Articles related to BLEEDING/BLOOD DISORDERS

Review Publication: Hematology AdvisorDesign: At the Annual Meeting of the Society of Hematologic Oncology, researchers presented a study identifying a higher percentage of patients with germline predisposition syndromes (GPS).Results: Following a review of medical records of patients diagnosed with GPS between 1994 and 2018, the investigators reported that the detection of GPS positively impacted medical care in 91% of cases, including proper selection of a bone marrow donor, selection of drug and conditioning regimens, and genetic counseling.

Despite peripheral blood making up 80% of all of hematopoietic cell transplants, there are similar rates of overall survival, disease-free survival, and transplant-related mortality when comparing marrow and peripheral blood as graft sources. Chronic graft-versus-host disease (GVHD) and cytokine release syndrome (CRS) are more significant in those who received peripheral blood, yet the standard of care hasn’t changed. Here, two doctors reflect on the debate.

After diagnosis during a partial mastectomy, this patient’s estimated blood loss was 58 mL, causing anemia and requiring a red blood cell transfusion along with ventriculoperitoneal drain placement. With a substantive bleeding history before the diagnosis, what would you do next with this patient? Work her up for von Willebrand disease? Do a complete blood count test to look at platelet count, a peripheral smear to look at the morphology of the platelets, and a coagulation profile? Offer genetic testing for fibrinogen disorders? What would your next steps be? Read the full case presentation and expert opinion to see how your peers responded.

These evidence-based guidelines from the American Society of Hematology (ASH), the International Society on Thrombosis and Haemostasis (ISTH), the National Hemophilia Foundation (NHF), and the World Federation of Hemophilia (WFH) are intended to support patients, clinicians, and health care professionals in their decisions about management of von Willebrand Disease (VWD), a common inherited bleeding disorder.

In this symposium preceding the ASH Annual Meeting on 12/4/20, the overall objective is to inform participants about emerging diagnostic and therapeutic aspects of bleeding and thrombotic disorders. The speakers will illustrate how costly and unnecessary biochemical, phenotypic, and genetic testing can be avoided in the participants’ practices while enhancing highest quality medical care.

In this “How I Treat” feature from Blood, the authors conclude with three representative cases to both illustrate the application of the outlined diagnostic schema and discuss common management considerations, specifically the selection of anticoagulation vs. antiplatelet therapy for secondary prevention.