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Mayo Clinic Proceedings Jul 2005A complete blood cell count (CBC) is one of the most common laboratory tests in medicine. For example, at our institution alone, approximately 1800 CBCs are ordered... (Review)
Review
A complete blood cell count (CBC) is one of the most common laboratory tests in medicine. For example, at our institution alone, approximately 1800 CBCs are ordered every day, and 10% to 20% of results are reported as abnormal. Therefore, it is in every clinician's interest to have some understanding of the specific test basics as well as a structured action plan when confronted with abnormal CBC results. In this article, we provide practical diagnostic algorithms that address frequently encountered conditions associated with CBC abnormalities including anemia, thrombocytopenia, leukopenia, polycythemia, thrombocytosis, and leukocytosis. The objective is to help the nonhematologist recognize when a subspecialty consultation is reasonable and when it may be circumvented, thus allowing a cost-effective and intellectually rewarding practice.
Topics: Adult; Algorithms; Anemia; Blood Cell Count; Cost-Benefit Analysis; Diagnosis, Differential; Hematologic Diseases; Hematology; Humans; Leukocytosis; Leukopenia; Polycythemia; Practice Patterns, Physicians'; Referral and Consultation; Thrombocytopenia; Thrombocytosis
PubMed: 16007898
DOI: 10.4065/80.7.923 -
American Family Physician Jul 2020Millions of units of blood products are transfused annually to patients in the United States. Red blood cells are transfused to improve oxygen-carrying capacity in...
Millions of units of blood products are transfused annually to patients in the United States. Red blood cells are transfused to improve oxygen-carrying capacity in patients with or at high risk of developing symptomatic anemia. Restrictive transfusion thresholds with lower hemoglobin levels are typically clinically equivalent to more liberal thresholds. Transfusion of plasma corrects clinically significant coagulopathy in patients with or at high risk of bleeding. Mildly abnormal laboratory coagulation values are not predictive of clinical bleeding and should not be corrected with plasma. Transfused platelets prevent or treat bleeding in patients with thrombocytopenia or platelet dysfunction. Cryoprecipitate is transfused to treat hypofibrinogenemia. Many adverse reactions can occur during or after blood product transfusion. Transfusion-associated circulatory overload (i.e., volume overload) is the most common cause of mortality associated with blood products. Modifications to blood products can prevent or decrease the risks of transfusion-related adverse reactions. It is critical to quickly recognize when a reaction is occurring, stop the transfusion, assess, and support the patient. Reporting a reaction to the blood bank is part of ensuring patient safety and supporting hemovigilance efforts.
Topics: Blood Component Transfusion; Hematologic Diseases; Humans; Patient Safety; Practice Guidelines as Topic; Risk Adjustment; Risk Assessment; Transfusion Reaction
PubMed: 32603068
DOI: No ID Found -
American Journal of Hematology Nov 2021
Topics: Animals; Genetic Testing; Genetic Therapy; Genomics; Hematologic Diseases; High-Throughput Nucleotide Sequencing; Humans
PubMed: 34536026
DOI: 10.1002/ajh.26353 -
Acta Haematologica 2022The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulted in changes in management and imaging routines for patients... (Review)
Review
The COVID-19 pandemic, caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), resulted in changes in management and imaging routines for patients with hematological malignancies. Treating physicians had to familiarize themselves with a new disease, with distinct imaging manifestations, sometimes overlapping with other infections prevalent in this patient population. In some aspects, infected hematological patients might exhibit a different disease course, and routine imaging in asymptomatic hematological patients may result in unexpected COVID-19 findings, implying covert infection, that should be further explored. Furthermore, some complications of hematological diseases and treatments may present with findings similar to COVID-19 manifestations, and treating physicians must consider both possibilities in the differential diagnosis. In this review, we aimed to present the influence the COVID-19 pandemic had on hematological malignancy imaging.
Topics: COVID-19; Hematologic Diseases; Hematologic Neoplasms; Humans; Pandemics; SARS-CoV-2
PubMed: 35100592
DOI: 10.1159/000522323 -
In Vivo (Athens, Greece) 2020Telomeres compose the end portions of human chromosomes, and their main function is to protect the genome. In hematological disorders, telomeres are shortened,... (Review)
Review
Telomeres compose the end portions of human chromosomes, and their main function is to protect the genome. In hematological disorders, telomeres are shortened, predisposing to genetic instability that may cause DNA damage and chromosomal rearrangements, inducing a poor clinical outcome. Studies from 2010 to 2019 were compiled and experimental studies using samples of patients diagnosed with hematological malignancies that reported the size of the telomeres were described. Abnormal telomere shortening is described in cancer, but in hematological neoplasms, telomeres are still shortened even after telomerase reactivation. In this study, we compared the sizes of telomeres in leukemias, myelodysplastic syndrome and lymphomas, identifying that the smallest telomeres are present in patients at relapse. In conclusion, the experimental and clinical data analyzed in this review demonstrate that excessive telomere shortening is present in major hematological malignancies and its analysis and measurement is a crucial step in determining patient prognosis, predicting disease risk and assisting in the decision for targeted therapeutic strategies.
