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Hematology (also spelled haematology in British English) is the branch of medicine concerned with the study of the cause, prognosis, treatment, and prevention of diseases related to blood.   It involves treating diseases that affect the production of blood and its components, such as blood cells , hemoglobin , blood proteins , bone marrow ...
Haematologica is a monthly, peer reviewed, scientific journal, published by the Ferrata Storti Foundation. The Editor in Chief is Dr. Jacob M. Rowe (Rambam Medical Center, Haifa, Israel). The focus of Haematologica is all topics related to experimental and clinical hematology, which results in a multidisciplinary scope.
- The Hematology Journal
- Jacob M. Rowe
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The American Society of Clinical Oncology ( ASCO) is a professional organization representing physicians of all oncology sub-specialties who care for people with cancer. Founded in 1964 by Fred Ansfield, Harry Bisel, Herman Freckman, Arnoldus Goudsmit, Robert Talley, William Wilson, and Jane C. Wright, it has nearly 45,000 members worldwide.
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Most people are diagnosed as having CLL based on the result of a routine blood test that shows a high white blood cell count, specifically a large increase in the number of circulating lymphocytes. These people generally have no symptoms. Less commonly, CLL may present with enlarged lymph nodes. This is referred to as small lymphocytic lymphoma. Less commonly the disease comes to light only after the cancerous cells overwhelm the bone marrow resulting in low red blood cells, neutrophils, or platelets.Or there is fever, night sweats, weight loss, and the person feels tired. CLL can be grouped with Small lymphocytic lymphoma (SLL) as one disease with two clinical presentations. Wherein, with CLL, diseased cells propagate from within the bone marrow, in SLL they propagate from within the lymphatic tissue. CLLs are, in virtually all cases, preceded by a particular subtype of monoclonal B-cell lymphocytosis (MBL). This subtype, termed chronic lymphocytic leukemia-type MBL (CLL-type MBL)...
CLL can be caused by many different genetic mutations, the most common being deletions in the 13q14.3 region, (seen in 50% of CLL cases), as well as trisomy in chromosome 12 (seen in 20% of cases), other deletions (i.e., in 11q22-23, 17p13, or 16q21 regions), and less commonly, translocations (for example, involving the 13q14 region). CLL can also be caused by a number of epigenetic changes, which can be classified into 3 different methylation subgroups (naïve B-cell-like, memory B-cell-like, and intermediate). Some relevant genetic mutations may be inherited. Since there is no one single mutation that causes CLL in all cases, an individual’s susceptibility may be impacted when multiple mutations that increase the risk of CLL are co-inherited. Up until 2014, very few of these mutations or significant “risk alleles” had been identified. Men are about twice as likely to get CLL as women, and risk increases with age. It is relatively rare among Asians. Exposure to Agent Orange increase...
CLL is usually first suspected by a diagnosis of lymphocytosis, an increase in a type of white blood cell, on a complete blood count test. This frequently is an incidental finding on a routine physician visit. Most often the lymphocyte count is greater than 5000 cells per microliter (µl) of blood but can be much higher. The presence of lymphocytosis in an elderly individual should raise strong suspicion for CLL, and a confirmatory diagnostic test, in particular flow cytometry, should be performed unless clinically unnecessary. A peripheral blood smear showing an abundance of damaged cells known as smudge cells or smear cells can also indicate the presence of the disease (smudge cells are due to cancer cells lacking in vimentin, a cytoskeletal protein).:1899 The diagnosis of CLL is based on the demonstration of an abnormal population of B lymphocytes in the blood, bone marrow, or tissues that display an unusual but characteristic pattern of molecules on the cell surface. This atypica...
CLL treatment focuses on controlling the disease and its symptoms rather than on an outright cure. In those without or only minimal symptoms watchful waitingis generally appropriate. CLL is treated by chemotherapy, radiation therapy, biological therapy, or bone marrow transplantation. Symptoms are sometimes treated surgically (splenectomy – removal of enlarged spleen) or by radiation therapy("de-bulking" swollen lymph nodes). Initial CLL treatments vary depending on the exact diagnosis and the progression of the disease, and even with the preference and experience of the health care practitioner. Any of dozens of agents may be used for CLL therapy.
Prognosis can be affected by the type of genetic mutation that the person with CLL has. Some examples of genetic mutations and their prognoses are: mutations in the IGHV region are associated with a median overall survival (OS) of more than 20–25 years, while no mutations in this region is associated with a median OS of 8–10 years; deletion of chromosome 13q is associated with a median OS of 17 years; and trisomy of chromosome 12, as well as deletion of chromosome 11q, is associated with a median OS of 9–11 years. While prognosis is highly variable and dependent on various factors including these mutations, the average 5-year relative survival is 86.1%.Telomere length has been suggested to be a valuable prognostic indicator of survival.
CLL is primarily a disease of older adults, with a median age of 70 years at the time of diagnosis. Though less common, CLL sometimes affects people between 30 and 39 years of age.[medical citation needed] The incidence of CLL increases very quickly with increasing age.[medical citation needed] In the United States during 2014, about 15,720 new cases are expected to be diagnosed, and 4,600 patients are expected to die from CLL. Because of the prolonged survival, which was typically about 10 years in past decades, but which can extend to a normal life expectancy, the prevalence (number of people living with the disease) is much higher than the incidence(new diagnoses). CLL is the most common type of leukemia in the UK, accounting for 38% of all leukemia cases. Approximately 3,200 people were diagnosed with the disease in 2011. In Western populations, subclinical "disease" can be identified in 3.5% of normal adults, and in up to 8% of individuals over the age of 70.That is, small clon...
Research in 2008 is comparing different forms of bone marrow transplants to determine which patients are the best candidates and which approach is best in different situations. Researchers at the Abramson Cancer Center of the University of Pennsylvania School of Medicine reported preliminary success in the use of gene therapy, through genetically modified T cells, to treat CLL. The findings, which were published in August 2011, were based on data from three patients who had modified T cells injected into their blood. The T cells had been modified to express genes that would allow the cells to proliferate in the body and destroy B cells including those causing the leukemia. Two patients went into remission, while the presence of leukemia in the third patient reduced by 70%. One of the patients had been diagnosed with CLL for 13 years, and his treatment was failing before he participated in the clinical trial. One week after the T cells were injected, the leukemia cells in his blood h...Chronic Lymphocytic Leukemia at American Cancer SocietyGeneral information about CLL from the US National Cancer Institute
The situation of both alleles determines the clinical picture: β thalassemia major (Mediterranean anemia or Cooley anemia) is caused by a β o /β o genotype. No functional β chains are produced, and thus no hemoglobin A can be assembled. This is the most severe form of β-thalassemia; β thalassemia intermedia is caused by a β + /β o or β ...
Nov 13, 2020 · Clinical hematology by Mary Louise Turgeon, 2012, Wolters Kluwer Health/Lippincott Williams & Wilkins edition, in English - 5th ed.