Pediatric Hematology/Oncology

Benign Hematology

Questions discussed in this category

How would you work up a patient with cutaneous mastocytosis?

Is a BM biopsy a must when there is skin involvement? If tryptase level is mildly elevated but less than 20 would you recommend a BM biopsy?

2 Answers available

How would you manage aplastic anemia refractory to multiple agents?

Treated initially with hATG/CNI/TPO, but then relapsed. Subsequently treated with cyclosporine, danazol, ESA, and alemtuzumab, but still with pancytop...

1 Answer 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...

4 Answers available

What is your recommended long term management of extensive dural venous sinus thrombosis in an otherwise healthy young patient?

When would you stop anticoagulation?

4 Answers available

How would you manage a patient with HbSS and severe pulmonary hypertension on home oxygen?

No evidence of VTE on multiple scans. On Crizanlizumab but not tolerant of hydroxyurea. The patient is admitted frequently for VOCs with acute on chro...

1 Answer available

Is there any benefit of using aspirin to mitigate VTE risk in testosterone-induced polycythemia?

2 Answers available

What experience have you had with familial clustering of polycythemia vera?

Patient has a father and sister with both polycythemia vera with confirmed JAK2 V617F mutations. There is also suspicion for PV in a niece with pulmon...

1 Answer available

Is there specific data on using luspatercept for sickle beta+ thalassemia with transfusion-dependent anemia?

For this subpopulation, are there additional risks such as thrombosis?

3 Answers available

How do you counsel patients with acute intermittent porphyria when it comes to fasting for religious reasons?

Is there a way to determine a safe time period that allows a patient to fulfill their religious obligations or do you just recommend against fasting?

1 Answer available

Can anti-cardiolipin or anti-beta-2 glycoprotein antibodies cause prolonged PTT in the absence of a lupus anticoagulant?

Labs with normal PT, but prolonged PTT (47 sec, ULN 40 sec) that does not correct on immediate mix. Lupus anticoagulant negative (DRVVT and hexagonal ...

1 Answer available

In massive transfusion protocol from suspected hemorrhage, is it worth obtaining a TEG to guide transfusion?

1 Answer available

Can lupus anticoagulant be positive despite a normal aPTT?

How often does this occur and does this lower your suspicion for a "true" or clinically significant lupus anticoagulant?

1 Answer available

How do you approach the work-up for a patient with iron deficiency anemia who is not responding to oral iron therapy?

Presuming good medication adherence.

1 Answer available

How would you manage elevated vWF and FVIII levels in a patient with a family history of coagulopathy?

vWF and FVIII activities ~200% and were checked because of the patient's family history of "coagulopathy". Is there any utility in repeating the test...

1 Answer available

For von Willebrand type 2B, do you expect a decline in platelet count over time as vWF increases with age?

1 Answer available

For mild to moderate hemophilia B, do you routinely screen for inhibitors?

Assume the patient has infrequent bleeding events every few years, with use of FIX replacement for acute bleeds only.

1 Answer available

How do you manage significant asymptomatic indirect hyperbilirubinemia in patients with hemolytic diseases (SCD, HS, etc.)?

Do you consider starting Ursodiol? Do you perform routine abdominal ultrasound to monitor for cholelithiasis?

1 Answer available

How quickly do you expect iron stores to decrease after starting iron chelators?

After what time period would you consider adding a second iron chelator?

1 Answer available

How do you counsel sickle cell patients on the use of G-CSF to treat neutropenia from other causes, like malignancy?

Do you discuss the risk of sickle cell crises with G-CSF? What about for patients with sickle cell trait?

1 Answer available

Is there any benefit to using desmopressin over vWF replacement therapy for vWD?

If not, has your practice changed to use vWF replacement therapy more routinely for perioperative or acute bleeding management? Do you still perform D...

1 Answer available

How would you approach secondary stroke prevention in an adult with Hemoglobin SC disease?

Would you consider chronic RBC exchange versus HU?

1 Answer available

How do you decide between HSCT and immunosuppressive therapy for treating hepatitis associated aplastic anemia?

1 Answer available

How would you approach post-operative VTE prophylaxis for renal transplant in patients with a prior history of provoked VTE?

Are there specific guidelines for managing this patient population?

1 Answer available

Is there any indication for hydroxyurea in patients with sickle cell trait?

2 Answers available

What would your next line of treatment be for a patient with Hb SC with history of recurrent VOC and new bone infarct who is already on hydroxyurea and phlebotomy?

