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Hematology (all articles)

Post hoc analysis | Low-dose aspirin linked to increased risk of anemia in older adults

29 Jun, 2023 | 14:06h | UTC

Summary: In a post hoc analysis of the ASPREE randomized controlled trial, the impact of daily low-dose aspirin on anemia, hemoglobin, and serum ferritin concentrations in elderly individuals was investigated. The study included 19,114 community-dwelling individuals aged 70 years and older (or ≥65 years for Black and Hispanic individuals) from Australia and the United States.

Findings reveal an increased incidence of anemia in the aspirin group compared to the placebo group (51.2 events versus 42.9 events per 1000 person-years, respectively). This correlates to a 20% increase in risk (hazard ratio, 1.20 [95% CI, 1.12 to 1.29]). Hemoglobin concentrations displayed a more pronounced decline in the aspirin group by 0.6 g/L per 5 years. Additionally, among participants with ferritin measures, the aspirin group exhibited a greater prevalence of ferritin levels less than 45 µg/L at year 3 and overall decline in ferritin by 11.5%. The study found similar results even in the absence of major bleeding.

This research underscores the risk of anemia and decline in ferritin in otherwise healthy older adults taking low-dose aspirin, highlighting the need for periodic monitoring of hemoglobin levels. However, the study lacked data on the causes of anemia, indicating the need for further research.

Article: Effect of Low-Dose Aspirin Versus Placebo on Incidence of Anemia in the Elderly: A Secondary Analysis of the Aspirin in Reducing Events in the Elderly Trial – Annals of Internal Medicine (link to abstract – $ for full-text)

News Release: Low-dose aspirin may increase anaemia risk in healthy older adults: study – Monash University

Commentaries:

Aspirin Use Ups Risk of Anemia in Elderly Patients: ASPREE – TCTMD

Low-dose aspirin associated with 20% increase in risk of anemia among older adults – ACP Internist

Original Study: Effect of Aspirin on All-Cause Mortality in the Healthy Elderly – New England Journal of Medicine

 


M-A | Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery

29 Jun, 2023 | 14:03h | UTC

Prophylactic intravenous tranexamic acid and thromboembolism in non-cardiac surgery: a systematic review, meta-analysis and trial sequential analysis – Anaesthesia

 


Podcast | Antiplatelets, anticoagulation for coronary artery disease and atrial fibrillation

28 Jun, 2023 | 13:11h | UTC

#400 Antiplatelets, Anticoagulation for Coronary Artery Disease and Afib – The Curbsiders

 


RCT | Cyclophosphamide-based regimen enhances GVHD-free survival after hematopoietic stem-cell transplantation

27 Jun, 2023 | 13:54h | UTC

Summary: The article details a phase 3 trial comparing the efficacy of two graft-versus-host disease (GVHD) prophylactic regimens in hematologic cancer patients undergoing allogeneic hematopoietic stem-cell transplantation (HSCT). The experimental group received cyclophosphamide–tacrolimus–mycophenolate mofetil, and the standard group received tacrolimus–methotrexate. The patients, a total of 431, underwent HSCT from an HLA-matched related donor or a matched or 7/8 mismatched unrelated donor.

The primary end point was GVHD-free, relapse-free survival at 1 year. Results indicated a significantly higher incidence of this outcome in the experimental group (hazard ratio, 0.64; 95% confidence interval [CI], 0.49 to 0.83; P=0.001). At 1 year, adjusted GVHD-free, relapse-free survival was 52.7% (95% CI, 45.8 to 59.2) in the experimental group, compared to 34.9% (95% CI, 28.6 to 41.3) in the standard group.

Notably, patients in the experimental-prophylaxis group appeared to have less severe acute or chronic GVHD and a higher incidence of immunosuppression-free survival at 1 year. Overall survival, disease-free survival, relapse, transplantation-related death, and engraftment did not show a substantial difference between the groups. These results suggest that cyclophosphamide–tacrolimus–mycophenolate mofetil may offer a more effective prophylaxis against GVHD in HSCT patients.

Article: Post-Transplantation Cyclophosphamide-Based Graft-versus-Host Disease Prophylaxis – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Study Sets New Standard for Graft-Versus-Host Disease Prevention After Stem Cell Transplant – Johns Hopkins Medicine

 

Commentary on Twitter

 


Review | Renal thrombotic microangiopathy

27 Jun, 2023 | 13:34h | UTC

Renal Thrombotic Microangiopathy: A Review – American Journal of Kidney Diseases

 

Commentary on Twitter

 


Report | Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000–2021

23 Jun, 2023 | 13:40h | UTC

Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000–2021: a systematic analysis from the Global Burden of Disease Study 2021 – The Lancet Haematology

News Release: Sickle cell disease is 11 times more deadly than previously recorded – Institute for Health Metrics and Evaluation

 

Commentary on Twitter (thread – click for more)

 


Consensus Paper | Primary prophylaxis of invasive fungal diseases in patients with hematological malignancies

23 Jun, 2023 | 13:23h | UTC

Primary prophylaxis of invasive fungal diseases in patients with haematological malignancies: 2022 update of the recommendations of the Infectious Diseases Working Party (AGIHO) of the German Society for Haematology and Medical Oncology (DGHO) – Journal of Antimicrobial Chemotherapy

 


Review | Nonsurgical management of major hemorrhage

22 Jun, 2023 | 15:16h | UTC

Nonsurgical management of major hemorrhage – Canadian Medical Association Journal

 


M-A | Anticoagulation options for continuous renal replacement therapy in critically ill patients

22 Jun, 2023 | 14:54h | UTC

Anticoagulation options for continuous renal replacement therapy in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials – Critical Care

