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Fibrinolytic Agents in Thromboembolic Diseases: Historical Perspectives and Approved Indications
Semin Thromb Hemost DOI: 10.1055/s-0044-1781451Fibrinolytic agents catalyze the conversion of the inactive proenzyme plasminogen into the active protease plasmin, degrading fibrin within the thrombus and recanalizing occluded vessels. The history of these medications dates to the discovery of the first fibrinolytic compound, streptokinase, from bacterial cultures in 1933. Over time, researchers identified two other plasminogen activators in human samples, namely urokinase and tissue plasminogen activator (tPA). Subsequently, tPA was cloned using recombinant DNA methods to produce alteplase. Several additional derivatives o...
Source: Seminars in Thrombosis and Hemostasis - March 1, 2024 Category: Hematology Authors: Rashedi, Sina Greason, Christie M. Sadeghipour, Parham Talasaz, Azita H. O'Donoghue, Michelle L. Jimenez, David Monreal, Manuel Anderson, Christopher D. Elkind, Mitchell S. V. Kreuziger, Lisa M. Baumann Lang, Irene M. Goldhaber, Samuel Z. Konstantinides, Tags: Review Article Source Type: research

Variable Performance of D-dimer Testing by Hemostasis Laboratories: The Australasian/Asia-Pacific Experience
Semin Thromb Hemost DOI: 10.1055/s-0044-1781450D-dimers represent the breakdown products of fibrin. Thus, elevated plasma D-dimers will arise following a thrombotic event, such as a deep vein thrombosis or a pulmonary embolism, and therefore, a nonelevated D-dimer is used to effectively exclude such events. D-dimers are also elevated in a range of other conditions, for example, during disseminated intravascular coagulation. D-dimer levels may also be associated with prognostic value. For example, highly raised D-dimer levels can be associated with worsening clinical features in coronavirus disease 2019. Thus, D-dimer testi...
Source: Seminars in Thrombosis and Hemostasis - March 1, 2024 Category: Hematology Authors: Favaloro, Emmanuel J. Arunachalam, Sandya Dean, Elysse Tags: Review Article Source Type: research

Lupus Anticoagulant-Hypoprothrombinemia Syndrome: Literature Review and Description of Local Case in a 3-Year-Old Chinese Girl
In conclusion, LAHPS is most commonly observed in female patients, particularly those under 18 years of age. LAHPS is characterized by hemorrhage, occurring at various sites and with varying degrees of severity, but the majority of patients improve with appropriate treatment and management. [...] Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Abstract  |  Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - February 23, 2024 Category: Hematology Authors: Wang, Bin Tang, Ning Zhang, Chi Tags: Review Article Source Type: research

Venous Thrombosis in Airborne Viral Infections: Is Coronavirus Disease 2019 now Any Different from Influenza?
Semin Thromb Hemost DOI: 10.1055/s-0044-1780507One of the hallmarks of coronavirus disease 2019 (COVID-19), particularly in complicated cases (i.e., requiring hospitalization or intensive care support), is persistent hemostasis activation, which may be associated with a vast array of thrombotic episodes involving both the arterial and venous systems. The renewed emphasis on the relationship between viral infections and venous thrombosis paves the way for determining whether a more common and often underestimated infection disease, such as influenza, may also be associated with a significant burden of venous thrombotic epis...
Source: Seminars in Thrombosis and Hemostasis - February 23, 2024 Category: Hematology Authors: Lippi, Giuseppe Favaloro, Emmanuel J. Nocini, Riccardo Tags: Review Article Source Type: research

Innovative Therapies for Acquired Hemophilia A
Semin Thromb Hemost DOI: 10.1055/s-0044-1779737Acquired hemophilia A (AHA) is a rare autoimmune bleeding disorder which can be life-threatening. AHA is due to autoantibodies against coagulation factor VIII. Disease onset may be idiopathic (approximately half of the cases) or triggered by autoimmune disorders, cancers, drugs, infections, or pregnancy. Besides treating the underlying disorder, specific AHA treatments include management of bleeding and inhibitor eradication. Various first-line and second-line hemostatic and immunosuppressive agents are currently available for the management of AHA. Recently, the hemostatic dr...
Source: Seminars in Thrombosis and Hemostasis - February 23, 2024 Category: Hematology Authors: Franchini, Massimo Focosi, Daniele Tags: Review Article Source Type: research

