : 2025-01-01Epub Date: 2024-11-25DOI: 10.1159/000542704
Muhammad Faisal Aslam, Asfand Yar Cheema, Daniyal Shahid, Bibi Maryam, Debduti Mukhopadhyay, Mishaal Munir, Ali Najam, Hossam M Ali, Qaiser Bashir, Faiz Anwer
{"title":"Historical Perspective of Allogeneic Hematopoietic Stem Cell Transplantation for Multiple Myeloma.","authors":"Muhammad Faisal Aslam, Asfand Yar Cheema, Daniyal Shahid, Bibi Maryam, Debduti Mukhopadhyay, Mishaal Munir, Ali Najam, Hossam M Ali, Qaiser Bashir, Faiz Anwer","doi":"10.1159/000542704","DOIUrl":"10.1159/000542704","url":null,"abstract":"<p><strong>Background: </strong>Advances in novel therapies have improved outcomes for multiple myeloma (MM) patients and the use of allo-SCT has decreased. Current guidelines no longer support allo-SCT as consolidation therapy for newly diagnosed MM, even in high-risk cases.</p><p><strong>Summary: </strong>Allo-SCT is now typically considered only within clinical trials for young, high-risk patients with relapsed or refractory MM (RRMM). It has not proven favorable despite its historical use. CAR T-cell therapy and bispecific antibodies have shown promise in treating triple- and penta-exposed/refractory MM, yet relapse remains common with poor survival rates. The efficacy of allo-SCT following BCMA-directed therapy and other new T-cell-directed therapies is unclear. Allo-SCT might be a viable option for eligible patients who relapse after these therapies, or where such options are unavailable. Advancements in reduced-intensity conditioning regimens have led to lower toxicity and transplant-related (TR) morbidity, lower graft-versus-host disease (GvHD), and TR mortality. Expanded use of alternative donors, like haploidentical donors, has yielded comparable outcomes. Better post-transplant GvHD regimens and maintenance strategies to prevent relapse have been developed.</p><p><strong>Key messages: </strong>This review analyzes available literature to better understand the safety, efficacy, and current role of allo-SCT in managing MM. Newer regimens are needed as routine use of allo-SCT cannot be recommended.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"315-329"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12112892/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142714998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta HaematologicaPub Date : 2025-01-01Epub Date: 2024-05-06DOI: 10.1159/000539225
Inbar Cohen, Iuliana Vaxman, Morie A Gertz
{"title":"Historical Perspective of High-Dose Therapy Followed by Autologous Stem Cell Transplantation in Multiple Myeloma.","authors":"Inbar Cohen, Iuliana Vaxman, Morie A Gertz","doi":"10.1159/000539225","DOIUrl":"10.1159/000539225","url":null,"abstract":"<p><strong>Background: </strong>High-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) has become part of standard of care (SOC) in newly diagnosed multiple myeloma. In this review, we provide a historical perspective on ASCT since its introduction in the 1990s.</p><p><strong>Summary: </strong>Overall survival (OS) benefit for HDT followed by ASCT was demonstrated in studies comparing HDT with ASCT to standard-dose therapy (SDT) before the era of novel agents. Conditioning is done with melphalan 200 mg/m2. Lower doses (MEL140, MEL150) for older patients with comorbidities are safe and have comparable results. The addition of busulfan to melphalan improves progression-free survival (PFS) but not OS. HDT with ASCT after induction with novel agents prolongs PFS but not OS compared to SDT alone. The benefit is more evident in patients with high-risk cytogenetics. Mobilization can be achieved with granulocyte colony-stimulating factor alone, but is improved with the addition of chemotherapy. Plerixafor reduces mobilization failure and enables sufficient stem cell collection after induction with novel agents. ASCT is safe with a low rate of mortality (1%), and selected patients can be managed as outpatients.</p><p><strong>Key messages: </strong>HDT followed by ASCT remains part of SOC due to its PFS benefit and relatively low toxicity.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"289-299"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140846838","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta HaematologicaPub Date : 2025-01-01Epub Date: 2022-03-02DOI: 10.1159/000523874
