Benign Hematology

In the setting of no personal or family history and no other risk factors for thrombosis, is systemic anticoagulation warranted if local treatments (e...

4 Answers available

How do you interpret elevations in antiphospholipid antibodies that are lower than Sapporo criteria?

(e.g. beta 2 glycoprotein IgM > 20 but <40)

2 Answers available

How do you dose Eliquis in patients with CrCl <30 mL/minute?

0 Answers available

How would you manage someone with antithrombin deficiency who has recurrent VTE on a DOAC?

APLA syndrome, obesity, non compliance ruled out and prefers another oral anticoagulation. Is higher dose of rivaroxaban or apixaban an option?

2 Answers available

Would you give antithrombin concentrate for surgical VTE prophylaxis in case of congenital AT deficiency?

1 Answer available

To what extent does the degree of thrombocytopenia correlate with the severity of cirrhosis?

1 Answer available

Do you recommend hydroxyurea in patients with sickle cell disease with hereditary persistence of fetal hemoglobin who have recurrent vaso-occlusive crises requiring hospital admission?

If hydroxyurea modifies the course of sickle cell disease by increasing fetal hemoglobin, is there any benefit to using it in patients with fetal hemo...

1 Answer available

How do you manage patients who develop minor antigen antibodies and require multiple blood transfusions?

e.g. K, Fya, s, etc

1 Answer available

How do you manage a patient with sickle cell disease during pregnancy?

2 Answers available

How long after starting anticoagulation would you remove an IVC filter in a patient with a DVT presenting with stroke and PFO which is now closed?

1 Answer available

How do you determine duration of anticoagulation for an ovarian vein thrombosis following a provoking event?

1 Answer available

In sickle cell patients with continued pain crises despite hydroxyurea, how do we sequence the use of newer agents?

While L-glutamine has minimal side effects and would likely be added after hydrea, how do you decide between the use of voxelotor and crizanlizumab?

3 Answers available

Would you anticoagulate recurrent venous thromboembolism in a patient with Ehlers Danlos syndrome?

How would the approach differ if the patient had a significant bleeding phenotype vs only minor bruising and mucosal bleeding?

1 Answer available

What are your recommendations for management of patients with familial polycythemia due to EPOR mutation during pregnancy?

1 Answer available

Based on recent data would you consider adding ATRA to low dose rituximab for steroid refractory ITP?

https://doi.org/10.1182/blood.2021013393

1 Answer available

Would you retry rituximab in steroid refractory warm autoimmune hemolytic anemia which responded to rituximab before?

Last rituximab 6 months ago

1 Answer available

What are the alternatives to anticoagulation in an individual with an atrial thrombus and absolute contraindications to anticoagulation?

1 Answer available

How would you manage a patient with essential thrombocythemia and persistent pruritus despite adequate control of CBC with hydroxyurea and aspirin?

ET is JAK2+

1 Answer available

Would you consider using DOACs in a young patient with SLE and Libman-Sacks endocarditis, who is negative for APS?

1 Answer available

When and how do you initiate therapeutic phlebotomy for patients with hereditary hemochromatosis without evidence of end-organ injury?

1 Answer available

Would you discontinue anticoagulation in patients with antiphospholipid antibody syndrome, who have a remote history of thrombotic events and are now negative for pathogenic antiphospholipid antibodies?

Would the answer differ if the index event was arterial vs venous?

3 Answers available

Would you give a TPO agonist for thrombocytopenia in alcoholic cirrhosis?

1 Answer available

Would you check vitamin B6 routinely in the work up of anemia?

1 Answer available

How do you approach heparin management in patients who have suprathetherapeutic Xa levels on minimal heparin?

1 Answer available

Do you repeat antiphospholipid antibody testing in a patient that previously met criteria for APLS?

If so, how long after diagnosis do you do so?

1 Answer available

What is your recommended management algorithm for bleeding associated with an acquired factor VIII inhibitor?

1 Answer available

When do you consider plasma exchange for multiorgan failure in a patient with sickle cell disease?

2 Answers available

How do you manage recurrent portal vein thromboses in a patient with JAK2+ PV on therapeutic anticoagulation and appropriate cytoreduction?

Recurrent thromboses despite therapeutic enoxaparin. Other hypercoagulable work-up negative.

1 Answer available

Does 4G/5G polymorphism in the plasminogen activator inhibitor (PAI-1) gene increase the risk of thrombosis?

In the absence of a VTE would you consider prophylaxis after a surgical procedure? Often non-hematologists order this testing but we are consulted for...

1 Answer available

Does potential longterm risk for leukemia influence your decision for using hydroxyurea in young patients with myeloproliferative neoplasms?

Would pegylated interferon be preferred?

1 Answer available

Are there any situations you would recommend prophylactic anticoagulation for a patient with Factor V heterozygosity?

FVL heterozygotes are often treated similarly to the general population. Aside from avoiding other VTE risk factors, are there situations where prophy...

1 Answer available

In which platelet function disorders would you consider use of Novoseven as opposed to platelet transfusion?

Are there particular clinical scenarios that would affect your decision?

1 Answer available

How do you approach very treatment-refractory ITP?

Such as the case in which a patient is unresponsive to steroids, IVIG, TPO-agonist, rituximab, splenectomy, and even fostamitinib.

