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Clinical Vignettes Part I
Patients with sickle cell disease and/or (rarely) trait are at increased risk for developing recurrent episodes of priapism, also known as stuttering priapism, and major ischemic priapism. Treatment of acute ischemic priapism is reactive; whereas ideal management consists of preventative approaches to ultimately promote the best improvement in patient ’s quality of life.Leg ulcers in patients with sickle cell disease (SCD) are quite common, with ∼20 % of patients with HBSS reporting either having an active or a past ucler. They can be confused with venous ulcers, with lower extremity hyperpigmentation confounding furth...
Source: Hematology/Oncology Clinics of North America - November 16, 2022 Category: Cancer & Oncology Authors: Jason A. Levy, Arthur L. Burnett, Caterina P. Minniti, William Ennis, Anusha Vittal, Theo Heller, David Kleiner, Swee Lay Thein Source Type: research

Structural Racism and Impact on Sickle Cell Disease
Wealth begets health: the health care system in the United States is run by and benefits the groups that have traditionally held power. Systems of structural racism and health care disparities persist. Patients with sickle cell disease (SCD) remain particularly vulnerable to disparities. They suffer from stigmas, lack of well-trained providers, and from misalignment of their needs with the priorities of their health care teams. These critically important burdens may actually be worsening rather than improving mortality for individuals living with SCD. Changes must be made at the federal, state, and local levels in order to...
Source: Hematology/Oncology Clinics of North America - November 16, 2022 Category: Cancer & Oncology Authors: Wally R. Smith, Cecelia Valrie, India Sisler Source Type: research

Sickle Cell Disease and the Kidney
Throughout the lifespan, the kidney of a person with sickle cell disease is at increased risk of injury to the glomeruli, tubules, and renal vasculature. This injury manifests as urine concentrating defects, enuresis, albuminuria, acute kidney injury, chronic kidney disease, and end-stage kidney disease. The outcomes for patients who progress to end-stage kidney disease are poor and access to organ transplantation is limited. Therefore, identifying risk factors for progression, intervening with renoprotective agents early in life, and improving access to care are vital for sickle cell patients. (Source: Hematology/Oncology...
Source: Hematology/Oncology Clinics of North America - November 16, 2022 Category: Cancer & Oncology Authors: Jeffrey D. Lebensburger, Vimal K. Derebail Source Type: research

Clinical Vignettes, Part II: Eyes, Teeth, and Bone
Microvascular occlusions caused by sickle cell disease (SCD) can affect all ocular and orbital structures. Sickle cell retinopathy (SCR) is the most common ophthalmic manifestation of SCD. Fortunately, most individuals with SCR are visually asymptomatic. Vision loss in SCD most commonly occurs as a consequence of proliferative sickle cell retinopathy (PSR), in which pathologic retinal neovascularization occurs. To prevent significant vision loss and blindness, which can occur from complications of PSR, regular retinopathy surveillance screening examinations and consistent follow-up with a retina specialist are recommended....
Source: Hematology/Oncology Clinics of North America - November 16, 2022 Category: Cancer & Oncology Authors: Adrienne W. Scott, Grace R. Reilly, Brian Laurence, Oyebimpe O. Adesina Source Type: research

Sickle Cell Disease: New Approaches for an Old Disease
It has the feel of a myth; a single person in sub-Saharan Africa experiences a mutation in their beta-globin gene 7300 years ago,1 and their children and their children ’s children, over 360 generations, are modestly protected from cerebral malaria and death (heterozygous). While innumerable lives have been spared due to the presence of this mutation, for those that are homozygous, their life is one of suffering and early death. (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 16, 2022 Category: Cancer & Oncology Authors: Sophie Lanzkron, Jane Little Tags: Preface Source Type: research

Sickle Cell Syndromes
HEMATOLOGY/ONCOLOGY CLINICS OF NORTH AMERICA (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 16, 2022 Category: Cancer & Oncology Authors: Sophie Lanzkron, Jane Little Source Type: research