Maria Dritsa, Marina Economou, Vasilios Perifanis, Aikaterini Teli, Athanasios Christoforidis
{"title":"Retrospective Evaluation of Oral Glucose Tolerance Test in Young Patients with Transfusion-Dependent Beta-Thalassemia.","authors":"Maria Dritsa, Marina Economou, Vasilios Perifanis, Aikaterini Teli, Athanasios Christoforidis","doi":"10.1159/000523874","DOIUrl":"10.1159/000523874","url":null,"abstract":"<p><strong>Background: </strong>Current guidelines recommend yearly evaluation of glucose metabolism with oral glucose tolerance test (OGTT) in patients with thalassemia major (TM) from their 10th year onwards.</p><p><strong>Aims: </strong>The aim of the study was to retrospectively evaluate all the OGTT tests performed in a single pediatric center during the last decade and assess the necessity of yearly performed OGTT in patients with TM during the second decade of life.</p><p><strong>Results: </strong>One hundred and seventy tests performed on 39 patients (24 boys) were included in the analysis. Mean age at the time of each OGTT was 14.15 ± 2.79 years. Seventeen tests (10%) in 8 patients (5 boys) were characterized as impaired glucose tolerance (IGT), whereas in 2 tests (1.18%), fasting glucose values were above 200 mg/dL (diabetes mellitus). Acknowledging the fact that there could be sporadic technical errors, especially in fasting glucose abnormal values, we selectively separated patients with either IGT and abnormal HOMA, MATSUDA, or QUICKI indices or persistently impaired fasting glucose or IGT. With these criteria, 7 patients (4 boys) were identified. No significant differences were observed in demographic and anthropometric parameters, ferritin levels, and mean volume of blood transfused in patients with a definite abnormal glucose metabolism. In order to address selection criteria for performing OGTT without missing a single patient with a definite glucose intolerance, these criteria should include (i) a first OGTT test at the initiation of puberty, (ii) OGTT in any patient with a fasting glucose above 100 mg/dL, and (iii) OGTT in any patient with a ΗΟΜΑ-IR index above 1.85 and yearly onwards. By adopting these criteria, total OGTT tests performed could have been reduced from 170 to only 91, translating to a significant reduction of 46.47%.</p><p><strong>Conclusions: </strong>Only a small percentage of young patients with transfusion-dependent b-thalassemia exhibit abnormal glucose metabolism during their second decade of life. By adopting specific selection criteria, one may avoid performing this time- and money-consuming test in a significant proportion of patients, albeit without sacrificing timely detection and intervention.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":"1 1","pages":"1-7"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43094096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta HaematologicaPub Date : 2025-01-01Epub Date: 2024-06-11DOI: 10.1159/000539756
Jennifer Marvin-Peek, Valerie Shelton, Kelly Brassil, Bryan Fellman, Austin Barr, Kelly Sharon Chien, Danielle Hammond, Mahesh Swaminathan, Nitin Jain, William Wierda, Alessandra Ferrajoli, Courtney DiNardo
{"title":"Effect of Digital Health Coaching on Self-Efficacy and Patient-Reported Outcomes in Individuals with Acute Myeloid and Chronic Lymphocytic Leukemia: A Pilot Randomized Controlled Trial.","authors":"Jennifer Marvin-Peek, Valerie Shelton, Kelly Brassil, Bryan Fellman, Austin Barr, Kelly Sharon Chien, Danielle Hammond, Mahesh Swaminathan, Nitin Jain, William Wierda, Alessandra Ferrajoli, Courtney DiNardo","doi":"10.1159/000539756","DOIUrl":"10.1159/000539756","url":null,"abstract":"<p><strong>Introduction: </strong>Promotion of self-efficacy can enhance engagement with health care and treatment adherence in patients with cancer. We report the outcomes of a pilot trial of a digital health coach intervention in patients with leukemia with the aim of improving self-efficacy.