complications for CLL appear to be increased by regimens including idelalisib. Combination therapy clinical trials including idelalisib were halted by the Federal Drug Administration and European Drug Agency because of concerns for excess toxicity including increased rates of PJP and CMV infections [ 29 ]. There are limited data on the effect of duvelisib and umbralisib on risk of infection in CLL patients.
ManagementManagement of infection in CLL patients requires education of patients and care givers to respond rapidly to evidence of infection, appropriate
Olga Hilda Orasan, Iulia Breaban, Andreea Maria Stefan, Adela Sitar-Taut, Sorina Cezara Coste, Ioan Alexandru Minciuna, Teodora Alexescu, Angela Cozma, Laura Urian and Remus Aurel Orasan
Chronic hepatitis C viral infection is an important cause of morbidity and mortality in patients with end-stage renal disease treated with hemodialysis. Liver fibrosis represents a main determinant of liver disease prognosis and clinical management, and its assessment by liver biopsy can decide treatment allocation. Although liver biopsy is the gold standard for staging liver fibrosis, it is an invasive procedure associated with complications that are more prevalent in patients with end-stage renal disease. FibroTest represents a surrogate marker of fibrosis which evaluates the levels of apolipoprotein A1, total bilirubin, haptoglobin, gamma-glutamyltransferase and α2-macroglobulin, generating a score that indicates the level of fibrosis. Discrepancies were observed in clinical practice between FibroTest score and histopathological findings. The aim of this study was to evaluate how hemodialysis influences the level of each FibroTest parameter and the final score. The systematic literature review conducted by us suggests that hemodialysis induces a reduction in apolipoprotein A1, haptoglobin and bilirubin levels, with an increase in gamma-glutamyltransferase and alpha-2-macroglobulin levels. In conclusion, hemodialysis modifies the levels of FibroTest parameters, suggesting that it may also have an impact on the accuracy of liver fibrosis assessment in hemodialysis patients.
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Elena Binzari, Mihaela Zaharia, Stefan Barbu, Oana Roxana Oprea and Minodora Dobreanu
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ekspertów Hct powinien być dostosowany do normy obowiązującej w danym trymestrze ciąży (31-41% w I trymestrze, 30-38% w II trymestrze i 28-39% w III trymestrze) [ 16 ]. Nie jest wskazana suplementacja żelaza ze względu na ryzyko wzrostu parametrów czerwonokrwinkowych.
Terapia u pacjentki z nowotworem mieloproliferacyjnym w ciąży w zależności od czynników ryzyka [ 5 , 14 , 16 ]
Table II. Management of pregnant women with myeloproliferative neoplasm according to risk factors [ 5 , 14 , 16 ]
Terapia w trakcie ciąży
Terapia w trakcie
are ambiguous. The summary, based on large studies, is presented in table XI
Because of high worldwide seroprevalence and latency, infections with herpesviruses are, and will be, frequent. Current strategies of management of CMV and EBV are based on mandatory monitoring of DNA-emia and administration of preemptive therapy if DNA-emia is positive; however, pharmacological prophylaxis is a renewed possibility in case of CMV (letermovir) and is an option for EBV infection (rituximab). In case of HHV-6, no routine screening is recommended; however, in
transplantation patients: a surmountable challenge Hematology Am Soc Hematol Educ Program 2012 2012 265 70
 Ljungman P, de la Camara R, Cordonnier C, et al. European Conference on Infections in L: Management of CMV, HHV-6, HHV-7 and Kaposisarcoma herpesvirus (HHV-8) infections in patients with hematological malignancies and after SCT. Bone Marrow Transplant 2008;42:227-40. 10.1038/bmt.2008.162 Ljungman P de la Camara R Cordonnier C et al European Conference on Infections in L: Management of CMV, HHV-6, HHV-7 and Kaposisarcoma herpesvirus (HHV-8