Topics: Hematologic Diseases; Hematologic Neoplasms; Humans; Neoplasms; Telomerase; Telomere
PubMed: 33144412
DOI: 10.21873/invivo.12142 -
The American Journal of Tropical... Feb 2021COVID-19 is caused by SARS-CoV-2. Although pulmonary manifestations have been identified as the major symptoms, several hematological abnormalities have also been... (Review)
Review
COVID-19 is caused by SARS-CoV-2. Although pulmonary manifestations have been identified as the major symptoms, several hematological abnormalities have also been identified. This review summarizes the reported hematological abnormalities (changes in platelet, white blood cell, and hemoglobin, and coagulation/fibrinolytic alterations), explores their patho-mechanisms, and discusses its management. Common hematological abnormalities in COVID-19 are lymphopenia, thrombocytopenia, and elevated D-dimer levels. These alterations are significantly more common/prominent in patients with severe COVID-19 disease, and thus may serve as a possible biomarker for those needing hospitalization and intensive care unit care. Close attention needs to be paid to coagulation abnormalities, and steps should be taken to prevent these occurring or to mitigate their harmful effects. The effect of COVID-19 in patients with hematological abnormalities and recognized hematological drug toxicities of therapies for COVID-19 are also outlined.
Topics: Biomarkers; Blood Coagulation; Blood Platelets; COVID-19; Erythrocytes; Hematologic Diseases; Humans; Leukocytes; Lymphopenia; SARS-CoV-2; Thrombocytopenia
PubMed: 33606667
DOI: 10.4269/ajtmh.20-1536 -
European Journal of Haematology Mar 2017Commonly known for its critical role in calcium homeostasis and bone mineralization, more recently vitamin D has been implicated in hematological cancer pathogenesis and... (Review)
Review
Commonly known for its critical role in calcium homeostasis and bone mineralization, more recently vitamin D has been implicated in hematological cancer pathogenesis and shows promise as an anti-cancer therapy. Serum levels of 25(OH)D , the precursor to the active form of vitamin D, calcitriol, are frequently lower in patients with hematological disease compared to healthy individuals. This often correlates with worse disease outcome. Furthermore, diseased cells typically highly express the vitamin D receptor, which is required for many of the anti-cancer effects observed in multiple in vivo and in vitro cancer models. In abnormal hematological cells, vitamin D supplementation promotes apoptosis, induces differentiation, inhibits proliferation, sensitizes tumor cells to other anti-cancer therapies, and reduces the production of pro-inflammatory cytokines. Although the dosage of vitamin D required to achieve these effects may induce hypercalcemia in humans, analogs and combinatorial treatments have been developed to circumvent this side effect. Vitamin D and its analogs are well tolerated in clinical trials, and thus, further investigation into the use of these agents in the clinic is warranted. Here, we review the current literature in this field.
Topics: Animals; Antineoplastic Agents; Drug Resistance, Neoplasm; Drug Synergism; Hematologic Diseases; Hematologic Neoplasms; Humans; Immune System; Janus Kinases; Receptors, Calcitriol; STAT Transcription Factors; Signal Transduction; Vitamin D
PubMed: 27743385
DOI: 10.1111/ejh.12818 -
Blood Transfusion = Trasfusione Del... Jan 2020
Topics: Blood; Blood Transfusion; Hematologic Diseases; Hematology; Humans; Regenerative Medicine
PubMed: 32129167
DOI: 10.2450/2020.0033-20 -
Blood Mar 2016
Topics: Animals; Blood Platelets; Hematologic Diseases; Humans; Megakaryocytes
PubMed: 26787732
DOI: 10.1182/blood-2015-11-664029 -
Experimental Hematology Sep 2016DNA methylation is an important epigenetic modification that can have profound and widespread effects on gene expression and on cellular fate and function. Recent work... (Review)
Review
DNA methylation is an important epigenetic modification that can have profound and widespread effects on gene expression and on cellular fate and function. Recent work has indicated that DNA methylation plays a critical role in hematopoietic development and hematopoietic disease. DNA methyltransferases and Ten-eleven translocation enzymes are required to add and remove methyl "marks" from DNA, respectively, and both sets of genes have been found necessary for proper formation and maintenance of hematopoietic stem cells and for differentiation of downstream hematopoietic lineages during development. DNA methylation and demethylation enzymes have also been implicated in hematopoietic disorders such as acute myeloid leukemia and myelodysplastic syndrome. Here, we review some of the recent literature regarding the role of DNA methylation in hematopoietic health and disease.
Topics: Animals; Cell Differentiation; DNA Methylation; Epigenesis, Genetic; Gene Expression Regulation; Genetic Predisposition to Disease; Hematologic Diseases; Hematologic Neoplasms; Hematopoiesis; Hematopoietic Stem Cells; Humans
PubMed: 27178734
DOI: 10.1016/j.exphem.2016.04.013