Haematology Topic Homepage
Haematology Overview
Haematology encompasses the study of blood formation (haemopoiesis) and function, as well as the diagnosis and treatment of diseases of the blood.1
Anaemia is a disease that causes an abnormally low erythrocyte cell mass, either by reduced production or increased break down of these cells.2 The most common cause of anaemia is a lack of iron, causing reduced production of haemoglobin and reduced oxygen ...
... distribution. This is easily treated with iron supplements and a healthy balanced diet.3 It is a disease in its own right, but it is also associated with many others (heart disease,4,5 cancer6 and diabetes7).
Sickle cell anaemia is an autosomal recessive disease which causes structural mutations in haemoglobin molecules and sickle shaped erythrocytes.8 There is a high prevalence of sickle cell anaemia among the Afro Caribbean population. It can cause pulmonary complications such as acute chest syndrome and sickle chronic lung disease.9 The high morbidity and mortality associated with this disease make it public health issue.
Genetic mutations in coagulation factors can lead to coagulation disorders which cause excessive bleeding. Haemophilia, caused by a mutation in the factor VIII gene, is the most common of these disorders; however deficiencies of other coagulation factors can also occur.10
Leukemias and lymphomas are both classified as cancers of the blood; they affect white blood cells and the lymphatic system respectively. There are four main types of leukaemia; acute lymphoblastic leukaemia, acute myeloid leukaemia, chronic myeloid leukaemia and chronic lymphocytic leukaemia.11 Lymphomas can be divided into Hodgkin's lymphomas (HL), and non-Hodgkin's lymphomas (NHL). Both form neoplasms in the lymphatic system, NHL are more prevalent and can be further separated into B-cell or T/NK-cell neoplasms.12
1. Hoffbrand A.V. et al. Essential Haematology. Wiley-Blackwell. 2006 ; 5 (698) : viii.
2. Uthman E. Understanding Anemia. Understanding Health and Sickness Series. Univ. Press of Mississippi. 1998 : 3-10.
3. Jacoby D.B. et al. Encyclopedia of Family Health. Marshall Cavendish. 2004 ; 5 : 88-90.
4. Dimopoulos K. et al. Anemia in Adults With Congenital Heart Disease Relates to Adverse Outcome. Journal of the American College of Cardiology. November 2009 ; 54 (22) : 2093-2100.
5. Teng K.T.-H. et al. Mild Anaemia is Associated with Increased All-cause Mortality in Heart Failure. Heart, Lung and Circulation. January 2010 ; 19 (1) : 31-37.
6. Ludwig H. et al. The European Cancer Anaemia Survey (ECAS): A large, Multinational, Prospective Survey Defining the Prevalence, Incidence, and Treatment of Anaemia in Cancer Patients. European Journal of Cancer. October 2004 ; 40 (15) : 2293-2306.
7. McGill H.B. et al. Anemia and the Role of Erythropoietin in Diabetes. Journal of Diabetes and its Complications. July-August 2006 ; 20 (4) : 262-272.
8. Peterson J.M. Sickle Cell Anaemia. The Rosen Publishing Group. 2008 : 15-25.
9. Greenough A. et al. Systemic Disease Sickle Cell Disease. Encyclopedia of Respiratory Medicine. May 2006 : 212-218.
10. Hoffbrand A.V. et al. Essential Haematology. Wiley-Blackwell. 2006 ; 5 (698) : 290-296.
11. Basso G. et al. Diagnosis and Genetic Subtypes of Leukemia Combining Gene Expression and Flow Cytometry. Blood Cells, Molecules and Diseases. September-October 2008 ; 39 (2) : 164-168.
12. Ottensmeir C. The Classification of Lymphocytes and Leukaemias. Chemico-Biological Interactions. June 2001 ; 135-136 : 653-664.
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Soft Tissue Sarcoma
Soft Tissue Sarcomas (STS) are malignant (cancerous) tumors that develop in tissues which connect, support, or surround other structures and organs of the body. Muscles, tendons (bands of fiber that connect muscles to bones), fibrous tissues, fat, blood vessels, nerves, and synovial tissues are types of soft tissue.
Soft tissue sarcomas are grouped together because they share certain microscopic characteristics, have similar symptoms, and are generally treated in similar ways.1 They are usually named for the type of tissue in which they begin.
Every year approximately 13,000 new cases of soft tissue sarcomas are diagnosed in adults and children in Europe. The 5-year survival rate for patients with soft tissue sarcoma is around 90% if the cancer is detected in early phases and before it has spread. However, the 5-year survival rate is 10% to 15% for sarcomas with metastasis.
Management of STS depends on the stage of disease and histological subtype.2 Surgery is the mainstay of treatment for patients with localised disease and is often curative. However, as recurrence is likely to occur when tumour cells remain after surgery, adjuvant radiotherapy is often also considered, especially for patients with intermediate or high-grade tumours. Radiotherapy is also often administered for patients in whom surgery is inappropriate or who decline surgery.2
There are a number of Associations and Organisations across Europe who strive to inform others of this disease as well as offer help and support to those affected or to those who know and want to help those suffering.
