Hematology (all articles)
RCTs | Fitusiran prophylaxis reduces bleeding in people with hemophilia A or hemophilia B
3 Apr, 2023 | 13:44h | UTCEfficacy and safety of fitusiran prophylaxis in people with haemophilia A or haemophilia B with inhibitors (ATLAS-INH): a multicentre, open-label, randomised phase 3 trial – The Lancet (link to abstract – $ for full-text)
Fitusiran prophylaxis in people with severe haemophilia A or haemophilia B without inhibitors (ATLAS-A/B): a multicentre, open-label, randomised, phase 3 trial – The Lancet Haematology (link to abstract – $ for full-text)
News Release: Monthly injections of fitusiran reduces bleeds in patients with haemophilia A and B – The Lancet
Position Paper | Prehospital hemorrhage control and treatment by clinicians
27 Mar, 2023 | 13:20h | UTC
Study shows increased bleeding complications in ESKD patients undergoing AF ablation
24 Mar, 2023 | 13:09h | UTCSummary: The study analyzed 347 procedures in 307 patients with end-stage kidney disease (ESKD) undergoing atrial fibrillation (AF) catheter ablation in 12 referral centers in Japan.
Despite a vast majority of patients having subtherapeutic international normalized ratio (INR) values during the peri-procedural period, 35 patients (10%) experienced major complications, with the majority being major bleeding events (19 patients; 5.4%), including 11 cases of cardiac tamponade (3.2%). There were also two peri-procedural deaths (0.6%), both related to bleeding events. A pre-procedural INR value of 2.0 or higher was identified as the only independent predictor of major bleeding.
Current peri-procedural anticoagulation guidelines state that patients undergoing AF ablation should be under therapeutic anticoagulation throughout the peri-procedural period. The findings of this study suggest that these guidelines may not be appropriate for ESKD patients undergoing the procedure, and the role of peri-procedural anticoagulation in this population should be further investigated.
Commentary on Twitter
Peri-procedural anticoagulation in patients with end-stage kidney disease undergoing #afib ablation ? despite undertreatment with warfarin, the rate of haemorrhagic complications is high! https://t.co/3W8gEtZYdy#kidney #afib #anticoagulation #ablation #cardiotwitter #europace pic.twitter.com/vI27UeIpRf
— European Society of Cardiology Journals (@ESC_Journals) March 16, 2023
RCT | 4F-PCC fails to reduce blood product consumption and raises thromboembolic events in trauma patients
22 Mar, 2023 | 13:41h | UTCSummary: The PROCOAG Randomized Clinical Trial aimed to investigate the efficacy and safety of 4-factor prothrombin complex concentrate (4F-PCC) in trauma patients at risk of massive transfusion. Conducted in 12 French trauma centers, this double-blind, randomized, placebo-controlled superiority trial involved 324 patients. All patients were treated according to European traumatic hemorrhage guidelines and received early ratio-based transfusion (packed red blood cells:fresh frozen plasma ratio of 1:1 to 2:1). The primary outcome measured was 24-hour blood product consumption (efficacy), while arterial or venous thromboembolic events were assessed as a secondary outcome (safety).
The trial revealed no significant difference in 24-hour blood product consumption between the 4F-PCC and placebo groups, with median consumption of 12 units and 11 units, respectively. However, the study identified a statistically significant higher risk of thromboembolic events in the 4F-PCC group, with 35% of patients experiencing at least one event compared to 24% in the placebo group.
In conclusion, the study found no beneficial effect of incorporating 4F-PCC into a ratio-based transfusion strategy for patients with severe trauma at risk of massive transfusion. Furthermore, the higher rate of thromboembolic events in the 4F-PCC group indicated potential harm. The findings do not support the routine use of 4F-PCC in patients experiencing trauma who are at risk for extensive transfusion.
