Raudanpuute ilman anemiaa - miten ferritiiniarvoa tulkitaan?

Plasman ferritiinipitoisuuden mittaus on elimistön rautapitoisuuden perusseulontakoe. Sen tulkinta ei ole kuitenkaan aina helppoa. Osoitettu raudanpuute voi olla rautahoidon aihe, vaikkei siihen liittyisikään anemiaa. Terveen henkilön varastorautavajaus korjataan yleensä suun kautta otettavilla valmisteilla

Monimuotoinen myelooma

Teema : Hematologiset syövät. English summaryPeer reviewe

Miten turvataan myelooman yhdenvertainen hoito tulevaisuudessa?

Myelooman vuosittainen ilmaantuvuus on pysynyt vakaana, mutta ­kehittyneiden hoitojen ansiosta potilaiden elinikä pitenee. Siksi hoidossa olevien potilaiden määrä kasvaa.Kliinisen hematologian erikoislääkärien määrän huomattava vaje voi vaarantaa hoidon yhdenvertaisen toteutumisen.Hoidon kustannukset kasvavat pääasiassa lääkekustannusten nousun vuoksi. Lääkekustannuksia pyritään hallitsemaan erilaisilla riskinjako-­sopimuksilla.Kliiniset lääketutkimukset tarjoavat arvokasta varhaisvaiheen käyttö­kokemusta ja konkreettista säästöä sairaaloiden lääkebudjetteihin. Niiden toteuttaminen sujuvasti rinnakkain rutiinihoidon kanssa tulisi mahdollistaa.</p

Miten turvataan myelooman yhdenvertainen hoito tulevaisuudessa?

Vertaisarvioitu.• Myelooman vuosittainen ilmaantuvuus on pysynyt vakaana, mutta kehittyneiden hoitojen ansiosta potilaiden elinikä pitenee. Siksi hoidossa olevien potilaiden määrä kasvaa. • Kliinisen hematologian erikoislääkärien määrän huomattava vaje voi vaarantaa hoidon yhdenvertaisen toteutumisen. • Hoidon kustannukset kasvavat pääasiassa lääkekustannusten nousun vuoksi. Lääkekustannuksia pyritään hallitsemaan erilaisilla riskinjako- sopimuksilla. • Kliiniset lääketutkimukset tarjoavat arvokasta varhaisvaiheen käyttö- kokemusta ja konkreettista säästöä sairaaloiden lääkebudjetteihin. Niiden toteuttaminen sujuvasti rinnakkain rutiinihoidon kanssa tulisi mahdollistaa.Peer reviewe

Miten turvataan myelooman yhdenvertainen hoito tulevaisuudessa?

Vertaisarvioitu.• Myelooman vuosittainen ilmaantuvuus on pysynyt vakaana, mutta kehittyneiden hoitojen ansiosta potilaiden elinikä pitenee. Siksi hoidossa olevien potilaiden määrä kasvaa. • Kliinisen hematologian erikoislääkärien määrän huomattava vaje voi vaarantaa hoidon yhdenvertaisen toteutumisen. • Hoidon kustannukset kasvavat pääasiassa lääkekustannusten nousun vuoksi. Lääkekustannuksia pyritään hallitsemaan erilaisilla riskinjako- sopimuksilla. • Kliiniset lääketutkimukset tarjoavat arvokasta varhaisvaiheen käyttö- kokemusta ja konkreettista säästöä sairaaloiden lääkebudjetteihin. Niiden toteuttaminen sujuvasti rinnakkain rutiinihoidon kanssa tulisi mahdollistaa.Peer reviewe

Copy number alterations define outcome in Philadelphia chromosome-positive acute lymphoblastic leukemia

