Open journal of hematology最新文献

{"title":"Making Allogeneic Bone Marrow Transplantation Available to Patients in Developing Countries: The Mexican Experience","authors":"G. Ruiz-Argüelles, D. Gómez-Almaguer","doi":"10.2174/1874276900802010067","DOIUrl":"https://doi.org/10.2174/1874276900802010067","url":null,"abstract":"Non-myeloablative allogeneic stem cell transplantation (NST) has been one of the most exciting developments in the treatment of hematologic malignancies in the last years. Since 1999, we have chosen to employ in Mexico a regi- men to conduct NST, introducing some changes with the main goal of decreasing the cost of the procedure and in turn, making it available to a larger number of patients in developing countries. Using this method we have done over 400 al- lografts in Latin American patients with different both malignant and non-malignant diseases: Chronic myelogenous leu- kemia, acute myelogenous leukemia, acute lymphoblastic leukemia, myelodysplasia, thalassemia major, relapsed Hodg- kins disease, Blackfan-Diamond syndrome, adrenoleukodystrophy, Hunters syndrome, aplastic anemia and several solid tumors. In the whole group, the median granulocyte recovery time to 0.5 x 10 9 /L was 13 days, whereas the median platelet recovery time to 20 x 10 9 /L was 12 days. Around one third of the patients did not need red blood cell transfusions and also one third did not need platelet transfusions. In more than 70% of cases the procedure could be completed totally on an outpatient basis. The follow up time of the patients ranges between 30 and 2000 days. Approximately 50% of the al- lografted individuals have developed acute graft versus host disease (GVHD), whereas around 30% developed chronic GVHD. The median post-allograft overall survival (SV) has not been reached and the 2000 day overall SV is 54%, the 100-day mortality being 16%. In the whole group of patients, the median cost of each NST was 18 000 USD, a figure which contrasts with that informed from developing countries. More than 95% of the patients who were allografted in Mexico and Latin America using this method could not have afforded the cost of a conventional or more expensive stem cell transplant; accordingly, this procedure has enabled doctors in Mexico and Latin America to offer this therapeutic ap- proach to a larger number of individuals.","PeriodicalId":89702,"journal":{"name":"Open journal of hematology","volume":"414 1","pages":"67-73"},"PeriodicalIF":0.0,"publicationDate":"2008-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84894239","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":"The Evaluation of the Efficacy of Oxygent® as an Oxygen-Carrying Substitute on Cerebral Blood Flow","authors":"Chrystal D. Price, N. El-Badri, D. Haas, Rafael E. Chaparro, D. Mangar, E. Camporesi","doi":"10.2174/1874276900802010062","DOIUrl":"https://doi.org/10.2174/1874276900802010062","url":null,"abstract":"Cerebral blood flow (CBF) is tightly regulated to meet metabolic demands, and it increases during hemodilu- tion as arterial oxygen content (CaO2) falls. Oxygent® is a perfluorocarbon (PFC) emulsion that has a high capacity to dissolve oxygen and can thus increase CaO2 in patients breathing supplemental oxygen. PFCs have shown excellent oxy- gen therapeutic value in both phase II and phase III clinical trials. However, the effects of Oxygent® on CBF in hemodilu- tion are unknown. We performed this study to investigate how Oxygent® alters CBF in rats undergoing stepwise iso- volumetric hemodilution under isoflurane anesthesia with 100% oxygen ventilation. In vivo Laser Doppler Flow (LDF) probes measured CBF as blood was gradually replaced with equal volumes of either 5%Albumin (controls) or (1:1) PFC and Albumin. Hematocrit and blood gases were measured and CaO2 calculated after each dilution. Target values were to achieve a hematocrit value of 10% and fluorocrit between 7.5-10%. We compared CBF in the Oxygent® vs. control group at decreasing levels of hematocrit and CaO2 with repeated t-tests. At hematocrits less than 15%, CBF rate approached baseline in the Oxygent® group, and was lower than the control group (p = 0.004). At maximal hemodilution, Oxygent® treated rats also showed higher PaO2 (p < 0.001) and