Author Archive of Candoc

Cytogenetics for myelofibrosis -Pro

Cytogenetics are now routinely recommended for myelofibrosis. Guidelines (Reilly et al) indicate that beyond a routine bone marrow aspiration and biopsy, JAK2 V617F mutation screening should be carried out routinely in patients with primary myelofibrosis (PMF). Quantitative results are not required for clinical management.BCR-ABL1 rearrangement should be excluded in cases with atypical trephine biopsy features, or if the patient lacks a mutation

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DLI for T cell leukemia and lymphoma – pro

Donor lymphocyte infusions are designed to awaken some degree of graft versus host reaction, which contains within it also the graft versus disease effect. It is a modality that can be used after allogeneic transplantation to treat relapse by "awakening" an immune response. . Almost all work on DLI was in B cell leukemias and lymphomas.  How it affects T cell malignancies is not well studied and most of what is known was in Adult T-Cell leukami/Lymphoma.

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Symphony suite of tests for Breast Cancer – pro
'Breast cancer' highlighted in pink with felt tip pen

Symphony suite of tests includes Mammaprint, BluePrint and TargetPrint. According to the online article titled “Comparison of MammaPrint, BluePrint, and TargetPrint with Clinical Parameters in Patients with Breast Cancer: Findings from a Prospective United States Cohort”, it states that the multigene signature MammaPrint, as well as BluePrint and TargetPrint, provides additional information for treatment guidance. By combining MammaPrint with

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Atypical CML

Atypical chronic myelogenous leukemia (aCML) is a leukemic disorder that exhibits both myelodysplastic and myeloproliferative features at the time of diagnosis. What this means is that it is not truly a CML but a condition that can be confused with CML, but is essentially different. It is not very common. It is thought that these features denote a poor prognosis, but these cases ahve a variety of genetic abnormalities that are different from CML

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Atypical CML – pro
doc at microscope

Atypical chronic myelogenous leukemia (aCML) is a leukemic disorder that exhibits both myelodysplastic and myeloproliferative features at the time of diagnosis. It is thought that these features dennote a poor prognosis. Atypical CML cases are usually BCR-ABL negative. The optimal treatment of aCML is uncertain because of the rare incidence of this chronic leukemic disorder. Treatment with hydroxyurea may lead to short-lived partial remissions of

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Personalized medicine is an up and coming approach, by which individual's risks and factors are taken into account to prescribe therapy. Genetic tests are a part of the approach. BREVAGen evaluates 7 breast cancer-associated factors. Risk is calculated by multiplying the product of the individual risks by the Gail model risk The Gail model is the first of several proposed ways to calcucalte an individual's riask for breast cancer.  BREVAGen has

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Olysio and Sovaldi: Two new drugs for Hepatitis C

Hepatitis C is a major public health problem, especially in Southeast Asia. Interferon and ribavirin have been the standard of care in various combinations. The literature supports intereferon with the two recently FDA  approved oral medications that can be used in combination with the current antiviral regimen or to replace the injectable component of the regimen, peginterferon alfa. The two new drugs are Olysio (simeprevir) capsules and Sovaldi

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Does measuring antibodies to infliximab help?

Antibodies to infliximab (ATIs) have been associated with loss of clinical response and lower serum infliximab (IFX) levels in some studies of patients with inflammatory bowel disease (IBD). Presumable lower levels mean less effectiveness, but it needs to be proven. It may be clinically useful to be able to  assess and predict diminishing response. A recent meta-analysis of all available studies concluded that the presence of ATIs is associated

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Rituxan for Hairy Cell Leukemia

Recent literature suggests that a subgroup of Hairy Cell Leukemia(HCL), sometimes called Variant Hairy Cell(HCL-V)  may in fact be a different type of Lymphoma and not Hairy Cell, and that it may respond to rituximab to a much higher extent than common Hairy Cell does. It is what was called Leukemic Reticuloendotheliosis in the past. It accounts for approximately 0.4% of chronic lymphoid malignancies and 10% of all HCl cases. In contrast to HCl-C,

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Velcade for Graft Vesus Host Disease

Shen transplanted from an immunologically different person, graft cells can attack the host's body. This is called Graft Versus Host Diseas*GVHD)e and remains a serious problem in transplantation.  One trial by Koreth and others found that Velcade was beneficial in GVHD; but his was a phase II trial other phase II trials are ongoing. Koreth treated 45 patients; 89% of patients who were treated had a one-locus and 11% of patients were treated with

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