The incorporation of the novel drugs thalidomide, bortezomib, and lenalidomide has resulted in a significant survival prolongation in patients with multiple myeloma (MM). However, MM remains incurablewith an important life-expectancy shortening.Autologous stem cell transplantation (ASCT) is the gold standard in younger patients and the incorporation of novel drugs in the induction phase has imp...

Over the past 10 years, significant progress has been made in understanding HIV-associated lymphomas and improving the prognosis of these diseases. With the advent of combination antiretroviral therapy and the development of novel therapeutic strategies, most patients with HIV-associated lymphomas are cured. The outcome for the majority of patients with HIV-associated diffuse large B-cell lymph...

The challenges in medical management of cobalamin deficiency lie in attention to the unique pathophysiology that underlies cobalamin deficiency, more than in the mechanics of therapy. The central physiologic principles are that clinically important deficiency is more likely to occur (and progress) when intrinsic factor–driven absorption fails than when diet is poor and that most causes take yea...

Although no randomized controlled trials have addressed this question, I recommend a 3to 6-month course of peginterferon-based therapy (with or without ribavirin) in those patients who have failed to clear acute infection. Success rates in this setting (ie, rates of sustained viral clearance) approach 90%. The importance of early treatment is clear: these success rates vastly eclipse those seen...

See related article, pages 1243–1247 As noninvasive brain imaging for sometimes dubious indications becomes more and more ubiquitous, greater numbers of asymptomatic lesions are being found and management decisions are being required. Cerebral arteriovenous malformations (AVM) represent a particularly challenging subset of these lesions, given their overall low incidence and the high frequency ...

M.A. is a 73-year-old white man who presented to our Thrombosis Center 2 days after ultrasonographic diagnosis of occlusive portal vein thrombosis (PVT). He had known liver cirrhosis secondary to chronic alcohol consumption (Child class A). The ultrasound test was ordered because the patient complained of abdominal pain during the previous 5 days. The remaining clinical history was unremarkable...

Many patients in the terminal phase of their illness experience reduced oral intake before death, due to causes related to their cancer or its treatment. When oral intake is not adequate, dehydration and malnutrition are the obvious results. But these terminally ill patients present a challenge to healthcare providers: to rehydrate these patients or not and, if so, how? Adequate hydration level...

Epstein-Barr virus (EBV)–associated Bcell lymphoproliferation is a life-threatening complication after hematopoietic stem cell or solid organ transplantation resulting from outgrowth of EBV-infected B cells that would normally be controlled by EBVcytotoxic T cells. During the past decade, early detection strategies, such as serial measurement of EBV-DNA load in peripheral blood samples, have he...

3104. 60. Larson RA, Dodge RK, Burns CP, et al. A five-drug remission induction regimen with intensiveconsolidation for adults with acute lymphoblasticleukemia: cancer and leukemia group B study8811. Blood. 1995;85(8):2025-2037. 61. van Schie RM, Brüggemann RJ, HoogerbruggePM, te Loo DM. Effect of azole antifungal therapyon vincristine toxicity in childhood acutelymp...

Patients with -thalassemia major (TM) and other refractory anemias requiring regular blood transfusions accumulate iron that damages the liver, endocrine system, and most importantly the heart. The prognosis in TM has improved remarkably over the past 10 years. This improvement has resulted from the development of magnetic resonance imaging (MRI) techniques, especially T2*, to accurately measur...