Monoclonal gammopathy: The good, the bad and the ugly
Monoclonal gammopathy of undetermined significance (MGUS) is a condition characterized by the presence of a monoclonal gammopathy (MG) in which the clonal mass has not reached a predefined state in which the condition is considered malignant. It is a precursor to conditions such as multiple myeloma or lymphoma at a rate of ~1%/year. Thus, from a hematologic standpoint, MGUS is a fairly benign condition. However, it is now recognized that organ damage resulting from just the MG without the need MM or lymphoma can occur. (Source: Blood Reviews)
Source: Blood Reviews - December 17, 2015 Category: Hematology Authors: Siobhan V. Glavey, Nelson Leung Tags: Review Source Type: research
Cross-talk between platelet and tumor microenvironment: Role of multiligand/RAGE axis in platelet activation
While platelets are well known to play a central role in hemostasis and thrombosis, there is emerging experimental evidence to suggest that they also mediate tumor cell growth, angiogenesis and metastasis. The receptor for advanced glycation end products (RAGE) has been extensively reported in many tumor types and initiates a downstream proinflammatory signaling cascade. RAGE ligands are expressed and secreted by tumor cells and are associated with poorer outcomes in a wide variety of tumors. In addition RAGE has been identified on human platelets and RAGE ligands may contribute to platelet activation. (Source: Blood Reviews)
Source: Blood Reviews - December 16, 2015 Category: Hematology Authors: Eduardo Fuentes, Iván Palomo, Armando Rojas Tags: REVIEW Source Type: research
Swallowing a bitter pill–oral arsenic trioxide for acute promyelocytic leukemia
Parenteral arsenic trioxide (ATO) has been firmly established as a standard therapy for acute promyelocytic leukemia (APL). Despite widespread use of oral arsenicals in medicine historically, they had disappeared from modern pharmacopeia until oral ATO was redeveloped in Hong Kong in 2000. Since then, over 200 patients with leukemia (predominantly APL) have been treated with oral ATO in Hong Kong and China. Oral arsenic trioxide and other formulations of arsenic appear to have a clinical efficacy comparable to that of IV formulations. (Source: Blood Reviews)
Source: Blood Reviews - December 3, 2015 Category: Hematology Authors: Pallawi Torka, Omar Al Ustwani, Meir Wetzler, Eunice S. Wang, Elizabeth A. Griffiths Tags: Review Source Type: research
A promising sword of tomorrow: Human γδ T cell strategies reconcile allo-HSCT complications
Allogeneic hematopoietic stem cell transplantation (Allo-HSCT) is potentially a curative therapeutic option for hematological malignancies. In clinical practice, transplantation associated complications greatly affected the final therapeutical outcomes. Currently, primary disease relapse, graft-versus-host disease (GVHD) and infections remain the three leading causes of a high morbidity and mortality in allo-HSCT patients. Various strategies have been investigated in the past several decades including human γδ T cell-based therapeutical regimens. (Source: Blood Reviews)
Source: Blood Reviews - November 25, 2015 Category: Hematology Authors: Yongxian Hu, Qu Cui, Chao Luo, Yi Luo, Jimin Shi, He Huang Tags: REVIEW Source Type: research
Immune checkpoint blockade: Releasing the brake towards hematological malignancies
Tumor cells utilize co-inhibitory molecules to avoid host immune destruction. Checkpoint blockade has emerged as a promising approach to treat cancer by restoring T cell effector function and breaking a tumor permissive microenvironment. Patients with hematological malignancies often have immune dysregulation, thus the role of checkpoint blockade in treatment of these neoplasms is particularly intriguing. In early trials, antibodies targeting cytotoxic T lymphocyte antigen 4 (CTLA-4) or the programmed death 1 (PD-1) signaling pathway have displayed significant efficacy with minimal toxicity in patients with relapsed/refrac...
