Articles related to Hematology

Here are some details for your patients who may be taking Eliquis and need to understand how their diet may impact both their health and the potency of the medication. Eliquis, also known as apixaban, is a blood thinner used to prevent and treat blood clots, including conditions like venous thromboembolism, pulmonary embolism, and deep vein thrombosis. It’s also used to prevent strokes and blood clots associated with atrial fibrillation (AFib). Unlike warfarin, a well-known blood thinner, Eliquis doesn’t require your patients to avoid certain foods. Eliquis works by blocking a clotting factor in our blood called factor Xa. This makes it different from warfarin, which interacts with vitamin K-rich foods. Eliquis comes in 2.5 mg and 5 mg doses, taken twice daily. Importantly, it doesn’t require monitoring of PT/INR, a blood clotting test, unlike warfarin. When it comes to diet, Eliquis doesn’t interact negatively with any foods. Even foods that usually cause drug-food interactions, like leafy greens, grapefruit juice, cranberry juice, coffee, and peppermint tea, are safe with Eliquis. However, if you have patients taking Eliquis, ensure they still pay attention to their diet. Many patients on Eliquis have underlying heart disease, so a diet rich in fruits, vegetables, […]

Cilta-cel CAR-T-cell therapy: A ray of hope for refractory multiple myeloma patients. A new study on ciltacabtagene autoleucel CAR-T-cell therapy (cilta-cel) shows promise for relapsed/refractory multiple myeloma (RRMM) patients. Published in Blood, the study led by Dr. Adam Cohen from the University of Pennsylvania, focuses on patients with previous exposure to noncellular anti-B-cell maturation antigen (BCMA) therapies. The team’s objective was achieving the primary endpoint of minimal residual disease (MRD) negativity, alongside multiple secondary endpoints. They tested on patients above 18 with RRMM, progressive disease within 12 months of their last treatment or six months of prior therapy, and measurable disease at baseline. They conducted a multicohort study, primarily focusing on cohort C which entailed cilta-cel treatment. A total of 20 patients met the eligibility criteria and received cilta-cel. Among them, 35% had BsAb as their latest anti-BCMA treatment, while 65% had ADC. With a median follow-up of 11.3 months, 7 patients achieved MRD negativity. The overall response rate stood at 60%, with 55% achieving very good partial response (VGPR) or better, and 30% achieving complete remission (CR) or better. However, all patients experienced treatment-emergent adverse events, majorly grade 3 to 4 cytopenias. Most of these cytopenia events recovered to […]

Enhancing Platelet Dysfunction Diagnosis with Platelet Function Screen The Platelet Function Screen (PFA-100®) is a critical in vitro system for detecting platelet dysfunction. It uses citrated whole blood samples under high shear flow conditions, demonstrating its sensitivity. As blood is aspirated through collagen-coated membranes, platelet adhesion forms an initial matrix. Adding to the mix, platelet aggregation is stimulated by either epinephrine (COL/EPI) or adenosine diphosphate (COL/ADP), coating the membranes. In this process, the time required to form a platelet plug that blocks the aperture, known as closure time (CT), is the key measure of platelet function. Interestingly, several conditions can cause prolonged CT, including drug effects, low hematocrit, thrombocytopenia, von Willebrand Disease (vWD), and platelet disorders. Notably, aspirin therapy impacts the COL/EPI closure time more than COL/ADP. While assessing results, hematological considerations are pivotal, particularly with anemia and thrombocytopenia that could extend CT. Platelet counts below 150,000/uL or hematocrit below 35% could interfere with the results, thus, the test might not serve patients with counts below 100,000/uL or hematocrit under 30%. Moreover, hematocrit over 50% could generate inconsistent outcomes. Fundamentally, normal CT with both COL/EPI and COL/ADP signifies healthy platelet function. The COL/EPI membrane, while sensitive to primary hemostasis disorders, […]

This article reviews the novel CXCR4 inhibitor motixafortide and its use in hematopoietic stem-cell mobilization. We present a history of stem-cell mobilization and update of recent innovations in novel mobilization strategies. Hematopoietic stem-cell mobilization is a crucial step in autologous stem-cell transplantation. Motixafortide is a novel CXCR4 inhibitor that has been shown in preclinical and clinical trials to mobilize hematopoietic stem cells (HSCs) for transplantation. The drug has extended in vivo activity (>48 h) and high affinity (Ki, 0.32 nM). In a phase 1, two-part study, motixafortide administered to healthy subjects was safe, well tolerated, and led to a rapid and robust increase in the number of circulating HSCs. Motixafortide has been evaluated in a randomized phase 3 trial for autologous transplantation in multiple myeloma. The study showed that the combination of motixafortide and granulocyte colony-stimulating factor (G-CSF) was superior to G-CSF alone in terms of the number of CD34+ cells collected and the time to engraftment. The drug has also been evaluated in combination with plerixafor, another CXCR4 inhibitor, in a phase 1/2 study for autologous transplantation in multiple myeloma. The study showed that the combination of motixafortide and plerixafor was safe and effective in mobilizing HSCs. Motixafortide has […]

Oncologists and cancer drug shortages are creating a crisis, with patient care at risk and legal liabilities looming. In the face of critical cancer drug shortages, oncologists grapple with suboptimal patient care and possible legal liabilities. The issue worsens due to insufficient guidelines for alternative treatment options. A contributing factor is the weak financial incentive for drug manufacturers to produce unprofitable generic drugs, compared to branded ones. Consequently, there’s greater dependence on foreign factories, leading to supply chain hitches and quality control issues. Barbara McAneny, MD, CEO of New Mexico Cancer Center, foresees drug shortages persisting, particularly affecting low-cost treatments. The American Society of Health-System Pharmacists (ASHP) reports shortages of vital oncology drugs like methotrexate, cisplatin, carboplatin, and fluorouracil, crucial for treating various common cancers. Furthermore, the lack of guidelines on alternative treatments exacerbates oncologists’ concerns about patient outcomes and legal liabilities. This absence of direction leaves physicians making crucial decisions single-handedly. In response, the American Society of Clinical Oncology (ASCO) has formed an advisory group to develop clinical guidance during these drug shortages. Immediate recommendations include reprioritizing nonessential use of scarce antineoplastic drugs, increasing interval cycles, reducing doses when clinically acceptable, and selecting evidence-based alternatives. Dr. Jeff Patton, CEO […]

Dive into the intriguing relationship between POT1 mutations and long telomere length in relation to cellular aging and cancer development. The study, funded by the National Institutes of Health, closely examines the effects of POT1 mutations, a telomere-related gene, on aging and cancer. Specifically, they focused on individuals with heterozygous loss-of-function mutations in POT1 and their noncarrier relatives. Initially, they assessed 17 POT1 mutation carriers alongside 21 noncarrier relatives. Moreover, they incorporated a validation cohort of six additional mutation carriers. They found that a substantial majority, specifically 9 of the 13 evaluated, of the POT1 mutation carriers possessed long telomeres – a rare case falling above the 99th percentile. In contrast, the study identified a variety of benign and malignant neoplasms in POT1 mutation carriers affecting different tissues, including epithelial, mesenchymal, and neuronal, along with B- and T-cell lymphoma and myeloid cancers. Additionally, they found that 28% of POT1 mutation carriers had T-cell clonality. This percentage rose to 67% when evaluating for clonal hematopoiesis of indeterminate potential. With age, this predisposition to clonal hematopoiesis followed an autosomal dominant pattern of inheritance. Interestingly, common somatic hotspot mutations, specifically DNMT3A and JAK2, frequently occurred. They theorize that these somatic driver mutations arose […]