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Impact of Diet and Exercise on Colorectal Cancer
The evidence is consistent that certain dietary and lifestyle factors modulate the risk of colorectal cancer (CRC) development and differential survival outcomes. Emerging prospective data in addition to earlier studies largely support the notion that specific dietary products or patterns and physical activity are associated with protection against CRC development and mortality. However, few randomized controlled trials evaluating causal relationships exist, and much of the current data remain limited to nonmetastatic CRC. More widespread integration of assessment of dietary and lifestyle factors on disease-related outcome...
Source: Hematology/Oncology Clinics of North America - April 30, 2022 Category: Cancer & Oncology Authors: Seohyuk Lee, Jeffrey A. Meyerhardt Source Type: research

Immunotherapy-associated Autoimmune Hemolytic Anemia
Over the past decade, the role of immunotherapy treatment in cancer has expanded; specifically, indications for immune checkpoint inhibitors (ICI) have multiplied and are used as first-line therapy. ICIs include cytotoxic T-lymphocyte-associated protein 4 and programmed cell death protein 1 inhibitors, as monotherapies or in combination. Autoimmune hemolytic anemia (AIHA) has emerged as a rare yet serious immune-related adverse event in ICI use. This review describes diagnosis and management of immunotherapy related AIHA (ir-AIHA) including an algorithmic approach based on severity of anemia. Suggested mechanisms are discu...
Source: Hematology/Oncology Clinics of North America - March 24, 2022 Category: Cancer & Oncology Authors: Steven R. Hwang, Antoine N. Saliba, Alexandra P. Wolanskyj-Spinner Source Type: research

Autoimmune Hemolytic Anemia: An Old Disease with New Twists
In 1529, Actuarius in Constantinople was the first to describe “azure and livid” as well as black urine in patients exposed to cold. In his writings, he goes on to state that they also experienced a “dramatic loss of strength,” likely depicting the first description of paroxysmal cold hemoglobinuria. Further elucidation of autoimmune hemolytic anemia (A IHA) would have to wait until the mid-nineteenth century when the observation of microcytes in the form of spheres (microcythemia) was documented in patients with non-liver-associated jaundice. (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - March 24, 2022 Category: Cancer & Oncology Authors: Alexandra P. Wolanskyj-Spinner, Ronald S. Go Tags: Preface Source Type: research

New Developments in the Understanding and Treatment of Autoimmune Hemolytic Anemia
HEMATOLOGY/ONCOLOGY CLINICS OF NORTH AMERICA (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - March 24, 2022 Category: Cancer & Oncology Authors: Alexandra P. Wolanskyj-Spinner, Ronald S. Go Source Type: research

Copyright
ELSEVIER (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - March 24, 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 - March 24, 2022 Category: Cancer & Oncology Source Type: research

Contents
Alexandra P. Wolanskyj-Spinner and Ronald S. Go (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - March 24, 2022 Category: Cancer & Oncology Source Type: research

Forthcoming Issues
Colorectal Cancer (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - March 24, 2022 Category: Cancer & Oncology Source Type: research

New Developments in the Understanding and Treatment of Autoimmune Hemolytic Anemia: Traditional and Novel Tests
Careful consideration of the clinical history with traditional testing such as an antibody screen and direct antiglobulin test (DAT) allow for the categorization of most forms of autoimmune hemolytic anemia. Based on the initial findings, specialized testing can further categorize disease entities and increase the sensitivity of testing. In this section, we explain the diagnostic findings of both traditional and novel testing and how their appropriate interpretations help distinguish the forms of autoimmune hemolytic anemia (AIHA). (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - March 11, 2022 Category: Cancer & Oncology Authors: Tristan F.P. McKnight, Maggie A. DiGuardo, Eapen K. Jacob Source Type: research

Updates in the Management of Warm Autoimmune Hemolytic Anemia
Warm autoimmune hemolytic anemia (wAIHA) is an uncommon and heterogeneous disorder caused by autoantibodies to RBC antigens. Initial evaluation should involve the DAT, with wAIHA typically IgG positive with or without C3 positivity, and a search for underlying conditions associated with secondary wAIHA, which comprise 50% of cases. First-line therapy involves glucocorticoids, increasingly with rituximab, though a chronic relapsing course is typical. While splenectomy and a number of immunosuppressive therapies have been used in the setting of relapsed and refractory disease, the optimal choice and sequence of therapies is ...
Source: Hematology/Oncology Clinics of North America - March 11, 2022 Category: Cancer & Oncology Authors: Jennifer C. Yui, Robert A. Brodsky Source Type: research

