EJHaem最新文献

{"title":"Optimisation of the Danish national haemoglobinopathy screening programme – A prospective intervention study","authors":"E. Gravholt, Finn Stener Jørgensen, Charlotte Holm, Jesper Petersen, A. Nardo‐Marino, M. Mottelson, A. Glenthøj","doi":"10.1002/jha2.980","DOIUrl":"https://doi.org/10.1002/jha2.980","url":null,"abstract":"The Danish national haemoglobinopathy screening programme offers screening to at‐risk pregnant women. Despite efforts to increase awareness of the screening programme, most women in the target population remain unscreened. In contrast, > 90% of pregnant women in Denmark attend a screening for chromosomal abnormalities by combined first‐trimester screening (cFTS).This study aimed to improve adherence to the Danish national haemoglobinopathy screening programme by offering screening to at‐risk unscreened pregnant women in relation to their cFTS.During a 27‐week intervention period, 3254 women attended cFTS at Copenhagen University Hospital—Amager Hvidovre Hospital. Of these, 938 women (28.8%) were identified as at risk of carrying haemoglobinopathy variants based on their ethnic origins. Of the 938 women at risk, 539 (57.5%) were unscreened prior to their cFTS and were targeted for the intervention. These women were contacted with an offer of haemoglobinopathy screening. Subsequently, 253/539 (46.9%) of the at‐risk unscreened women were tested for haemoglobinopathies, of these 4/253 (1.6%) carried haemoglobinopathy variants necessitating partner screening. No partners carried haemoglobinopathy variants necessitating testing of the fetus.The study increased the proportion of at‐risk pregnant women tested for haemoglobinopathies from 42.5% to 69.5% and made haemoglobinopathy screening more readily available to women attending cFTS.","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A phase 1 trial of venetoclax in combination with liposomal vincristine in patients with relapsed or refractory B‐cell or T‐cell acute lymphoblastic leukemia: Results from the ECOG‐ACRIN EA9152 protocol","authors":"Neil D. Palmisiano, Ju‐Whei Lee, David F. Claxton, E. Paietta, H. Alkhateeb, Jae Park, N. Podoltsev, Ehab L. Atallah, Dale G. Schaar, S. Dinner, Jonathan A. Webster, S. Luger, M. Litzow","doi":"10.1002/jha2.991","DOIUrl":"https://doi.org/10.1002/jha2.991","url":null,"abstract":"Relapsed or refractory (r/r) acute lymphoblastic leukemia (ALL) or lymphoblastic lymphoma (LL) remains a therapeutic challenge. Preclinical data in both B‐ and T‐ALL suggests synergy of venetoclax (VEN) with vincristine (VCR). We designed a phase I/II trial (EA9152) of the combination of L‐VCR and VEN for patients with r/r B‐or T‐cell ALL or LL. Here, we report the safety and efficacy outcomes of the phase I portion of this trial (NCT03504644).In a 3+3 dose escalation design, r/r ALL subjects were given single‐agent VEN doses reaching 400, 600, or 800 mg for the three respective dose levels. Weekly L‐VCR at 2.25 mg/m2 IV was started on D15 of cycle 1. The primary phase I objective was to determine the maximum tolerated dose (MTD) of the combination.Among the 18 patients in phase I, grade ≥ 3 treatment‐related adverse events were reported in 89% of treated patients. Two patients (two of three) at dose level 3 experienced dose‐limiting toxicities. Therefore, the MTD of the combination was determined to be dose level 2 (VEN 600 mg). Twenty‐two percent of evaluable patients (N = 4) achieved a complete response, with two of them showing no evidence of measurable residual disease (MRD).The combination of VEN and L‐VCR was found to be safe for patients with r/r ALL and encouraging preliminary efficacy, including MRD negative responses. With the removal of L‐VCR from the US market, the phase 2 portion of this trial is actively enrolling with vincristine sulfate.","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141929565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the nephrotoxic profile of BCR-ABL tyrosine kinase inhibitors: A real-world experience in Africa","authors":"Zekarias Seifu Ayalew,&nbsp;Gebeyehu Tessema Azibte,&nbsp;Fisihatsion Tadesse,&nbsp;Biruk Abate Legesse,&nbsp;Zerubabel Getahun Kiflu,&nbsp;Mahlet Tsige Weldeamanuel,&nbsp;Kibrekidusan Aynekulu Tsige,&nbsp;Bereket Abraha Molla,&nbsp;Addisu Melkie Ejigu","doi":"10.1002/jha2.988","DOIUrl":"https://doi.org/10.1002/jha2.988","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The efficacy of BCR-ABL tyrosine kinase inhibitors (TKIs) in treating chronic myelogenous leukemia and other malignancies is well-documented. However, concerns about potential nephrotoxicity have raised questions. This