Article: Efficacy and Safety of Early Administration of 4-Factor Prothrombin Complex Concentrate in Patients With Trauma at Risk of Massive Transfusion: The PROCOAG Randomized Clinical Trial – JAMA (free for a limited period)
See also: Visual Abstract
Review | Diagnosis and treatment of chronic lymphocytic leukemia
22 Mar, 2023 | 13:39h | UTCDiagnosis and Treatment of Chronic Lymphocytic Leukemia: A Review – JAMA (free for a limited period)
Audio clinical review: Diagnosis and Management of Chronic Lymphocytic Leukemia – JAMA
Review | Gene Therapy for Hemophilia — Opportunities and Risks
21 Mar, 2023 | 13:25h | UTCGene Therapy for Hemophilia—Opportunities and Risks – Deutsches Ärzteblatt International
Cohort Study | COVID-19 outpatients mostly at low risk for VTE, but age, being male, and obesity are risk factors
17 Mar, 2023 | 13:11h | UTCSummary: The article discusses a cohort study that aimed to assess the risk of venous thromboembolism (VTE) among outpatients with COVID-19 and identify independent predictors of VTE.
The study used data from two integrated healthcare delivery systems in California and included 398.530 nonhospitalized adults aged 18 years or older with COVID-19 diagnosed between January 1, 2020, and January 31, 2021, with follow-up through February 28, 2021.
The results showed that the overall risk of VTE among outpatients with COVID-19 is low, but higher in the first 30 days after diagnosis. Factors associated with a higher risk of VTE in COVID-19 outpatients included:
- Age 55 years or older.
- Being male.
- history of VTE or thrombophilia.
- Body mass index greater than or equal to 30.0.
The study’s results could inform future randomized trials to explore targeted VTE preventive strategies and more intensive short-term surveillance for patients with COVID-19 who are at a higher risk of developing VTE.
Commentary: Venous blood clots rare among COVID-19 outpatients, study finds – CIDRAP
Commentary on Twitter
The rate of VTE was low in outpatients with #COVID19 in the first 30 days, and even lower >30 days. Factors associated with a higher risk of VTE in included age ≥55, male, prior VTE/thrombophilia, and BMI ≥30. https://t.co/3hwfDW88k4
— JAMA Network Open (@JAMANetworkOpen) March 13, 2023
RCT | Overall survival with Daratumumab, Lenalidomide, and Dexamethasone in previously treated multiple myeloma
16 Mar, 2023 | 13:07h | UTCOriginal Study: Daratumumab, Lenalidomide, and Dexamethasone for Multiple Myeloma – New England Journal of Medicine
Primary myelofibrosis | 2023 update on diagnosis, risk-stratification, and management
16 Mar, 2023 | 12:57h | UTC
Retrospective Cohort | Arrhythmogenic cardiotoxicity associated with contemporary treatments of lymphoproliferative disorders
14 Mar, 2023 | 13:27h | UTC
ISCCM Consensus Statement | Prevention of venous thromboembolism in the critical care unit
13 Mar, 2023 | 14:53h | UTC
DNA sequencing may identify an increased risk of relapse in adults with AML prior to hematopoietic cell transplantation
13 Mar, 2023 | 14:47h | UTCDNA Sequencing to Detect Residual Disease in Adults With Acute Myeloid Leukemia Prior to Hematopoietic Cell Transplant – JAMA (free for a limited period)
Commentary on Twitter
Among patients w AML in first remission prior to allogeneic hematopoietic cell transplant, the persistence of residual variants in the blood at an allele fraction ≥0.01% was assoc'd w increased relapse & worse survival vs those w/o these variants. https://t.co/KCnaQ1NRXJ
— JAMA (@JAMA_current) March 11, 2023
Minimum platelet count threshold before invasive procedures in cirrhosis: evolution of the guidelines
13 Mar, 2023 | 14:36h | UTC
Single-arm study | Gene therapy with Etranacogene Dezaparvovec for Hemophilia B
9 Mar, 2023 | 14:07h | UTCGene Therapy with Etranacogene Dezaparvovec for Hemophilia B – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary: Gene Therapy Beneficial for Patients With Hemophilia B – HealthDay
Cohort Study | Personalized progression prediction in patients with MGUS or smouldering multiple myeloma
9 Mar, 2023 | 13:59h | UTCInvited Commentary: The PANGEA model: catching the drift from precursor conditions to myeloma in individual patients – The Lancet Haematology
Commentary from the author on Twitter (thread – click for more)
‼️ The PANGEA Model is out now @TheLancetHaem ‼️
A ?on how PANGEA improves prediction accuracy of MGUS & SMM progression to #MultipleMyeloma & is the 1st model that is #personalized to the individual #mmsm patient! @LabGhobrial @DanaFarber | 1/https://t.co/e2rEWXLahT
— Annie (@anniencowan) February 28, 2023
Guideline | Management of severe peri-operative bleeding
8 Mar, 2023 | 14:18h | UTC
M-A | Oral iron supplementation and anemia in children according to schedule, duration, dose and cosupplementation
7 Mar, 2023 | 12:53h | UTCSummary:
The article is a systematic review and meta-analysis of 129 randomized trials on iron supplementation and anemia in children. The study aimed to identify the optimal schedule, duration, dose, and cosupplementation regimen for iron supplementation in children and adolescents aged under 20 years.
