Hematology/Oncology Clinics of North America
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Diagnosis and risk stratification in multiple myeloma.
Multiple myeloma (MM) is a tumor of monoclonal plasma cells, which produce a monoclonal antibody and expand predominantly in the bone marrow. Patients present with hypercalcemia, renal impairment, anemia, and/or bone disease. Only patients with symptomatic MM require therapy, whereas asymptomatic pa...
Allogeneic stem cell transplantation for multiple myeloma.
Prospective trials comparing tandem autologous stem cell transplantation (ASCT) with ASCT followed by allogeneic stem cell transplantation (AlloSCT) have shown mixed results with regard to progression-free and overall survival rates. Thus, AlloSCT, although a potentially curative treatment, is not r...
Hemoglobin s polymerization and red cell membrane changes.
Different pathways lead from the simple point mutation in hemoglobin to the membrane changes that characterize the altered interaction of the sickle red blood cell with its environment, including endothelial cells, white blood cells, and platelets. Polymerization and oxidation-induced damage to both...
The role of adhesion receptors in the pathogenesis of multiple myeloma.
There is now an improved understanding of the types of adhesion receptors present on normal and malignant plasma cells. This knowledge has been helpful in identifying plasma cells and in beginning to understand the pathogenesis of myeloma. Future research is needed to delineate the signaling pathway...
Infusion of donor peripheral blood mononuclear cells to treat relapse after transplantation for chronic myelogenous leukemia.
Until recently, the only curative therapy for patients with chronic myelogenous leukemia (CML) who relapse after allogeneic bone marrow transplantation (BMT) has been second allogeneic BMT. Recently, donor mononuclear cells have been given to patients with relapsed CML to induce a potent graft-versu...
Autotransplants in multiple myeloma: pushing the envelope.
Substantial progress has been made in understanding the role of autotransplants in multiple myeloma. High dose therapy consistently induces a higher remission rate, longer remission duration, and overall survival. This article summarizes the results of several major studies to illustrate the above c...
Bone marrow metastases.
This article discusses the clinical significance of bone marrow metastases and the current methods being used to detect tumor cells in marrow. The strategies being investigated for eradicating cancer cells from marrow in patients receiving hematopoietic cell autografts also are reviewed.
Coagulation abnormalities in liver disease.
Hemostasis is intimately related to liver function, because most coagulation factors are synthesized by liver parenchymal cells and the liver's reticuloendothelial system serves an important role in the clearance of activation products. The extent of coagulation abnormalities depends upon the degree...
Hemostatic abnormalities in multiple myeloma and related disorders.
Patients with multiple myeloma, Waldenström's macroglobulinemia, benign monoclonal gammopathy, and other B-cell disorders associated with high titer serum paraproteins can manifest unique hemostatic disorders. Most of these disorders predispose the patient to hemorrhage, especially following surgic...
Drug-induced alterations of hemostasis and fibrinolysis.
The hemostatic and fibrinolytic systems contribute significantly to the overall pathophysiologic status of a patient in a given clinical setting. Drug modulation of these systems plays a crucial role in the facilitation of the therapeutic effects but may also produce bleeding or thrombotic disorders....