1 Answer available

How have you been counseling patients with sickle cell regarding a 3rd COVID vaccine?

4 Answers available

Would you consider using HMA in management of polycythemia vera?

i.e. treatment-refractory PV, prior to progression to PMF or AML

1 Answer available

Should we recommend the COVID-19 booster vaccine to patients who had a DVT or any other complications such as hemolytic anemia or thrombocytopenia from prior vaccine doses?

2 Answers available

Do you find IgA isotypes of anti-beta2-glycoprotein antibodies and anticardiolipin antibodies to be clinically useful in the evaluation for APS?

Do you routinely check IgA anticardiolipin and beta-2 glycoprotein antibody IgA in your practice? And how would a positive result change your manageme...

2 Answers available

In a patient with a heterozygous prothrombin gene mutation who has COVID with minimal symptoms, do you recommend prophylactic and/or therapeutic anticoagulation?

1 Answer available

Is antiplatelet or anticoagulant therapy preferred for the secondary prophylaxis of cryptogenic stroke in a patient with underlying malignancy?

4 Answers available

How do you manage drug-induced thrombocytopenia when the implicated drug is essential?

e.g. DITP from eptifibatide after a cardiac intervention

1 Answer available

What is your preferred anticoagulant for acute portal vein thrombosis?

How does cirrhosis and/or underlying thrombophilia affect your decision?

1 Answer available

For treatment of ITP, what would you add to dexamethasone to achieve the fastest recovery in a patient waiting for a procedure?

IVIG, TPO, or other agents?

1 Answer available

What is your practice for work up and treatment of incidental splenic infarcts with or without splenomegaly in patients without sickle cell disease?

1 Answer available

How do you differentiate between JAK2 positive ET and PV when peripheral blood shows erythrocytosis and thrombocytosis?

Concordant low EPO level and bone marrow with megakaryocyte hyperplasia

2 Answers available

What are your considerations for peri-operative anticoagulation in patients with a mechanical heart valve undergoing a major noncardiac surgery?

Please comment on bridging.

1 Answer available

What are contraindications for growth factors in patients with hematologic malignancies?

2 Answers available

Do you routinely check platelet counts after COVID-19 vaccines in patients with chronic ITP?

1 Answer available

Does variable allele frequency (VAF) of JAK mutation affect your clinical decision-making in MPN in any scenario?

Does VAF <1% make you want to do a BM biopsy for confirmation?

3 Answers available

Does testing for elevated serum homocysteine have any relevance in thrombophilia management?

What should be done with a high level?

1 Answer available

How do you counsel male-to-female transgender patients on the VTE risk of hormonal therapy?

1 Answer available

Are you comfortable using DOACs in obese patients with VTE?

1 Answer available

How would you manage a patient with JAK2-positive PV who is not responding to hydroxyurea or IFN-alpha for cytoreduction?

This is in the setting of a patient who is now on ruxolitinib with rising leukocytosis and thrombocytosis, but cannot be on aspirin due to recent blee...

3 Answers available

What is your experience managing myelosuppression from busulfan, prescribed for PV?

2 Answers available

Do you approach the diagnosis and treatment of HIT patients differently in the outpatient setting or in a resource-limited community setting?

For example, for outpatients or resource-limited settings with a moderate probability 4-T score (but low clinical suspicion), would you ever consider ...

1 Answer available

How do you manage HIT in a patient with high bleeding risk?

e.g. in the setting of using prophylactic heparin in the past but now requiring therapeutic anticoagulation

1 Answer available

Is there a role for phlebotomy in secondary polycythemia?

Aside from addressing the underlying case, is there a role for phlebotomy in secondary polycythemia such as in COPD or post-renal transplant erythrocy...

1 Answer available

What is your typical workup for a patient with a spontaneous renal infarct?

Please also discuss the type and duration of anticoagulation.

1 Answer available

How do you manage a patient with transfusion-dependent MDS with concurrent hemochromatosis requiring phlebotomy?

1 Answer available

In patients who develop a VTE, what conditions do you consider as persistent, provoking risk factors, and at what point are they controlled enough to stop anticoagulation?

I.e., what constitutes well-controlled cancer, IBD, nephrotic syndrome, etc. What other diseases do you put in this category (obesity, autoimmune dise...

1 Answer available

In patients with thrombocytosis with negative MPN workup from peripheral blood and bone marrow, is there a role for daily 81mg aspirin or other treatment?

2 Answers available

Is there experience/reports of using voxelotor in sickle cell patients who are Jehovah Witnesses with few crises but who have fatigue and/or dyspnea?

Also is there value in using voxelotor for the purpose of reducing hemolysis, and if so what parameters do you use to determine when to initiate voxel...

2 Answers available

Do you routinely check for copper deficiency as part of workup for bicytopenia with leukopenia/anemia or pancytopenia?

1 Answer available

What is your preferred approach for patients with anti-phospholipid syndrome with recurrent thrombosis on coumadin and LMWH?

1 Answer available

How would you approach moderate neutropenia (ANC < 1000) in a solid organ transplant recipient?

Is there a particular sequence you would adjust contributing antirejection or antimicrobial medications? Is the use of G-CSF appropriate and at what c...