required lower phenylephrine infusion rates to maintain blood pres- sure (p = 0.002). These data support that administration of Oxygent® improves tissue oxygenation during hemodilution.","PeriodicalId":89702,"journal":{"name":"Open journal of hematology","volume":"151 1","pages":"62-66"},"PeriodicalIF":0.0,"publicationDate":"2008-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79859219","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":"Endothelial Progenitor Cells Significantly Contribute to Vasculatures in Human and Mouse Breast Tumors","authors":"J. Chizea, V. Dailey, E. Williams, Michael D. Johnson, R. Pestell, J. Ojeifo","doi":"10.2174/1874276900802010030","DOIUrl":"https://doi.org/10.2174/1874276900802010030","url":null,"abstract":"The development of blood supply is crucial to the growth and progression of breast tumors. However, the contribution and role of endothelial progenitor cells (EPCs) in blood vessel formation in human breast tumors is undefined. Here, we demonstrate for the first time that ~68% of the cells integrated into vasculatures in late stage human breast tumors express CD34 and CD133 (the putative EPC markers). We also demonstrate that metastatic human breast cancer and mouse mammary gland carcinomas (MGCas) aberrantly express granulocyte colony-stimulating factor (G-CSF). Inhibition of the MGCa-derived G-CSF significantly decreased the numbers of EPCs in circulation and tumor vasculatures, as well as microvascular density and growth of transplanted MGCa in mice. These results indicate that EPCs may significantly contribute to blood vessel formation in advanced stage, G-CSF-expressing breast tumors and that patients with GCSF-producing breast tumors may benefit from angiotherapeutic protocols that inhibit G-CSF-mediated neovascularization.","PeriodicalId":89702,"journal":{"name":"Open journal of hematology","volume":"33 1","pages":"30-61"},"PeriodicalIF":0.0,"publicationDate":"2008-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86265629","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":"Clinical Evaluation of Platelet Concentrates Either in Plasma or in Additive Solution","authors":"L. Larrea, N. Carpio, C. Arbona, Soler Ma, J. Rubia, R. Roig","doi":"10.2174/1874276900802010025","DOIUrl":"https://doi.org/10.2174/1874276900802010025","url":null,"abstract":"Background and Objectives. Platelet concentrates (PC) obtained from Buffy-Coat (BC) may be diluted in a platelet additive solution (PAS). These PCs may reduce plasma-related adverse reactions. We have tried to assess the rela- tionship between PAS PCs and adverse reactions. Materials and Methods. During 6 months, patients treated with inten- sive chemotherapy, participated in a prospective study and were randomly assigned to receive, on a prophylactic basis, PCs in either plasma or PAS-2. Five iso-group BCs were pooled diluted in either plasma or PAS-2. One hour after each transfusion, corrected count increments (CCIs) were calculated, presence of hemorrhage and adverse reactions were re- corded. Results. Platelet increment, 1-hour platelet count, and corrected count increments (CCI) after transfusion in both groups were similar. There were more transfusion- dependent adverse reactions in plasma group. Conclusion. Use of PAS-2 resulted in less transfusion related reactions; therefore, we recommend synthetic additive solutions to dilute PCs. BACKGROUND AND OBJECTIVES Bleeding in a number of acute and chronic conditions that require medical and surgical treatment may be prevented and treated with platelet transfusions (1). Prophylactic plate- let concentrate (PC) transfusions in patients with severe thrombocytopenia have increased over the last years due to more frequent and more intensive radiations and chemother- apy treatments. PC may be obtained from whole blood col- lected into a multiple plastic bag set. The procedures for the preparation of PC from whole blood donations are the buffy- coat (BC) and the platelet-rich plasma (PRP) methods. The former one is performed in Europe and the latter in North America and in several European countries. PCs obtained from BC may be diluted in autologous plasma or in a platelet additive solution (PAS). The use of a synthetic medium re- duces the plasma