Seminars in hematology
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Seminars in hematology · Jan 2013
Review Historical ArticleAdvanced and relapsed/refractory Hodgkin lymphoma: what has been achieved during the last 50 years.
During the last 50 years there has been great progress in understanding the biology of Hodgkin disease, which is now called Hodgkin lymphoma (HL), since it has been definitely shown to be a lymphoid neoplasm and its B-cell origin has been documented in the vast majority of cases. Progress in biology has also resulted in the identification of numerous biological prognostic factors, which may facilitate the definition of high-risk groups of patients and provide guidance for individualized therapy. Unfortunately, biological prognostic factors have not been incorporated in prognostic models applicable in everyday practice and need prospective validation. ⋯ Furthermore, better understanding of the biology of HL has permitted the development of targeted therapy. Anti-CD30 targeting with brentuximab vedotin (BV) was the first targeted therapy to be approved for relapsed/refractory HL, either after autologous stem cell transplantation (auto-SCF) failure or after failure of two regimens in patients who were not candidates for transplant. Hopefully, the determination of the optimal role and timing of BV treatment and the development and approval of other targeted compounds will further improve the outcome of advanced stage as well as relapsed/refractory HL.
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Seminars in hematology · Jan 2013
ReviewIndividualized treatment for immune thrombocytopenia: predicting bleeding risk.
Treatment of patients with immune thrombocytopenia (ITP) is often directed at increasing the platelet count and preventing significant hemorrhage even when there is minimal bleeding present. This approach, however, requires that a large number of patients receive prophylactic treatment to prevent major bleeding events. Identification of initial risk factors for development of severe bleeding would allow for more directed and personalized therapy. This review provides a summary of the current literature with the intent to explore various clinical and laboratory risk factors for severe bleeding including mucosal bleeding, platelet count, and aspects of platelet function.
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Seminars in hematology · Jan 2012
ReviewQuality of life, social challenges, and psychosocial support for long-term survivors after allogeneic hematopoietic stem-cell transplantation.
Over the last two decades quality of life (QoL) and the social challenges of allogeneic hematopoietic stem cell transplant (allo-HSCT) survivors have been emerging as subjects of extensive research and are now considered as very important aspects in the pretransplant evaluation and management of allo-HSCT recipients. Recognition of QoL challenges in allo-HSCT survivors allows timely interventions leading to improvement of post-transplant outcomes. It needs to be recognized that long-lasting life changes associated with survivorship after allo-HSCT also significantly affect QoL of partners of allo-HSCT survivors. Currently, resources should be focused on how research findings can be used by patients, their partners, and physicians to optimize QoL and psychosocial adjustment.
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Seminars in hematology · Oct 2011
ReviewPregnancy-associated venous thromboembolism: prevention and treatment.
Pregnancy is associated with an increased risk of venous thromboembolism (VTE) and this condition remains an important cause of maternal morbidity and mortality. The use of anticoagulant therapy for treatment and prophylaxis of VTE during pregnancy is challenging because of the potential for fetal, as well as maternal, complications. Although evidence-based recommendations for the use of anticoagulants have been published, given the paucity of available data, guidelines are based largely upon observational studies and from data in nonpregnant patients. This article reviews the available literature and provides guidance for the management and prevention of VTE during pregnancy.
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Multiple myeloma (MM) is consistently preceded by its pre-malignant states, monoclonal gammopathy of undetermined significance (MGUS) and/or smoldering multiple myeloma (SMM). By definition, precursor conditions do not exhibit end-organ disease (anemia, hypercalcemia, renal failure, skeletal lytic lesions, or a combination of these). However, new imaging methods are demonstrating that some patients in the MGUS or SMM category are exhibiting early signs of MM. ⋯ Also various imaging techniques have been used to provide an assessment of bone involvement and identify extra-osseous disease. This review emphasizes the current state of the art and emerging imaging methods, which may help to better define high-risk versus low-risk MGUS/SMM. Ultimately, improved imaging could allow more tailored clinical management, and, most likely play an important role in the development of future treatment strategies for high-risk precursor disease.