2 Answers available

Are there any circumstances where you consider repeating CT Angiogram Chest after 3-6 months of anticoagulation for pulmonary embolism?

1 Answer available

Is prophylactic anticoagulation indicated in patients with frequent ulcerative colitis flares?

If so, what agent(s) do you prefer?

1 Answer available

What is the role of hydroxyurea in variant sickle cell genotypes?

Hydroxyurea is demonstrated to reduce complications and improve long-term outcomes in severe genotypes HbSS and sickle beta0 thalassemia. What clinica...

2 Answers available

How do you diagnose sickle hepatopathy?

1 Answer available

What is your standard workup and treatment for an incidentally-noted splanchnic vein thrombosis?

What is your duration of anticoagulation?

1 Answer available

In what circumstances would you give G-CSF to a patient with severe neutropenia and HLH?

1 Answer available

What is your approach to a patient with positive antiphospholipid antibodies who otherwise do not meet clinical criteria for APS?

What if the patient is triple-positive or has continued seropositivity on repeat lab testing? What is the appropriate interval of monitoring and does ...

3 Answers available

Do you utilize D-dimer to inform anticoagulation duration in the treatment of VTE?

Provoked or unprovoked VTE: Do you use D-Dimer (or even repeat imaging to reassess residual clot) in any capacity to guide anticoagulation duration? E...

2 Answers available

How would you manage VTE in a patient with bleeding disorder such as hemophilia?

Have you used anticoagulants other than coumadin? Or is that the only appropriate agent given monitoring is based on PT/INR?

1 Answer available

In your practice, do you usually check MMA and B12 simultaneously or start with B12 levels and check MMA only if indeterminate?

1 Answer available

Do you send an antiphospholipid antibody panel routinely for all patients with an unprovoked thrombus?

2 Answers available

Do you recommend COVID vaccination in patients with antiphospholipid antibody positivity or other prothrombotic states not on anti-coagulation?

1 Answer available

How would you manage a patient with acquired von Willebrand disease who requires DAPT for arterial disease?

1 Answer available

In the absence of symptoms would you still treat high risk myelofibrosis if transplant ineligible?

Is leukocytosis and thrombocytosis alone an indication for treatment?

1 Answer available

Would you treat iron deficiency in post PV myelofibrosis if anemia is the predominant concern?

1 Answer available

In a patient with progressive thrombocytosis but negative MPN mutations on peripheral blood, what are your diagnostic and treatment recommendations?

Do you ever recheck JAK2/CALR/MPL/BCR-ABL? Would you recommend a bone marrow biopsy? Is cytoreductive therapy indicated?

2 Answers available

When do you check for EPOR gene mutations in your workup for erythrocytosis, and if found, how do you manage it?

Is there a role for aspirin or hydroxyurea? Do you perform phlebotomy, and if so, what goals?

1 Answer available

What hematologic conditions are contraindications for a COVID vaccine?

2 Answers available

How would you manage a patient with type 1 cryoglobulinemia secondary to MGUS?

What if the patient is no longer responding to steroids?

1 Answer available

Do you consider low-dose aspirin for primary thromboprophylaxis in patients with high-risk antiphospholipid antibody profiles?

While low-dose aspirin for primary thrombosis prevention in aPL without APS is not typically recommended outside cardiovascular prevention guidelines ...

1 Answer available

How do you approach management of sickle cell patients who mistrust Western medicine and prefer naturopathic therapies?

While building a trusting patient-physician relationship, what therapies could be discussed that may be aligned with naturopathic medicine? (i.e. L-gl...

1 Answer available

What is the anticoagulation recommendation for a chronic DVT?

2 Answers available

Would you routinely use G-CSF prophylaxis in a CMML patient for decitabine-related neutropenia?

1 Answer available

In the rare setting of enoxaparin injection-induced abdominal wall hematoma in patients requiring long-term anticoagulation, what is your timeline for restarting anticoagulation?

Would appreciate expert opinion on when to reimage and when to restart anticoagulation depending on findings.

1 Answer available

In which patients with oncologic or hematologic disorders are you recommending a 3rd dose of mRNA COVID vaccine?

2 Answers available

What is the role, if any, for next generation sequencing testing in patients with suspected MPN who test negative for commonly identified mutations such as JAK2, CALR, MPL, and BCR-ABL?

3 Answers available

How would you manage symptomatic iron deficiency in patients with PV on frequent phlebotomies?

Is this a reason to start hydrea? Would you give oral iron after adequate control on hydrea?

2 Answers available

Do you recommend anticoagulation for a splenic infarct in patients with myelofibrosis and splenomegaly?

1 Answer available

What is the maximum pRBC volume you can transfuse when performing a manual exchange transfusion in an adult-sized patient with sickle cell disease?

1 Answer available

How often should you repeat iron testing in patients with hemochromatosis, not on phlebotomy?

Patient with ferritin level <1000 ng/mL and no evidence of end-organ damage

1 Answer available

How soon after a VTE would you feel comfortable with a patient undergoing an elective surgery?

While there are many factors involving:- type (DVT vs PE, unprovoked vs provoked) and severity of venous thromboembolism (VTE) size- duration of antic...

1 Answer available

How do you approach an isolated T-cell gene arrangement found in the setting of persistent hypereosinophilia?

If all work-up including peripheral flow, bone marrow biopsy, PET-CT returns negative, what additional management (if any) would be recommended?

