Anemia
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  • ||||||||||  Reticulocyte Hemoglobin Content As a Diagnostic Tool for Myelodysplastic Syndrome: Findings from a 20-Year Retrospective Study () -  Dec 7, 2024 - Abstract #ASH2024ASH_8737;    
    CHr is used in the evaluation of iron content to assess iron deficiency anemia; however, our findings suggest that elevated CHr (with its very high specificity) could be a valuable diagnostic tool for MDS, particularly in patients with complicating health conditions.Conclusion : These preliminary results indicate that the Reticulocyte Hemoglobin content has moderate sensitivity and very high specificity for diagnosing Myelodysplastic Syndrome (MDS) in the veteran population at our hospital. Further analysis and a larger sample size may help refine these findings and improve the diagnostic accuracy.
  • ||||||||||  SHMT2-Folate-Folate Receptor Axis Impaired Erythropoiesis in Myelodysplastic Syndrome () -  Dec 7, 2024 - Abstract #ASH2024ASH_8731;    
    FOLR2 up-regulated IRF2 and IRF2BP2 expression levels and inhibited normal erythropoiesis.Taken together, our findings demonstrated that SHMT2-folate-folate receptor axis inhibited erythropoiesis in MDS, and targeting SHMT2 had therapeutic effectiveness for MDS treatment. Our findings also provided more comprehensive understanding on the relationship between folate and erythropoiesis.
  • ||||||||||  The Relationship between Anemia, Transfusion Dependence, Quality of Life and Survival in Myelofibrosis () -  Dec 7, 2024 - Abstract #ASH2024ASH_8714;    
    Among them, one identified a significant correlation between anemia and increased symptom scores; another observed a numerical but not statistically significant difference in symptom reduction or HRQoL improvement between anemic and non-anemic groups; and the third study noted a greater improvement for those who responded to anemia treatment compared to non-responders.Only 1 study reported on TD and HRQoL and found a significant association between requiring transfusions and greater symptom burden.Conclusion : Evidence collated in this study demonstrates that anemia and TD have a detrimental association with survival in MF across variations in patient characteristics and clinical settings and should be considered as part of treatment decision-making. Limited available evidence indicates a trend between anemia, TD and poorer HRQoL and increased symptom burden in MF, however additional research is required to confirm and quantify this relationship.
  • ||||||||||  Outcome of Splenectomy in JAK2 Inhibitor Treated Patients with Myelofibrosis: A Mayo Clinic Experience in 34 Consecutive Cases () -  Dec 7, 2024 - Abstract #ASH2024ASH_8699;    
    In addition, among 5 non-transplanted patients with baseline thrombocytopenia ( 100 x 109/L (median; 170 x 109/L, range : 119-279 x 109/L) within 3 months post-procedure.Conclusions : Splenectomy following JAKi-resistant or intolerant MF is associated with improvement of transfusion-dependent anemia (46% response), resolution of severe thrombocytopenia (80%), and may allow for successful transition to ASCT (35%). However, the procedure is associated with significant perioperative complications occurring in the majority of patients and underscores the need for future collaborative studies to develop selection criteria and evaluate alternative treatment modalities.
  • ||||||||||  Jakafi (ruxolitinib) / Incyte, Ojjaara (momelotinib) / GSK
    Cost Comparison of Ruxolitinib and Momelotinib in Patients with Myelofibrosis and Anemia () -  Dec 7, 2024 - Abstract #ASH2024ASH_8694;    
    One limitation of this model is the lack of precise estimates of transfusion costs; however, analyses with alternate estimates for transfusion costs varied the magnitude but consistently resulted in cost savings with ruxolitinib. In addition, due to the lack of accurate data in total cost of care, this model did not incorporate other clinical benefits associated with either ruxolitinib or momelotinib, including symptom response rate, spleen response rate, and potential secondary benefits of lower transfusion need, which are also important considerations in addition to cost.Conclusions : The model predicts substantial per-patient cost savings with ruxolitinib due to its lower pharmacy costs, which offset estimated higher transfusion costs, and suggests the clinical transfusion benefit of momelotinib does not lead to savings in the cost of care.