study, conducted at Tikur Anbesa Specialized Hospital (TASH) in Addis Ababa, Ethiopia, aimed to investigate the association between TKIs and renal toxicities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A hospital-based cross-sectional design was used to enroll 260 TASH patients actively receiving BCR-ABL TKIs. Demographic information, diagnoses, treatment details, and laboratory test results were collected for each participant's Electronic Medical Record. The primary goal was to assess adverse renal events, a combination of events of a decrease in estimated glomerular filtration rate (eGFR) exceeding 30% from baseline, significant proteinuria, and a diagnosis of acute kidney injury (AKI) or chronic kidney disease (CKD). A logistic regression model was used to analyze the data and identify factors associated with developing adverse renal events.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Our analysis revealed a statistically significant decrease in eGFR following treatment with TKIs. However, the observed rate of adverse renal events (13.1%) was lower than reported in some previous studies. Factors significantly associated with adverse renal events included longer TKI duration, male sex (protective), hypertension, HIV infection, and achieving complete molecular remission and/or a complete hematologic response. No significant associations were found with diabetes mellitus, age, angiotensin-converting enzyme inhibitors use, or baseline creatinine level.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While this study found that BCR-ABL TKIs can lead to a decline in eGFR, AKI, and CKD, it also demonstrated that they were relatively safer in our study population.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.988","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141994060","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}

{"title":"Antiphospholipid syndrome, monoclonal gammopathy, and cryoglobulinemia overlap leading to recurrent cutaneous microvascular thrombosis: A case report and retrospective cohort study","authors":"Alexandra Bohm, Bo Angela Wan, Amir Karin, Lauren J. Lee, Agnes Y. Y. Lee, Edward M. Conway, Chieh Min Benjamin Lai","doi":"10.1002/jha2.987","DOIUrl":"https://doi.org/10.1002/jha2.987","url":null,"abstract":"Antiphospholipid syndrome (APS), cryoglobulinemia, and monoclonal gammopathies are variably accompanied by thrombotic complications. We describe a patient with recurrent skin microvascular thrombosis, APS, cryoglobulinemia, marginal zone lymphoma, and IgMκ monoclonal gammopathy, responsive to chemoimmunotherapy. The cryoglobulin fraction contained the IgMκ paraprotein, while antiphospholipid antibodies (aPL) were predominantly in the cryosupernatant. A retrospective analysis of aPL‐positive patients in our institution showed that 8.1% co‐expressed monoclonal gammopathy. These overlap patients had thrombotic complications and most had recurrences. Patients with multiple gammopathies of thrombotic significance may have several autoantibodies and constitute a high‐risk group.","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141797176","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"IDH2 mutation accelerates TPO-induced myelofibrosis with enhanced S100a8/a9 and NFκB signaling in vivo","authors":"Chien-Chin Lin,&nbsp;Chi-Yuan Yao,&nbsp;Yu-Hung Wang,&nbsp;Yueh-Chwen Hsu,&nbsp;Chang-Tsu Yuan,&nbsp;Tsung-Chih Chen,&nbsp;Chia-Lang Hsu,&nbsp;Sze-Hwei Lee,&nbsp;Jhih-Yi Lee,&nbsp;Pin-Tsen Shih,&nbsp;Chein-Jun Kao,&nbsp;Po-Han Chuang,&nbsp;Yuan-Yeh Kuo,&nbsp;Hsin-An Hou,&nbsp;Wen-Chien Chou,&nbsp;Hwei-Fang Tien","doi":"10.1002/jha2.983","DOIUrl":"10.1002/jha2.983","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p><i>IDH2</i> mutation is an unfavorable prognostic factor in patients with primary myelofibrosis (PMF) but its effect on myelofibrosis (MF) remains largely unclear.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In this study, we aimed to elucidate the roles of <i>IDH2</i> mutation in the development and progression of MF by transcriptomic and molecular techniques using the <i>Idh2</i>^R172K transgenic mice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We found that thrombopoietin (TPO)-overexpressed <i>Idh2</i>^R172K (<i>Idh2</i>^R172K + TPO) mice had accelerated progression to MF, compared with TPO-overexpressed <i>Idh2-</i>wild (WT + TPO) mice, showing activation of multiple inflammatory pathways, among which nuclear factor κB (NFκB) was the most significantly enhanced. Single-cell transcriptomes of the marrow cells in early MF showed that <i>S100a8/a9</i> expression was mainly