Layperson

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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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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BREVAgen

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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Capsule Endoscopy

Capsule Endoscopy(CE) is a procedure in which a capsule with a miniature camera is swallowed and it transmits images as it goes through the gastrointestinal tract. It has advantages and disadvantages. While easier on the patient, it does not allow for a biopsy, and if it shows a suspicious findings, full endoscopyto perform a biopsy will still be required. A recent European guideline says that patients at high risk for CRC, because of symptoms or

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Antibodies to inflixumab

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). Lower drug levels can mean less effect ont eh disease.  It is clinically useful to be able to  assess and predict diminishing response. A recent meta-analysis concluded that the presence of ATIs is associated with a significantly higher risk of loss of clinical

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Afirma test for thyroid nodules: ACEG – pro

The majority of FNAs of tyroid nodules show benign histological findings but some are indeterminate or non-diagnostic. In an attempt to separate out patients with a worse prognosis, Afirma has develoiped a proprietory tests, Benign Gene Expression Classifier.  In 2010, two modest-sized validation studies showed that the AGEC test could identify a benign gene expression signature in indeterminate cytology thyroid FNA samples with a negative predictive

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