1 Answer available

Do you use premedications (acetaminophen, diphenhydramine) before pRBC and plt transfusions to prevent febrile nonhemolytic transfusion reactions and allergic reactions?

Does manipulation of blood products (leukoreduction, irradiated) affect your approach? There is growing evidence that routine premedication (at least ...

1 Answer available

Would you extend the duration of anticoagulation in patients with a provoked DVT, but evidence of residual clot at 3 months?

While follow up ultrasound is not usually recommended in provoked DVT, it often is done either for other reasons or by other physicians. Would this in...

1 Answer available

Under what circumstances would you consider anticoagulation in a young female patient with persistently elevated factor XI activity?

While this is a known risk factor for venous [Meijers et al NEJM 2000] and potentially arterial [Yang et al, Am J Clin Pathol 2006] thrombosis, it is ...

1 Answer available

Would you offer a complement inhibitor to a minimally symptomatic PNH patient with mild non-transfusion dependent hemolytic anemia?

1 Answer available

What is your perioperative approach to holding and restarting hydroxyurea in patients with essential thrombocythemia?

1 Answer available

Are there any special considerations when evaluating patients with non-malignant hematologic or immunodeficiency disorders for allogeneic transplant?

Are there major differences in standard conditioning and/or GVHD prophylaxis regimens utilized? Does the non-relapse mortality different significantl...

3 Answers available

With what agents can you replace PPIs if they cause thrombocytopenia?

1 Answer available

Should platelet transfusions be considered for anti-platelet agent reversal in patients with major bleeding?

1 Answer available

Should assessing for a MTHFR mutation be part of the thrombophilia evaluation in a patient presenting with a thrombus?

1 Answer available

How long do you continue caplacizumab in relapsed refractory TTP?

How often do you monitor ADAMTS-13 levels off therapy?

1 Answer available

Are there any reasons to consider a prolonged course of steroids with taper over a shorter course of pulsed steroids in the treatment of ITP?

For example, do we prefer one regimen over the other in patients with a bleeding history or who have relapsed after a lengthy remission?

1 Answer available

Can you use other iron formulations if a patient develops Stevens-Johnson Syndrome with ferumoxytol?

1 Answer available

How often do you follow ferritin and organ iron-deposition in a patient who has known hereditary hemochromatosis, but no current evidence of iron overload?

e.g. a genetic mutation picked up through a family member

1 Answer available

Is there any role for iron chelation in a patient with iatrogenic transfusion-induced iron overload such as in patients with end-stage kidney or liver disease?

Does transplant eligibility make a difference for management?

1 Answer available

How do you manage testosterone replacement therapy-induced erythrocytosis?

Do you recommend therapeutic phlebotomy to a certain Hct goal? Any strong evidence for thromboembolic risk related to erythrocytosis or if this is mit...

3 Answers available

What is your perioperative approach for a patient with severe hemophilia?

What type, dosage, and duration of treatment do you use? How does your practice change when there is an inhibitor?

1 Answer available

Do you routinely obtain bone marrow biopsy in newly diagnosed autoimmune hemolytic anemia when working up potential underlying etiologies?

1 Answer available

How do you advise a patient with VTE on indefinite anticoagulants regarding the Ad26.COV2.S Johnson & Johnson/Janssen COVID vaccine?

1 Answer available

How do you approach evaluation of pulmonary vein thrombosis?

Is there any difference between anticoagulants in this clinical context (e.g. anti-Xa inhibitors vs warfarin vs LMWH)?

1 Answer available

How would you approach chronic isolated severe non-cyclic neutropenia with negative bone marrow and rheumatologic work-up?

Is there a role for empiric antibiotics if there is history of opportunistic infection?

1 Answer available

How do you approach the treatment of drug-induced thrombotic microangiopathy?

When do you consider initiating eculizumab?

1 Answer available

Do you consider splenic response as adequate to judge efficacy of JAK2 inhibitors in myeloproliferative disorders?

1 Answer available

What is the transfusion management of a sickle cell patient during pregnancy?

What are your target goals during transfusion, either prophylactically or during acute complication? Does your management change between vaginal deliv...

1 Answer available

Would you recommend use of ESA for anemia of kidney disease in the setting of metastatic solid tumor malignancy?

1 Answer available

How would you manage an incidental catheter-related thrombosis in a functioning dialysis catheter?

- Dialysis catheter used for hemodialysis- RIJ thrombus in dialysis catheter was incidentally found- Patient asymptomatic with no prior history of VTE...

1 Answer available

How would you advise patients with known stable autoimmune thrombocytopenia regarding the Ad26.COV2.S (Johnson & Johnson/Janssen) vaccine?

1 Answer available

In patients with autoimmune cytopenias, is there any reservation for COVID vaccination?

While benefits outweigh known harms and limited data, do you worry about vaccination in patients with a history of or active autoimmune cytopenias (e....

1 Answer available

How do you approach transfusing a patient with sickle cell disease who has a history of hyperhemolysis?

1 Answer available

When (if ever) do you check for anti-platelet antibodies for workup of thrombocytopenia?

1 Answer available

In patients with a history of HIT, how do you counsel them on the use of the AstraZeneca vaccine given reports of unusual thrombosis and association with PF4/heparin antibodies?