</p><p><strong>Methods: </strong>Adult patients with newly diagnosed acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL) were randomized 1:1 to a digital health coach intervention or standard of care. The primary outcome of self-efficacy was measured by the Cancer Behavior Inventory (CBI) score.</p><p><strong>Results: </strong>A total of 147 patients (37 AML, 110 CLL) were enrolled from July 2020 to December 2022. In the AML cohort, there was a mean increase in CBI score of 7.03 in the digital health coaching arm compared to a mean decrease of -3.57 in the control arm at 30 days (p = 0.219). There were no significant associations between the intervention and other patient-reported outcomes for patients with CLL.</p><p><strong>Conclusion: </strong>There were numerical, but not statistically significant increases in self-efficacy metrics in AML patients who received digital health coaching. Although this trial was underpowered due to enrollment limitations during a pandemic, digital health coaching may provide benefit to patients with hematologic malignancy and warrants further investigation.</p><p><strong>Introduction: </strong>Promotion of self-efficacy can enhance engagement with health care and treatment adherence in patients with cancer. We report the outcomes of a pilot trial of a digital health coach intervention in patients with leukemia with the aim of improving self-efficacy.</p><p><strong>Methods: </strong>Adult patients with newly diagnosed acute myeloid leukemia (AML) and chronic lymphocytic leukemia (CLL) were randomized 1:1 to a digital health coach intervention or standard of care. The primary outcome of self-efficacy was measured by the Cancer Behavior Inventory (CBI) score.</p><p><strong>Results: </strong>A total of 147 patients (37 AML, 110 CLL) were enrolled from July 2020 to December 2022. In the AML cohort, there was a mean increase in CBI score of 7.03 in the digital health coaching arm compared to a mean decrease of -3.57 in the control arm at 30 days (p = 0.219). There were no significant associations between the intervention and other patient-reported outcomes for patients with CLL.</p><p><strong>Conclusion: </strong>There were numerical, but not statistically significant increases in self-efficacy metrics in AML patients who received digital health coaching. Although this trial was underpowered due to enrollment limitations during a pandemic, digital health coaching may provide benefit to patients with hematologic malignancy and warrants further investigation.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"233-243"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11632142/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141305069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta HaematologicaPub Date : 2025-01-01Epub Date: 2024-06-05DOI: 10.1159/000539541
Alexandra Power-Hays, Ruth Namazzi, Charles Kato, Kathryn E McElhinney, Andrea L Conroy, Heather Hume, Chandy John, Sara M O'Hara, Susan E Stuber, Adam Lane, Teresa S Latham, Robert O Opoka, Russell E Ware
{"title":"Pharmacokinetic-Guided Hydroxyurea to Reduce Transfusions in Ugandan Children with Sickle Cell Anemia: Study Design of the Alternative Dosing And Prevention of Transfusions Trial.","authors":"Alexandra Power-Hays, Ruth Namazzi, Charles Kato, Kathryn E McElhinney, Andrea L Conroy, Heather Hume, Chandy John, Sara M O'Hara, Susan E Stuber, Adam Lane, Teresa S Latham, Robert O Opoka, Russell E Ware","doi":"10.1159/000539541","DOIUrl":"10.1159/000539541","url":null,"abstract":"<p><strong>Introduction: </strong>People with sickle cell anemia (SCA) may require frequent blood transfusions to treat acute and chronic complications. Hydroxyurea is a life-saving treatment for SCA that could also decrease the need for blood transfusions. Inadequate medication access and challenges in dose optimization limit the widespread use of hydroxyurea in Africa. If feasible, pharmacokinetic (PK) dosing might improve dose determination to minimize toxicities and maximize clinical benefits. The Alternative Dosing And Prevention of Transfusions (ADAPT, NCT05662098) trial will analyze the impact of hydroxyurea on transfusion rate and serve as a pilot study to evaluate the feasibility of PK-guided hydroxyurea dosing in Uganda.