ABC of clinical haematology by Drew Provan

By Drew Provan

This ABC has validated itself as a well-liked advent to scientific Haematology, appropriate either for postgraduate scholars and first care practitioners. Now in its 3rd variation, the ABC of medical Haematology has been completely revised, that includes the newest remedies for leukemia, antithrombotics and medicine for lymphoma and protecting the most recent advances in hematology and bone marrow transplantation.

With every one bankruptcy written through experts of their respective fields, this is often an awesome simple textual content for basic perform and health facility employees with sufferers who've blood comparable difficulties, specifically GPs, hematology nurses, junior medical professionals, hematologists, and trainees in hematology.

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O’Brien SG, Guilhot F, Larson RA et al. Interferon and low dose cytarabine compared with imatinib for newly diagnosed chronic phase chronic myeloid leukemia. New England Journal of Medicine 2003; 348: 994–1004. Sawyers C. Chronic myeloid leukemia. New England Journal of Medicine 1999; 340: 1330–40. CHAPTER 6 The Acute Leukaemias Mark Cook, Charles Craddock OVERVIEW • Acute leukaemias develop as a consequence of acquired genetic abnormalities in haemopoietic stem cells • Acute leukaemias can be subdivided into acute myeloid leukaemia (AML) and acute lymphoblastic leukaemia (ALL) • AML and ALL both present with symptoms of bone marrow failure caused by anaemia, neutropenia or thrombocytopenia • Chromosomal (cytogenetic) abnormalities define different biological subgroups of AML and ALL • Patient age, cytogenetic classification and response to initial chemotherapy are important factors allowing risk stratification • Treatment of both ALL and AML is initially with myelosuppressive chemotherapy • Allogeneic stem cell transplantation is reserved for patients predicted to have a poor outcome with chemotherapy alone Acute leukaemia is a malignant disorder of white cells caused by a failure of normal differentiation of haemopoietic stem cells and progenitors into mature cells.

The success of such an intensive treatment strategy is predictable at the time of relapse by three main factors: patient age, cytogenetics and duration of first remission. In patients whose duration of first remission is < 1 year, long-term survival rates even with intensive treatment are < 10%, and this information is clearly important when coming to a decision with the patient on whether to proceed down such an arduous road. Novel therapies There is clearly a need for the development of new treatments in AML.

MYH9-related thrombocytopenias MYH9-related thrombocytopenias, including the May Hegglin anomaly, are autosomal dominant conditions associated with macrothrombocytopenia. The genetic abnormality is in the MYH9 gene, located on chromosome 22. Variants of Alport’s syndrome are also characterized by giant platelets, associated with progressive hereditary nephritis and deafness (Fig. 3). Disorders of the surface membrane Disorders of the surface membrane are characterized by absence or abnormalities of platelet membrane glycoproteins, resulting in defective platelet adhesion and aggregation.

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