Copyright
ELSEVIER (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 16, 2022 Category: Cancer & Oncology Source Type: research

Contributors
GEORGE P. CANELLOS, MD (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 16, 2022 Category: Cancer & Oncology Source Type: research

Contents
Sophie Lanzkron and Jane Little (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 16, 2022 Category: Cancer & Oncology Source Type: research

Forthcoming Issues
Breast Cancer (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - November 16, 2022 Category: Cancer & Oncology Source Type: research

What Can We Learn About Pancreatic Adenocarcinoma from Imaging?
Imaging and endoscopy play several important roles in the diagnosis and management of pancreatic ductal adenocarcinoma (PDAC). Computed tomography (CT) and endoscopic ultrasound play complimentary roles in the initial diagnosis and pathologic confirmation of PDAC. Endoscopy can also be used to manage biliary obstruction and gastrointestinal complications. MRI and fluorodeoxyglucose-PET-CT are typically used as problem-solving tools for complex cases. Neoadjuvant chemotherapy and surgery are often selected based on imaging findings related to vascular involvement by tumors and invasion of adjacent structures. Posttreatment ...
Source: Hematology/Oncology Clinics of North America - October 1, 2022 Category: Cancer & Oncology Authors: Michael Rosenthal, Khoschy Schawkat, Mayssan Muftah, Kunal Jajoo Source Type: research

Screening and Surveillance for Pancreatic Adenocarcinoma in High-Risk Individuals
Pancreatic ductal adenocarcinoma (PDAC) is an aggressive disease with high mortality, largely due to late stage at diagnosis. Approximately 10% to 15% are hereditary, and detection of early stage PDAC or precursor lesions through pancreatic surveillance programs may improve outcomes. Current surveillance is annual, typically with endoscopic ultrasound and/or magnetic resonance imaging. (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - October 1, 2022 Category: Cancer & Oncology Authors: Arielle J. Labiner, Anne Aronson, Aimee L. Lucas Source Type: research

Decision-Making Regarding Perioperative Therapy in Individuals with Localized Pancreatic Adenocarcinoma
Pancreatic cancer is a fatal malignancy that is projected to emerge as the second leading cause of cancer-related death in the United States. Despite the critical advances in surgical strategies, radiographic techniques, and systemic therapy, the treatment modality has remained largely unchanged over the past two  decades eliciting a dire need for clinical trials in improving quality of life and prolonging survival in this patient population. Emergence of innovative strategies including novel combination chemotherapy, immunotherapy, vaccines, small compound drugs, among others is avenues under investigation to improve per...
Source: Hematology/Oncology Clinics of North America - October 1, 2022 Category: Cancer & Oncology Authors: Malvi Savani, Rachna T. Shroff Source Type: research

Novel Considerations in Surgical Management of Individuals with Pancreatic Adenocarcinoma
The management of localized pancreatic cancer (PC) has evolved significantly in the last decade, moving away from prioritizing surgery as the primary treatment modality to embracing the need for preoperative (neoadjuvant) multimodality therapy to achieve durable disease-free control. Neoadjuvant therapy is currently recommended for all patients with borderline and locally advanced PC, and is being increasingly utilized in patients with resectable disease as well. When assessing operability the following 3 factors should be considered: clinical stage of disease, response to neoadjuvant therapy, and patient performance statu...
Source: Hematology/Oncology Clinics of North America - October 1, 2022 Category: Cancer & Oncology Authors: Chad A. Barnes, Susan Tsai Source Type: research

Germline Testing for Individuals with Pancreatic Adenocarcinoma and Novel Genetic Risk Factors
This article reviews current understanding of germline mutations associated with PDAC risk and implications of genetic testi ng. (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - October 1, 2022 Category: Cancer & Oncology Authors: Anu Chittenden, Sigurdis Haraldsdottir, Ethan Chen, Sahar Nissim Source Type: research