@kirolloskamel.bsky.social
Kiwi classical Haematologist working in Townsville - passionate about lab haem, Haemostasis and thrombosis. Coptic Orthodox Christian.
Check out my latest publication summarizing the most recent evidence around reduced dose DOACs in secondary VTE prevention #Hemesky doi.org/10.1111/imj....
Reduced‐dose DOACs for secondary prevention of venous thromboembolism: interpreting the latest evidence
Click on the article title to read more.
doi.org
🚨FDA approves rilzabrutinib – 1st BTK inhibitor for ITP LUNA3: heavily pre-treated pts (median 4 prior lines, 28% splenectomy), durable PLT response 23% vs 0% PBO; 64% initial rise; median 15d. ↓ rescue Rx, ↓ bleeding, ↑ QoL. Well-tolerated Australia needs this! 🇦🇺 @thanzblood.bsky.social #hemesky
Results of HIPRO single centre RCT out In pts w/ provoked VTE + enduring risk (obesity, chronic inflammation, CVD, lung dz), 12 mo low-dose apixaban cut recurrence 1.3% vs 10% (HR 0.13, NNT≈12). Major bleed rare; CRNM bleed ↑ (NNH≈32). Subgroup analysis underpowered. www.nejm.org/doi/full/10....
Apixaban for Extended Treatment of Provoked Venous Thromboembolism | NEJM
The appropriate duration of anticoagulation for venous thromboembolism (VTE) in patients who have a transient provoking factor (e.g., surgery, trauma, or immobility) and concomitant enduring risk f...
nejm.org
Poll question for haematologists Is there still a role for Activated Protein C Resistance testing in the assessment for thrombophilia, when FVL PCR is readily available? 1️⃣ YES 2️⃣ NO Reply with number below. #hemesky
www.sciencedirect.com/science/arti... I came across this “practical guideline” for major heritable thrombophilia. I am not sure I agree with some of their recommendations - should generate an interesting debate though. Also have never tested for the F2 AT resistance mutations! #hemesky
Practical guideline for major hereditary thrombophilia
sciencedirect.com
I think this drug will settle many an argument …. jamanetwork.com/journals/jam...
Prothrombin Complex Concentrate vs Frozen Plasma in Cardiac Surgery
This clinical trial compares the efficacy and safety of prothrombin complex concentrate with frozen plasma in patients requiring coagulation factor replacement for bleeding during cardiac surgery.
jamanetwork.com
Fascinating paper; which reinforces my own clinical experience that the majority of clinically encountered type I protein S deficiency behave like a low risk thrombophilia, presumably as they have the missense variant. We need more studies like this! jamanetwork.com/journals/jam...
Population-Scale Studies of Protein S Abnormalities and Thrombosis
This cross-sectional study evaluates the risk associated with protein S deficiency across multiple arterial thrombosis phenotypes in population-level cohorts.
jamanetwork.com
📢 Hematology Breakthrough! 🧑⚕️🔬 📌 Follow us for more updates: @displaycia.bsky.social 🔗 Read more: displaycia.com/medic... #Hematology #HealthScience #Breakthrough #MedicalScience #ManuscriptSubmission #ScientificResearch #Innovation #Displaycia
Bottom line - the LLN for Ferritin in both women and men should be at least 30 in the absence of inflammation and chronic kidney disease.
American Society of Hematology@ash.hematology.org · last yr.Non-anemic iron deficiency (NAID) and iron deficiency anemia (IDA) affect millions of women, yet many are often underdiagnosed and undertreated. Why? Structural barriers, inconsistent diagnostic thresholds, and lack of awareness. Learn more: https://bit.ly/4c901LU #Hematology #HemeSky
FARES-II: Much anticipated randomized trial @jama.com comparing Plasma to PCC in cardiac surgery (n=420) Those in PCC arm had ↑ hemostatic efficacy and ↓ RBC transfusion Hopefully practice-changing for many! jamanetwork.com/journals/jam... #transfusion #hemesky
Finally! More data to add to the EVE trial APICAT showed non inferiority of apixaban 2.5BD in patients with CAVTE who have completed 6m anticoagulation to 5BD in terms of VTE recurrence (2.1% v 2.8%) and lower clinically relevant bleeding (12.1% v 15.6%) #Hemesky #BSH www.nejm.org/doi/full/10....