Enter the Soft Tissue Sarcoma Knowledge Centre
References
1. Cormier JN, Pollock RE. Soft tissue sarcomas. CA: A Cancer Journal for Clinicians 2004; 54(2):94–109.
2. Clark MA, Fisher C et al. (2005) “Soft-tissue sarcomas in adults.” N Engl JMed 353(7): 701–11.
Anti-Infectives Knowledge Centre
The last decade has seen an increase in the incidence and severity of Clostridium difficile infections (CDI), making it one of the most talked about disease topics with many recent congresses focusing on the disease.
As the leading cause of nosocomial diarrhoea in industrialised countries1 detection and treatment of CDI is extremely important. The ESCMID guidelines recommend that diagnosis is based upon both signs and symptoms and laboratory evidence of toxin producing C. difficile in stools.1,2 In addition antibiotic treatment to eradicate severe C. difficle infection is recommended in these guidelines.2
The management of systemic fungal infections is also a major challenge for healthcare professionals. Due to the invasive nature of fungal infections, many treatments are pre-emptive and are therefore initiated without identifying the specific fungus involved. Targeted approaches will become a more viable option as the speed and delivery of diagnostic methods improve.
The Anti-infectives Knowledge Centre aims to provide you with the most recent information in the areas of both CDI and systemic fungal infections with regularly updated content to help assist in the fight against these diseases.
The Knowledge Centre currently provides information on CDI, including:
- Prevalence – the incidence of CDI and the factors that have been attributed to the rise in these infections
- Symptoms – the symptoms of CDI, including how pseudomembranous colitis manifests
- Recurrence – the impact of recurring infection on patient outcomes
- Diagnosis – the importance of early diagnosis and the diagnostic tests available
- Treatment – treatment options recommended by the current ESCMID guidelines
Additional information on systemic fungal infections will be added soon.
Enter the Anti-infectives Knowledge Centre
References
1. Crobach MJ, et al. Clin Microbiol Infect 2009; 15: 1053‐1066
2. Bauer MP, et al. Clin Microbiol Infect 2009; 15: 1067‐1079
Date of preparation November 2012 AI/12/0038/EUc
Anti-Infectives Knowledge Network
The Anti-infectives Knowledge Network (AIKN), an initiative by Astellas Pharma Europe Ltd, shares the expertise and experience of a number of Thought leaders in the area of anti-infectives.
Topics from EBMT 2013 covered include:
- Advances in prevention strategies for cytomegalovirus (CMV)
- Managing infectious complications in HSCT recipients
- Prophylaxis and management of fungal infections
- Advances and on-going challenges in managing invasive fungal infections
This is in addition to reports and sponsored presentations from ISICEM 2013 and our 2012 coverage from a number of meetings including ECCMID and ISHAM.
Additional content recently added to the Anti-infectives Knowledge Network includes:
- Slides shared by the faculty from the Seeing CDI differently CME-accredited meeting held in London, February 2013. This meeting was funded by Astellas Pharma Europe Ltd. Content was driven by a scientific steering committee
- Free downloadable 2012 ESCMID Guidelines Supplement for the diagnosis and management of Candida diseases and related slides for use in your own presentations
Future 2013 coverage will include congress reports and interactive presentations from ECCMID, EHA, ESOT and TIMM.
We encourage you to return regularly to read the news, clinical insights, and essential information from the latest congresses.
Click here to enter the Anti-infectives Knowledge Network.
Date of Preparation: May 2013 AI/13/0011/EUf
Chronic Myeloid Leukemia
The World Health Organization (WHO) classifies chronic myeloid leukaemia (CML) as a myeloproliferative disease characterised by the presence of the Philadelphia chromosome (Ph) or the BCR-ABL fusion oncogene.1 The diagnosis is generally easily made on the basis of morphological examination of a peripheral blood smear, but confirming genetic studies have become essential with the advent of molecularly targeted therapy.3-6
Leukaemias account for 300,000 new cases (~3% of all new cancer cases) each year and 220,000 deaths worldwide.2 CML accounts for about 15%-20% of all adult leukaemias and occurs slightly more frequently in men than in women (incidence ratio: 1.4 to 2.2:1).
Chronic myeloid leukemia typically progresses through 3 stages or phases. Most patients present in chronic phase, deteriorate during the subsequent accelerated phase, and finally progress to a brief terminal phase, blast crisis. Although the lengths of the phases were altered by previous therapies, the clinical course and natural history of CML had not been changed before the molecular era.
Within the treatment section we examine the following treatment options:
Advances in the investigation of the molecular biology of cancer over several decades have made it possible to rationally design drugs to target oncogenic events with unprecedented specificity.7
Enter the Chronic Myeloid Leukemia (CML) Knowledge Centre
References:
1. Vardiman JW, Harris NL, Brunning RD. The World Health Organization (WHO) classification of the myeloid neoplasms. Blood. 2002;100:2292-2302.
2. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin. 2005;55:74-108.