Hb at goal of 9-10

2 Answers available

How would you treat suspected secondary HLH in patients whom etoposide is contraindicated?

No clear inciting etiology found. Would you consider dexamethasone +/- cytokine blockade (IL-1, IL-6, or IFN-g)? What do you think about the data for...

1 Answer available

How is your experience with point-of-care INR systems for home monitoring of vitamin K antagonists?

Are the INRs reliable? In what scenarios would you not recommend POC INR use for warfarin monitoring? Are these typically covered by insurance? Are t...

1 Answer available

How do you manage arthritis resulting from deferiprone in transfusion dependent thalassemia?

1 Answer available

Would you consider continuing or re-trialing hydroxyurea for sickle cell patients after development of a leg ulcer?

1 Answer available

Do you use direct oral anticoagulants to treat port-a-cath related VTE in patients with an active malignancy?

Do social or economic factors (i.e., relative cost of acquiring LMWH, the patient being injection averse) affect your decision to use DOACs? Do you s...

1 Answer available

How do you treat factor XI deficient patients with surgery or trauma related bleeding?

Is there a factor XI goal that you target? Would you consider FVIIa products instead?

1 Answer available

How do you manage hemophilia A carriers with no history of bleeding complications but with mildly low factor VIII activity (6-40%)?

1 Answer available

What subset of sickle cell disease patients are you offering sickle cell disease gene therapy?

1 Answer available

How do you manage hyperalgesia in patients with sickle cell disease?

1 Answer available

What hemoglobin level do you target for adult beta thalassemia intermedia patients with a pre-transfusion Hb >7 g/dl?

Should adult hemoglobin targets be different than pediatrics?

1 Answer available

Is it true that a ferritin above 200 essentially rules out iron deficiency?

Does this hold true when the patient has significant inflammation?

1 Answer available

Is there any indication for monitoring for renal medullary carcinoma in patients with sickle cell trait?

Patients sometimes ask for annual urinalysis and ultrasound to monitor, but it is unclear if this is indicated.

1 Answer available

When would you initiate chronic therapeutic phlebotomy in a patient with erythrocytosis secondary to a high hemoglobin-oxygen affinity hemoglobinopathy?

1 Answer available

Do you screen adults in your practice with sickle cell disease for silent cerebral infarcts?

The ASH 2020 guidelines have "recommended that adults with HbSS or HbSβ0 thalassemia be screened at least once for silent cerebral infarcts even ...

1 Answer available

How do you monitor risk of erythrocytosis from testosterone use for female to male transgender patients?

1 Answer available

For a patient with May-Thurner syndrome and DVT, would you recommend anticoagulation for 3-6 months or indefinitely?

4 Answers available

How do you manage mild Type 1 von Willebrand disease undergoing wisdom teeth removal?

Antifibrinolytic therapy alone +/- DDAVP?

1 Answer available

What additional testing is recommended with heterozygous HFE C282Y mutation whose ferritin is elevated and transferrin saturation percentage is at baseline?

Ferritin >2200, TSAT >80%

2 Answers 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

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...

3 Answers available

How do you approach an ITP patient who responds very well to steroids but the response is short-lived?

How would you counsel the patient if he/she wants to continue on steroids?

3 Answers available

Do you use FVIII levels to differentiate between DIC and coagulopathy of liver disease?

Common thought is that FVIII may be used for differentiating coagulopathy in liver disease (normal to increased, from reduced clearance of VWF/FVIII) ...

4 Answers available

How do you approach anticoagulation in the setting of HIT and thrombocytopenia?

I.e. platelet count <30. Would your management change if HIT were only suspected rather than confirmed?

1 Answer available

How would you treat a woman with iron deficiency anemia, unresponsive to iron sulfate, and with allergic reaction to iron sucrose?

Anemia is secondary to menorrhagia. No gynecologic interventions were possible.

1 Answer available

Are there any possible scenarios where you would do phlebotomies for heterozygous hemochromatosis?

1 Answer available

What is your approach to using medications that can cause bone marrow suppression in SLE patients who have persistent leukopenia?

3 Answers available

Would you anticoagulate a patient with splenic infarctions in the setting of CMV viremia?

If so, for how long?

1 Answer available

How do you interpret a low VWF activity/antigen ratio, when both activity and antigen levels are above 50%?

E.g. Normal F8, VWF activity ~50%, VWF antigen ~100%, ratio 0.5 sent in a patient with positive bleeding history Is there any clinical significance t...