confined to neutrophil progenitors in the WT + TPO mice, but highly expressed in several types of myeloid precursor cells, including the megakaryocyte progenitors in the <i>Idh2</i>^R172K + TPO group. Furthermore, <i>Idh2</i>^R172K mice at age of 18 months had larger spleens, increased <i>S100a8/a9-Tlr4</i> expression, and elevated serum S100a8/a9 levels compared with WT mice. PMF patients with <i>IDH2</i> mutations had higher bone marrow plasma S100A8/A9 levels than those without <i>IDH2</i> mutations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Overall, our findings showed that <i>IDH2</i> mutation induced proinflammatory effects, which further exacerbated MF, as evidenced by the increase in S100a8/a9 levels and NFκB hyperactivation in <i>Idh2</i>^R172K + TPO mice.</p>\u0000 </section>\u0000 </div>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.983","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141797076","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}

{"title":"Bleeding management in type 3 von Willebrand disease with anti‐von Willebrand factor inhibitor: A literature review and case report","authors":"Aurélie Briane, V. Horvais, M. Sigaud, M. Trossaërt, Nicolas Drillaud, C. Ternisien, M. Fouassier, Antoine Babuty","doi":"10.1002/jha2.984","DOIUrl":"https://doi.org/10.1002/jha2.984","url":null,"abstract":"Treatment of type 3 von Willebrand disease by infusion of von Willebrand factor (VWF) and factor VIII (FVIII) concentrates may lead to the development of anti‐VWF antibodies, challenging haemostasis management. The systematic review of the literature presented here retrieved 15 such cases (surgery n = 11, bleeding n = 4). The heterogeneous patient management mostly involved continuous infusion of FVIII, or recombinant FVIIa together with various other strategies. Off‐label infusion of the bispecific monoclonal antibody emicizumab was prescribed in three cases and in a complex local case, ultimately well‐controlled with emicizumab. This illustrates the fact that emicizumab appears as a therapeutic option in this context of allo‐immunisation.","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141802875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world outcomes of intensive induction approaches in core binding factor acute myeloid leukemia","authors":"Alexandra E. Rojek,&nbsp;Benjamin J. McCormick,&nbsp;Joanna Cwykiel,&nbsp;Oluwatobi Odetola,&nbsp;Yasmin Abaza,&nbsp;Nhi Nai,&nbsp;Charles E. Foucar,&nbsp;Rohan K. Achar,&nbsp;Rory M. Shallis,&nbsp;Danielle Bradshaw,&nbsp;Meaghan Standridge,&nbsp;Vamsi Kota,&nbsp;Guru Subramanian Guru Murthy,&nbsp;Talha Badar,&nbsp;Anand A. Patel","doi":"10.1002/jha2.981","DOIUrl":"10.1002/jha2.981","url":null,"abstract":"<p>Core-binding factor acute myeloid leukemia (CBF-AML) is characterized by the presence of inv(16)/t(16;16) or t(8;21) and is classified as a favorable risk by the 2022 European LeukemiaNet (ELN) guidelines. The CD33-targeting antibody-drug conjugate, gemtuzumab ozogamicin (GO), is commonly added to intensive chemotherapy (IC) in CBF-AML. We sought to compare outcomes in patients treated with IC with or without GO in CBF-AML. We included 200 patients with CBF-AML treated with IC across seven academic centers. Induction treatment regimens were categorized as IC alone, IC with GO, or IC with KIT inhibitor (dasatinib or midostaurin). Median follow-up for the whole cohort was 2.5 years. Three-year overall survival (OS) was 70% and 3-year event-free survival (EFS) was 51%. Patients treated with IC with GO experienced a 3-year EFS of 50% compared to those treated with IC alone who experienced a 3-year EFS of 47%, with no statistically significant difference (<i>p</i> = 0.62). Similarly, those treated with IC with GO did not experience an improved OS compared to those treated with IC alone (<i>p</i> = 0.67). Patients treated with IC with KIT inhibitor experienced a significantly improved 3-year EFS of 85% compared to those with IC with or without GO (<i>p</i> = 0.04). We find in our study that there is no survival benefit in patients treated with IC with the addition of GO; improved EFS was seen in patients with CBF-AML treated with IC plus KIT inhibitors, consistent with outcomes noted in prospective studies utilizing this approach.</p>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.981","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141809005","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}

