From the 2011 ASH Annual Meeting - Updates in Hematology Oncology

The American Society of Hematology (ASH) is hosting more than 20,000 attendees from around the globe at its 53rd annual meeting December 10-13 at the San Diego Convention Center in San Diego, CA. Data from more than 4,200 scientific abstracts – representing more than 1,000 oral and 3,000 poster presentations – will reveal the latest research in the field during the meeting.

As usual, the meetings have been full of attendees interested in the latest research and groundbreaking clinical updates. This year, some of the topics that grabbed my attention included an abstract on GVHD and another abstract on VTE:

A new study reveals that peripheral blood stem cell (PBSC) transplants from unrelated donors are associated with higher rates of chronic graft-versus-host-disease (GVHD) and have no survival advantage when compared to transplants using stem cells taken from the bone marrow.

Follow #ASH11 for Twitter Updates from ASH

Want to get updates from 2011 American Society of Hematology conference in San Diego? Here are a few ways you can see what's happening:

Follow the official ASH Twitter account here: http://twitter.com/ash_hematology

Follow the annual meeting conversation at #ASH11.

For the complete annual meeting program and abstracts, visit http://www.hematology.org/2011abstracts.

The American Society of Hematology is the world’s largest professional society concerned with the causes and treatment of blood disorders. Its mission is to further the understanding, diagnosis, treatment, and prevention of disorders affecting blood, bone marrow, and the immunologic, hemostatic, and vascular systems by promoting research, clinical care, education, training, and advocacy in hematology. The official journal of ASH is Blood, the most cited peer-reviewed publication in the field, which is available weekly in print and online.

FREE patient and family conference about Aplastic Anemia & MDS

If you're in the Boston area, you may wish to recommend this free patient and family conference for people who have aplastic anemia, MDS, or PNH.

When:

Saturday, May 14, 2011
8:30 am to 5:00 pm

Where:

Westin Waltham-Boston
70 Third Avenue
Waltham, MA 02451

This FREE conference will bring you face-to-face with leading medical experts, connect you to more than 100 other patients and their families, and leave you feeling hopeful and energized. Whether you are newly diagnosed patient, a long-term survivor, a caregiver or friend of a patient, this conference will have something for you.

FDA approves Corifact for congenital Factor XIII Deficiency

FDA approves product to prevent bleeding in people with rare genetic defect
Corifact is 1st treatment for congenital Factor XIII Deficiency

The U.S. Food and Drug Administration today approved Corifact, the first product intended to prevent bleeding in people with the rare genetic defect congenital Factor XIII deficiency.

Patients with congenital Factor XIII deficiency don’t make enough Factor XIII, a substance that circulates in the blood and is important for normal clotting. Without treatment, people with the condition are at risk for life-threatening bleeding.

New Bone Marrow Biopsy Technology Delivers Superior Samples

Studies Show New Bone Marrow Biopsy Technology Delivers Superior Samples, Less Pain when Compared to Manual Devices

OnControl Bone Marrow System Debuted in March 2010

[San Antonio, Texas – February 9, 2011] For many cancer patients, a bone marrow biopsy and/or aspiration is one of the most dreaded aspects of their diagnosis and treatment plan. The traditional method for gaining bone marrow involves grinding a needle by hand through a patient’s skin and bone, and the procedure is often described as extremely painful.

Vidacare’s OnControl Bone Marrow System is changing that.

Three separate clinical studies evaluating Vidacare Corporation’s OnControl Bone Marrow System, which was introduced commercially in March of 2010, found that the rotary-powered device yields superior samples and decreased patient pain when compared to traditional manual devices. The studies were presented at the 52nd annual American Society of Hematology in Orlando, Florida in December.

Cell Saver blood-recovery system (Haemonetics)

I was reading about a medical case the other day in the New England Journal of Medicine about a "Pregnant Woman with Abdominal Pain and Fluid in the Peritoneal Cavity." The management of this patient involved the use of the Cell Saver blood-recovery system (Haemonetics). The Cell Saver system recovered approximately 600 ml of red cells. That's quite impressive. Here's some information about this technology (from the company's website:

Haemonetics pioneered intraoperative cell salvage. Since its introduction in 1972 our Cell Saver® Autologous Blood Recovery system led the industry to become the standard of care.

The Cell Saver 5+ system is designed for surgeries like CABG, valve replacement, trauma, transplant, and other procedures where medium- to high-volume blood loss occurs. With the ability to deliver between 50-60% hematocrit and to remove nearly all traces of undesirable components such as free hemoglobin, the Cell Saver system is the standard of care and a critical tool to help avoid unnecessary allogeneic transfusions. And in a recent lab test, SmartSuction Harmony® surgical suction system significantly reduced hemolysis. Based on this finding, when a SmartSuction Harmony device is used with the Cell Saver system there may be an increase in the number of viable red blood cells reinfused to patients.

sP-selectin and D-dimer used to predict VTE risk in cancer patients

Cancer patients have a higher risk for VTE, but should they all receive anticoagulation therapy? When is pharmacological prophylaxis warranted?  A recent published paper seems to suggest that sP-selectin and D-dimer may be used to help predict VTE risk in cancer patients.