Source: Blood Reviews - November 25, 2015 Category: Hematology Authors: Yi Xia, L. Jeffrey Medeiros, Ken H. Young Tags: REVIEW Source Type: research
Maximizing anthracycline tolerability in hematologic malignancies: Treat to each heart's content
Anthracyclines are the cornerstone of therapy for a wide spectrum of malignancies and have improved patient survival. Concern for anthracycline-related cardiotoxicity often leads to dose reductions or use of second-line regimens, which may adversely impact survival. Development of cardiotoxicity depends on a combination of cumulative dose modulated by individual patient characteristics, which we have termed individual cardiotoxic threshold (ICT). Patients with cancer often have characteristics such as age, gender, genetic predisposition and preexisting cardiovascular disease that can potentiate cardiotoxicity. (Source: Blood Reviews)
Source: Blood Reviews - November 6, 2015 Category: Hematology Authors: Guilherme H. Oliveira, Sadeer G. Al-Kindi, Paolo F. Caimi, Hillard M. Lazarus Tags: Review Source Type: research
Potential diagnostic markers for disseminated intravascular coagulation of sepsis
Disseminated intravascular coagulation (DIC) is an acquired thrombo-haemorrhagic disorder which arises in clinical scenarios like sepsis, trauma and malignancies. The clinic-laboratory diagnosis of DIC is made in a patient who develops the combination of laboratory abnormalities in the appropriate clinical scenario. The most common laboratory parameters in this setting have been the clotting profile, platelet count, serum fibrinogen and fibrin degradation markers. These tests had the advantage that they could be performed easily and in most laboratories. (Source: Blood Reviews)
Source: Blood Reviews - November 5, 2015 Category: Hematology Authors: Toshiaki Iba, Takashi Ito, Ikuro Maruyama, Bernd Jilma, Thorsten Brenner, Marcella C.A. Müller, Nicole P. Juffermans, Jecko Thachil Tags: REVIEW Source Type: research
Chimeric antigen receptor T cell therapy: 25years in the making
Chimeric antigen receptor (CAR) T cell therapy of cancer is generating enormous enthusiasm. Twenty five years after the concept was first proposed, major advances in molecular biology, virology and good manufacturing practices (GMP)-grade cell production have transformed antibody-T cell chimeras from a scientific curiosity to a fact of life for academic cellular immunotherapy researchers and increasingly, for patients. In this review we explain the preclinical concept, outline how it has been translated to the clinic and draw lessons from the first years of CAR T cell therapy for the practicing clinician. (Source: Blood Reviews)
Source: Blood Reviews - November 5, 2015 Category: Hematology Authors: Saar Gill, Marcela V. Maus, David L. Porter Tags: REVIEW Source Type: research
Vaccinations in patients with hematological malignancies
Patients with hematological malignancies are at risk for a number of infections that are potentially preventable by vaccinations such as pneumococcal infections and influenza. Treatment, especially with anti-B-cell antibodies and hematopoietic stem cell transplantation (HSCT), negatively impacts the response to vaccination for several months. It is therefore recommended that patients be vaccinated before initiating immunosuppressive therapy if possible. The risk of side-effects with inactivated vaccines is low, but care has to be taken with live vaccines, such as varicella-zoster virus vaccine, since severe and fatal compl...
Source: Blood Reviews - November 2, 2015 Category: Hematology Authors: C. Tsigrelis, P. Ljungman Tags: Review Source Type: research
The post thrombotic syndrome: Ignore it and it will come back to bite you
Post thrombotic syndrome (PTS) is a very common chronic complication of deep venous thrombosis (DVT), as three out of ten patients with lower extremity DVT will develop PTS. The possibility to identify patients at risk is limited. Diagnosis is challenging, because there is no gold standard diagnostic method. Progress in diagnostic options may therefore change future diagnostic strategies. The better understanding of pathophysiologic processes that underlie PTS may stimulate the development of treatment modalities and improve and diversify management options. (Source: Blood Reviews)
Source: Blood Reviews - October 5, 2015 Category: Hematology Authors: Arina J. ten Cate-Hoek, Peter K. Henke, Thomas W. Wakefield Source Type: research
The post thrombotic syndrome: Ignore it and it will come back to bite you!