Fibrinolysis-Mediated Pathways in Acute Liver Injury
Semin Thromb Hemost DOI: 10.1055/s-0044-1779738Acute liver injury (ALI), that is, the development of reduced liver function in patients without preexisting liver disease, can result from a wide range of causes, such as viral or bacterial infection, autoimmune disease, or adverse reaction to prescription and over-the-counter medications. ALI patients present with a complex coagulopathy, characterized by both hypercoagulable and hypocoagulable features. Similarly, ALI patients display a profound dysregulation of the fibrinolytic system with the vast majority of patients presenting with a hypofibrinolytic phenotype. Decades o...
Source: Seminars in Thrombosis and Hemostasis - February 23, 2024 Category: Hematology Authors: Capece, Gina E. Luyendyk, James P. Poole, Lauren G. Tags: Review Article Source Type: research

Risk of Venous Thromboembolism by Cancer Type: A Network Meta-Analysis
This study was conducted to estimate the risk of VTE by cancer type and factors influencing VTE risk. The Embase, MEDLINE, and Cochrane Library repositories were systematically searched to identify clinical trials and observational studies published from 2005 to 2022 that assessed the risk of primary cancer-related VTE among two or more distinct cancer types. Studies with similar cancer populations and study methods reporting VTE occurring within 1 year of diagnosis were included in the NMA. Relative VTE rates across cancer types were estimated with random-effects Bayesian NMAs. Absolute VTE rates were calculated from thes...
Source: Seminars in Thrombosis and Hemostasis - February 23, 2024 Category: Hematology Authors: Betts, Marissa B. Liu, Xuejun Junqueira, Daniela R. Fahrbach, Kyle Neupane, Binod Ronnebaum, Sarah Dhamane, Amol D. Tags: Review Article Source Type: research

Development of a Coagulation Disorders Unit
Semin Thromb Hemost DOI: 10.1055/s-0044-1779633Our Coagulation Disorders Unit in Helsinki, Finland, provides 24/7 services for local and national hospitals and colleagues upon requests regarding bleeding and thrombosis diagnostics and management, including follow-up. The unit has a tight connection between the clinic and laboratory, and its maintenance and sharing knowledge and observations have been priorities, already for over 20 years and will continue to be of major importance. The consultation service is provided by phone during daytime and on-call hours, and in written form sent electronically to the consulting stake...
Source: Seminars in Thrombosis and Hemostasis - February 19, 2024 Category: Hematology Authors: Szanto, Timea Helin, Tuukka Joutsi-Korhonen, Lotta Lehtinen, Anna-Elina El Beayni, Nancy Lep äntalo, Aino Lassila, Riitta Tags: Review Article Source Type: research

The History of Diagnosing Venous Thromboembolism
Semin Thromb Hemost DOI: 10.1055/s-0044-1779484An accurate and prompt diagnosis of deep vein thrombosis and/or pulmonary embolism is important to prevent serious complications and mortality. Because the clinical presentation of venous thromboembolism (VTE) is often nonspecific, objective testing by means of radiological imaging is required to confirm the diagnosis. Historically, a diagnosis of VTE involved invasive imaging techniques like contrast venography or conventional pulmonary angiography. Technological developments toward more accurate and less invasive diagnostics have driven the implementation of a variety of new...
Source: Seminars in Thrombosis and Hemostasis - February 19, 2024 Category: Hematology Authors: Martens, Emily S.L. Huisman, Menno V. van Mens, Thijs E. Klok, Frederikus A. Tags: Review Article Source Type: research

Tranexamic Acid: An Evergreen Hemostatic Agent
Semin Thromb Hemost DOI: 10.1055/s-0044-1779632Tranexamic acid (TXA) is an important antifibrinolytic agent, which inhibits plasminogen activation and fibrinolysis. Several controlled randomized trials have investigated the role of TXA in preventing or decreasing blood loss across different surgical interventions or medical conditions characterized by excessive bleeding, consistently documenting its effectiveness and safety. Although the first clinical use of TXA dates back to more than 60 years ago, TXA remains the focus of intense research. This narrative review summarizes the more recent results and indications on the c...
Source: Seminars in Thrombosis and Hemostasis - February 9, 2024 Category: Hematology Authors: Franchini, Massimo Focosi, Daniele Mannucci, Pier Mannuccio Tags: Review Article Source Type: research

