Platelet E-News: July 30, 2013

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 and Platelet Disorders Research and Treatments

Hospitals, Insurance, and Medical Care

General Health and Medicine

 

ITP and Platelet Disorders Research and Treatments

Low Vitamin D Levels Linked to ITPLow Vitamin D Levels Linked to ITP

In a study of vitamin D status in ITP, the 45 participants with ITP had lower levels of two types of vitamin D in their blood and an increased expression of the vitamin D gene than the 30 healthy controls.  The researchers concluded: “…Vitamin D level and its receptor expression may play an important role in ITP, and vitamin D and its similarities may be a new agent to treat patients with ITP.”

Mu W, et al. “Expression and significance of vitamin d and its receptor mRNA in the peripheral blood of initial immune thrombocytopenic patients.” Chinese Journal of Hematology.2013 Jun;21(3):684-7.
http://www.ncbi.nlm.nih.gov/pubmed/23815922

Veltuzimab: New Treatment, Preliminary Results

Veltuzumab is an anti-CD20 monoclonal antibody that depletes B-cells, similar to rituximab (Rituxan®).  It produced a meaningful response in 55% of the 41 people with ITP tested in a phase 1 study. The treatment can be given by IV or under the skin (sub-cutaneous).  People responded to both infusion methods at all dose levels, with those diagnosed less than a year having a better response rate and longer time to relapse. The positive response and low rate of severe adverse reactions lead to a positive conclusion: ”Sub-cutaneous veltuzumab appears convenient, well-tolerated, and with promising clinical activity in relapsed ITP.”

Liebman HA et al. “Low-dose anti-CD20 veltuzumab given intravenously or subcutaneously is active in relapsed immune thrombocytopenia: a phase I study.”  Br J Haematol. 2013 Jul 6.
http://www.ncbi.nlm.nih.gov/pubmed/23829485

Better ITP Treatments, Improved T-cells

People with ITP were separated into groups to test three different treatments and to compare their levels of T-regulatory (Tregs) cells with healthy controls. One ITP group was treated with prednisone, another with dexamethasone, and the third with rituximab plus dexamethasone. The rituximab plus dexamethasone group fared best with 67% maintaining a sustained response.  When the researchers compared the Tregs of the sustained responders to those who relapsed, they found the responders had an increase in their Tregs. Tregs are important in ITP and other diseases because they play a role in balancing the immune system and preventing autoimmune disease. 

Note: Prior ITP research has shown that people with ITP have a different T-cell profile compared to those in good health and that effective treatments alter their T-cells.

Li ZY et al. “Effect of different therapeutic regimens on regulatory T cells in patients of primary immune thrombocytopenia.”  Chinese Journal of Hematology. 2013 Jun 14;34(6):478-81.
http://www.ncbi.nlm.nih.gov/pubmed/23827100

Manufactured Platelets in the Works

Platelet transfusions can be a problem. Platelets are difficult to obtain, don’t last long in storage, and are prone to contamination. So it is not surprising that scientists are looking for other ways to help people who can benefit from receiving someone else’s platelets. In one option, researchers reprogramed active stem cells to produce blood cells, including platelets, outside of the body.  A company in Scotland is gearing up to mass produce these new cells and test them in humans. In a second option, scientists manufactured two chains of molecules that, when put together, act like platelets to form blood clots. They are looking at using these artificial platelets in wounded soldiers for emergency situations since these artificial platelets could cause too many blood clots in people who aren’t already in a life-threatening situation.

Press Release. “Researchers identify novel approach to create red blood cells, platelets in vitro.” Boston University.  2013 May 30.
http://www.bumc.bu.edu/2013/05/30/researchers-identify-novel-approach-to-create-red-blood-cells-platelets-in-vitro/

“World's first human trials of synthetic blood could take place in Scotland.” MRC Centre for Regenerative Medicine. 2013 May 30.
https://www.univercellmarket.com/@offers/news/view/3484/

Minor S. “A biomedical breakthrough could quicken the clotting process.” Atlanta. June 10, 2013.
http://www.atlantamagazine.com/agenda/2013/06/10/battlefront-biomedicine-georgia-tech

 

Hospitals, Insurance, and Medical Care

Medicare Enhances Doctor WebsiteMedicare Enhances Doctor Website

Medicare staff, as part of the new healthcare law, are beginning to collect and preparing to publish physician performance data, including patient ratings and treatment success. As a first step, the Doctor Compare website was updated to include an enhanced search, more accurate contact information, and data on physician specialties. Group practice information will be added in 2014. The goal is help patients make better choices and to help reduce the more than $2.5 trillion the US spends for healthcare each year.

Rau J. “Medicare Enhances Doctor-Rating Website.” Kaiser Health News. 2013 Jun 27.
http://capsules.kaiserhealthnews.org/index.php/2013/06/medicare-enhances-doctor-rating-website/

American Health Lags. Improvements Possible

The US lags behind most other industrialized countries in every major health measure from deaths to diminished quality-of-life. The rankings and individual quality-of-life can be improved by more people embracing a healthy diet, losing weight, exercising, and stopping smoking. But other factors responsible for the dismal ratings are less straight forward. The county level statistics varied considerably indicating that someone’s place of residence is a strong predictor or health and longevity.

Christopher J et al. “The State of US Health, 1990-2010 Burden of Diseases, Injuries, and Risk Factors.” JAMA. 2013 July 10.
http://jama.jamanetwork.com/article.aspx?articleid=1710486

Fineberg HV. “The State of Health in the United States.” JAMA. 2013 July 10.
http://jama.jamanetwork.com/article.aspx?articleid=1710485

Fox M. “Americans live a little longer, still lag other rich countries.” NBC News. 2013 July 10.
http://www.nbcnews.com/health/americans-live-little-longer-still-lag-other-rich-countries-6C10588107

 

General Health and Medicine

Tick Diseases Can Drop PlateletsTick Diseases Can Drop Platelets: Protect Yourself

The best way to prevent illnesses caused by ticks is prevention. Here are some suggestions: If you walk in the woods, wear long pants and long sleeves. When you leave a tick-prone area, check for ticks immediately and shower within two hours. If you find a tick, remove it with a tweezers, grabbing close to where it is attached to the skin. Ticks must stay in place for 36 hours to infect someone, so immediate attention is important.

Note: Ticks can transmit Lyme disease, Rocky Mountain spotted fever, babesiosis, and ehrlichiosis, all of which can cause low platelets. “Protect Yourself Against Tick-Borne Disease.” US Food and Drug Administration. 2013 June 26.
http://www.fda.gov/ForConsumers/ConsumerUpdates/ucm358486.htm

Born Between 1945 and 1965? Screen for Hepatitis C

The U.S. Preventive Services Task Force recommends screening all adults born between 1945 and 1965 for hepatitis C, even if they have no symptoms of liver problems.  People born between those dates have a greater risk of having hepatitis C than others because infusion-related infection was more likely during that timeframe. Treating the disease, if found, can prevent serious liver complications. Repeat testing is not necessary.

Note:  A healthy liver is very important for people with ITP since the liver makes thrombopoietin and clotting factors.
Moyer VA. “Screening for Hepatitis C Virus Infection in Adults: U.S. Preventive Services Task Force Recommendation Statement.” Ann Intern Med. 25 June 2013
http://annals.org/article.aspx?articleid=1700383

 

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This e-newsletter is published by the Platelet Disorder Support Association, 133 Rollins Avenue, Suite 5, Rockville, MD 20852, phone 1-87-Platelet, fax: 301-770-6638, web: http://www.pdsa.org, e-mail: pdsa@pdsa.org

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