AstraZeneca may cause PF4 antibodies leading to vaccine-induced prothrombotic immune thrombocytopenia (VIPIT).

1 Answer available

Do you check pertussis serologies when sending labs for antiphospholipid syndrome?

2 Answers available

In a patient with breakthrough VTE on rivaroxaban, would you switch to apixaban or an agent with a different mechanism of action?

Assuming the patient is a candidate for all anticoagulation options (no mechanical valve, antiphospholipid syndrome, patient-specific contraindication...

1 Answer available

Should patients receive thrombophilia testing in the setting of a provoked VTE secondary to hormonal therapy/OCPs?

While thrombophilia testing is not routinely recommended prior to starting OCPs, how about after the development of a VTE?

2 Answers available

How would you manage a patient with antiphospholipid syndrome in the setting of severe steroid-refractory thrombocytopenia?

Especially in a triple-positive patient with an acute ischemic stroke who may have urgency for anticoagulation with high bleeding risk and severe thro...

2 Answers available

Would you ever consider prophylactic anticoagulation in patients with CKD requiring ESA therapy?

While the CKD population is at high thrombotic and bleeding risk, would you consider anticoagulating a patient prophylactically if they had a history ...

1 Answer available

How do you treat refractory cold agglutinin disease?

The patient who has not responded to steroids, rituximab/bendamustine, and splenectomy?

2 Answers available

What is the best way to monitor intraoperative heparin use in a patient with factor XII deficiency?

In a patient with severe factor XII deficiency with a baseline prolonged PTT, what is the best method to monitor their ACT or heparin levels when on c...

1 Answer available

When do you refer AYA patients with newly diagnosed severe aplastic anemia for transplant?

Would you give a trial of IST first or immediately refer for SCT if the patient has matched siblings?

2 Answers available

How do you manage prophylactic antimicrobial medications in patients who undergo ATG/cyclosporine/eltrombopag induction for severe aplastic anemia?

What would you recommend within the first year after ATG and thereafter if still maintained on cyclosporine?

1 Answer available

Do you routinely start anticoagulation for a patient with newly diagnosed hepatocellular carcinoma presenting with a portal venous thrombosis?

3 Answers available

How do you approach the treatment of ITP in a pregnant patient who did not respond to prednisone?

Would you consider high-dose dexamethasone (deliberating adverse effects of antenatal steroids) or move to next-line therapies?

1 Answer available

How can healthcare providers better serve as allies of the sickle cell community?

Has your medical practice taken any steps either in community outreach or within the clinic to show support for this medically vulnerable population, ...

2 Answers available

What could explain discordant iron studies?

For a patient with low ferritin, but high TSAT?

1 Answer available

How do you workup erythrocytosis with a normal or elevated serum erythropoietin?

2 Answers available

Do you generally reduce DOAC dosing for extended anticoagulation in patients with first unprovoked VTE?

Ref: EINSTEIN-CHOICE and AMPLIFY-EXT Would you approach this differently in patients with inherited thrombophilias?

1 Answer available

What are the current official guidelines regarding COVID-19 vaccination for patients with cancer or for hematologic conditions?

2 Answers available

Do you account for the effect of coffee on platelet aggregation studies?

1 Answer available

Why are autoantibodies not often detected on monoclonal gammopathy assays (SPEP/IFE, quantitiative immunoglobulins)?

For example, in cold agglutinin disease or AIHA, antibodies can be detected via DAT, but are often not observed on assays for monoclonal gammopathies.

1 Answer available

How would you approach the treatment of patients with von Willebrand disease or hemophilia A previously managed with intranasal DDAVP during the recall?

During the Stimate recall, how are we performing DDAVP challenges for newly diagnosed hemophilia A or von Willebrand disease?

1 Answer available

Is there an equivalent test for serum viscosity in sickle cell disease?

1 Answer available

Is there a role for G-CSF treatment for SLE patients with persistent neutropenia?

1 Answer available

Do you routinely refer young patients with iron deficiency anemia for GI evaluation?

In low-risk patients (age < 40) or patients with very obvious causes of blood loss or iron deficiency (menorrhagia, pregnancy), do you routinely pe...

1 Answer available

How do you approach unresectable or borderline resectable symptomatic nasal/paranasal Rosai-Dorfman disease?

Are there effective therapy options that do not include steroids?

1 Answer available

In which patients with atypical HUS would you consider eculizumab discontinuation?

Given the high cost of eculizumab, are there patient characteristics that inform which patients, if any, should be on indefinite therapy versus a time...

2 Answers available

How do you manage a delayed hemolytic transfusion reaction in a patient with sickle cell disease?

How do you manage an uncomplicated DHTFR versus a hyperhemolysis?

1 Answer available

What is your threshold for pursuing bone marrow biopsy in a lupus patient with cytopenias?

2 Answers available

How do you approach the management of a patient with symptomatic iron deficiency anemia who is intolerant of iron?

Such as a patient who cannot tolerate oral iron and has had a anaphylaxis to intravenous iron

4 Answers available

What is the target ferritin level for patients with hereditary hemochromatosis and signs of end-organ damage?

For example, a patient with hypogonadism unless it matters which organ is involved. Are other markers of iron storage useful in guiding therapy?