  • ||||||||||  Tafinlar (dabrafenib) / Novartis
    BRAFV600E-Mutated Histiocytic Sarcoma Presenting on a Background of Clonal Cytopenia Responsive to Dabrafenib: Case Report and Review of the Literature () -  Dec 7, 2024 - Abstract #ASH2024ASH_8692;    
    He was treated with a weaning course of dexamethasone 8 mg dailyand urgent radiotherapy (8Gy single fraction) to the base of skull lesion...Levetiracetam 500 mg twice a daywas given as anti-epileptic prophylaxis.Over the following week, his condition rapidly improved, he became pain-free, conversant and able to feed himself although he remained bed-bound...Generally, these treatments were well tolerated and associated with manageable toxicity. Although responses were not durable and 50% of cases had progressed within 12 months,the advantage of a non-toxic regimen is clear when preserving quality of life is the goal of therapy, as in this case.Note : The use of Dabrafenib for histiocytic sarcoma is off-label
  • ||||||||||  Vonjo (pacritinib) / SOBI
    Early Anemia Response in Patients with Myelofibrosis Treated with Pacritinib in Real-Word Clinical Settings () -  Dec 7, 2024 - Abstract #ASH2024ASH_8689;    
    Similar improvements in median PLT were observed among patients with moderate anemia from index (68.0 x109/L; IQR : 30.8, 116.0) (n=8), through day 90 (107.0 x109/L; IQR : 67.0, 137.0) (n=5), and day 180 (94.0 x109/L; IQR : 62.0, 109.0) (n=5).Conclusions : The majority of patients who had anemia at the time of treatment initiation experienced an early anemia response with PAC treatment which was maintained over the follow up period. Meaningful improvements in Hb and PLT counts over follow up were observed overall and across categories of baseline Hb.
  • ||||||||||  Jakafi (ruxolitinib) / Incyte
    Burden of Anemia in Myelofibrosis Patients in Japan, South Korea, Taiwan, and Canada: A Real-World Survey and Multinational Database Analysis () -  Dec 7, 2024 - Abstract #ASH2024ASH_8686;    
    Most physicians (81% [21/26]) reported that ruxolitinib (RUX) increased the severity of anemia in pts with MF.PRFs were completed for 44 pts (South Korea : n=5, Taiwan : n=27, Canada : n=12)...Physicians agreed that reducing transfusion burden, improving Hb levels, and reducing fatigue are critical factors that determine the choice of therapy, especially as existing JAKi significantly increase these risks. Anemia complicates the management of MF and reiterates the need for tailored therapeutic approaches that addresses the underlying disease and the associated hematologic complications.
  • ||||||||||  Jakafi (ruxolitinib) / Incyte, Tasigna (nilotinib) / Novartis, Inhibikase
    A Case Series on Post Essential Thrombocytosis Myelofibrosis Conversion to Chronic Myeloid Leukemia () -  Dec 7, 2024 - Abstract #ASH2024ASH_8655;    
    Initial bone marrow showed hypercellular marrow, and she was treated with Aspirin (81mg daily)...The patient was started on nilotinib 300 mg twice daily and had complete remission within 6 months...BCR-ABL PCR was positive and was started on Imatinib for treatment of CML.The transformation from ET to CML, as observed in our cases, highlights a rare but critical pathway in the natural history of MPNs...The presence of this mutation has been well-documented in various MPNs, but its role in the transition from ET to CML requires further elucidation. Early intervention to diagnose and treat ET, followed by prevention of myelofibrosis may need to be investigated to decelerate the progression to CML.
  • ||||||||||  Bosulif (bosutinib) / Pfizer
    Real-Life Outcomes of Bosutinib in Patients with Chronic Myeloid Leukemia: A Multicenter Nationwide Study from Turkey () -  Dec 7, 2024 - Abstract #ASH2024ASH_8627;    
    The percentage of pts with optimal responses were significantly higher with BOS when compared to those achieved prior to BOS therapy (p<0.001). EMR rates were significantly higher in pts receiving 500 mg/day BOS than those with a daily dose <500 mg (34.2% vs. 64.8%, p=0.023).Conclusion : Our multicenter, nationwide study among pts with CML in the real world setting demonstrated that BOS is an effective 2GTKI in pts who failed at least one TKI therapy with a generally manageable toxicity profile.
  • ||||||||||  Yinuokai (orelabrutinib) / InnoCare, Biogen, Brukinsa (zanubrutinib) / BeiGene, Imbruvica (ibrutinib) / AbbVie, J&J
    BTK Inhibitor Synergizes with CD19-Targeted Chimeric Antigen Receptor-T Cells in Patients with Relapsed or Refractory B-Cell Lymphoma: An Open-Label Pragmatic Clinical Trial () -  Dec 7, 2024 - Abstract #ASH2024ASH_8590;    
    P3
    Fludarabine-based lymphodepletion chemotherapy was followed by CART19 infusion...Other objectives included the pharmacokinetics of CAR-T cells and the phenotype of T cells.Results : At data cutoff, 37 patients included were assigned to CAR-T cell monotherapy (n = 24) or combination therapy with BTKi (n = 13) , among who 3 patients received ibrutinib, 6 received zanubrutinib, and 4 received orelabrutinib...Single-cell RNA analysis of the patient indicated that T cells at relapse obtained a more dysfunctional immunotype, and monocytes/macrophages at relapse highly expressed M2-related genes.Conclusion : Our study demonstrated that the combination of BTKi and CART19 induced good efficacy in terms of response depth and long-term survival. Prolonging the duration of BTKi maintenance might contribute to superior outcomes in patients with BCL through improving immune function.
