Hematology Commons^™

Maternal Thrombocytopenia In Pregnancy, Usha Perepu, Lori Rosenstein

Proceedings in Obstetrics and Gynecology

Thrombocytopenia is a common occurrence in pregnancy. Although pregnancy is associated with physiological changes in platelet count, several pathological conditions cause thrombocytopenia, which can have a significant impact on the mother and the baby. There are diverse etiologies for thrombocytopenia, some of which are unique to pregnancy. This review provides a detailed discussion of the diagnosis and management of the various causes of thrombocytopenia in pregnancy.

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Identifying The Health And Supportive Care Needs Of Adolescent And Young Adult Survivors Diagnosed With Cancer: A Mixed Methods Study, Elena Tsangaris

Open Access Dissertations and Theses

Purpose: Current cancer programs in Canada manage adolescents (15-18 years) under a pediatric model of care, and young adults (19-25 years) under a disease-centered model of care. Key issues arise because neither of these models adequately meets the needs of adolescents and young adults (AYA). The aim of this study is to identify health and supportive care (HSC) needs of AYA survivors with cancer. Method: A concurrent nested mixed-method design was employed. Qualitative description and a systematic literature review (SLR) were used. Medline, Cochrane Central, PubMed, PsycInfo CINAHL and EMBASE were searched from their date of inception to October 2011 ...

A 2-Step Approach To Myeloablative Haploidentical Stem Cell Transplantation With Optimized T-Cell Dosing: Early Immune Reconstitution Leads To Better Outcomes, Sameh Gaballa, Onder Alpdogan, Matthew Carabasi, Joanne Filicko, Margaret Kasner, Ubaldo E. Martinez-Outshoorn, Md, John L Wagner, Mark Weiss, Neal Flomenberg, Delores Grosso

Department of Medical Oncology Faculty Papers

We developed a 2-step approach to myeloablative haploidentical HSCT in which patients receive a large fixed dose of cyclophosphamide (CY)-tolerized T cells separately frm the HSC infusion in the hopes of accelerating post HSCT immune reconstitution (IR). The uniformity of the T cell dosing facilitates comparison of patients without (low risk) and with (high risk) active malignancy at HSCT to ascertain the impact of disease status at HSCT on IR with fewer confounding effects from conditioning or T cell dosing.

The Use Of Infliximab To Control Recurrent Cytokine Storms In Ebv-Associated Angioimmunoblastic Lymphoma And Hemophagocytic Syndrome, Sameh Gaballa, Emmanuel Besa, Onder Alpdogan

Department of Medical Oncology Faculty Papers

Introduction: Chronic active Epstein-Barr virus infection (CAEBV) has been implicated in several diseases including hemophagocytic lymphohistiocytosis (EBV-HLH) and lymphomas including Angioimmunoblastic T cell lymphoma. The exact mechanism by which EBV infection causes these complications is currently not well understood. EBV-HLH is a syndrome in which T-cells, NK cells and macrophages are aberrantly activated. Cytokine storms play a major role in cellular damage and organ dysfunction. In the event that the body is unable to clear the EBV viremia, dysregulated T, NK cells and macrophages continue to release cytokines leading to the accumulation of lymphohistiocytic infiltrates into organs and organ damage ...

Sickle Cell Pain: A Critical Reappraisal., Samir K. Ballas, Kalpna Gupta, Patricia Adams-Graves

Department of Medicine Faculty Papers

Sickle cell pain includes 3 types: acute recurrent painful crises, chronic pain syndromes, and neuropathic pain. The acute painful crisis is the hallmark of the disease and the most common cause of hospitalization and treatment in the emergency department. It evolves through 4 phases: prodromal, initial, established, and resolving. Each acute painful episode is associated with inflammation that worsens with recurrent episodes, often culminating in serious complications and organ damage, such as acute chest syndrome, multiorgan failure, and sudden death. Three pathophysiologic events operate in unison during the prodromal phase of the crisis: vaso-occlusion, inflammation, and nociception. Aborting the acute ...