2 Answers available

How do you approach anticoagulation in patients with catastrophic antiphospholipid syndrome and thrombocytopenia?

1 Answer available

Do you recommend long term anticoagulation for all patients with first time unprovoked VTE?

1 Answer available

What are your thoughts on adding mycophenolate to steroids in the first line treatment of ITP based on the results of the FLIGHT trial?

Presented at ASH: FLIGHT trial

1 Answer available

How would you manage a patient with PV or ET who is experiencing breakthrough thrombosis?

For example, a patient on cytoreductive therapy and aspirin BID, but suffers an arterial event, or a patient who is already on therapeutic anticoagula...

2 Answers available

Should venous thrombosis in a patient with Behcet syndrome be treated with both immunosuppression and anticoagulation?

1 Answer available

How would you manage OCPs in a patient who develops a VTE while on treatment?

In a patient with a medical or personal indication to induce oligomenorrhea/amenorrhea, how would you manage OCP therapy if a patient develops a VTE d...

1 Answer available

Would you place an IVC filter in a patient with an acute PE and an absolute contraindication for anticoagulation, but negative imaging for proximal DVT?

3 Answers available

Is there a role for anti-neutrophil antibody testing in the workup of neutropenia?

If autoimmune neutropenia already suspected, is this test informative or unnecessary?

1 Answer available

Do hemoglobin S levels always correlate with SCD phenotype?

What is the lowest level you have seen with uncomplicated or complicated crises?

4 Answers available

How do you decide to transition a patient with stable PNH on eculizumab to extended half-life ravulizumab?

1 Answer available

How do you approach diagnosing a patient with Iron Refractory Iron Deficiency Anemia (IRIDA)?

Do you go straight to TMPRSS2 genetic testing or what other lab testing (e.g. hepcidin) could be helpful?

1 Answer available

What is your preferred formulation of parenteral iron?

There are various formulations of intravenous iron; each with varying costs, test dose requirement, elemental dose, and number or time of infusions ne...

1 Answer available

What is the preferred immunosuppressive modality for patients with an acquired factor 8 inhibitor?

1 Answer available

Are there patients who can forgo anticoagulation with asymptomatic, incidentally discovered subsegmental pulmonary embolism?

If there are a low-risk patients who can be monitored, how would you do so? If unprovoked, would you consider stopping anticoagulation?

2 Answers available

What is the optimal VTE prophylaxis for hospitalized patients with COVID-19?

Should we use a different dose in critically ill patients in the ICU? When should we consider intermediate-dose anticoagulation?

1 Answer available

What is the optimal management of a patient with refractory TTP who has had poor response to plasma exchange, steroids, rituximab, especially when caplacizumab is unavailable?

1 Answer available

How do you manage VTE in the setting of persistent severe thrombocytopenia?

Is there a preferred strategy of transfusional support versus reduced-dose anticoagulation during the duration of thrombocytopenia?

3 Answers available

Which patients may benefit from eculizumab in refractory APS?

2 Answers available

Do you routinely prophylactically anticoagulate patients undergoing systemic chemotherapy outside of the perioperative period?

1 Answer available

For a patient with previously relapsed TTP but in clinical remission, what is the role of rituximab in treating asymptomatic ADAMTS13 deficiency to prevent relapse?

Rituximab has entered the treatment algorithm in the first-line setting for the initial treatment of TTP. However, in remission, the role of adjuvant ...

1 Answer available

Is there any role for direct oral anticoagulants in the treatment of antiphospholipid syndrome?

What if this was "triple-negative" antiphospholipid syndrome?

2 Answers available

How often do you utilize soluble transferrin receptor or hepcidin testing in the diagnosis of ambiguous iron deficiency, such as with concomitant anemia of chronic disease?

Does recent iron intake affect the iron panel, and if so, do you often order fasting labs in practice?

1 Answer available

Would you anticoagulate a patient with an isolated arterial thrombosis in the setting of an inherited thrombophilia?

Does your opinion change based on the specific underlying inherited thrombophilia? The original case was a central retinal artery occlusion in a patie...

2 Answers available

How do you evaluate an isolated prolonged aPTT in patients?

Especially in a patient without hemophilia or thrombosis history?

1 Answer available

Would you recommend anticoagulation for patients with partial false lumen thrombosis in type B aortic dissection?

Would you offer this routinely or only if specific complications arise, such as distal emboli?

2 Answers available

Is there a role for ruxolitinib in essential thrombocythemia?

In patients who are intolerant to hydroxyurea, anagrelide and interferon

1 Answer available

When should you use caplacizumab in the treatment of acute TTP patients?

1 Answer available

Papers discussed in this category

Blood,

How I treat unexplained arterial thrombosis.

Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis, 2016-04

Apixaban for the Secondary Prevention of Thrombosis Among Patients With Antiphospholipid Syndrome: Study Rationale and Design (ASTRO-APS).

Blood, 2018 Jul 12

Rivaroxaban vs warfarin in high-risk patients with antiphospholipid syndrome.

Ann. Intern. Med., 2019 Oct 15

Rivaroxaban Versus Vitamin K Antagonist in Antiphospholipid Syndrome: A Randomized Noninferiority Trial.

Blood Transfus, 2018 Oct 24

Platelet cut-off for anticoagulant therapy in thrombocytopenic patients with blood cancer and venous thromboembolism: an expert consensus.