{"title":"Carfilzomib use in patients with relapsed/refractory multiple myeloma in France: A national retrospective cohort study","authors":"Cyrille Hulin,&nbsp;Nadia Quignot,&nbsp;Heng Jiang,&nbsp;Hakima Mechiche,&nbsp;Gaëlle Désaméricq","doi":"10.1002/jha2.946","DOIUrl":"10.1002/jha2.946","url":null,"abstract":"<p>Carfilzomib is a proteasome inhibitor that has been shown to improve progression-free survival and overall survival (OS) in patients with relapsed/refractory multiple myeloma (RRMM) [<span>1-3</span>]. In Europe, carfilzomib is approved for the treatment of patients with RRMM in combination with dexamethasone (Kd); lenalidomide and dexamethasone (KRd); and, since 2020, daratumumab and dexamethasone (D-Kd) [<span>4-6</span>]. A recent observational cohort study described the use of KRd and Kd across Europe and Israel [<span>7, 8</span>], but survival data in the real-world setting have not been reported for carfilzomib-treated patients in Europe. Using and expanding on a previous study of patients with RRMM from the Système Nationale des Données de Santé (SNDS) national claims database [<span>9</span>], this comprehensive real-world analysis describes the treatment patterns and outcomes of patients receiving carfilzomib (KRd and Kd) in France between 2016 and 2019.</p><p>Briefly, adults who were diagnosed with multiple myeloma and had received at least one dose of carfilzomib between 2014 and 2019 were included. The study design has previously been published [<span>9</span>]; this study extension had an end date of December 31, 2019. Carfilzomib became available in France in 2016 under an Authorization for Temporary Use, and then became fully available in July 2018. For each patient, data were collected on clinical characteristics and were analysed as a primary objective. Data on treatment patterns were also analysed. OS and time-to-next treatment (TTNT) were estimated in an exploratory analysis. OS was defined as the time from the start of carfilzomib treatment until death or the end of follow-up. TTNT was defined as the start of carfilzomib treatment until the initiation of the next line of treatment or death.</p><p>The database included 2471 patients treated with carfilzomib-based regimens. Clinical characteristics are presented by treatment group (KRd or Kd) and treatment line (second line [2L], third line [3L], and fourth or later lines [4L+]) in Table 1. Overall, 40% (<i>n</i> = 993) of patients received KRd. Half of patients (<i>n</i> = 497; 50%) receiving KRd initiated it as a 2L treatment, and 44%–60% had autologous stem cell transplantation (ASCT) at first line (1L). Most patients (<i>n</i> = 1478; 60%) received the Kd regimen, which was generally initiated as 4L+ (<i>n</i> = 1133; 77%). Among patients receiving Kd at 4L+, 40% had ASCT at 1L and most had previous exposure to bortezomib (98%), lenalidomide (91%), or daratumumab (60%) (Table 1).</p><p>Patients receiving KRd were followed up for a mean of 11–15 months. The median OS estimates for patients receiving KRd were 40, 39, and 16 months at 2L (<i>n</i> = 497), 3L (<i>n</i> = 203), and 4L+ (<i>n</i> = 293), respectively. For patients initiating KRd in 2018, the median TTNT was longer when carfilzomib was received at earlier lines than later lines (2L, 14 months; 3L, 11 months; 4L","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.946","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141810259","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}

{"title":"Catastrophic venous and arterial thrombosis in a young female with cervical cancer","authors":"Jordan Burgess,&nbsp;Fraser Hendry,&nbsp;Catherine Bagot,&nbsp;Brian Doherty","doi":"10.1002/jha2.973","DOIUrl":"10.1002/jha2.973","url":null,"abstract":"<p>A 31-year-old woman presented with progressive left arm, and neck swelling 2 weeks after a blood transfusion via a cannula in her left antecubital fossa, for severe menorrhagia. Imaging (Figure 1) demonstrated extensive deep vein thrombosis of the left arm extending to the skull base (top left image), extensive bilateral pulmonary emboli, and prominent, subcentimeter para-aortic and bilateral pelvic lymph nodes. The D-dimer level was significantly elevated at 46,212 ng/mL (0‒230). She was immediately started on apixaban.</p><p>Two weeks later, she presented with progressive headache and visual loss and was diagnosed with a left sigmoid sinus thrombus, a short segment occlusion of the left middle cerebral artery (bottom left image) and bilateral parieto-occipital infarction (middle left image). The strokes manifested as cortical blindness and aphasia. There were no concerns regarding the patient's compliance with apixaban; an anti-Xa apixaban level confirmed that she had taken a recent dose. The patient was switched to twice daily enoxaparin, aiming for a peak anti-Xa level of 1.0‒1.2 U/mL. Aspirin 75 mg daily was also initiated.