Eltrombopag for advanced myelodysplastic syndromes or acute myeloid leukaemia and severe thrombocytopenia (ASPIRE): a randomised, placebo-controlled, phase 2 trial

In this study (ASPIRE), we aimed to assess eltrombopag, an oral thrombopoietin receptor agonist, for thrombocytopenia (grade 4) treatment in adult patients with advanced MDS or AML. Methods ASPIRE consisted of an open-label, double-blind phase for 8 weeks and a randomised, double-blind phase (parts 1 and 2, reported here) for 12 weeks, and an open-label extension (part 3). Eligible patients were men and women aged 18 years or older, with intermediate-2 or high-risk MDS or AML, with bone marrow blasts of 50% or less, and had either grade 4 thrombocytopenia due to bone marrow insufficiency (platelet counts <25 × 109 per L) or grade 4 thrombocytopenia before platelet transfusion, with 25 × 109 platelets per L or greater after transfusion. Additionally, eligible patients had at least one of the following within the screening period of 4 weeks: platelet transfusion, symptomatic bleeding, or platelet count of less than 10 × 109 per L. During part 1, patients received eltrombopag, and dose-escalation criteria for part 2 were determined. In part 2, we randomly allocated patients 2:1 using an interactive voice-response system to eltrombopag or placebo, stratified by baseline platelet count (<10 × 109 platelets per L vs ≥10 × 109 platelets per L) and disease (MDS vs AML). In parts 1 and 2, patients received supportive standard of care and initiated eltrombopag or placebo at 100 mg per day (50 mg per day for patients of east-Asi...
Source: The Lancet Haematology - Category: Hematology Source Type: research

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Authors: Bennett A, Lepage C, Thavorn K, Fergusson D, Murnaghan O, Coyle D, Singh SS Abstract Traditionally, hysteroscopy has been performed in the main operating room with the patient under general anaesthesia. Hysteroscopy performed in an office setting avoids the risks of general anaesthesia. The aim of this review was to evaluate the effectiveness of outpatient hysteroscopy compared with hysteroscopy performed in the operating room to diagnose and/or treat intrauterine pathology. Relevant electronic databases were searched, including Medline, EMBASE, and the Cochrane Library. RCTs and nonrandomized studies that...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
Authors: Yimer H, Woldie H Abstract The number of CS procedures has increased dramatically both in developed and developing countries in recent decades. CS has been associated with chronic pain. A vicious impediment on quality of life may occur among women who experience chronic post-CS pain (CPCSP). Therefore, this systematic review aimed to synthesize the available evidence on the incidence of chronic pain after Caesarean delivery and the possible risk factors for the development of chronic pain. The PubMed, Embase, and Google Scholar databases were searched for articles published in English between 2004 and Janu...
Source: Journal of Obstetrics and Gynaecology Canada : JOGC - Category: OBGYN Tags: J Obstet Gynaecol Can Source Type: research
We present the case of a 15-year-old teenager pregnant within 24 weeks admitted from the emergency department with the diagnosis of acute abdomen and operated for generalized peritonitis due to a perforated appendicitis. The microscopic analysis of the specimen indicated the presence of ulceration and extensive and deep and necrosis of the appendicle wall, the residual structures being dissected by a predominantly polymorphonuclear leukocytes inflammatory infiltrate associated with eosinophilic fibrinous deposits. Gangrenous extended necrosis of appendicle tissues, on the background of inflammatory thrombosis of appendicle...
Source: Romanian Journal of Morphology and Embryology - Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
CONCLUSIONS: The diode laser TSCPC is an efficient method of lowering IOP and decreasing eye pain. The "slow burn" technique has been shown its efficiency for extending the indications of cyclophotocoagulation also in glaucomatous eyes with better functional prognosis. PMID: 30534827 [PubMed - in process]
Source: Romanian Journal of Morphology and Embryology - Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
Authors: Sfarti VC, Bălan G, Chiriac AŞ, Stanciu C, Bălan G, Gafencu-Şavlovschi D, Trifan AV Abstract AIM: The aim of our study was to compare baseline characteristics and clinical data as well as endoscopic retrograde cholangiopancreatography (ERCP) results in patients with and without periampullary diverticulum (PAD). PATIENTS, MATERIALS AND METHODS: A single center retrospective analysis was conducted from June 2016 to June 2017 and the patients that had undergone ERCP were divided into two groups, according to the presence (Group A, 43 patients) or absence (Group B, 55 patients) of PAD. RESULTS: Mea...
Source: Romanian Journal of Morphology and Embryology - Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
Authors: Boşca AB, Şovrea AS, Miclăuş V, Ruxanda F, Mihu CM, Melincovici CS, Constantin AM, Petrescu BN, Câmpian RS, Pârvu AE, Ilea A Abstract Giant cell granulomas in the oral cavity are reactive hyperplastic lesions that arise either peripherally in the mucoperiosteum or centrally in the bone. The peripheral giant cell granuloma (PGCG) is a benign lesion induced by local chronic irritation. It may develop at any age, and tends to be more frequent in females. Central giant cell granuloma (CGCG) is a reactive lesion of unknown etiology. It commonly occurs in children and young adults. It is also pre...
Source: Romanian Journal of Morphology and Embryology - Category: General Medicine Tags: Rom J Morphol Embryol Source Type: research
[VOA] Africans who have the blood disorder sickle cell anemia met this week in the northern Cameroon town of Garoua to step up an awareness campaign.
Source: AllAfrica News: Health and Medicine - Category: African Health Source Type: news
Authors: Passouant O, Hentzien M, Viguier M, Vernet-Garnier V, Bani-Sadr F, Cousson J PMID: 30528272 [PubMed - as supplied by publisher]
Source: Medecine et Maladies Infectieuses - Category: Infectious Diseases Tags: Med Mal Infect Source Type: research
T-cell acute lymphoblastic leukemia (T-ALL) is less common than B-cell acute lymphoblastic leukemia (B-ALL) in pediatric as well as adult malignancies, comprising 15% of ALL cases in children and 25% of cases in adults [1]. However, the relative adverse outcome of T-ALL warrants special attention, with many pathogenic gene mutations having been identified. Rapid identification of clone specific subgroups is of primary importance for stratifying responses to treatment, with the ultimate goal of improving cure rates.
Source: Cancer Genetics and Cytogenetics - Category: Genetics & Stem Cells Authors: Tags: Original Article Source Type: research
To investigate the efficacy and safety of non-invasive intravesical instillation of OBTX-A through systematic review and meta-analysis. Recently, several studies of non-invasive intravesical instillation of Onabotulinum Toxin-A (OBTX-A) have been published. However, its efficacy is not well validated yet compared to well-known efficacy of minimally invasive intravesical injection of OBTX-A.
Source: Urology - Category: Urology & Nephrology Authors: Source Type: research
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