3. Druker BJ. Perspectives on the development of a molecularly targeted agent. Cancer Cell. 2002;1:31-36.
4. Greenlee RT, Hill-Harmon MB , Murray T, Thun M. Cancer statistics, 2001. CA Cancer J Clin. 2001;51:15-36.
5. Ries LAG, Eisner MP, Kosary CL, et al. SEER Cancer Statistics Review, 1975-2001. National Cancer Institute. Available at: http://seer.cancer.gov 11 November 2011
6. Cortes J. Natural history and staging of chronic myelogenous leukemia. Hematol Oncol Clin North Am. 2004;18:569-584.
7. Druker BJ. Perspectives on the development of a molecularly targeted agent. Cancer Cell. 2002;1:31-36.
Drug News
Phase III EXTEND trial shows Pixuvri (Cell Therapeutics) offers effective salvage therapy for Non-Hodgkin's Lymphoma
18-06-2013Results from sub-set analyses of data from the Phase III EXTEND (PIX301) clinical trial of Pixuvri (pixantrone), from Cell Therapeutics, in patients with relapsed or refractory aggressive B-cell...
EU approves Revlimid (Celgene) for transfusion dependent anaemia associated with Myelodysplastic Syndromes
18-06-2013
The European Commission has amended the marketing authorisation for Revlimid (lenalidomide)from Celgene.This decision means that Revleimd is now approved to treat patients with...
Phase III COMFORT-II study shows Jakafi/Jakavi (Novartis) improves overall survival in Myelofibrosis patients
17-06-2013Results from a Phase III three-year follow-up study that showed Jakafi/Jakavi (ruxolitinib), from Novartis, demonstrated improved overall survival and sustained reductions in spleen size compared...
Haematology Drug Data - A-Z
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Recent Drug Updates
octanate 50IU/ml
09-04-2013Treatment and prophylaxis of bleeding in patients with haemophilia A (congenital factor VIII deficiency) This preparation does not contain von Willebrand factor in pharmacologically effective...
Fersaday 100mg Tablets
14-11-2012Prophylaxis and treatment of iron deficiency states....
Galfer Capsules
14-11-2012For the treatment and prophylaxis of uncomplicated iron deficiency anaemia....
Clinical Guidelines
Guidelines on the diagnosis and management of heparininduced thrombocytopenia: second edition
Oct 2012The objective of this guideline is to provide healthcare professionals with clear guidance on the..
... clinical features of heparin-induced thrombocytopenia (HIT), the indications for monitoring of patients on heparins for HIT, the investigation of suspected HIT and the treatment of HIT.
Guidelines for the investigation and management of mantle cell lymphoma
Sep 2012This guideline is the first BCSH guideline on the topic of mantle cell lymphoma, and therefore, does..
... not supersede any previous guidance.
Online CME
Reversal of Warfarin Treatment
Apr 2013
... and the how and when to carry out reversal in both bleeding and non-bleeding patients.
GP Fact File - Vitamin B12 deficiency
Apr 2013
... vitamin B12 deficiency.
Clinical Trials
NOPHO-DBH AML 2012 Protocol Research study for treatment of children and adolescents with acute myeloid leukaemia 0-18 years
20-03-2013The AML 2012 study is a treatment and research protocol with the overall aim of improving prognosis for children and adolescents with AML. This is to be achieved by better risk stratification based on MRD quantification and more intensive induction compared to previous NOPHO protocols. Specific research aims are 1) To..
... investigate if DaunoXome® has a higher efficacy than Mitoxantrone, when given in course 1 for treatment of pediatric AML
2) To investigate if FLADx has a higher efficacy than ADxE when given as the second induction course for treatment of pediatric AML
3) To investigate the correlation between MRD measurement by PCR and flow cytometry and the prognostic impact of MRD with either method after course 1 and 2 respectively.
Cologne Cohort of Neutropenic Patients (CoCoNut)
19-03-2013The Cologne Cohort of Neutropenic Patients (CoCoNut) is a non-interventional cohort study assessing risk factors, interventions, and outcome of immunosuppressed patients with or without opportunistic infections.
Medical Videos
Medical Journal Abstracts
Low-fat diet with omega-3 fatty acids increases plasma insulin–like growth factor concentration in healthy postmenopausal women
Nutrition Research
Jun 2013
The insulin-like growth factor pathway plays a central role in the normal and abnormal growth of tissues; however, nutritional determinants of insulin-like growth factor I (IGF-I) and its binding proteins in healthy individuals are not well defined. Three test diets—high-fat diet (40% energy as fat), low-fat diet (LF;..
Life-threatening hypokalemia following rapid correction of respiratory acidosis
Heart & Lung: The Journal of Acute and Critical Care
May 2013
A 56-year-old woman with a history of paraplegia and chronic pain due to neuromyelitis optica (Devic's syndrome) was admitted to a spinal cord injury unit for management of a sacral decubitus ulcer. During the hospitalization, she required emergency transfer to the intensive care unit (ICU) because of progressive..
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William's manual of hematology - £44.93
Social Media
To vitamin D or not to D? That is the question!
on doc2doc... that if you think on vit D deficiency you should check 25(OH)D level in blood. We are diagnosing in the base of evidences and proofs. Not on ...
To vitamin D or not to D? That is the question!
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Can hypoglycaemia occur in otherwise normal folk?
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