Platelet E-News - March 18, 2010

This e-newsletter is a monthly publication of the Platelet Disorder Support Association. The information in this newsletter is for educational purposes only. For advice on your unique medical condition, please consult a health care professional.

Contents:

ITP Research and Treatments

Hospitals, Insurance, and Medical Care

General Health and Medicine

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ITP Research and Treatments

 

NOW AVAILABLE: NEW INTERNATIONAL CONSENSUS REPORT ON INVESTIGATION AND MANAGEMENT OF ITP

“The International Consensus Report on the Investigation and Management of Immune Thrombocytopenia,” the culmination of years of work by 22 researchers, clinicians, and patient representatives, provides an up-to-date guide for all on ITP treatment. The report, published in the journal Blood and available on-line, summarizes hundreds of research studies and distills the practical knowledge of the committee on the diagnosis of ITP and its management in adults, pregnancy, and in children.

Provan, D, “International consensus report on the investigation and management of primary immune thrombocytopenia,” Blood. 2010 Jan 14; 115 (2):168-86.

http://bloodjournal.hematologylibrary.org/cgi/content/full/115/2/168

The link to the new report is also available on the PDSA Web Site

 

 

COMBINATION IMMUNOSUPPRESSANT TREATMENT MAY BENEFIT CHRONIC REFRACTORY ITP PATIENTS

A combination of azathioprine (Imuran, Azasan), mycophenolate mofetil (CellCept), and cyclosporine (Sandimmune), all immunosuppressive drugs, were given to 19 patients with ITP who had failed many prior treatments. Of the 19, 14 achieved a response for about 24 months. Over time, eight of the 14 relapsed and were subsequently re-treated with six responding. Two of the 14 were able to discontinue all medications. Half of the patients on the trial reported adverse event, none severe.

Arnold DM, et al. “Combination immunosuppressant therapy for patients with chronic refractory immune thrombocytopenic purpura.” Blood. 2010 Jan 7;115 (1):29-31

http://www.ncbi.nlm.nih.gov/pubmed/19897578

 

 

STOOL TESTS FOR HELICOBACTER PYLORI ALLOW RAPID NONINVASIVE ASSESSMENT FOR BACTERIAL INFECTION

Three new tests for H. pylori, STAT, RAPID, and IDEIA use stool samples to diagnose H. pylori and assure its clearance after treatment. None are perfect, but of the three IDEIA proved best in a comparison test. Blood and breath tests are also available to help diagnose an H. pylori infection.

Calvet X, et al. “Comparative accuracy of 3 monoclonal stool tests for diagnosis of Helicobacter pylori infection among patients with dyspepsia.” Clin Infect Dis. 2010 Feb 1;50 (3):323-8.

http://www.ncbi.nlm.nih.gov/pubmed/20043753

(Note: H. plyori infections have been associated with ITP. Some patients find their platelets rise when the infection is treated.)

 

 

MICE WITH SEVERE ITP RESPOND DIFFERENTLY TO IVIg TREATMENT

The destruction of platelets in people who have ITP can be initiated in at least two ways, via antibodies that may attach to the platelets (B-cell mediated) or similar to the way the body destroys other damaged cells within the blood stream (T-cell mediated). Researchers in Canada tested IVIg on a mouse model they created that exhibits these two types of platelet destruction. They found that IVIg addressed the antibody-mediated platelet destruction but did not address the T-cell-mediated platelet removal.

Chow L. “A murine model of severe immune thrombocytopenia is induced by antibody- and CD8+ T cell-mediated responses that are differentially sensitive to therapy.” Blood. 2010 Feb 11;115 (6):1247-53.

http://www.ncbi.nlm.nih.gov/pubmed/ 20007808

 

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Hospitals, Insurance, and Medical Care

 

HOSPITALIZED PATIENTS PREFER TO DISCUSS ADVANCE DIRECTIVES WITH THEIR ONCOLOGIST OR PRIMARY CARE PHYSICIAN

An advance directive, sometimes called a ‘living will’, is a legal document that describes the patient’s desires for treatment if he/she is no longer capable of making those decisions. According to a 2009 study, hospitalized patients prefer to discuss the contents of this document with one of their own physicians. Recently, a new document, Five Wishes, was developed (legal in 42 states) that encompasses additional information including the designation of a proxy decision maker, treatment preferences, end-of-life specifics, and instructions for loved ones. A do-not-resuscitate (DNR) order or a Physician Order for Life-Sustaining Treatment (POLST) are also important documents in assuring patients’ wishes are followed.

Harman, S, “An update on advance directives,” HemOncToday, Feb. 10, 2010.

http://www.hemonctoday.com/article.aspx?rid=60875

 

 

FDA ANNOUNCES CLASS 1 RECALL OF DEFECTIVE INFUSION NEEDLES

More than two million Huber needle units manufactured from January 2007 to August 2009, used in ports and distributed by Exelint, are being recalled because some defective needles have left slivers of silicone in a patient’s blood stream. The American Society of Hematology and the FDA have posted a list of specific catalog numbers for the defective units.

http://www.hematology.org/News/2010/4883.aspx

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm198728.htm

 

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General Health and Medicine

 

DR OZ RECOMMENDS DARK CHOCOLATE TO HELP THE SPLEEN AND IMMUNE SYSTEM

In a segment of his syndicated TV show, Dr. Oz talked about the important functions of the spleen and suggested eating dark chocolate to boost the spleen’s immune function. He also suggested wearing a seat belt to protect your spleen and mentioned the importance of vitamin B6.

http://www.doctoroz.com/videos/why-you-need-your-spleen

(Note: Dark chocolate can interfere with the action of platelets. If your platelets are very low or you have bleeding symptoms, please discuss any diet changes with your doctor. PDSA has a list of foods that can interfere with platelet function at http://www.pdsa.org/about-itp/warnings.html

 

 

EXERCISE PROMOTES BONE HEALTH AND REDUCES FALLS IN WOMEN OVER 65

In a study of 227 women over 65, those in the 18-month exercise program had 66% fewer falls, half the fractures due to falls, and improved rather than reduced bone density compared to the women who did not participate in the exercise program. The researchers noted that the benefits were derived without an increase in costs.

Kemmler W,”Exercise effects on bone mineral density, falls, coronary risk factors, and health care costs in older women: the randomized controlled senior fitness and prevention (SEFIP) study.” Arch Intern Med. 2010 Jan 25;170 (2):179-85.

http://www.ncbi.nlm.nih.gov/pubmed/20101013

 

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