</p><p><strong>Methods: </strong>Herein we describe the rationale and design of ADAPT, a prospective cohort study of ∼100 children with SCA in Jinja, Uganda. The primary hypothesis is that hydroxyurea will decrease blood transfusion use by ≥ 50%, comparing the transfusion incidence rate ratio between a 3-month pretreatment and a 12-month treatment period. A key secondary hypothesis is that our PK-dosing approach will generate a suitable hydroxyurea dose for ≥80% of participants. Every ADAPT participant will undergo hydroxyurea PK testing, and if a dose is generated within 15-35 mg/kg/day, participants will start on their individualized dose. If not, they will start on a default dose of 20 mg/kg/day. Hydroxyurea dose optimization will occur with periodic dose adjustments.</p><p><strong>Conclusion: </strong>Overall, demonstrating the reduction in blood transfusion utilization with hydroxyurea treatment would provide leverage to increase hydroxyurea access, and PK-guided hydroxyurea dosing should optimize the safe and effective treatment of SCA across sub-Saharan Africa.</p><p><strong>Introduction: </strong>People with sickle cell anemia (SCA) may require frequent blood transfusions to treat acute and chronic complications. Hydroxyurea is a life-saving treatment for SCA that could also decrease the need for blood transfusions. Inadequate medication access and challenges in dose optimization limit the widespread use of hydroxyurea in Africa. If feasible, pharmacokinetic (PK) dosing might improve dose determination to minimize toxicities and maximize clinical benefits. The Alternative Dosing And Prevention of Transfusions (ADAPT, NCT05662098) trial will analyze the impact of hydroxyurea on transfusion rate and serve as a pilot study to evaluate the feasibility of PK-guided hydroxyurea dosing in Uganda.</p><p><strong>Methods: </strong>Herein we describe the rationale and design of ADAPT, a prospective cohort study of ∼100 children with SCA in Jinja, Uganda. The primary hypothesis is that hydroxyurea will decrease blood transfusion use by ≥ 50%, comparing the transfusion incidence rate ratio between a 3-month pretreatment and a 12-month treatment period. A key secondary hypothesis is that our PK-dosing approach will generate a ","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"208-219"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11617603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141199231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta HaematologicaPub Date : 2025-01-01Epub Date: 2024-06-26DOI: 10.1159/000539880
Hunter D Niehus, Jean Sabile, Richard T Maziarz, Gabrielle Meyers, Rachel Cook, Arpita P Gandhi, Jennifer N Saultz, Shauna Rakshe, Andy Kaempf, Theodore Braun, Yazan Migdady
{"title":"Enhanced Survival of Chronic Myelomonocytic Leukemia-Dysplastic over Proliferative Subtype after Allogeneic Hematopoietic Cell Transplant: A Tertiary Center Experience and Literature Review.","authors":"Hunter D Niehus, Jean Sabile, Richard T Maziarz, Gabrielle Meyers, Rachel Cook, Arpita P Gandhi, Jennifer N Saultz, Shauna Rakshe, Andy Kaempf, Theodore Braun, Yazan Migdady","doi":"10.1159/000539880","DOIUrl":"10.1159/000539880","url":null,"abstract":"<p><strong>Introduction: </strong>CMML is a rare neoplasm with overlapping myelodysplastic and myeloproliferative features whose only potential cure is allogeneic hematopoietic cell transplantation (allo-HCT).</p><p><strong>Methods: </strong>This retrospective study examined 27 CMML patients with high-risk clinical features who underwent first allo-HCT at our institution between 2004 and 2022.