  • ||||||||||  R-Cmop and Pola-R-CMP Regimes As First-Line Treatment for Diffuse Large B-Cell Lymphoma with Cardiac Comorbidity () -  Dec 7, 2024 - Abstract #ASH2024ASH_8576;    
    For several decades, the R-CHOP regimen (rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone) has been the backbone of DLBCL treatment, achieving overall cure rates in the range of 60% to 70%...Therefore, there is a need for a novel treatment approach for these patients.Aims : The study was a prospective, single-arm, multicenter clinical trial to evaluate the safety and efficacy of R-CMOP (rituximab, cyclophosphamide, mitoxantrone hydrochloride liposome, vincristine, prednisone) or Pola-R-CMP (polatuzumab vedotin, rituximab, cyclophosphamide, mitoxantrone hydrochloride liposome, prednisone) regimes as first-line therapy for newly diagnosed DLBCL with cardiac comorbidity or in whom cardiac adverse events happened after 1-3 cycles R-CHOP treatment.Methods : Adult patients with newly diagnosed DLBCL with cardiac comorbidity or in whom cardiac adverse events happened after 1-3 cycles R-CHOP treatment...The most common grade 3/4 TRAEs with an incidence of ?20% were lymphopenia (57.1%), anemia (57.1%), leucopenia (42.9%), fever (28.6%), neutropenia (28.6%), pneumonia(28.6%). There was no newly found or aggravated cTnT, CK-MB, BNP value abnormality, QTC abnormality and lower LV function after medication.Conclusion : CMOP and Pola-R-CMP regimens as first-line treatment for Diffuse Large B-Cell Lymphoma with cardiac comorbidity exhibited manageable safety and encouraging efficacy without an increased risk of cardiotoxicity.This study is ongoing and updated results will be presented in the future.
  • ||||||||||  Xpovio (selinexor) / Karyopharm, Rituxan (rituximab) / Roche
    XR-EPOCH for Nwely Diagnosed HIV-Associated Diffuse Large B Cell Lymphoma(DLBCL) Patients () -  Dec 7, 2024 - Abstract #ASH2024ASH_8572;    
    P4
    All toxicities were manageable by supportive care.Conclusions : Selinexor plus R-EPOCH regimen demonstrated a favorable Interim efficacy and manageable safety profile in patients with HIV-associated DLBCL. The change of HIV RNA load and CD4+ cell count still requires further evaluation.
  • ||||||||||  Rituxan (rituximab) / Roche
    Toxicities and Financial Costs Associated with CNS Prophylaxis in Diffuse Large B-Cell Lymphoma: A Retrospective Analysis in Nova Scotia, Canada () -  Dec 7, 2024 - Abstract #ASH2024ASH_8570;    
    We conducted a cost-consequence analysis using real-world data from a third-party payer perspective, comparing 53 patients with DLBCL who received R-CHOP and HD-MTX prophylaxis (treatment group) to 28 DLBCL patients who received R-CHOP or similar (control group)...With recent large retrospective studies questioning the benefit of this therapy, our data further supports allocating resources away from this toxic and expensive treatment. With this evolving data, each health institution needs to carefully consider their local guidelines for CNS prophylaxis in DLBCL.
  • ||||||||||  Epidaza (chidamide) / Chipscreen
    BTK Inhibitors and Chidamide-Combined Therapy in Relapsed or Refractory Diffuse Large B-Cell Lymphoma with MYC+ () -  Dec 7, 2024 - Abstract #ASH2024ASH_8569;    
    P=N/A
    Chidamide combined with BTK inhibitors showed high efficacy and manageable tolerability in R/R DLBCL patients with MYC+. Although the majority of patients were treated with BTK inhibitors and experienced relapse and resistance, the addition of chidamide brought patients back into remission, suggesting that chidamide can enhance the efficacy of BTK inhibitors and overcome acquired resistance.
