International journal of hematology
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Sickle cell disease (SCD) is reported to be the most common genetic disorder affecting Nigerians. Children with SCD are at a high risk of neurological morbidity. The main objective of this study was to determine the pattern of adverse neurological outcomes among a cohort of Nigerian children with SCD. ⋯ Adverse neurological events are common in Nigerian children with SCD, with a significantly higher risk in Hb SS than Hb SC disease. Stroke represents a major underlying cause of symptomatic epilepsy in SCD. Institution of primary preventive measures for stroke in SCD will significantly reduce the burden of stroke and epilepsy associated with SCD in Nigeria.
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This study was designed to evaluate the effect of the warfarin dose-associated genotypes, CYP2C9*3 (rs1057910), VKORC1 -1639 G/A (rs9923231), and CYP4F2 1347 C/T (rs2108622), on hemorrhagic complications in Han Chinese patients. Consecutively recruited patients requiring more than 1 year of warfarin treatment were followed from the initiation of warfarin anticoagulation for at least 3 months. CYP2C9*3, VKORC1 -1639 G/A, and CYP4F2 1347 C/T were genotyped by sequencing. ⋯ VKORC1 -1639 G/A, and CYP4F2 rs2108622 did not confer significant increase in risk for hemorrhage or over-anticoagulation. Kaplan-Meier curves showed that time to all hemorrhagic events was significantly shorter for patients with CYP2C9*3 genotype than non-carriers (P = 0.001), but not for patients with VKORC1 -1639 G/A or CYP4F2 rs2108622 genotype (P = 0.3 and 0.2). CYP2C9*3 may be the main genetic factor in hemorrhagic complications in Chinese patients under warfarin anticoagulation.
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Anti-T lymphocyte globulin (ATG) is commonly used as prophylaxis for graft-versus-host disease (GVHD), especially in patients who are at high risk of GVHD. The appropriate dosage of ATG in Japan has not yet been assessed. We therefore conducted a nationwide survey of patients who received ATG-Fresenius as GVHD prophylaxis for unrelated bone marrow transplantation (uBMT). ⋯ In adult patients, there was a reduction of acute GVHD with high-dose ATG (>10 mg/kg), which did not reach statistical significance. In conclusion, the addition of low-dose ATG to GVHD prophylaxis in Japanese patients who received uBMT resulted in decreased incidences of both acute and chronic GVHD without compromising OS. The effects of low-dose ATG should be assessed in a prospective clinical trial.