Clopidogrel Desensitization: Background and Recommendations for Use of a Rapid (4 Hour) Protocol.

Discussion: The exact immunologically mediated mechanism of how rapid oral desensitization works is not fully understood and yet to be defined. Ultimately desensitization results in causing antigen-specific mast cell tolerance. Various protocols have been published. The length of desensitization ranged from 2 h using 9 doses to 7 h using 15 doses. Recommendations: Taking the above into account, we recommend using a modification to the protocol that has the largest number of patients to undergo a standardized clopidogrel desensitization. This approach is shorter, as time is often of the essence in these patients. Dosing starts at 10 mg dose and with 60 min intervals between doses, this now becomes a 4 h desensitization protocol. PMID: 30378498 [PubMed - as supplied by publisher]
Source: Current Vascular Pharmacology - Category: Drugs & Pharmacology Authors: Tags: Curr Vasc Pharmacol Source Type: research

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Immune checkpoint inhibitors are able to reactivate the immune system therefore enhance the anti-tumor effects. However, over-activated T cells may induce immune related adverse events (irAEs). Hematological irAEs are rarely reported, which mainly represent as mono-lineage cytopenia or pancytopenia, including autoimmune hemolytic anemia (AIHA), immune thrombocytopenia (ITP), neutropenia and aplastic anemia, sometimes even lethal, such as hemophagocytic lymphohistiocytosis. The clinical manifestations of hematological irAEs will be summarized and recommendations of diagnosis and treatment are proposed. 
 DOI: 10.3779/
Source: Chinese Journal of Lung Cancer - Category: Cancer & Oncology Source Type: research
ConclusionsSevere hypercalcemia and aplastic anemia are potential paraneoplastic syndromes of adult T-type lymphoblastic lymphoma, with fatal short-term outcome.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
This study assessed the effect of the kampo medicine kamikihito (KKT) on platelet count irrespective of type of illness.MethodsA single ‐center, retrospective pilot study was performed from March 2014 to March 2017. The subjects were patients who received KKT treatment and had blood samples collected in the 2 weeks prior to treatment initiation and ≤9 weeks after treatment completion at Toyama University Hospital.ResultsA total of 16 patients were identified as potential subjects, and their medical records were assessed. Their diagnoses were patent ear canal, insomnia, idiopathic thrombocytopenic purpura...
Source: Traditional and Kampo Medicine - Category: Complementary Medicine Authors: Tags: ORIGINAL ARTICLE Source Type: research
Publication date: Available online 29 August 2019Source: The Lancet HaematologyAuthor(s): Jong Wook Lee, Sung-Eun Lee, Chul Won Jung, Silvia Park, Hiroyuki Keta, Soo Kyeong Park, Jin-A Kim, Il-Hoan Oh, Jun Ho JangSummaryBackgroundAplastic anaemia is a rare, life-threatening condition, characterised by pancytopenia with hypocellular bone marrow. Haematopoietic stem cells and most progenitor cells express thrombopoietin receptor (c-MPL). Romiplostim is a peptibody with c-MPL agonist activity that stimulates endogenous thrombopoietin production and leads to promoting the proliferation and differentiation of megakaryocytes in ...
Source: The Lancet Haematology - Category: Hematology Source Type: research
AbstractEltrombopag is an orally available thrombopoietin receptor agonist indicated for the treatment of immune thrombocytopenia (ITP). Beyond the effect on megakaryopoiesis, the drug also showed a stimulating effect on the hematopoietic stem cell with consistent clinical efficacy in aplastic anemia (AA) and myelodysplastic syndromes (MDS). Eltrombopag is highly effective in ITP and less so in AA and MDS. This observation underlines the importance of residual normal hematopoiesis, which is maximal in ITP, minimal/absent in AA, and dysregulated in MDS. In ITP, the drug at 50 –75 mg daily induced up to 85% respon...
Source: Drugs - Category: Drugs & Pharmacology Source Type: research
ConclusionsAcute febrile illnesses like dengue, enteric fever, malaria are the predominant causes of neutropenia. Mild neutropenia was seen in over 50% children requiring a short duration of admission (5 –8 d); without any complications.
Source: Indian Journal of Pediatrics - Category: Pediatrics Source Type: research
In conclusion, this study provides a systematic analysis of the expression of TRAIL-Rs in human primary B cells and of their capacity to signal and induce apoptosis. This dataset forms a basis to further study and understand the dysregulation of TRAIL-Rs and TRAIL expression observed in autoimmune diseases. Additionally, it will be important to foresee potential bystander immunomodulation when TRAIL-R agonists are used in cancer treatment. Introduction The homeostasis of humoral immunity requires a tight control of generation, survival, activation and maturation of B lymphocytes. Therefore, pro-survival and pro-apo...
Source: Frontiers in Immunology - Category: Allergy & Immunology Source Type: research
Roser Calvo* Patient Safety, Safety Science, AstraZeneca Pharmaceuticals, Gaithersburg, MD, United States Immune-related hematological adverse events are amongst the rare but potentially life-threatening complications of immune checkpoint inhibitors. The spectrum of these toxicities is broadening as the number of patients exposed to these agents is increasing. Yet, they are still relatively unknown to many clinicians, possibly due to a lack of specific diagnostic criteria, which poses a challenge for their recognition and proper reporting, and partly due to their low incidence, often too low to be noted in most c...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
In conclusion, AUB secondary to AA can be acute and severe. Hemostasis is more difficult due to progressive pancytopenia. For young women with future fertility desire, LNG-IUS following hysteroscopic resection of endometrial functional layer is a safe and effective way against endometrial ablation or hysterectomy.
Source: Medicine - Category: Internal Medicine Tags: Research Article: Clinical Case Report Source Type: research
We present our single institution experience.
Source: Biology of Blood and Marrow Transplantation - Category: Hematology Authors: Tags: 183 Source Type: research
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