</p><p><strong>Results: </strong>Nineteen patients were diagnosed with the proliferative subtype (CMML-MPN) and 8 with the dysplastic subtype (CMML-MDS). Median OS was 15 months post-HCT (95% CI: 5-71); OS at 1, 3, and 5 years was 52%, 35%, and 35%, respectively. Compared to those with CMML-MPN, patients with CMML-MDS had longer OS (median, 8.6 vs. 0.9 years; p = 0.025), RFS (4.4 vs. 0.5 years; p = 0.021), and GVHD-free, relapse-free survival (GRFS, 9.4 vs. 3.4 months; p = 0.033) as well as lower 1-year NRM (13 vs. 47%; p = 0.043), with the statistical significance of this CMML subtype effect maintained in multivariable models. High-risk cytogenetics were associated with shorter GRFS in the univariable (median, 3.1 vs. 6.2 months; p = 0.013) and multivariable (HR = 4.88; p = 0.006) settings.</p><p><strong>Conclusions: </strong>Patients who underwent transplant for CMML-MDS experienced substantially better outcomes than those transplanted for CMML-MPN. Future studies are needed for transplantation optimization in CMML, especially CMML-MPN.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"198-207"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141454557","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta HaematologicaPub Date : 2025-01-01Epub Date: 2024-10-28DOI: 10.1159/000542286
Christina Klötzer, Franziska Schnabel, Anne-Sophie Kubasch, Madlen Jentzsch, Georg-Nikolaus Franke, Jens Uhlig, Helene Faust, Robin-Tobias Jauss, Henry Oppermann, Denny Popp, Klaus H Metzeler, Johannes R Lemke, Vladan Vučinić, Uwe Platzbecker
{"title":"Thiamine-Responsive Megaloblastic Anemia Syndrome Mimicking Myelodysplastic Neoplasm.","authors":"Christina Klötzer, Franziska Schnabel, Anne-Sophie Kubasch, Madlen Jentzsch, Georg-Nikolaus Franke, Jens Uhlig, Helene Faust, Robin-Tobias Jauss, Henry Oppermann, Denny Popp, Klaus H Metzeler, Johannes R Lemke, Vladan Vučinić, Uwe Platzbecker","doi":"10.1159/000542286","DOIUrl":"10.1159/000542286","url":null,"abstract":"<p><strong>Introduction: </strong>Thiamine-responsive megaloblastic anemia syndrome (TRMA) is a rare autosomal recessive disease with a homozygous or compound-heterozygous mutation in the SLC19A2 gene characterized by megaloblastic anemia, diabetes mellitus (DM), and sensorineural hearing loss with onset in childhood. Folic acid and vitamin B12 in serum are normal with dysplastic erythropoiesis in the bone marrow often mimicking myelodysplastic neoplasms (MDS) as a potential differential diagnosis. Thiamine substitution leads to normalization of anemia, without effects on hearing loss or DM.</p><p><strong>Case presentation: </strong>We report about a 38-year-old male patient, presented with a 12-year history of anemia, insulin dependent DM, optic neuropathy, and a cataract since early childhood. The laboratory showed megaloblastic anemia. Other values were normal. The bone marrow smear showed dysplastic erythropoiesis with megaloblastic changes, and normal findings in cytogenetic and molecular genetic examinations. Next-generation sequencing-based diagnostics revealed a heterozygous missense variant in the SLC19A2 gene on the maternal allele and a 3.4 Mb inversion in the chromosomal region 1q24.2 with breaking points in FAM78B and SLC19A2 on the paternal allele. Treatment with oral thiamine 100 mg daily was initiated, and 12 weeks later hemoglobin levels and bone marrow morphology had normalized.</p><p><strong>Conclusion: </strong>Late-onset TRMA should be considered in adult patients with indicative comorbidities and a typical phenotype, which may mimic features of MDS.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"380-385"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12306944/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142520637","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta HaematologicaPub Date : 2025-01-01Epub Date: 2025-06-13DOI: 10.1159/000546663
Tsahi T Lerman, Shmuel Tiosano, Roy Beigel, Michal Cohen-Shelly, Ran Kornowski, Refael Munitz, David A Nace, Shuja Hassan, Karen Scandrett, Daniel E Forman, Boris Fishman