  • ||||||||||  Polivy (polatuzumab vedotin-piiq) / Roche
    Polatuzumab Vedotin Plus Anti-CD20 Monoclonal Antibody and Dexamethasone in Previously Untreated Very Old/Frail Patients with Diffuse Large B-Cell Lymphoma () -  Dec 7, 2024 - Abstract #ASH2024ASH_8566;    
    Although the majority of patients were treated with BTK inhibitors and experienced relapse and resistance, the addition of chidamide brought patients back into remission, suggesting that chidamide can enhance the efficacy of BTK inhibitors and overcome acquired resistance. Introduction For previously untreated patients with diffuse large B-cell lymphoma (DLBCL) who aged over 80 years or classified as frail group by comprehensive geriatric assessment (CGA), R-miniCHOP is the standard regimen...Participants received up to six 21-day cycles of Pola-RD therapy : Pola 1.8 mg/kg IV day 1, anti-CD20 monoclonal antibody (rituximab 375mg/m2 IV, or Obinutuzumab 1000mg IV day 1), and dexamethasone 15mg QD day1-5, followed up to two cycles of anti-CD20 monoclonal antibody
  • ||||||||||  Duoenda (mitoxantrone liposomal) / CSPC Pharma, Gazyva (obinutuzumab) / Roche, Biogen
    A Phase II Study of Dual Epigenetic Agents Plus Obinutuzumab-Mitoxantrone Liposome in Relapsed/Refractory Diffuse Large B-Cell Lymphoma Patients Failure of Salvage Immunochemotherapy () -  Dec 7, 2024 - Abstract #ASH2024ASH_8549;    
    P2
    However, grade III/IV hematological toxicity was 92.7% and it is extremely important to modify dual epigenetic immunochemotherapy regimen.Aims : This study aimed to evaluate the efficacy and safety of dual epigenetic priming immunochemotherapy CAGM regimen including chidamide, azacitidine, obinutuzumab and mitoxantrone liposome in R/R DLBCL patients.Methods : Patients with R/R DLBCL failure of combined salvage immunochemotherapy were enrolled in this ongoing, prospective, multicenter, open-label phase II study(NCT05823701)...All toxicities were transient and reversible.Conclusions : This study demonstrates a favorable efficacy and significantly lower hematological toxicities of CAGM regimen in R/R DLBCL patients and expands therapeutic options for R/R DLBCL patients. More updated clinical data will be presented from this ongoing study.
  • ||||||||||  Brukinsa (zanubrutinib) / BeiGene
    A Multicenter Study on Front-Line Treatment of Diffuse Large B-Cell Lymphoma with Zanubrutinib Combination Therapy () -  Dec 7, 2024 - Abstract #ASH2024ASH_8543;    
    The Guidance-01 study, which incorporated genotyping and targeted agents for newly diagnosed, intermediate to high-risk DLBCL, demonstrated that RCHOP+X was superior to RCHOP alone, with CR rate(CRR)of 88% vs. 66% (P=0.003), overall response rate (ORR) of 92% vs. 73% (P=0.005), two-year progression-free survival (PFS) rate of 88% vs. 63% (P<0.001), and two-year OS rate of 94% vs. 77% (P=0.001).ObjectivesTo retrospectively analyze the efficacy and safety of combination therapy with zanubrutinib in the front-line treatment of diffuse large B-cell lymphoma across multiple centers.MethodsPatient information was collected from August 2020 to October 2023 for those newly diagnosed with DLBCL who received zanubrutinib first-line combination regimens...There were no treatment-related deaths in this study.ConclusionsThe first-line treatment of DLBCL with zanubrutinib combined regimens show good efficacy, particularly for the MCD subtype, and is associated with fewer adverse effects. This approach merits further exploration.
  • ||||||||||  Duoenda (mitoxantrone liposomal) / CSPC Pharma, Rituxan (rituximab) / Roche
    R-Cmop in Elderly Patients with Newly Diagnosed Diffuse Large B-Cell Lymphoma: A Multicenter, Prospective Study () -  Dec 7, 2024 - Abstract #ASH2024ASH_8539;    
    P2
    A previous study (DOI : 10.1007/s10637-021-01182-7.) found that the incidence of cTnT elevation was much lower in the mitoxantrone hydrochloride liposome (Lipo-MIT) group than in the mitoxantrone group (3.3% vs. 36.7%), indicating better cardiac safety with Lipo-MIT...Eligible patients received the R-CMOP regimen every 21 days for up to 6-8 cycles, consisting of rituximab (375mg/m2 on day 0), cyclophosphamide (750mg/m2 on day 1), Lipo-MIT (18mg/m2 on day 1), vincristine (1.4mg/m2, maximum dose 2 mg on day 1) and prednisone (100mg on days 1-5) for pts aged 60-80 years, while rituximab (375mg/m2 on day 0), cyclophosphamide (400mg/m2 on day 1), Lipo-MIT 12mg/m2 on day 1), vincristine (1mg on day 1) and prednisone (40 mg/m2 on days 1-5) for pts aged 80 years or older.The primary endpoint was the objective response rate (ORR), and secondary endpoints included complete response (CR) rate, progression-free survival (PFS), overall survival rate (OS), and safety assessment according to the NCI-CTCAE v5.0.Results : From May 20, 2022 to July 13, 2024, a total of 17 pts with newly diagnosed DLBCL were enrolled in the study...Importantly, no cardiac toxicities were reported during this study.Conclusion : The R-CMOP regimen has demonstrated inspiring efficacy in newly diagnosed DLBCL pts aged 60 years or older with a manageable safety profile. Subsequent research will focus on expanding the clinical cohort and confirming its clinical significance.