Autoimmune Hemolytic Anemia: Diagnosis and Differential Diagnosis
The causes of hemolytic anemia are numerous and a systematic approach is critical for proper identification and classification. The direct antiglobulin test can establish the diagnosis and subclassify the majority of autoimmune hemolytic anemias. Further testing to identify the driver of AIHA can have significant implications in overall management. Advanced testing for rare nonimmune acquired hemolytic anemias or hereditary hemolytic anemias may be necessary if DAT testing is negative. (Source: Hematology/Oncology Clinics of North America)
Source: Hematology/Oncology Clinics of North America - March 11, 2022 Category: Cancer & Oncology Authors: Caleb J. Scheckel, Ronald S. Go Source Type: research

Red Cell Antigens and Antibodies
Autoimmune hemolytic anemia (AIHA) is caused by the production of “warm-” or “cold-” reactive autoantibodies directed against RBC antigens that may be of undefined specificity, reacting with all RBCs tested or may have an apparent specificity. Autoantibodies may be of IgG, IgM, or rarely IgA isotypes and their production can be triggered by disease, viral infection, or drugs; from breakdown in immune system tolerance to self-antigens; or from exposure to foreign antigens that induce antibodies that cross-react with self-RBC antigens. Increasingly, AIHA is being reported in patients following allogeneic hematopoieti...
Source: Hematology/Oncology Clinics of North America - March 11, 2022 Category: Cancer & Oncology Authors: Christine Lomas-Francis, Connie M. Westhoff Source Type: research

Complications of Autoimmune Hemolytic Anemia
Autoimmune hemolytic anemia (AHIA) is the group of acquired autoimmune conditions resulting from the development of autologous antibodies directed against autologous red blood cell antigens resulting in red cell lysis. Beyond the presence, severity, and duration of hemolysis which can lead to symptomatic anemia, additional complications at presentation and during treatment require a high degree of clinical vigilance. These include among others cutaneous, thrombotic, renal disorders, and infectious disorders. Complications can be due to the presence of the pathologic antibody itself, the process of hemolysis, or attributed ...
Source: Hematology/Oncology Clinics of North America - March 11, 2022 Category: Cancer & Oncology Authors: Surbhi Shah, Leslie Padrnos Source Type: research

Adult Evans' Syndrome
Evans syndrome (ES) is a rare immune disorder defined as the simultaneous or sequential occurrence in a single patient of immune thrombocytopenia (ITP) and warm autoimmune hemolytic anemia (wAIHA)  ± autoimmune neutropenia (AIN). ES represents approximately 5% to 10% of all wAIHA and 2%-5% of all ITP cases in adults and its mortality rate is high. When ITP and wAIHA occurred concomitantly, other differential diagnoses must be ruled out. ES can be primary or secondary and isolated or associ ated with another underlying disorder and secondary ES. The management of ES is mostly empirical with a low level of evidence. This ...
Source: Hematology/Oncology Clinics of North America - March 11, 2022 Category: Cancer & Oncology Authors: Marc Michel Source Type: research

Updates on the Diagnosis and Management of Cold Autoimmune Hemolytic Anemia
Cold agglutinin disease represents a form of immune-mediated hemolytic anemia whereby an IgM protein either monoclonal or polyclonal deposits complement on the surface of the red blood cell. Once complement is deposited, the 3rd component of complement is recognized by receptors in the mononuclear phagocyte system resulting in spherocytic extravascular hemolysis. This results in a Coombs positive hemolytic anemia with the peripheral blood film showing agglutination. In many instances, the source is a clonal population of lymphoplasmacytic cells in the bone marrow producing a monoclonal IgM protein. Traditional and emerging...
Source: Hematology/Oncology Clinics of North America - March 10, 2022 Category: Cancer & Oncology Authors: Morie A. Gertz Source Type: research