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Monoclonal Gammopathy of Undetermined Significance - Patient Characteristics and Referral Patterns
ConclusionMGUS is often incidentally detected as part of a work up for other medical conditions, and our results reveal that there is a variety of reasons for which monoclonal testing is performed. With recent developments in our understanding of the significance of monoclonal gammopathy and its association with certain renal and organ damage (Fermand et al., 2018; Leung et al., 2012), there may be a change in how the paraproteinemia investigations are utilized by clinicians in different disciplines. It will be important to recognize and establish appropriate indications for testing. Furthermore, MGUS patients present with...
Source: Blood - November 21, 2018 Category: Hematology Authors: Lee, H., Street, L., Tay, J., Grossman, J., Thaell, J. F., Goodyear, D., McCulloch, S., Duggan, P., Neri, P., Jimenez-Zepeda, V. Tags: 651. Myeloma: Biology and Pathophysiology, excluding Therapy: Poster III Source Type: research

A Nationwide Analysis of Outcomes of Stroke in Hospitalized Patients with Essential Thrombocythemia: 2006 to 2014
Conclusions:Patients with ET who are hospitalized with stroke have significantly worse outcomes. This study demonstrated that a statistically significant difference exists among different age groups of patients with ET and stoke who died during hospitalization when stratification is made using age groups and Charlson Score. This study may serve as an initial point to include new risk factors for further risk stratification. Early identification of patients at higher risk may reduce the incidence and decrease the morbidity of stroke in patients with ET.DisclosuresKota: BMS: Honoraria; Novartis: Honoraria; Xcenda: Honoraria;...
Source: Blood - November 21, 2018 Category: Hematology Authors: Ajebo, G., Badin, K., Forehand, W., Guddati, A. K., Kota, V. Tags: 634. Myeloproliferative Syndromes: Clinical: Poster III Source Type: research

Characterizing a Population with Severe Manifestations of Sickle Cell Disease Using U.S. Real-World Evidence
ConclusionsBased on this contemporary real-world evidence from the U.S. setting, a substantial proportion of patients with SCD experience a diverse set of severely debilitating complications of the disease, as well as other co-morbidities associated with the disease. The high rate of comorbidities across all age groups and overrepresentation of patients younger than 30 years of age (relative to age distribution of general U.S. population) indicate that patients with SCD still experience significant morbidity and early mortality with current standard medical care. Given the notable heterogeneity of the clinical manifestatio...
Source: Blood - November 21, 2018 Category: Hematology Authors: Paramore, C., Kong, A., Minegishi, S., Shi, W. Tags: 903. Outcomes Research-Non-Malignant Hematology: Poster III Source Type: research

Quality of Care Indicators in Patients with Sickle Cell Disease (SCD): Influenza Vaccination and Routine Eye Examination Are Associated with Outpatient Utilization but Not Acute Hospital Care, Whereas Comorbidity Indexes Are Strongly Associated with Both
In conclusion, outpatient-based candidate quality indicators of care examined (influenza vaccination and eye examination), were associated with increased outpatient utilization, but not acute visits or hospitalizations. Co-morbidity indexes have significant confounding effects on outpatient and hospital utilization. Administrative data based quality indicators of care such as influenza vaccination, as well as SCD specific comorbidity indexes warrant further studies as these may help better understand optimal allocation of health care resources for patients with SCD.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - November 21, 2018 Category: Hematology Authors: Adamkiewicz, T., Baltrus, P., Li, C., Carter-Wicker, K., Gaglioti, A. Tags: 903. Outcomes Research-Non-Malignant Hematology: Poster II Source Type: research

Impact of Immune Thrombocytopenia in Patients Admitted with Coronary Artery Disease: Results from National Inpatient Sample 2009-2011
Conclusion: Our study shows that in patients with coronary artery disease-associated ITP, adjusted LOS and mortality was significantly higher compared to patients without ITP.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - November 21, 2018 Category: Hematology Authors: Aryal, M., Basnet, S., Dhital, R., Gosain, R., Donato, A. Tags: 903. Outcomes Research-Non-Malignant Hematology Source Type: research

