Hematology (all articles)
Post hoc analysis | Low-dose aspirin linked to increased risk of anemia in older adults
29 Jun, 2023 | 14:06h | UTCSummary: 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
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 | UTCSummary: 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
In this trial, 1-year GVHD-free, relapse-free survival after stem-cell transplantation was 52.7% in the cyclophosphamide–tacrolimus–mycophenolate mofetil group and 34.9% in the tacrolimus–methotrexate group. https://t.co/wCdvP1LChu
— NEJM (@NEJM) June 21, 2023
Review | Renal thrombotic microangiopathy
27 Jun, 2023 | 13:34h | UTCRenal Thrombotic Microangiopathy: A Review – American Journal of Kidney Diseases
Commentary on Twitter
Renal Thrombotic Microangiopathy: A Review https://t.co/YabUm18t4q (FREE)@CPQMD @ReichHeather @UofTNephrology pic.twitter.com/Y9rSnuTFBo
— AJKD (@AJKDonline) June 24, 2023
Report | Global, regional, and national prevalence and mortality burden of sickle cell disease, 2000–2021
23 Jun, 2023 | 13:40h | UTCNews 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)
Ahead of #WorldSickleCellDay #WSCD23 we are publishing the first detailed global estimates on the burden of #sicklecell disease
Read it #openaccess https://t.co/pVlWZ6s1G4
The authors show that mortality linked to #sicklecell disease is higher than previously described? pic.twitter.com/WplWr0gXqJ
— The Lancet Haematology (@TheLancetHaem) June 16, 2023
Consensus Paper | Primary prophylaxis of invasive fungal diseases in patients with hematological malignancies
23 Jun, 2023 | 13:23h | UTC
Review | Nonsurgical management of major hemorrhage
22 Jun, 2023 | 15:16h | UTCNonsurgical 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
RCT | LMWH does not increase live birth rates in women with thrombophilia and recurrent miscarriage
21 Jun, 2023 | 13:39h | UTCHeparin for women with recurrent miscarriage and inherited thrombophilia (ALIFE2): an international open-label, randomised controlled trial – The Lancet (link to abstract – $ for full-text)
Commentary on Twitter (thread – click for more)
New study: Many women with recurrent miscarriage are tested for inherited thrombophilia. If confirmed positive, daily subcutaneous low-molecular-weight heparin (LMWH) is given.
This is despite an absence of evidence that such treatment is beneficial ? https://t.co/0IuFhvjlZr
— The Lancet (@TheLancet) June 2, 2023
Position statement | Gastrointestinal bleeding and endoscopic procedures in patients on antiplatelet and/or anticoagulant therapy
21 Jun, 2023 | 13:22h | UTCPosition 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
RCT | Thrice-weekly oral iron shows non-inferiority and fewer gastrointestinal effects in treating iron-deficiency anemia
20 Jun, 2023 | 12:48h | UTCA 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
Review | Updates in immunohistochemistry for hematopoietic and lymphoid neoplasms
20 Jun, 2023 | 12:36h | UTC
RCT | Avapritinib superior to placebo in reducing symptoms, mast-cell burden in indolent systemic mastocytosis patients
20 Jun, 2023 | 12:34h | UTCAvapritinib versus Placebo in Indolent Systemic Mastocytosis – NEJM Evidence
Commentary on Twitter
“…in this 24-week blinded phase of the PIONEER trial, avapritinib demonstrated superiority to placebo in improving symptoms in patients with moderate to severe symptomatic ISM [indolent systemic mastocytosis]….”#Oncology #ClinicalTrials @StanfordDeptMed @ProfMaurer
— NEJM Evidence (@NEJMEvidence) June 15, 2023
Guideline | Screening and diagnosis of significant hemoglobinopathies
20 Jun, 2023 | 12:32h | UTC
M-A | Anticoagulation options for continuous renal replacement therapy in critically ill patients
19 Jun, 2023 | 13:51h | UTC
Systematic Review | Tranexamic acid likely decreases red blood cell transfusion need in hip fracture surgery
16 Jun, 2023 | 14:09h | UTC
Review | Antifungal stewardship interventions in patients with hematologic malignancies
16 Jun, 2023 | 13:47h | UTCAntifungal 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 | UTCPrehospital 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
Late breaking at #CCR23: In the PATCH-Trauma trial involving adults with major trauma, treatment with tranexamic acid did not result in a greater number of patients surviving with a favorable functional outcome at 6 months than placebo. https://t.co/i8fu34ReCB pic.twitter.com/GEOtRphOBb
— NEJM (@NEJM) June 14, 2023
RCT | Second-line treatment with Axi-cel results in increased overall survival in large B-cell lymphoma
14 Jun, 2023 | 14:25h | UTCSurvival with Axicabtagene Ciloleucel in Large B-Cell Lymphoma – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Late breaking at #ASCO23: In the phase 3 ZUMA-7 trial, patients with relapsed or refractory large B-cell lymphoma who received axi-cel (CD19-specific CAR T cells) had a 27.4% lower risk of death than patients who received standard therapy. Full trial results:
— NEJM (@NEJM) June 5, 2023
RCT | Cilta-cel shows superior progression-free survival over standard care in lenalidomide-refractory multiple myeloma
14 Jun, 2023 | 14:22h | UTCCilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
Original Article: Cilta-cel or Standard Care in Lenalidomide-Refractory Multiple Myeloma (CARTITUDE-4) https://t.co/Wag2UTKOfH#ASCO23
— NEJM (@NEJM) June 6, 2023
Review | Acute graft-versus-host disease
14 Jun, 2023 | 14:20h | UTCAcute graft-versus-host disease – Nature Reviews Disease Primers (if the link is paywalled, try this one)
Commentary on Twitter
Tissue damage resulting from allogenic hematopoietic cell transplantation conditioning regimens triggers cellular interactions and #inflammatory cascades that lead to acute #GraftVersusHost disease symptoms https://t.co/iHyUVoV75J pic.twitter.com/ob9X7zQWB8
— Nature Reviews Disease Primers (@DiseasePrimers) June 11, 2023
Brief Review | Resistance to unfractionated heparin in the ICU: evaluation and management options
12 Jun, 2023 | 13:32h | UTCResistance to unfractionated heparin in the ICU: evaluation and management options – Intensive Care Medicine (if the link is paywalled, try this one)
Commentary on Twitter
? Resistance to unfractionated heparin in #ICU, evaluation & management options
? monitoring UFH
? mechanisms of resistance
? how to manage UFH resistance
PS check supplement table on IV anticoagulants in ICU#FOAMcc @JerroldLevy @Dr_Cit @foamecmo
?️ https://t.co/ojQw5On5ZL pic.twitter.com/0uPQuwUmOr— Intensive Care Medicine (@yourICM) June 7, 2023