content in every PC and therefore may re- duce plasma-related adverse reactions. We have performed a prospective clinical trial trying to assess the relationship be- tween PAS PCs, adverse reactions and their clinical effec- tiveness.","PeriodicalId":89702,"journal":{"name":"Open journal of hematology","volume":"2 1","pages":"25-29"},"PeriodicalIF":0.0,"publicationDate":"2008-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77370666","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":"Hemophilia: A High Cost Low Volume Disease: Suitable Preventive Strategies for Developing and Developed Countries","authors":"K. Ghosh, S. Shetty, Kinjalka Ghosh","doi":"10.2174/1874276900802010020","DOIUrl":"https://doi.org/10.2174/1874276900802010020","url":null,"abstract":"Hemophilia A & B are congenital bleeding disorders affecting 1:10-20,000 population and 1:20 to 40,000 population respectively. Hemophilia represents the prototype of high cost low volume disease. Eighty persons of world hemophilia population lives in financially poor developing countries, where <2% of GDP is usually spent for total health care. In India, with a population of more than 1 billion and growth rate of around 2% atleast 2000 new hemophilia patients are born every year . On a conservative estimate 50% of them have severe disease and with modern treatment, will require additional USD 36,000/year/patient i.e a 36 million dollar incremental additional health care burden each year to manage these 1000 severe hemophilia patient. Which is added to our existing pool of haemophiliacs, estimated at 1,00,000- 1,20,000. One of the ways to manage this challenge is to establish prenatal diagnostic centres, for hemophilia, spread widely for easy accessibility. These diagnostic centers can eventually develop into prenatal diagnosis centres for other diseases like common hemoglobinopathies and they should be equipped with modest molecular diagnostic facilities. Presently there are a series of techniques of different levels of difficulties and complexities, available for foetal tissue sampling and laboratory detection of prenatal diagnosis of hemophilia, allowing a centre to chose the technology suitable for their expertise and financial capability.","PeriodicalId":89702,"journal":{"name":"Open journal of hematology","volume":"17 1","pages":"20-24"},"PeriodicalIF":0.0,"publicationDate":"2008-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82092660","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":"Prevalence and Risk Factors of Anaemia Among Pregnant women in Nigeria","authors":"F. Buseri, Uko Ek, Zaccheaus Awortu. Jeremiah, E. A. Usanga","doi":"10.2174/1874276900802010014","DOIUrl":"https://doi.org/10.2174/1874276900802010014","url":null,"abstract":"To assess the prevalence and risk factors of anaemia in pregnancy and recommend a cut-off value for antenatal women in developing countries, a cross sectional study was carried in the University of Port Harcourt Teaching Hospital, Port Harcourt, a 523 bed tertiary health care institution in Nigeria. 1371 apparently healthy asymptomatic pregnant women visiting the antenatal clinic for the first time were enrolled for the study. Another 60 age-matched non-pregnant apparently healthy women served as controls. Haemoglobin concentration, malaria, human immunodeficiency virus (HIV)S, haemoglobin electrophoretic pattern and C-reactive protein as marker of infection were investigated using stan- dard haematological and serological procedures. Anaemia in pregnancy (Hb <11.0g/dl) and (Hb<10.0g/dl) were found to be 23.2% and 6.7% respectively. The aetiology of anaemia was found to be multifactorial; 40.2% had anaemia of infec- tion, 20.3% had Plasmodium falciparum alone, 8.5% had HIV alone, 2.5% had HIV and malaria parasite co-infection; 8.9% undetermined infections and 0.6% had sickle cell anaemia. There is moderate prevalence of anaemia in pregnancy in this part of the world. Since the mean Hb value of the pregnant women in this study was 11.62±1.21g/dl and the pregnant women with Hb values around 10g/dl are apparently healthy, a cut-off value of 10.0g/dl may be considered ideal for de- fining anaemia in pregnancy in developing countries.","PeriodicalId":89702,"journal":{"name":"Open