Role of Automated Red Cell Exchange in Acute and Chronic Complications of Sickle Cell Disease
Discussion. Our study shows that red cell exchange is an effective treatment modality for patients with sickle cell disease. It contributes to improvement in weight, increase in Hb and Hct and decrease in wbc, plt, HbS% and iron overload. It also decreases inpatient and ED admissions. The procedure is safe and tolerable with minimal complications. Long term studies are needed study the efficacy of this treatment modality and its contribution to improvement of quality of life and life expectancy in sickle cell disease patients.DisclosuresNo relevant conflicts of interest to declare.
Source: Blood - November 21, 2018 Category: Hematology Authors: Jain, S., Rock, A., Lopes, C., Saraf, S. L., Zhang, X., Gowhari, M., Molokie, R. E., Gordeuk, V. R., Campbell-lee, S. Tags: 114. Hemoglobinopathies, Excluding Thalassemia-Clinical: Poster III Source Type: research

Anti ‐thrombotic therapy for atrial fibrillation in patients with chronic kidney disease: Current views
Abstract Chronic kidney disease (CKD) occurs in approximately one‐third of patients with non‐valvular atrial fibrillation (AF). The presence of CKD, particularly advanced CKD, confers increased risk of both thromboembolism and major bleeding in this group of patients who are already at risk for ischemic stroke and systemic embolism and at risk of bleeding due to anticoagulation. Studies assessing the effect of warfarin on risk of ischemic stroke, systemic embolism, and major bleeding have produced disparate results, particularly in patients with advanced CKD including those treated with hemodialysis. The direct oral an...
Source: Hemodialysis International - October 24, 2017 Category: Hematology Authors: Rugheed Ghadban, Greg Flaker, Natraj Katta, Martin A. Alpert Tags: REVIEW ARTICLE Source Type: research

Evaluating safety of thrombolysis in chronic kidney disease patients presenting with pulmonary embolism using propensity score matching
AbstractTo assess the safety of thrombolytic therapy in chronic kidney disease (CKD) patients who present with pulmonary embolism (PE). We used the Nationwide Inpatient Sample Database to identify patients who underwent thrombolysis for PE between 2010 and 2014. The patients were divided into two groups: (1) No CKD and (2) CKD. Patients with and without CKD were matched using 1:1 propensity score matching and a caliper width of 0.01. The primary outcomes were in-hospital mortality and hemorrhagic events. The secondary outcomes were blood transfusions, length of stay and total hospitalization charge. Two separate, multivari...
Source: Journal of Thrombosis and Thrombolysis - September 1, 2017 Category: Hematology Source Type: research

Nonvitamin K-dependent oral anticoagulants (NOACs) in chronic kidney disease patients with atrial fibrillation
Atrial fibrillation (AF) represents the most common arrhythmia in patients with chronic kidney disease (CKD). As in the general population, in CKD patients AF is associated with an increased risk of thromboembolism and stroke. However, CKD patients, especially those on renal replacement therapy (RRT), also exhibit an increased risk of bleeding, especially from the gastrointestinal tract.Oral anticoagulation is the most effective form of thromboprophylaxis in patients with AF presenting increased risk of stroke.
Source: Thrombosis Research - May 3, 2017 Category: Hematology Authors: L. Di Lullo, C. Ronco, M. Cozzolino, D. Russo, L. Russo, B. Di Iorio, A. De Pascalis, V. Barbera, M. Galliani, E. Vitaliano, C. Campana, F. Santoboni, A. Bellasi Tags: Review Article Source Type: research

Antithrombotic therapy in end ‐stage renal disease
Abstract The delicate balance of risk vs. benefit of using antiplatelet and antithrombotic agents in the general population is well established. The decision to use these agents in the end stage renal disease (ESRD) population remains complex and difficult. The concomitant association of a prothombotic state with high risk of bleeding in the ESRD population requires individualization and careful clinical judgment before implementing such therapy. There remains a paucity of clinical trials and lack of substantial evidence in literature for safe and effective use of antithrombotic drugs in patients with advanced chronic kidn...
Source: Hemodialysis International - April 1, 2017 Category: Hematology Authors: Svetha Chunduri, Jon E. Folstad, Tushar J. Vachharajani Tags: Review Article Source Type: research