Extended Reduced-Dose Apixaban for Cancer-Associated Venous Thromboembolism | NEJM
In patients with active cancer and venous thromboembolism, whether extended treatment with a reduced dose of an oral anticoagulant is effective in preventing recurrent thromboembolic events and dec...
nejm.org
New in The Journal of Haemophilia Practice: a paper reporting on the hopes and goals of a group of men with #haemophilia B, including how new treatments, such as #genetherapy, could help support and redefine their aspirations. Open access here: loom.ly/vJmE2Wg #HemeSky #BloodSky #MedSky
RPTH Cares about Women's Health 🌸: NAID and IDA are extremely prevalent among women, largely due to iron losses from vaginal blood loss. Explore the findings: www.rpthjournal.org/article/S247... @isth.org #IronDeficiency #WomensHealth
The detrimental impact of ferritin “normal” ranges on diagnosis of bleeding disorders in women
In this editorial, we use the term “women” to highlight the experiences of and care gaps for women with nonanemic iron deficiency (NAID) and iron deficiency anemia (IDA) and the term “females” in refe...
rpthjournal.org
#ASHWomenWednesday ♀️🩸: Learn about why hematologists should care about heavy periods, and test your knowledge with a quick quiz. Share your insights in the comments! #ASHEducation #ASHWomenWednesday #WomenInHeme #Shematology #BloodSisters #HemeHeroines #BloodEducation #Microlearning #Hematology
Funny things patients say in clinic - part 1 “I don’t like those compression stockings for my post thrombotic syndrome. They’re tight” 🧐🧐🧐 #Hemesky
I have sympathy for Americans who can no longer access clinical trials due to politicization of healthcare by ignorant folk At the same time, I hope people can appreciate the lack of access to the most basic healthcare (which people take for granted) in >80% of the world, including many war zones.
Simple cheap intervention, low risk of side effects, improved outcomes for mum (lower PPH, lower risk RBC transfusion and allomunisation, feeling better in herself) and now for baby! This is ripe for low-middle income country quality improvement initiatives. @who.int
HCPLive@hcplivenews.bsky.social · 2y agoA single infusion of IV ferric carboxymaltose in the third trimester of pregnancy significantly lowered the occurrence of anemia before childbirth in a new study, outperforming the efficacy of iron tablets. 🔗 www.hcplive.com/view/iv-iron... #Hematology #IronDeficiency #WomensHealth
Latest publication in @haemophilia.bsky.social onlinelibrary.wiley.com/doi/10.1111/... #Hemesky
Factor VIII Antibodies Demonstrate Type I or Type II Kinetics in Acquired Haemophilia A
Background Acquired haemophilia A (AHA) is an acquired bleeding disorder resulting from autoantibodies against Factor VIII (FVIII). Previous studies have reported differences in FVIII inhibitor kine...
onlinelibrary.wiley.com
Since dreaming is free, here is my Haemostasis and Thrombosis Wishlist for 2025 (a 🧵) 1. Upfront Emicizumab for acquired Haemophilia A 2. Point of Care DOAC assays to dictate need for reversal (<50 vs >50) (1/4)
ascopubs.org/doi/10.1200/... <5% of 3345 leukaemia clinical trials between 2000-2020 have run in low-middle income countries. Healthcare is a human right and it truly is an injustice that access to novel therapies is denied to those who need it most in the world based on postcode lottery #Hemesky
Global Disparities in the Characteristics and Outcomes of Leukemia Clinical Trials: A Cross-Sectional Study of the ClinicalTrials.gov Database | JCO Global Oncology
PURPOSEMost clinical trials are conducted exclusively in high-income countries (HICs), with only a small fraction involving centers from low-middle income countries (LMICs). However, studies evaluatin...
ascopubs.org
#Hemesky What have you found most effective in the management of patients with recurrent IDA/GI bleeding and severe VWD/aVWS who have serial negative investigations? ☝️VWF concentrate prophylaxis 🤘Statins 🤟 Octeotide 🖖 steroids/hormonal treatments 🤚 IMiDs 👎 Nothing
The data for Emicizumab in AHA is increasingly robust. My experience is that these patients nowadays rarely die of bleeding but suffer greatly with the consequences of IST especially prolonged steroid therapy. I also strongly favour early use of steroid sparing therapy especially single dose Ritux.
Journal of Thrombosis and Haemostasis@jthjournal.bsky.social · 2y agoAcquired hemophilia is a severe bleeding disorder that is difficult to treat. This review provides an algorithmic approach to treatment that includes emicizumab, limits hemostatic product use, and minimizes immunosuppression toxicity. www.jthjournal.org/article/S153... #MedSky #HemeSky
doi.org/10.1182/bloo... This is a cool concept but not accessible to 99% of the world. Personally, I think we need a prospective multi-center RCT of cold storage platelets vs standard of care in patients with platelet function defects and high risk BDUCs requiring major surgery.
Genetic engineering of transfusable platelets with mRNA-lipid nanoparticles is compatible with blood banking practices
Key PointsDonor platelets can be directly genetically modified in plasma and platelet additive solution using mRNA-lipid nanoparticles.mRNA-LNP transfectio
doi.org