Lsk Derived Lsk- Cells Have A High Apoptotic Rate Related To Survival Regulation Of Hematopoietic And Leukemic Stem Cells, Cong Peng, Yaoyu Chen, Yi Shan, Haojian Zhang, Zhiru Guo, Dongguang Li, Shaoguang Li

Open Access Articles

A balanced pool of hematopoietic stem cells (HSCs) in bone marrow is tightly regulated, and this regulation is disturbed in hematopoietic malignancies such as chronic myeloid leukemia (CML). The underlying mechanisms are largely unknown. Here we show that the Lin(-)Sca-1(+)c-Kit(-) (LSK(-)) cell population derived from HSC-containing Lin(-)Sca-1(+)c-Kit(+) (LSK) cells has significantly higher numbers of apoptotic cells. Depletion of LSK cells by radiation or the cytotoxic chemical 5-fluorouracil results in an expansion of the LSK(-) population. In contrast, the LSK(-) population is reduced in CML mice, and depletion of leukemia stem cells (LSCs; BCR-ABL-expressing HSCs) by deleting ...

A Mouse Model Of Deep Vein Thrombosis Stability: The Effect Of Direct Thrombin Inhibition, Lisa J. Saldanha

Open Access Dissertations and Theses

The effect of direction thrombin inhibition on acute deep vein thrombosis (DVT) stability has not been defined and could contribute to pulmonary embolism (PE) risk. Direct thrombin inhibitors (DTIs) effectively inhibit free and clot-bound thrombin, which could potentiate thrombus instability through disruption of platelet, fibrin, and FXIIIa stabilizing mechanisms. This could manifest as increased thrombus embolization. A clinically relevant mouse model of DVT stability could further our understanding of venous thrombosis pathophysiology and define the effect of direct thrombin inhibition on PE. We hypothesized that acute DTI administration would decrease acute DVT stability and potentially increase PE risk. Platelets were ...

Clinical Significance Of Maternal Anti-Cw Antibodies: A Review Of Three Cases And Literature, Shabneez Malik, Bushra Moiz

Department of Pathology & Microbiology

Anti Cw antibody is a low frequency immunoglobulin (IgG) against red cell antigen- Cw. It is clinically significant and may cause haemolytic disease of the newborn. Due to its low frequency, it is not included in routine antenatal antibody screening panel. The incidence of Anti Cw antibodies has not been reported in our population. Here, we describe the clinical and laboratory spectra of three pregnant women having low titres anti Cw antibodies. Fortunately, haemolytic disease of the newborn was not encountered in any case.

Electronic Strategies To Enhance Venous Thromboprophylaxis In Hospitalized Medical Patients: A Randomized Controlled Trial, Menaka Pai

Open Access Dissertations and Theses

Venous thromboembolism (VTE), which encompasses deep vein thrombosis (DVT) and pulmonary embolism (PE), is the most preventable cause of death in hospitalized patients. Due to its high mortality, morbidity, and cost, health care providers are obligated to not only effectively diagnose and treat VTE, but also to prevent it if possible. This has been reinforced by a number of national and international quality initiatives to prevent hospital-acquired VTE. Despite the existence of well-accepted clinical practice guidelines on VTE prophylaxis, 1 in 3 hospitalized medical patients receives an inappropriate VTE prophylaxis strategy. Both underuse of prophylaxis in patients with VTE risk ...

Medication Errors In The Home: A Multisite Study Of Children With Cancer, Kathleen E. Walsh, Douglas W. Roblin, Saul N. Weingart, Kathleen E. Houlahan, Barbara Degar, Amy Billett, Christopher P. Keuker, Colleen Biggins, Justin Li, Karen Wasilewski, Kathleen M. Mazor

Clinical and Translational Science Research Retreat

Context: As treatment for many illnesses shifts from the hospital to the home, medications previously managed by nurses are now managed by patients and their families. Oral chemotherapy and other cancer-related medications are commonly administered to children with cancer at home by their parents.

Objective: To describe the types of errors occurring in the home medication management of children with cancer.

Design: In a prospective observational study at three pediatric oncology clinics in the Northeast and Southeast US, patients undergoing chemotherapy and their parents were recruited from 11/2007-4/2011. We reviewed medical records and checked prescription doses. A trained ...