Post Thrombotic Syndrome (PTS) is a very common chronic complication of deep venous thrombosis (DVT), as three out of ten patients with lower extremity DVT will develop PTS. The possibility to identify patients at risk is limited. Diagnosis is challenging, because there is no gold standard diagnostic method. Progress in diagnostic options may therefore change future diagnostic strategies. The better understanding of pathophysiologic processes that underlie PTS may stimulate the development of treatment modalities and improve and diversify management options. (Source: Blood Reviews)
Source: Blood Reviews - October 5, 2015 Category: Hematology Authors: Arina J. ten Cate-Hoek, Peter K. Henke, Thomas W. Wakefield Source Type: research
Fishing the targets of myeloid malignancies in the era of Next Generation Sequencing
Recent advent in next generation sequencing (NGS) and bioinformatics has generated an unprecedented amount of genetic information in myeloid malignancies. This information may shed lights to the pathogenesis, diagnosis and prognostication of these diseases and provide potential targets for therapeutic intervention. However, the rapid emergence of genetic information will quickly outpace their functional validation by conventional laboratory platforms. Foundational knowledge about zebrafish hematopoiesis accumulated over the past two decades and novel genome editing technologies and research strategies in this model organis...
Source: Blood Reviews - September 11, 2015 Category: Hematology Authors: Xiangguo Shi, Bai-Liang He, Alvin C.H. Ma, Anskar Y.H. Leung Tags: Review Source Type: research
The role of blood rheology in sickle cell disease
Studies performed in the last decades have highlighted the need to better understand the contribution of the endothelium, vascular function, oxidative stress, inflammation, coagulation, hemolysis and vascular adhesion mechanisms to the pathophysiology of acute vaso-occlusive like events and chronic organ damages in sickle cell disease (SCD). Although SCD is a hemorheological disease, a few works focused on the contribution of blood viscosity, plasma viscosity, red blood cell deformability and aggregation in the pathophysiology of SCD. (Source: Blood Reviews)
Source: Blood Reviews - August 25, 2015 Category: Hematology Authors: Philippe Connes, Tamas Alexy, Jon Detterich, Marc Romana, Marie-Dominique Hardy-Dessources, Samir K. Ballas Tags: REVIEW Source Type: research
Monoclonal antibodies — A new era in the treatment of multiple myeloma
Monoclonal antibodies (mAbs) are currently the most investigated therapeutic compounds in oncology, but there is no monoclonal antibody approved in the treatment of multiple myeloma (MM). Nevertheless several really promising molecules are under investigation in phase III clinical trials. Dominantly daratumumab (anti-CD38) and elotuzumab (anti-CS1) showed extraordinary effectiveness in phase I/II trials. The toxicity was acceptable which is important for their addition to standard anti-myeloma agents like proteasome inhibitors or immunomodulatory drugs. (Source: Blood Reviews)
Source: Blood Reviews - August 24, 2015 Category: Hematology Authors: Tomas Jelinek, Roman Hajek Tags: Review Source Type: research
Monoclonal antibodies - a new era in the treatment of multiple myeloma
Monoclonal antibodies (mAbs) are currently the most investigated therapeutic compounds in oncology, but there is no monoclonal antibody approved in the treatment of multiple myeloma (MM). Nevertheless several really promising molecules are under investigation in phase III clinical trials. Dominantly daratumumab (anti-CD38) and elotuzumab (anti-CS1) showed extraordinary effectiveness in phase I/II trials. The toxicity was acceptable which is important for their addition to standard anti-myeloma agents like proteasome inhibitors or immunomodulatory drugs. (Source: Blood Reviews)
Source: Blood Reviews - August 24, 2015 Category: Hematology Authors: Tomas Jelinek, Roman Hajek Tags: Review Source Type: research
