Hematology Reports

2 pages, 959 KiB

Open AccessCase Report

Therapeutic Innovation for Multi-Resistant Candidemics: Synergy of Isavuconazole and Caspofungin Association

by Andrea Duminuco, Elisa Mauro, Giuseppe A. M. Palumbo, Bruno Garibaldi, Marina Parisi, Francesco Di Raimondo, Cinzia Maugeri and Calogero Vetro

Hematol. Rep. 2021, 13(4), 9329; https://0-doi-org.brum.beds.ac.uk/10.4081/hr.2021.9329 - 26 Nov 2021

Cited by 1 | Viewed by 972

Abstract

Fungal infections occurring in immunocompromised patients after immuno-chemotherapy treatment, are often difficult to eradicate and capable of even being fatal. Systemic mycoses affecting severely immunocompromised patients often manifest acutely with rapidly progressive pneumonia, fungemia, or manifestations of extrapulmonary dissemination. Opportunistic fungal infections (mycoses) [...] Read more.

Fungal infections occurring in immunocompromised patients after immuno-chemotherapy treatment, are often difficult to eradicate and capable of even being fatal. Systemic mycoses affecting severely immunocompromised patients often manifest acutely with rapidly progressive pneumonia, fungemia, or manifestations of extrapulmonary dissemination. Opportunistic fungal infections (mycoses) include several pathogens elements, as Candidiasis, Aspergillosis, Mucormycosis (zygomycosis) and Fusariosis. Prompt diagnosis and effective therapy are needed to improve the associated morbidity and mortality, especially in cases with non-canonical fungal localizations and not responsive to the available antifungal drugs. Full article

6 pages, 1294 KiB

Open AccessReview

Direct Oral Anticoagulants: A Review for the Non-Specialist

by Thilina Gunawardena

Hematol. Rep. 2021, 13(4), 9239; https://0-doi-org.brum.beds.ac.uk/10.4081/hr.2021.9239 - 26 Nov 2021

Cited by 2 | Viewed by 960

Abstract

Thrombin inhibitors and direct factor Xa inhibitors represent a major breakthrough in the field of anticoagulation pharmacotherapy. These novel agents have replaced warfarin as the oral anticoagulant of choice in certain indications, as they possess equal or superior efficacy and better safety profiles. [...] Read more.

Thrombin inhibitors and direct factor Xa inhibitors represent a major breakthrough in the field of anticoagulation pharmacotherapy. These novel agents have replaced warfarin as the oral anticoagulant of choice in certain indications, as they possess equal or superior efficacy and better safety profiles. They have a quick onset of action, predictable pharmacokinetic properties and minimal drug and food interactions. So they do not require frequent blood monitoring and dose adjustments as with warfarin. Considering all the advantages, there seems to be a rapid increase in the number of patients who are started on these novel anticoagulants. In this review, we highlight the pharmacology of these direct oral anticoagulants and the evidence-based indications for their use. We aim to provide a clinical overview for the non-specialist who may be called upon to manage a patient who is currently on one of these novel anticoagulants. Full article

5 pages, 3339 KiB

Open AccessArticle

Lysine-Specific Histone Demethylase 1 Inhibition Enhances Robust Fetal Hemoglobin Induction in Human β⁰-Thalassemia/Hemoglobin E Rrythroid Cells

by Woratree Kaewsakulthong, Phitchapa Pongpaksupasin, Tiwaporn Nualkaew, Suradej Hongeng, Suthat Fucharoen, Natee Jearawiriyapaisarn and Orapan Sripichai

Hematol. Rep. 2021, 13(4), 9215; https://0-doi-org.brum.beds.ac.uk/10.4081/hr.2021.9215 - 26 Nov 2021

Cited by 3 | Viewed by 1061

Abstract

Induction of fetal hemoglobin (HbF) ameliorates the clinical severity of β-thalassemias. Histone methyltransferase LSD1 enzyme removes methyl groups from the activating chromatin mark histone 3 lysine 4 at silenced genes, including the γ-globin genes. LSD1 inhibitor RN-1 induces HbF levels in cultured human [...] Read more.

Induction of fetal hemoglobin (HbF) ameliorates the clinical severity of β-thalassemias. Histone methyltransferase LSD1 enzyme removes methyl groups from the activating chromatin mark histone 3 lysine 4 at silenced genes, including the γ-globin genes. LSD1 inhibitor RN-1 induces HbF levels in cultured human erythroid cells. Here, the HbF-inducing activity of RN-1 was investigated in erythroid progenitor cells derived from β⁰-thalassemia/HbE patients. The significant and reproducible increases in γ-globin transcript and HbF expression upon RN-1 treatment was demonstrated in erythroid cells with divergent HbF baseline levels, the average of HbF induction was 17.7 + 0.8%. RN-1 at low concentration did not affect viability and proliferation of erythroid cells, but decreases in cell number was observed in cells treated with RN-1 at high concentration. Delayed terminal erythroid differentiation was revealed in β⁰-thalassemia/HbE erythroid cells treated with RN-1 as similar to other compounds that target LSD1 activity. Downregulation of repressors of γ-globin expression; NCOR1 and SOX6, was observed in RN-1 treatment. These findings provide a proof of concept that a LSD1 epigenetic enzymes is a potential therapeutic target for β⁰-thalassemia/HbE patients. Full article

5 pages, 398 KiB

Open AccessArticle

Impact of Pharmacokinetics to Reduce Bleeding in a Cohort of Patients with Severe Hemophilia A in a Personalized Comprehensive Management Program

by Samuel Sarmiento Doncel, Gina Alejandra Diaz Mosquera, Javier Mauricio Cortes, Nelson Ramirez Plazas, Francisco Javier Meza and Carol Agudelo Rico

Hematol. Rep. 2021, 13(4), 8904; https://0-doi-org.brum.beds.ac.uk/10.4081/hr.2021.8904 - 26 Nov 2021

Cited by 4 | Viewed by 986

Abstract

In recent decades, hemophilia A treatment has been focused on body weight, without taking pharmacokinetic parameters into account. Previous research has shown that the individual pharmacokinetic response is more effective in predicting the required dose of clotting factor. We want to evaluate the [...] Read more.

In recent decades, hemophilia A treatment has been focused on body weight, without taking pharmacokinetic parameters into account. Previous research has shown that the individual pharmacokinetic response is more effective in predicting the required dose of clotting factor. We want to evaluate the impact on reducing the frequency of bleeding in patients treated with recombinant factor VIII, based on a personalized comprehensive management program. Our aim was to compare the results of a standard comprehensive treatment program (stage I) vs. a personalized pharmacokinetic-based treatment program (stage II) in a cohort of 60 patients with severe hemophilia without inhibitors. The median age was 15.5 years (3–68). The ABR was 1.03 (62 episodes) in the first stage and 0.58 (35 episodes) in the second one, (p = 0.004). By type of bleeding, the impact of the intervention differs significantly in spontaneous bleeding (p = 0.007) and a 73% reduction in the first stage. There were no significant differences in traumatic bleeding. The use of pharmacokinetics for personalized dosing of patients with severe hemophilia A, significantly reduces ABR and spontaneous bleeding, improving the patient's quality of life and costs for the health system. Full article

Journal Menu

Journal Browser

Hematol. Rep., Volume 13, Issue 4 (November 2021) – 4 articles

Further Information

Guidelines

MDPI Initiatives

Follow MDPI