1 Answer available

What is the ideal period to wait until curative surgery for patients with acute pulmonary embolism and solid malignancy?

Specifically, asymptomatic subsegmental PE diagnosed within a month from planned bilateral mastectomy for breast cancer.

1 Answer available

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

1 Answer available

Is there a correlation between spleen size and degree of thrombocytopenia?

1 Answer available

How is transferrin saturation a reliable indicator for any parameter if serum iron is not reliable?

Although TIBC is negative acute phase reactant, would it be a better indicator of iron deficiency (in combination with ferritin)?

1 Answer available

Should testing for genetic causes of HLH be performed in all patients with MAS or secondary HLH regardless of the patient's age?

2 Answers 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 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

For patients with incidental findings of venous thromboembolism during workup of a treatable malignancy, how do you approach discontinuation after the treatment is complete?

Would you consider low dose indefinite anticoagulation in any scenario? Any difference in approach between hematological malignancy and solid tum...

1 Answer available

In a young female with severe osteoporosis due to congenital estrogen deficiency, can estrogen be prescribed if genetic testing for congenital disorders reveals a heterozygous Factor V Leiden mutation?

No prior thrombosis; no family history of thrombosis. As per endocrine, the only useful therapy for the osteoporosis is estrogen.

1 Answer available

In the setting of secondary HLH associated with initial diagnosis of lymphoma, would you adjust steroid dose and type to account for differences in HLH and lymphoma treatment protocols?

1 Answer available

When should I consider anticoagulation in an unprovoked upper extremity superficial venous thrombosis?

Would it change your management if the thrombus was symptomatic? Or if larger >3 cm?

1 Answer available

What is your approach to further work-up and management of neutropenia in patients with SLE/RA overlap?

For example, a patient with a bone marrow biopsy that shows normocellular bone marrow. Prior management with leflunomide and HCQ with neutropenia attr...

2 Answers available

In a patient hospitalized for several days with a refractory pain crisis would you ever consider transfusion, either simple or possibly exchange in an attempt to get the patient over the crisis?

2 Answers 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

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

Would you use PCC for clotting factor repletion in acute life threatening hemorrhage in a patient with elevated INR from coagulopathy of liver disease?

2 Answers available

How do you approach a patient with chronic low ADAMTS13 activity and low level of inhibitor without signs of thrombocytopenia or hemolysis?

ADAMTS13 level <5% Inhibitor level <1

1 Answer available

How do you explain TTP to patients?

1 Answer available

Do you repeat images in patients with venous thrombosis to inform decision about duration of anticoagulation?

E.g. pulmonary embolism, portal vein thrombosis, cerebral venous sinus thrombosis

2 Answers available

Do you recommend starting an antiplatelet for primary prophylaxis in post splenectomy thrombocytosis given there is some increased risk of venous thrombosis?

If so, what platelet count threshold would you use? Would age impact your decision? Would you do a bone marrow to rule out primary MPD in adults if th...

1 Answer available

How do you perform fertility counseling for a patient with a duplication of one of the alpha genes and their partner who has a beta chain point mutation?

That is, extra copy of one of the alpha genes resulting in an atypical alpha thalassemia for the patient, and beta thalassemia heterozygous carrier fo...

1 Answer available

What precautions do you take prior to CABG in a patient with sickle cell trait?

Please comment on temperature recommendations and role of exchange transfusion.

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

How do you approach low to moderate titer of APLS when working up unprovoked DVT if it is persistent on repeat testing?

4 Answers available

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

2 Answers available

Do you screen for VWD in all women with menorrhagia severe enough to cause iron deficiency anemia?

3 Answers available

How should elevated PT of unclear etiology and significance be evaluated?

In the absence of concerning bleeding or thrombosis, family history of coagulopathy, current anticoagulant use, or malnutrition

2 Answers available

How would you approach a low to moderate titer of one of the APLS antibodies in a patient with a strong family history but no personal history of thrombosis?

Although testing was not indicated, what do u do with these results? Other hypercoagulability work up negative

2 Answers available

Is rituximab for refractory ITP contraindicated in the setting of an active COVID infection, particularly in a patient with asymptomatic COVID?

2 Answers 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

How do you advise patients with sickle cell disease on contraception?

Do you advise against combination OCPs?

1 Answer 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

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

How do you work up a young patient with increasing ferritin and normal TSAT without infectious, inflammatory, or liver disorders?