 


RCT | LMWH does not increase live birth rates in women with thrombophilia and recurrent miscarriage

21 Jun, 2023 | 13:39h | UTC

Heparin for women with recurrent miscarriage and inherited thrombophilia (ALIFE2): an international open-label, randomised controlled trial – The Lancet (link to abstract – $ for full-text)

News Release: Study recommends ending heparin use for women with recurrent miscarriage and inherited thrombophilia – National Institute for Health and Care Research

 

Commentary on Twitter (thread – click for more)

 


Position statement | Gastrointestinal bleeding and endoscopic procedures in patients on antiplatelet and/or anticoagulant therapy

21 Jun, 2023 | 13:22h | UTC

Position statement from the Indian Society of Gastroenterology, Cardiological Society of India, Indian Academy of Neurology and Vascular Society of India on gastrointestinal bleeding and endoscopic procedures in patients on antiplatelet and/or anticoagulant therapy – Indian Journal of Gastroenterology (if the link is paywalled, try this one)

 


Review | Traumatic hemorrhage and chain of survival

21 Jun, 2023 | 13:17h | UTC

Traumatic hemorrhage and chain of survival – Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine

 


RCT | Thrice-weekly oral iron shows non-inferiority and fewer gastrointestinal effects in treating iron-deficiency anemia

20 Jun, 2023 | 12:48h | UTC

A randomized controlled trial of thrice-weekly versus thrice-daily oral ferrous fumarate treatment in adult patients with iron-deficiency anemia – Ann Hematol (if the link is paywalled, try this one)

 


Consensus Paper | Management of febrile neutropenia in pediatric hematology and oncology patients

20 Jun, 2023 | 12:38h | UTC

Consensus document on the management of febrile neutropenia in paediatric haematology and oncology patients of the Spanish Society of Pediatric Infectious Diseases (SEIP) and the Spanish Society of Pediatric Hematology and Oncology (SEHOP) – Anales de Pediatría

 


Review | Updates in immunohistochemistry for hematopoietic and lymphoid neoplasms

20 Jun, 2023 | 12:36h | UTC

Updates in Immunohistochemistry for Hematopoietic and Lymphoid Neoplasms – Archives of Pathology & Laboratory Medicine

 


RCT | Avapritinib superior to placebo in reducing symptoms, mast-cell burden in indolent systemic mastocytosis patients

20 Jun, 2023 | 12:34h | UTC

Avapritinib versus Placebo in Indolent Systemic Mastocytosis – NEJM Evidence

 

Commentary on Twitter

 


Guideline | Screening and diagnosis of significant hemoglobinopathies

20 Jun, 2023 | 12:32h | UTC

Significant haemoglobinopathies: A guideline for screening and diagnosis: A British Society for Haematology Guideline – British Journal of Haematology

 


M-A | Anticoagulation options for continuous renal replacement therapy in critically ill patients

19 Jun, 2023 | 13:51h | UTC

Anticoagulation options for continuous renal replacement therapy in critically ill patients: a systematic review and network meta-analysis of randomized controlled trials – Critical Care

 


Systematic Review | Tranexamic acid likely decreases red blood cell transfusion need in hip fracture surgery

16 Jun, 2023 | 14:09h | UTC

Interventions for reducing red blood cell transfusion in adults undergoing hip fracture surgery: an overview of systematic reviews – Cochrane Library

Summary: What treatments reduce the need for a blood transfusion in adults who have broken their hip? – Cochrane Library

 


Review | Antifungal stewardship interventions in patients with hematologic malignancies

16 Jun, 2023 | 13:47h | UTC

Antifungal Stewardship Interventions in Patients with Hematologic Malignancies

 


RCT | Prehospital use of tranexamic acid in severe trauma cases shows no superiority over placebo

15 Jun, 2023 | 15:16h | UTC

Prehospital Tranexamic Acid for Severe Trauma – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Shining a new light on tranexamic acid for trauma care – Monash University

 

Commentary on Twitter

 


RCT | Second-line treatment with Axi-cel results in increased overall survival in large B-cell lymphoma

14 Jun, 2023 | 14:25h | UTC

Survival with Axicabtagene Ciloleucel in Large B-Cell Lymphoma – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: ASCO: Axi-cel significantly improves survival in patients with early relapsed or refractory large B-cell lymphoma – University of Texas MD Anderson Cancer Center

Commentary: Axicabtagene Ciloleucel Improves Overall Survival in Patients With Relapsed or Refractory Large B-Cell Lymphoma – The ASCO Post

 

Commentary on Twitter

 


RCT | Cilta-cel shows superior progression-free survival over standard care in lenalidomide-refractory multiple myeloma

14 Jun, 2023 | 14:22h | UTC

Cilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma – New England Journal of Medicine (link to abstract – $ for full-text)

News Release: Findings suggest cilta-cel may be key therapeutic option for patients with multiple myeloma after first relapse – Medical College of Wisconsin

Commentary: CARTITUDE-4 Shows Benefit With Ciltacabtagene Autoleucel in Lenalidomide-Refractory Multiple Myeloma – ASCO Daily News

 

Commentary on Twitter

 


Review | Acute graft-versus-host disease

14 Jun, 2023 | 14:20h | UTC

Acute graft-versus-host disease – Nature Reviews Disease Primers (if the link is paywalled, try this one)

 

Commentary on Twitter

 


Brief Review | Resistance to unfractionated heparin in the ICU: evaluation and management options

12 Jun, 2023 | 13:32h | UTC

Resistance to unfractionated heparin in the ICU: evaluation and management options – Intensive Care Medicine (if the link is paywalled, try this one)

 

Commentary on Twitter

 


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