ABC of Clinical Haematology by Drew Provan

By Drew Provan

Overlaying hematological features of parts akin to pathology, molecular technological know-how, melanoma, and normal medication, this advisor turns out to be useful as a reference for basic perform and health center employees, hematologists and trainees in hematology. This moment version displays advances within the realizing of the molecular biology of illness because the first version was once released in 1998.

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Spontaneous bruising, gingival bleeding, palatal and retinal haemorrhages, epistaxis, menorrhagia and prolonged bleeding after venepuncture are all relatively common. Infiltration Leukaemic blasts can infiltrate any organ. Bone pain is a direct consequence of marrow disease. Infiltration of the meninges, resulting in headache or cranial nerve palsies, is particularly common in ALL and consequently lumbar puncture is mandatory in newly diagnosed patients with ALL. Hepatosplenomegaly is frequently present at diagnosis in ALL, and mediastinal enlargement is well documented in T-cell ALL.

Novel therapies There is clearly a need for the development of new treatments in AML. The success of imatinib (Glivec®; Novartis) in patients with chronic myeloid leukaemia (CML) has led to the hope that it may be possible to identify similar targets in AML. Although there has been some encouraging preliminary experience in AML with drugs which target dysregulated genes, such as flt 3 or ras, in AML these agents have not as yet fulfilled their promise. Specific management of ALL Treatment of ALL follows the same principles as for AML with three main exceptions.

Idiopathic myelofibrosis. Seminars in Hematology 2005; 42: 248–58. Campbell PJ, Green AR. Management of polycythemia vera and essential thrombocythemia. Hematology 2005; 201–8. Finazzi G, Harrison C. Essential thrombocythemia. Seminars in Hematology 2005; 42: 230–8. Tefferi A, Barbui T. BCR/ABL-negative, classic myeloproliferative disorders: diagnosis and treatment. Mayo Clinic Proceedings 2005; 80: 1220–32. Vassiliou GS, Green AR. Postgraduate haematology. Chapter 46. In: Hoffbrand AV, Catovsky D & Tuddenham EGD, eds.

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