Progress in von Willebrand Disease Treatment: Evolution towards Newer Therapies
Semin Thromb Hemost DOI: 10.1055/s-0044-1779485von Willebrand disease (VWD) is a very heterogenous disease, resulting in different phenotypes and different degrees of bleeding severity. Established therapies (i.e., desmopressin, antifibrinolytic agents, hormone therapy for heavy menstrual bleeding, and von Willebrand factor [VWF] concentrates) may work in some subtypes, but not in all patients. In recent years, progress has been made in improving the diagnosis of VWD subtypes, allowing for more specific therapy. The impact of VWD on women's daily lives has also come to the fore in recent years, with hormone therapy, tranex...
Source: Seminars in Thrombosis and Hemostasis - February 8, 2024 Category: Hematology Authors: Moser, Miriam M. Schoergenhofer, Christian Jilma, Bernd Tags: Review Article Source Type: research

Risk Factors for Antiphospholipid Antibodies and Antiphospholipid Syndrome
Semin Thromb Hemost DOI: 10.1055/s-0043-1776910Persistence of serum antiphospholipid antibodies (aPL) is associated with a high thrombotic risk, both arterial and venous, and with pregnancy complications. Due to the potential morbidity and mortality associated with the presence of aPL, identifying and recognizing risk factors for the development of aPL and thrombosis in aPL carriers may help to prevent and reduce the burden of disease. Multiple elements are involved in the pathomechanism of aPL development and aPL-related thrombosis such as genetics, malignancy, and infections. This review will address the role of both wel...
Source: Seminars in Thrombosis and Hemostasis - January 16, 2024 Category: Hematology Authors: Aguirre del-Pino, Rodrigo Monahan, Rory C. Huizinga, Tom W.J. Eikenboom, Jeroen Steup-Beekman, Gerda M. Tags: Review Article Source Type: research

Shifting Paradigms and Arising Concerns in Severe Hemophilia A Treatment
Semin Thromb Hemost DOI: 10.1055/s-0043-1778103The management of hemophilia A has undergone a remarkable revolution, in line with technological advancement. In the recent past, the primary concern associated with Factor VIII (FVIII) concentrates was the risk of infections, which is now almost resolved by advanced blood screening and viral inactivation methods. Improving patients' compliance with prophylaxis has become a key focus, as it can lead to improved health outcomes and reduced health care costs in the long term. Recent bioengineering research is directed toward prolonging the recombinant FVIII (rFVIII) coagulant ac...
Source: Seminars in Thrombosis and Hemostasis - January 15, 2024 Category: Hematology Authors: Chandran, Rubhan Tohit, Eusni R. Mohd. Stanslas, Johnson Salim, Norazlinaliza Mahmood, Tuan M.T. Rajagopal, Mogana Tags: Review Article Source Type: research

Cancer-Associated Thrombosis and Beyond: Biomarkers, Treatments, and Cancer-Hemostasis Interactions
Semin Thromb Hemost DOI: 10.1055/s-0043-1778104 Thieme Medical Publishers, Inc. 333 Seventh Avenue, 18th Floor, New York, NY 10001, USAArticle in Thieme eJournals: Table of contents  |  Full text (Source: Seminars in Thrombosis and Hemostasis)
Source: Seminars in Thrombosis and Hemostasis - January 15, 2024 Category: Hematology Authors: Gyldenholm, Tua Larsen, Julie Brogaard Tags: Preface Source Type: research

Venous Thromboembolism in Children: The Rivaroxaban Experience
Semin Thromb Hemost DOI: 10.1055/s-0043-1778106The incidence of venous thromboembolism (VTE) in the pediatric population has increased more than 10-fold in the last 20 years, as a consequence of the advancement of resuscitation and surgical techniques and the global increase in life expectancy of children suffering from chronic pathologies. Monitoring anticoagulant therapy to achieve outcomes within the target range in childhood VTE, parenteral administration of medications, and frequent blood tests in children are often cumbersome. Availability of safe and effective oral agents with pediatric data to support use would be ...
Source: Seminars in Thrombosis and Hemostasis - January 5, 2024 Category: Hematology Authors: Spiezia, Luca Campello, Elena Tormene, Daniela Simioni, Paolo Tags: Review Article Source Type: research