J Thromb Haemost, 2018 May 08

Management of cancer-associated thrombosis in patients with thrombocytopenia: guidance from the SSC of the ISTH.

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Overdiagnosis of Pulmonary Embolism by Pulmonary CT Angiography.

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How I treat and manage strokes in sickle cell disease.

Blood Adv, 2020 Jan 28

American Society of Hematology 2020 guidelines for sickle cell disease: transfusion support.

Blood, 2015 Aug 24

Prophylactic transfusion for pregnant women with sickle cell disease: a systematic review and meta-analysis.

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The New England journal of medicine, 2019-02-21

Rivaroxaban for Thromboprophylaxis in High-Risk Ambulatory Patients with Cancer.

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The use of direct oral anticoagulants for primary thromboprophylaxis in ambulatory cancer patients: Guidance from the SSC of the ISTH.

N Engl J Med, 2018 Dec 04

Apixaban to Prevent Venous Thromboembolism in Patients with Cancer.

The New England journal of medicine, 2017-02-02

Crizanlizumab for the Prevention of Pain Crises in Sickle Cell Disease.

Blood, 2009 Nov 10

The effect of prolonged administration of hydroxyurea on morbidity and mortality in adult patients with sickle cell syndromes: results of a 17-year, single-center trial (LaSHS).

Chest, 1975-12

Symptomatic and puomonary response to acute phlebotomy in secondary polycythemia.

Clin Nephrol,

Therapeutic efficiency of phlebotomy in posttransplant hypertension associated with erythrocytosis.

Clinical immunology (Orlando, Fla.), 2019-09

Treatment of antiphospholipid syndrome beyond anticoagulation.

Seminars in arthritis and rheumatism, 2019-08

Secondary thrombotic microangiopathy in systemic lupus erythematosus and antiphospholipid syndrome, the role of complement and use of eculizumab: Case series and review of literature.

American journal of hematology, 2011-10

Safety and efficacy of rapidly administered (one hour) one gram of low molecular weight iron dextran (INFeD) for the treatment of iron deficient anemia.

The American journal of medicine, 2017-12

Results of the First American Prospective Study of Intravenous Iron in Oral Iron-Intolerant Iron-Deficient Gravidas.

American journal of hematology, 2018-05

Comparative safety of intravenous ferumoxytol versus ferric carboxymaltose in iron deficiency anemia: A randomized trial.

Am J Hematol, 2020 Jun 29

A 6 month extension trial evaluating safety and efficacy of ferric derisomaltose in patients with iron deficiency anemia: The FERWON-EXT trial.

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Single total dose infusion of ferumoxytol (1020 mg in 30 minutes) is an improved method of administration of intravenous iron.

Am J Hematol, 2018 Jun

Iron isomaltoside is superior to iron sucrose in increasing hemoglobin in gynecological patients with iron deficiency anemia.

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Blood, 2015 Dec 22

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Contraception, 2016 May 03

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BMJ, 2008 May 20

Hormone replacement therapy and risk of venous thromboembolism in postmenopausal women: systematic review and meta-analysis.

Circulation,

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Blood, 2017 Jan 19

How I treat cryoglobulinemia.

Blood Cancer J, 2018 Feb 09

The 2016 WHO classification and diagnostic criteria for myeloproliferative neoplasms: document summary and in-depth discussion.

Blood, 2017 May 08

How I treat recurrent venous thromboembolism in patients receiving anticoagulant therapy.

Journal of thrombosis and haemostasis : JTH, 2018-06-07

McMaster RARE-Bestpractices clinical practice guideline on diagnosis and management of the catastrophic antiphospholipid syndrome.

American journal of hematology, 2008-08

Serum ferritin concentrations and body iron stores in a multicenter, multiethnic primary-care population.

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ACG Clinical Guideline: Hereditary Hemochromatosis.

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Pathogenic Variants in Complement Genes and Risk of Atypical Hemolytic Uremic Syndrome Relapse after Eculizumab Discontinuation.

Blood, 2020 Dec 03

Eculizumab discontinuation in children and adults with atypical haemolytic uremic syndrome: a prospective multicentric study.

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Treatment of severe neutropenia due to Felty's syndrome or systemic lupus erythematosus with granulocyte colony-stimulating factor.

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Blood, 2018 May 02

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Effect of antithymocyte globulin source on outcomes of bone marrow transplantation for severe aplastic anemia.

Blood, 2018 Jun 13

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The Use of Erythropoiesis-Stimulating Agents in Patients With CKD and Cancer: A Clinical Approach.

Blood, 2016-01-21

Whole-exome sequencing identifies novel MPL and JAK2 mutations in triple-negative myeloproliferative neoplasms.

Seminars in hematology, 2013-07

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Thrombotic Thrombocytopenia after Ad26.COV2.S Vaccination.

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CD3CD4 Lymphocytic Variant Hypereosinophilic Syndrome: Diagnostic Tools Revisited.

Eur J Haematol, 2020 May 18

Causes of hypereosinophilia in 100 consecutive patients.

Br J Haematol, 2019 Nov 13

Pegylated interferon alpha 2a is an effective and well-tolerated treatment option for lymphocyte-variant hypereosinophilic syndrome.