</p><p>She was urgently investigated for possible causes of this severe prothrombotic state, including catastrophic anti-phospholipid syndrome, thrombotic thrombocytopenic purpura, myeloproliferative neoplasms, paroxysmal nocturnal hemoglobinuria, and auto-immune heparin-induced thrombocytopenia, all of which were negative. A further total body computed tomography demonstrated no change in the lymph node features but revealed new splenic and renal infarcts. On transthoracic echocardiogram, a thrombus was visible on both the tricuspid and mitral valves. In the absence of an identifiable cause, positron emission tomography was performed, demonstrating uptake in the cervix (right-sided image), para-aortic lymph nodes and peritoneal deposits. A cervical biopsy confirmed a diagnosis of metastatic cervical adenocarcinoma that was positive for high-risk human papillomavirus (HPV)45. Interestingly, cervical screening was HPV negative 20 months prior to this presentation. The patient unfortunately died shortly after commencing palliative chemotherapy.</p><p>Cancer is a hypercoagulable state associated with a sevenfold increase in venous thromboembolism; however, the association with arterial thromboembolism is less well-established [<span>1</span>]. Mucin-producing adenocarcinomas are one of the most common tumours associated with venous thromboembolism (VTE) [<span>2</span>] since mucin directly stimulates platelet activation [<span>3</span>]. Patients with cervical cancer have a higher cumulative risk of VTE as compared to the general population [<span>4</span>]. The incidence of thromboembolism has been demonstrated to be highest during chemotherapy [<span>5</span>].</p><p>Jordan Burgess wrote the paper. Fraser Hendry supplied images and performed interpretation of radiological findings. Catherine Bagot helped in writing the ","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.973","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141813039","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}

{"title":"Treatment comparison of hydroxyurea versus ruxolitinib in essential thrombocythaemia: A matched-cohort analysis","authors":"Michael R. Grunwald,&nbsp;Ellen K. Ritchie,&nbsp;Elisa Rumi,&nbsp;Albert Assad,&nbsp;J. E. Hamer-Maansson,&nbsp;Jingbo Yu,&nbsp;Tricia Kalafut,&nbsp;Evan Braunstein,&nbsp;Francesco Passamonti","doi":"10.1002/jha2.954","DOIUrl":"10.1002/jha2.954","url":null,"abstract":"<p>Hydroxyurea is the preferred first-line cytoreductive treatment for high-risk essential thrombocythaemia (ET), but many patients are intolerant or refractory to hydroxyurea. Ruxolitinib has been shown to improve symptoms in patients with ET. This post hoc analysis compared the clinical outcomes of patients with ET who received hydroxyurea only with those who switched from hydroxyurea to ruxolitinib due to intolerance/resistance to hydroxyurea. Patients with ET refractory/intolerant to hydroxyurea treated with ruxolitinib in a completed phase 2 study (HU-RUX) were propensity score matched with patients who received hydroxyurea only in an observational study (HU). Changes in leukocyte and platelet counts were reported at 6-month intervals during the 48-month follow-up. Following propensity score matching, 37 patients were included for analysis in each cohort. Mean (standard deviation [SD]) leukocyte and platelet counts at index were higher for HU-RUX versus HU (leukocyte: 9.3 [5.1] vs. 6.8 [3.1] × 10⁹/L; platelet: 1027.4 [497.8] vs. 513.9 [154.7] × 10⁹/L), both of which decreased significantly from index to 6 months through to 48 months in HU-RUX (mean [SD] change from index at 6 months—leukocyte: −1.8 [4.6] × 10⁹/L; platelet: −391.7 [472.9] × 10⁹/L; at 48 months—leukocyte: −3.8 [5.3] × 10⁹/L; platelet: −539.0 [521.8] × 10⁹/L), but remained relatively stable in HU (mean [SD] change from index at 6 months—leukocyte: 0 [1.8] × 10⁹/L; platelet: −5.7 [175.3] × 10⁹/L; at 48 months—leukocyte: −0.1 [2.7] × 10⁹/L; platelet: −6.9 [105.1] × 10⁹/L). In conclusion, these results demonstrate that switching from hydroxyurea to ruxolitinib in patients with ET who are intolerant or refractory to hydroxyurea could improve abnormal haematologic values similar to those who receive first-line hydroxyurea.</p>","PeriodicalId":72883,"journal":{"name":"EJHaem","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2024-07-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jha2.954","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141822784","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}