journal of hematology","volume":"13 1","pages":"14-19"},"PeriodicalIF":0.0,"publicationDate":"2008-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81907255","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":"Understanding Beta-Thalassemia with Focus on the Indian Subcontinent and the Middle East","authors":"P. Lahiry, S. Al-Attar, R. Hegele","doi":"10.2174/1874276900802010005","DOIUrl":"https://doi.org/10.2174/1874276900802010005","url":null,"abstract":"Beta-thalassemia is one of the most prevalent autosomal disorders in the world. Mutations in the HBB gene un- derlie deficiencies in hemoglobin production, which can interfere with oxygen delivery resulting in wide range of disease severity. Although >535 mutations have been characterized in the HBB gene, beta-thalassemia is broadly classified into three groups, based on clinical severity: beta-thalassemia major, beta-thalassemia intermedia and beta-thalassemia minor. In this article we review: 1) the molecular and biochemical basis of beta-thalassemia; 2) clinical features; 3) the range of common molecular variants of beta-thalassemia in a subset of geographic regions within the Indian Subcontinent and the Middle East; 4) potential molecular diagnostics; and 5) current and future treatments. We suggest that efforts to more completely characterize the HBB mutation distribution in high-risk areas, such as the Indian Subcontinent and the Middle East, may lead to improved diagnosis with earlier and more effective intervention strategies.","PeriodicalId":89702,"journal":{"name":"Open journal of hematology","volume":"37 1","pages":"5-13"},"PeriodicalIF":0.0,"publicationDate":"2008-01-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87211945","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":"Gender-Specific Distribution of Hematological Parameters in Adults Living in Nouna, Burkina Faso","authors":"T. Böhler, G. Kynast‐Wolf, B. Coulibaly, A. Sié, A. Kapaun","doi":"10.2174/1874276900802010001","DOIUrl":"https://doi.org/10.2174/1874276900802010001","url":null,"abstract":"We examined the distribution of hematological parameters in 186 adults (89 female, 97 male) living in Nouna, Burkina Faso. Median (5 th - 95 th percentile) hemoglobin concentration was 12.6 (10.3-15.3) g/dl, which was lower than reported from other populations in Africa. Iron deficiency may be the most important reason for this observation.","PeriodicalId":89702,"journal":{"name":"Open journal of hematology","volume":"434 14","pages":"1-4"},"PeriodicalIF":0.0,"publicationDate":"2008-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"72505844","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":"The Immunological Dilemma: Cellular Innate and Adaptive Immune Response Versus Human Acute Myeloid Leukemia","authors":"Elisabeth Ersvær, A. Olsnes, Ø. Bruserud","doi":"10.2174/1874276900701010001","DOIUrl":"https://doi.org/10.2174/1874276900701010001","url":null,"abstract":"It is generally accepted that acute myelogenous leukemia (AML) patients are immunocompromized. On the other hand, antileukemic immune reactivity is important for the improved survival of AML patients treated with alloge- neic stem cell transplantation and antileukemic immunotherapy is also considered for patients treated with conventional chemotherapy. In this article, we review the available studies of disease- and therapy- induced immune dysfunctions in AML patients, including the function of the cellular innate and adaptive immune system of AML patients (i) with newly diagnosed disease before treatment, (ii) immunological functions of AML patients with severe therapy induced cytopenia before hematopoietic reconstitution; and (iii) the immune reconstitution following the initial period of hematopoietic re- constitution after autologous and allogeneic stem cell transplantation. A more detailed knowledge about the immune sys- tems of these patients is essential for an optimal design of future clinical immunotherapy studies in AML.","PeriodicalId":89702,"journal":{"name":"Open journal of hematology","volume":"2 1","pages":"1-14"},"PeriodicalIF":0.0,"publicationDate":"2007-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76722057","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}