Here's the abstract:

The risk of venous thromboembolism (VTE) is increased in cancer patients. To improve prediction of VTE in cancer patients, we performed a prospective and observational cohort study of patients with newly diagnosed cancer or progression javascript:void(0)of disease after remission. A previously developed risk scoring model for prediction of VTE that included clinical (tumour entity and body-mass-index) and laboratory (hemoglobin level, thrombocyte- and leucocyte-count) parameters was expanded by incorporating two biomarkers, soluble P-selectin and D-dimer. Of 819 patients 61 (7.4%) experienced VTE during a median follow-up of 656 days. The cumulative VTE probability in the original risk model after 6 months was 17.7% in patients with the highest risk score (≥3, n=93), 9.6% in those with score 2 (n=221), 3.8% in those with score 1 (n=229) and 1.5% in those with score 0 (n=276). In the expanded risk model, the cumulative VTE probability after 6 months in patients with the highest score (≥5, n=30) was 35.0% and 10.3% in those with an intermediate score (score 3, n=130) as opposed to only 1.0% in patients with score 0 (n=200); the hazard ratio of patients with the highest compared to those with the lowest score was 25.9 (8.0-84.6). Clinical and standard laboratory parameters with addition of biomarkers enable prediction of VTE and allow identification of cancer patients at high or low risk of VTE.

Ay C, Dunkler D, Marosi C, Chiriac AL, Vormittag R, Simanek R, Quehenberger P, Zielinski C, Pabinger I. Prediction of venous thromboembolism in cancer patients. Blood. 2010 Sep 9.

Click here to read the abstract.

Remember our troops this Memorial Day

This Memorial Day, let's remember our troops. We still have many soldiers who are serving overseas. Advances in technology are improving medical care for soldiers who get wounded in battle, but we'll never reverse death.

Earlier this month, we learned that "Federal Agents Probing Army's Use Of Trauma Drug: Criminal Investigation Looking At Military's Use Of Blood-Clotting Injections For Treating War Casualties."  Is the military using NovoSeven for off-label purposes to save the lives of bleeding soldiers?

Here are some snippets from the Baltimore Sun:

May 16--Federal criminal investigators are exploring the Army’s use of a controversial and expensive blood-clotting drug injected into wounded troops in Iraq and Afghanistan.

The drug, called Factor VII, was hailed as a lifesaving breakthrough by military leaders and administered to hundreds of soldiers and Marines earlier in the wars. It has since proved largely ineffective in clinical trials and been the subject of safety warnings by U.S. and European regulators, who say it can cause potentially deadly blood clots.

The manufacturer, the Danish drug company Novo Nordisk, said it had received a subpoena in January from the Defense Department’s inspector general’s office. Company officials said they are cooperating with the U.S. attorney’s office in Baltimore, which is overseeing the investigation.

I don't know how this investigation will conclude, but perhaps we need to loosen restrictions when the country is at war and when we have bleeding soldiers on the field.

Sanofi-Aventis ends development of idrabiotaparinux and eplivanserin

Sanofi-Aventis announced that it will stop the development of idrabiotaparinux and eplivanserin. Have you heard of these agents?

• Idrabiotaparinux is a novel synthetic anticoagulant that links idraparinux, a specific, indirect factor Xa inhibitor, to biotin.
• Eplivanserin was being developed for insomnia.

These drugs got close. Sanofi-Aventis also announced it will buy the U.S. health care company Chattem Inc. for about $1.9 billion in cash. Sanofi-Aventis said the deal would create the world's fifth-largest consumer health care company.

I'm now on the Be the Match Marrow Registry by the NMDP

The Be the Match Registry is operated by the National Marrow Donor Program (NMDP). After swabbing my cheeks and submitting my DNA, I now have my own bone marrow donor identification card. I realize that there is a great need for bone marrow donors out there. I was inspired to join the registry because of the "Save Jodie Gee" group on Facebook. Perhaps you've heard of her. Jodie is a young woman who was very healthy until she discovered that she had aplastic anemia last November. She recently had a bone marrow transplant and it sounds like she's doing well. You can follow her story here on the Save Jodie Gee blog.

I know several other people who are currently in need of a bone marrow transplant. You probably too as well. If you're Asian, you can order a free kit from the www.AADP.org to be part of the national bone marrow registry. There is a significant need for donors from all ethnic groups. If you haven't joined the Be the Match Registry, perhaps you'll want to stop by a bone marrow drive or simply order a kit so that you can save a life.

Teen cries tears of blood (haemolacria)

This is a very unusual case. Calvino Inman is a 15-yr-old teen who lives in Tennessee. When he cries, he cries tears of blood. According to this story on CNN: Dr. Barrett G. Haik, director of the University of Tennessee's Hamilton Eye Institute, says... "crying blood," a condition called haemolacria, is common in people who have experienced extreme trauma or who have recently had a serious head injury." The strange part is that Inman has no history of head trauma. So why would he be crying blood?

The CNN story also notes that Inman will under a psychiatric evaluation to rule out the possibility that he might be faking those bloody tears.

Computers Dosing Coumadin

Dosing Coumadin (or warfarin) can be a perplexing challenge. Dosing to get that ideal INR can be very difficult because every patient is different. Well, researchers in the UK have been testing the effectiveness of some computer-based dosing programs. Once again, technology comes through to improve patient care. Want to read more? Check out the article in the Journal of Thrombosis and Haemostasis.

I'm sure there are other companies developing dosing algorithms and other types of software to simplify Coumadin administration. If this sounds interesting, then you may want to dig around and find some of these companies.