Funding Information: NGS library preparation, sequencing and sequence analysis were performed by the Institute for Molecular Medicine Finland (FIMM) Technology Center, University of Helsinki. We thank laboratory technicians Jay Klievink in Hematology Research Unit Helsinki (HRUH) and Minna Suvela in FIMM for technical support with the DNA extractions and laboratory coordinator Minna Tuominen in FIMM for technical support with multiplex ligation-dependent probe amplification. We are grateful to the members of the HRUH for discussions and technical help. We thank research nurses Anne Gesterberg, Jenni Raali and Susanna Helkkula for help with clinical data. We thank Dr Veli Kairisto in Tykslab, Dr Taru Kuittinen in Kuopio University Hospital and clinical laboratory geneticists Anne Juvonen and Tarja Salonen in HUSLAB for help with clinical samples. The samples of this project were provided by Finnish University Hospital clinical laboratories and the Finnish Hematology Registry and Clinical Biobank (FHRB) with appropriate ethics approval (Dnro 202/06.01.00/2013). We thank all the patients for their generous participation. The FHRB Biobank is supported by the Finnish Association of Hematology, the Finnish Red Cross Blood Service, Institute for Molecular Medicine Finland, and the participating hospitals in Finland. This study was supported by the Doctoral Program in Clinical Research at the University of Helsinki and personal grants (to HH) from Emil Aaltonen Foundation, Ida Montin Foundation, Blood Disease Research Foundation, Finnish Hematology Association, Finnish Medical Foundation, Biomedicum Helsinki Foundation, Paulo Foundation, (to SM) Finnish Cancer Organizations, Sigrid Juselius Foundation, Signe and Ane Gyllenberg Foundation, Relander Foundation, and state funding for university-level health research in Finland. The laboratory analytics costs of this study were funded by Incyte. Funding Information: TS (not related to this study) is a member of the advisory board of Celgene and AbbVie; is a member of the advisory board of and received lecture fees from Pfizer and Janssen-Cilag; received lecture fees from Bristol Myers Squibb; received congress fees from and is a member of the advisory board of Novartis; received congress fees from Amgen. MP (not-related to this study) is a member of the advisory board of Pfizer and AbbVie; received lecture and congress fees from Novartis. OB received consultancy fees from Novartis and Sanofi. SM (not related to this study) received research funding from Novartis, BMS, Janpix, and Pfizer. All other authors have no conflicts of interest to disclose. Funding Information: NGS library preparation, sequencing and sequence analysis were performed by the Institute for Molecular Medicine Finland (FIMM) Technology Center, University of Helsinki. We thank laboratory technicians Jay Klievink in Hematology Research Unit Helsinki (HRUH) and Minna Suvela in FIMM for technical support with the DNA extractions and laboratory coordinator Minna Tuominen in FIMM for technical support with multiplex ligation-dependent probe amplification. We are grateful to the members of the HRUH for discussions and technical help. We thank research nurses Anne Gesterberg, Jenni Raali and Susanna Helkkula for help with clinical data. We thank Dr Veli Kairisto in Tykslab, Dr Taru Kuittinen in Kuopio University Hospital and clinical laboratory geneticists Anne Juvonen and Tarja Salonen in HUSLAB for help with clinical samples. The samples of this project were provided by Finnish University Hospital clinical laboratories and the Finnish Hematology Registry and Clinical Biobank (FHRB) with appropriate ethics approval (Dnro 202/06.01.00/2013). We thank all the patients for their generous participation. The FHRB Biobank is supported by the Finnish Association of Hematology, the Finnish Red Cross Blood Service, Institute for Molecular Medicine Finland, and the participating hospitals in Finland.Non peer reviewe

Kohtauksittainen yöllinen hemoglobiinivirtsaisuus (PNH)

English summaryPeer reviewe

Copy number alterations define outcome in Philadelphia chromosome-positive acute lymphoblastic leukemia

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A cluster of Candida krusei infections in a haematological unit

<p>Abstract</p> <p>Background</p> <p><it>Candida krusei </it>infections are associated with high mortality. In order to explore ways to prevent these infections, we investigated potential routes for nosocomial spread and possible clonality of <it>C. krusei </it>in a haematological unit which had experienced an unusually high incidence of cases.</p> <p>Methods</p> <p>We searched for <it>C. krusei </it>contamination of the hospital environment and determined the level of colonization in patients and health care workers. We also analyzed the possible association between exposure to prophylactic antifungals or chemotherapeutic agents and occurrence of <it>C. krusei</it>. The <it>C. krusei </it>isolates found were genotyped by pulsed-field electrophoresis method in order to determine possible relatedness of the cases.</p> <p>Results</p> <p>Twelve patients with invasive <it>C. krusei </it>infection and ten patients with potentially significant infection or mucosal colonization were documented within nine months. We were unable to identify any exogenic source of infection or colonization. Genetic analysis of the isolates showed little evidence of clonal transmission of <it>C. krusei </it>strains between the patients. Instead, each patient was colonized or infected by several different closely related genotypes. No association between medications and occurrence of <it>C. krusei </it>was found.</p> <p>Conclusion</p> <p>Little evidence of nosocomial spread of a single <it>C. krusei </it>clone was found. The outbreak may have been controlled by cessation of prophylactic antifungals and by intensifying infection control measures, e.g. hand hygiene and cohorting of the patients, although no clear association with these factors was demonstrated.</p