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Treatment of lymphocyte-variant hypereosinophilic syndrome (L-HES): what to consider after confirming the elusive diagnosis.

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Non-hematologic effects of chronic iron deficiency. A study of patients with polycythemia vera treated solely with venesections.

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Pediatric blood & cancer, 2014-05

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Immune parameter analysis of children with sickle cell disease on hydroxycarbamide or chronic transfusion therapy.

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Respiratory Viral Infections in Sickle Cell Anemia: Special Emphasis on H1N1 Co-infection.

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Incidence Rate of COVID-19 Infection in Hemoglobinopathies: A Systematic Review and Meta-analysis.

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Absence of hypercoagulability after nCoV-19 vaccination: An observational pilot study.

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Blood, 2016 Sep 26

New concepts for anticoagulant therapy in persons with hemophilia.

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High-dose intravenous immunoglobulin for the treatment and prevention of heparin-induced thrombocytopenia: a review.

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Comparative effectiveness and safety of direct oral anticoagulants compared to warfarin in morbidly obese patients with acute venous thromboembolism: systematic review and a meta-analysis.

Transfusion, 2020 Sep 24

Sickle cell anemia and COVID-19: Use of voxelotor to avoid transfusion.

Lancet Haematol,

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Periprocedural heparin bridging in patients receiving vitamin K antagonists: systematic review and meta-analysis of bleeding and thromboembolic rates.

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Postoperative low molecular weight heparin bridging treatment for patients at high risk of arterial thromboembolism (PERIOP2): double blind randomised controlled trial.

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Sex differences in the JAK2 V617F allele burden in chronic myeloproliferative disorders.

Exp Hematol, 2008 Nov

Phenotypic variability within the JAK2 V617F-positive MPD: roles of progenitor cell and neutrophil allele burdens.

Blood, 2008-07-15

The revised World Health Organization diagnostic criteria for polycythemia vera, essential thrombocytosis, and primary myelofibrosis: an alternative proposal.

N Engl J Med, 2017 Jun 1

Myeloproliferative Neoplasms.

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Polycythemia vera: the natural history of 1213 patients followed for 20 years. Gruppo Italiano Studio Policitemia.

Leukemia, 2021 Apr 28

Are polycythemia vera, essential thrombocytosis, and primary myelofibrosis 1, 2, or 3 diseases?

J Am Heart Assoc, 2020 Nov 23

Direct Oral Anticoagulants in Patients With Inherited Thrombophilia and Venous Thromboembolism: A Prospective Cohort Study.

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Thromb Haemost, 2020 Jul 21

Is There an Additional Value in Detecting Anticardiolipin and Anti-β2 glycoprotein I IgA Antibodies in the Antiphospholipid Syndrome?

Archives of internal medicine, 2006-07-10

Low testosterone levels and the risk of anemia in older men and women.

The American journal of medicine, 1997-01

Inapparent polycythemia vera: an unrecognized diagnosis.

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An elevated venous haemoglobin concentration cannot be used as a surrogate marker for absolute erythrocytosis: a study of patients with polycythaemia vera and apparent polycythaemia.

Haematologica, 2019 Aug 14

Masked polycythemia vera: analysis of a single center cohort of 2480 red cell masses.

Blood,

Persistent leukocytosis in polycythemia vera is associated with disease evolution but not thrombosis.

Blood Cancer J, 2018 Nov 12

Hydroxyurea prevents arterial and late venous thrombotic recurrences in patients with myeloproliferative neoplasms but fails in the splanchnic venous district. Pooled analysis of 1500 cases.

Lancet Haematol, 2020 Jan 31

Ropeginterferon alfa-2b versus standard therapy for polycythaemia vera (PROUD-PV and CONTINUATION-PV): a randomised, non-inferiority, phase 3 trial and its extension study.

J Clin Oncol, 2018 Aug 28

Hydroxycarbamide Plus Aspirin Versus Aspirin Alone in Patients With Essential Thrombocythemia Age 40 to 59 Years Without High-Risk Features.

Leukemia, 2021 Mar 02

Interferon-alpha for treating polycythemia vera yields improved myelofibrosis-free and overall survival.

Transfusion, 2017 May 03

From total blood exchange to erythrocytapheresis and back to treat complications of sickle cell disease.

Autoimmun Rev, 2017 Sep 09

Can we withdraw anticoagulation in patients with antiphospholipid syndrome after seroconvertion?

Br J Haematol, 2013 Aug 02

A multi-centre retrospective study of rituximab use in the treatment of relapsed or resistant warm autoimmune haemolytic anaemia.

Blood Adv, 2017 Jun 22

Ovarian vein thrombus: to treat or not to treat?

Blood, 2019 Apr 25

J Clin Med, 2020 Nov 23

Fetal Hemoglobin in Sickle Hemoglobinopathies: High HbF Genotypes and Phenotypes.

Am J Hematol, 2012 May 28

Genetic modifiers of sickle cell disease.

Lupus, 2021 May 27

16th International congress on antiphospholipid antibodies task force report on clinical manifestations of antiphospholipid syndrome.

Journal of the National Medical Association, 2009-10

Exposure to hydroxyurea and pregnancy outcomes in patients with sickle cell anemia.

Blood,

Reproductive issues in sickle cell disease.

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