Ferritin uptrending >1000, no additional lab abnormalities. HFE wildtype. Too young for age-appropriate cancer screening. Asymptomatic except fatig...

1 Answer available

In a patient with Type I von Willebrand disease with history of VTE and heavy menses, would tranexamic acid be a treatment option?

Is thrombotic risk too significant? Patient failed OCPs.

3 Answers available

Do you stop hydroxyurea or switch to an alternative therapy in a male patient with controlled Hb SC disease who is interested in having children?

2 Answers available

At what ferritin threshold would a patient with anemia of inflammation or malignancy no longer benefit from iron supplementation for functional iron deficiency?

For example, if TSAT is less than 20% but ferritin is over 200.

1 Answer available

How do you workup splenomegaly related to possible hematologic etiology in the absence of abnormal blood counts, adenopathy or severe constitutional symptoms?

For instance, evaluation by primary care and GI without other etiology for splenomegaly

1 Answer available

Do you recommend continuous antibiotic prophylaxis for patients on complement inhibitors such as eculizumab?

Do you just use antibiotic prophylaxis if therapy is started prior to meningococcal vaccination?

3 Answers available

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

Wu et al., PMID 34665865

1 Answer available

When do you stop trying to eradicate an acquired factor VIII inhibitor?

Patient with high titer acquired FVIII inhibitor with no causative etiology. Bleeding is well-controlled on emicizumab, but inhibitor has failed...

3 Answers available

What recommendations do you have for a transgender female patient with history of prothrombin gene mutation who is interested in starting gender affirming hormone therapy?

The patient has no personal history of VTE, but has positive family history of VTE. Any prophylactic anticoagulation options? How would manage...

1 Answer available

Do you hold IV iron in the setting of active infection?

1 Answer available

Do you routinely send NGS testing from bone marrow samples in patients with unexplained cytopenia or cytoses?

For instance, if clonal hematopoiesis of indeterminate potential (CHIP) suspected

1 Answer available

In patients with severe hemophilia A on emicizumab for prophylaxis, in case of noncompliance leading to a lapse of more than 2-3 months off therapy, do you reload with emicizumab?

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

How soon do you anticipate response to cyclosporine in red cell aplasia and what cyclosporine trough levels do you target?

1 Answer available

How would you work up and manage persistent lymphopenia in an asymptomatic patient?

ALC<200

1 Answer available

Do you consider travel as a risk factor for DVTs in the absence of any other underlying predisposing factors?

i.e. long car rides or plane rides

1 Answer available

Do you offer iron supplementation to a non-anemic adolescent athlete with a low ferritin?

1 Answer available

Is an elevated CRP an expected finding in an otherwise healthy patient with hemoglobin S - alpha thalassemia?

CRP 39 mg/L (normal < 10) and normal ESR

1 Answer available

Does normal methylmalonic acid levels absolutely rule out vitamin B12 deficiency?

1 Answer available

In a patient with sickle cell disease on hydroxyurea who is planning to have a family, for how long should they be off the drug before trying to conceive?

1 Answer available

At what platelet count would you feel comfortable dosing aspirin 81 mg for coronary artery disease in a patient with ITP?

Presuming strong indication for ASA - eg history of NSTEMI

1 Answer available

How do you counsel patients with elevated factor VIII levels for their thrombosis risk?

Should we stop checking factor VIII levels as part of thrombosis workup?

1 Answer 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

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

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

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

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

Last rituximab 6 months ago

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

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

2 Answers 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

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

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

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

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 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

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

1 Answer 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...

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

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

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

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

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

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

2 Answers 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

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

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

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

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

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

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

When would you consider upfront eculizumab for sickle cell hyperhemolysis?

How long after eculizumab infusion would you wait before giving blood transfusions?

0 Answers available

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

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

How do you treat refractory cold agglutinin disease?

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

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

2 Answers 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 a role for G-CSF treatment for SLE patients with persistent neutropenia?

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

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

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

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 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

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

Would you start a patient with sickle cell disease and COVID-19 on prophylactic anticoagulation?

0 Answers available

Papers discussed in this category

Blood, 2021 Apr 01

Real-world experience with caplacizumab in the management of acute TTP.

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.

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).

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.

Am J Hematol, 2019 Sep

A prospective, multi-center, randomized comparison of iron isomaltoside 1000 versus iron sucrose in patients with iron deficiency anemia; the FERWON-IDA trial.

Am J Hematol, 2019 Sep

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

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Pediatric Hematology/Oncology

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