The results showed that frequent (3-7 times/week) and intermittent (1-2 times/week) iron supplementation could be equally effective at increasing hemoglobin and decreasing anemia, iron deficiency, and iron deficiency anemia.
The study supports WHO recommendations regarding the frequency, duration, and dose of iron supplementation, including 3 months annually of daily oral iron supplementation for children aged 6 months to 12 years living in regions with a high burden of anemia. However, it also suggests that weekly iron supplementation might be considered an alternative to the recommended daily regimen in some contexts, given evidence of similar efficacy.
Consensus Statement on the definition and classification of metabolic hyperferritinemia
3 Mar, 2023 | 13:58h | UTCConsensus Statement on the definition and classification of metabolic hyperferritinaemia – Nature Reviews Endocrinology (if the link is paywalled, try this one)
Review | Practical guide for anticoagulant and antiplatelet reversal in clinical practice
3 Mar, 2023 | 13:42h | UTCPractical Guide for Anticoagulant and Antiplatelet Reversal in Clinical Practice – Pharmacy
The European guideline on management of major bleeding and coagulopathy following trauma
2 Mar, 2023 | 13:04h | UTC
Review | Platelet aggregation inhibitors and anticoagulants in gastroenterological and visceral surgical procedures
1 Mar, 2023 | 14:03h | UTC
RCT | Momelotinib vs. danazol in symptomatic patients with anemia and myelofibrosis
1 Mar, 2023 | 13:39h | UTCMomelotinib versus danazol in symptomatic patients with anaemia and myelofibrosis (MOMENTUM): results from an international, double-blind, randomised, controlled, phase 3 study – The Lancet (link to abstract – $ for full-text)
Review | Antiphospholipid syndrome: advances in diagnosis, pathogenesis, and management
28 Feb, 2023 | 14:00h | UTCAntiphospholipid syndrome: advances in diagnosis, pathogenesis, and management – The BMJ
Cohort Study | Risk of second primary malignancies in patients with chronic lymphocytic leukemia
28 Feb, 2023 | 13:27h | UTC
Commentary on Twitter
Our recent population-based study shows that patients with chronic lymphocytic leukemia (CLL) have an increased risk of developing second primary malignancies (SPMs) in the long term. 1/3#CLLsm #OpenAccess #NKRdata #IKNL @BloodCancerJnl @IKNL https://t.co/epgVnnwv2W
— Dr. Avinash Dinmohamed (@ADinmohamed) January 19, 2023
Single-arm study | Two-year outcomes of Valoctocogene Roxaparvovec therapy for Hemophilia A
27 Feb, 2023 | 12:51h | UTCTwo-Year Outcomes of Valoctocogene Roxaparvovec Therapy for Hemophilia A – New England Journal of Medicine (link to abstract – $ for full-text)
Commentary on Twitter
In the GENEr8-1 trial, participants with hemophilia A received B-domain–deleted factor VIII gene therapy delivered in an AAV5 vector. A decrease in annualized bleeding rates was maintained for 2 years despite declining factor VIII levels. https://t.co/hYy3pT8ssa#hematology pic.twitter.com/HuJQa0HiTR
— NEJM (@NEJM) February 23, 2023