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Update in Hematology

Joseph P. Catlett, MD; and Barbara M. Alving, MD
[+] Article and Author Information

From Washington Hospital Center, Washington, D.C.; and National Institutes of Health, Bethesda, Maryland.


Requests for Single Reprints: Joseph P. Catlett, MD, Hematology/Oncology Section, Washington Hospital Center, 110 Irving Street NW, Washington, DC 20010-2975.

Current Author Addresses: Dr. Catlett: Hematology/Oncology Section, Washington Hospital Center, 110 Irving Street NW, Washington, DC 20010-2975.

Dr. Alving: National Heart, Lung, and Blood Institute, National Institutes of Health, Building 31, Room 5A 47, 10 Center Drive, Bethesda, MD 20892-2490.


Ann Intern Med. 2002;136(2):136-143. doi:10.7326/0003-4819-136-2-200201150-00011
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In the past several years, there has been a veritable explosion of new and impressive treatments that not only will alter the management of leukemia and lymphoma but are expected to have far-reaching effects in general internal medicine. Target-specific drugs, including monoclonal antibodies and selective enzyme inhibitors—along with so-called designer drugs—have ushered in a new era in medicine. Examples in this Update are rituximab, a monoclonal antibody effective in non-Hodgkin lymphoma and the oral antileukemia drug STI-571. We also discuss advances in the following areas of hematology: self-management of oral anticoagulant therapy, understanding risks for venous thromboembolism in women during pregnancy and in postmenopausal women who are undergoing hormone replacement therapy, and management of patients with sickle-cell disease.

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Figure.
Clinical course of a patient with chronic graft-versus-host disease in whom severe refractory immune-mediated thrombocytopenia responded to treatment with anti-CD20 monoclonal antibody.

Anti-CD20 = rituximab; Anti-D = anti-D antibody; CY = cyclophosphamide; IVIG = intravenous immunoglobulins; MP = methylprednisolone; Spln = splenectomy; VCR = vincristine. Reproduced from Ratanatharathorn et al. Ann Intern Med. 2000; 133:275-9.

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