Relationship between renal function and circulating microparticles, soluble P-selectin and E-selectin levels in atrial fibrillation
AbstractAtrial fibrillation (AF) and chronic kidney disease are closely related, and any associated risk of stroke and thromboembolism due to AF is increased by concurrent renal dysfunction. The mechanism(s) for this include abnormalities in platelets and endothelial cells. We hypothesized relationships between levels of circulating platelet microparticles (PMPs, defined by CD42b), soluble P selectin (both reflecting platelet activation), soluble E-selectin (reflecting endothelial activation) and endothelial/platelet microparticles (EPMPs, defined by CD31) with progressive renal dysfunction. Blood samples were obtained fro...
Source: Journal of Thrombosis and Thrombolysis - December 31, 2016 Category: Hematology Source Type: research

Dabigatran overdose: a case report of acute hepatitis. Extracorporeal treatment.
We report a case of dabigatran intoxication in an elderly man affected by heart failure and worsening renal function, who developed acute hepatitis and coma, which was successfully treated with continuous veno-venous hemodiafiltration. Although extracorporeal therapy has been suggested as a strategy for clearing dabigatran during acute bleeding, this approach may be useful in other dabigatran-related, life-threatening conditions, such as that described in this report. PMID: 27910004 [PubMed - as supplied by publisher]
Source: International Journal of Hematology - November 30, 2016 Category: Hematology Authors: Porru M, Mameli A, Cianchetti ME, Musu M, Schirru P, Ruberto MF, Barcellona D, Marongiu F Tags: Int J Hematol Source Type: research

Low ‐dose aspirin for prevention of cardiovascular disease in patients on hemodialysis: A 5‐y prospective cohort study
In this study, 406 patients on regular HD were involved during a 5‐y follow‐up. Among these, 152 and 254 propensity‐matched patients were enrolled in the aspirin and nonaspirin cohort, respectively. The cumulative survival rate was not significantly higher in the aspirin than in the nonaspirin users (log rank χ2 = 1.080, P = 0.299). Aspirin use was not significantly associated with reduced all‐cause mortality, fatal and nonfatal congestive heart failure, as well as acute myocardial infarction and ischemic stroke. The risk of fatal cerebral hemorrhage was not significantly increased in the aspirin users (HR...
Source: Hemodialysis International - February 29, 2016 Category: Hematology Authors: Jun Liu, Yu Pan, Lei Chen, Qing Yan Qiao, Jing Wang, Li Hua Pan, Yan Hong Gu, Hui Fang Gu, Shun Kun Fu, Hui Min Jin Tags: Original Article Source Type: research

To intervene or not? A man with multidrug-resistant hypertension, endovascular abdominal aneurysm repair, bilateral renal artery stenosis and end-stage renal disease salvaged with renal artery stenting.
We report the case of a 69-year-old man with uncontrolled multidrug-resistant secondary hypertension following a 10 year history of endovascular abdominal aortic aneurysm repair, with suprarenal fixation and concurrent angioplasty with stenting of the left renal artery for atherosclerotic renal disease, and progressive chronic kidney disease. Renal scintigraphy revealed complete loss of the right kidney's and severe reduction of the left kidney's perfusion and function. Following recent evidence and consultation with vascular surgeons regarding the technical difficulties of any procedure, escalation of antihypertensive tre...
Source: Blood Pressure - February 14, 2016 Category: Hematology Tags: Blood Press Source Type: research

Decision-making about the use of non-vitamin K oral anticoagulant therapies for patients with atrial fibrillation
Abstract Until recently, vitamin K antagonists, warfarin being the most commonly used agent in the United States, have been the only oral anticoagulant therapies available to prevent stroke in patients with atrial fibrillation (AF). In the last 5 years four new, non-vitamin K oral anticoagulants, the so-called NOACs or novel oral anticoagulants, have come to market and been approved by the Federal Drug Administration. Despite comparable if not superior efficacy in preventing AF-related stroke, and generally lower risks of major hemorrhage, particularly intracranial bleeding, the uptake of these agents has been s...
Source: Journal of Thrombosis and Thrombolysis - February 1, 2016 Category: Hematology Source Type: research

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