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4.  Pure erythroid leukemia in advanced breast cancer 
Blood research  2014;49(1):69-72.
doi:10.5045/br.2014.49.1.69
PMCID: PMC3974964  PMID: 24724072
7.  Azacitidine in Chronic Myelomonocytic Leukemia: An Effective and Manageable Approach 
Chronic myelomonocytic leukemia (CMML) is an uncommon neoplastic hematological disorder, typically affecting the elderly, and characterized by a marked clinical heterogeneity and a remarkable propensity for transformation into acute myeloid leukemia. Hypomethylating agents represent the most innovative management approach in this difficult setting. At our institution, between 2010 and 2012, we have treated with azacitidine 10 CMML patients with a median age of 75 (62–86) years. The overall response rate of 70% was achieved without remarkable toxicities; in particular, most therapy-induced side effects were managed on outpatient basis. With a median follow-up of 12,5 (2–27) months, 6 patients are alive, and 4 of them continue to receive the treatment; the median survival from the start of therapy was not reached. In conclusion, also in the light of our encouraging experience, azacitidine can offer new chances of treatment also in the difficult setting of elderly CMML.
doi:10.4084/MJHID.2014.020
PMCID: PMC3965718  PMID: 24678397
8.  Tyrosine Kinase Inhibitors and Pregnancy 
The management of patients with chronic myeloid leukemia (CML) during pregnancy has become recently a matter of continuous debate. The introduction of the Tyrosine Kinase Inhibitors (TKIs) in clinical practice has dramatically changed the prognosis of CML patients; in fact, patients diagnosed in chronic phase can reasonably expect many years of excellent disease control and good quality of life, as well as a normal life expectancy, including the necessity to address issues relating to fertility and pregnancy. Physicians are frequently being asked for advice regarding the need for, and/or the appropriateness of, stopping treatment in order to conceive. In this report, we will review the data published in terms of fertility, conception, pregnancy, pregnancy outcome and illness control for TKI treated CML patients, as well as how to manage a planned and/or unplanned pregnancy.
doi:10.4084/MJHID.2014.028
PMCID: PMC4010610  PMID: 24804001
14.  Managing myelodysplastic syndromes in very old patients: a teaching case report 
The introduction of hypomethylating agents in the treatment of myelodysplastic syndromes (MDS) has significantly changed the clinical scenario of these diseases, which afflict predominantly older individuals. However, some concerns regarding the optimal application of these innovative and costly agents in the treatment of geriatric high-risk MDS remain. We report here the case of a nonagenarian treated with hypomethylating agents achieving a long-lasting clinical response and a significant improvement in her functional status. Our case confirmed that functional status and biological status, rather than the chronological age alone, can substantially guide the plan of an appropriate treatment strategy in high-risk MDS patients; moreover, the current case emphasizes the need for targeted studies in the field of geriatric MDS in order to formulate guidelines on the appropriate use of these costly agents, so that candidate patients can receive adequate treatment to preserve their quality of life and life expectancy, but at the same time avoiding unnecessary costs deriving from the use of high-cost drugs for those in whom a significant therapeutic result cannot be reasonably expected.
doi:10.2147/CIA.S39536
PMCID: PMC3628529  PMID: 23610516
myelodysplastic syndromes; azacitidine; older patients
15.  Primary Pulmonary Hodgkin Lymphoma Simulating a Mediastinal Tumour: an Uncommon Occurrence 
The case of a patient with primary pulmonary Hodgkin Lymphoma simulating a mediastinal tumour is reported for its rarity and the diagnostic concerns encountered by us.
doi:10.4084/MJHID.2013.013
PMCID: PMC3591260  PMID: 23505601
22.  Management of immune thrombocytopoenia in a patient with newly-diagnosed smouldering myeloma and colorectal cancer 
BMJ Case Reports  2009;2009:bcr03.2009.1715.
Immune thrombocytopoenia (ITP) is one of the most common autoimmune manifestations of B cell lymphoproliferative diseases. The association with multiple myeloma (MM) and solid tumours is rare. Here, a case of ITP associated with asymptomatic multiple myeloma and colon carcinoma, refractory to standard therapy and responsive to rituximab, is described. ITP should be considered in the differential diagnosis of thrombocytopoenia in MM and colon cancer. Understanding of the potential risk and reversibility of ITP should aid in the management of these patients.
doi:10.1136/bcr.03.2009.1715
PMCID: PMC3028323  PMID: 21686970
23.  Management of Peritoneal Dialysis within a Home Care Program for Hematological Malignancies: Concerns and Perspectives Illustrated by a Case Report 
Indian Journal of Palliative Care  2011;17(2):166-167.
The case of an 86-year-old man suffering from acute myeloid leukemia and end-stage renal disease, managed at home, with continuous peritoneal dialysis regimen, is described.
doi:10.4103/0973-1075.84542
PMCID: PMC3183610  PMID: 21976861
Peritoneal dialysis; Hematological malignancies; Palliative care; Home care
24.  Anticoagulant and Anti-thrombotic Treatments in the Management of Hematological Malignancies in a Home Care Program 
Aim:
Anticoagulants (AC) and anti-platelet (AP) agents are widely administered to patients with hematological malignancies (HM). However, HM patients may be at high risk of bleeding and hemorrhagic complications, because of different form of coagulopathies and several degrees of thrombocytopenia.
Materials and Methods:
A prospective evaluation of the use of anticoagulant and anti-thrombotic agents as well as of bleeding and thrombotic complications in a consecutive cohort of patients, which were followed during the first semester of 2010 by our home care service, was performed. In this regard, three pharmacological class of agents, such as oral anticoagulants (warfarin and acenocumarine), low molecular weight heparin (LMWH) and anti-platelet (AP) drugs were considered.
Results:
Out of 129 patients, 26 (20%) were treated with AC/AP drugs. Warfarin, acenocumarine, LMWH as well as AP were used in 7, 11 and 12 patients, respectively. Adverse events (bleeding) were observed in 3 patients (11.5%), 2 cases being on warfarin (replaced by LMWH) and 1 being AP (suspension without replacement); out of the 3 patients with bleeding, none presented thrombocytopenia.
Conclusions:
Despite the frequent findings of hemostatic disorders in a population of frail patients managed in a home care setting, our experience demonstrated that the use of AC/AP drugs has been very rarely responsible for significant complications.
doi:10.4103/0973-1075.78450
PMCID: PMC3098544  PMID: 21633622
Acenocumarine; Bleeding; Hematological malignancies; Low molecular weight heparin; Warfarin

Results 1-25 (27)