{"title":"Machine Learning Application for Bleeding Risk Prediction in Patients with Atrial Fibrillation Treated with Oral Anticoagulation.","authors":"Tsahi T Lerman, Shmuel Tiosano, Roy Beigel, Michal Cohen-Shelly, Ran Kornowski, Refael Munitz, David A Nace, Shuja Hassan, Karen Scandrett, Daniel E Forman, Boris Fishman","doi":"10.1159/000546663","DOIUrl":"10.1159/000546663","url":null,"abstract":"<p><strong>Background: </strong>Atrial fibrillation (AF) is a prevalent cardiac arrhythmia associated with a significantly increased risk of systemic thromboembolism and stroke. Anticoagulation therapy, particularly with direct oral anticoagulants, has become the standard for stroke prevention but comes at the cost of an increased bleeding risk. With the introduction of effective alternatives to anticoagulation, such as percutaneous left atrial appendage occlusion, bleeding risk stratification has become essential to guide therapeutic decision-making. Conventional statistical methods have been used for bleeding risk stratification scores, such as HEMORR2HAGES, HAS-BLED, and ATRIA. However, these methods may inadequately address the multifactorial nature of bleeding risk in diverse patient populations, and their overall performance has been suboptimal. Summary and Key Messages: Recent advancements in machine learning (ML) offer promising opportunities to enhance bleeding risk prediction and optimize anticoagulation therapy. This review explores ML applications in AF patients receiving anticoagulation therapy, focusing on the development and validation of ML-based bleeding risk scores. These models have demonstrated improved predictive performance compared to traditional tools, leveraging complex datasets to identify nuanced patterns and interactions. Furthermore, ML-driven tools in warfarin management, including dose prediction, optimization of time in the therapeutic range, and the identification of drug-drug interactions, show significant potential to enhance patient safety and treatment efficacy.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"575-582"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144300938","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Acta HaematologicaPub Date : 2025-01-01Epub Date: 2025-04-08DOI: 10.1159/000545760
Aya Mudrik, Aya Mudrik, Orly Efros
{"title":"Artificial Intelligence and Venous Thromboembolism: A Narrative Review of Applications, Benefits, and Limitations.","authors":"Aya Mudrik, Aya Mudrik, Orly Efros","doi":"10.1159/000545760","DOIUrl":"10.1159/000545760","url":null,"abstract":"<p><p><p>Background: Venous thromboembolism (VTE), including deep vein thrombosis and pulmonary embolism, remains a leading cause of cardiovascular morbidity and mortality. Artificial intelligence (AI) holds promise for potential improvement of risk stratification, diagnosis, and management of VTE. Summary: This narrative review explores the applications, benefits, and limitations of AI in VTE management. AI models were shown to outperform conventional methods in identifying high-risk candidates for VTE prophylaxis treatments in several postsurgical settings. It has also been demonstrated to be efficient in the early detection of VTE events, particularly through point-of-care AI-guided sonography and computer tomography image processing. Data biases, model transparency, and the need for regulatory frameworks remain significant limitations in the full integration of AI into clinical practice. Key Messages: AI has the potential to improve VTE care by enhancing risk stratification and diagnosis. The integration of AI-driven models into clinical workflows has the potential to reduce costs, streamline diagnostic processes, and ensure effective management of VTE. Safe and effective integration of AI into VTE care requires addressing its limitations, such as interpretability, privacy, and algorithmic bias. </p>.</p>","PeriodicalId":6981,"journal":{"name":"Acta Haematologica","volume":" ","pages":"556-565"},"PeriodicalIF":1.1,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12091960/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810109","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}