For Healthcare Professionals

For Healthcare Professionals: Clinical Updates in Benign Blood Disorders

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The specialists on our Hematology Disease Management Team provide care for a spectrum of common and rare cancers that develop in the bone marrow, blood, and lymph nodes. The team provides high-dose chemotherapy treatments for lymphoma, leukemia, amyloidosis, and multiple myeloma in addition to the management of blood disorders characterized by the imbalanced production of certain types of blood cells. We provide multidisciplinary care to more than 100 patients with myelodysplasia annually, for example, and have been designated a Center of Excellence by the Myelodysplastic Syndromes Foundation in recognition of our authority in treating this cancer. Our physicians also have expertise in screening and diagnosing familial amyloidosis, and have had notable success in using stem cell transplantation for the condition.

We are actively searching for new nontoxic treatments for hematologic diseases, from vitamin therapies to vaccines, and can often provide access to novel therapies in clinical trials. We promptly evaluate patients referred for consultation and are readily available to referring physicians to assure continuity of care.

Romiplostim in Chemotherapy-Induced Thrombocytopenia (2011 ASH Conference)

Thrombocytopenia is a common effect of cytotoxic chemotherapy regimens in cancer patients, often necessitating reduction or delay in subsequent cycles. While the thrombocytopenia typically resolves with time, a subset of patients with chemotherapy-induced thrombocytopenia (CIT) have prolonged thrombocytopenia, of idiopathic etiology, that interferes with subsequent treatment.

Chief of the Hematology and Thrombosis Service Gerald Soff describes the use of weekly romiplostim in patients who had prolonged isolated thrombocytopenia beyond anticipated recovery from chemotherapy-induced platelet nadir. No resistance to romiplostim was observed, and no patient required subsequent delay or reduction of chemotherapy due to thrombocytopenia. In all patients, platelets rose to greater than 100K/mcL two to four weeks from initiation of romiplostim.

amyloidosis (A-muh-loy-DOH-sis)

A group of diseases in which protein builds up in certain organs (localized amyloidosis) or throughout the body (systemic amyloidosis). Amyloidosis may be either primary (with no known cause), secondary (caused by another disease, including some types of cancer, such as multiple myeloma), or hereditary (passed down from parents to children). Many organs are affected by amyloidosis. The organs affected may depend on whether the amyloidosis is the primary, secondary, or hereditary form.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

blood (blud)

A tissue with red blood cells, white blood cells, platelets, and other substances suspended in fluid called plasma. Blood takes oxygen and nutrients to the tissues, and carries away wastes.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

bone marrow (bone MAYR-oh)

The soft, sponge-like tissue in the center of most bones. It produces white blood cells, red blood cells, and platelets.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

cancer (KAN-ser)

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

cell (sel)

The individual unit that makes up the tissues of the body. All living things are made up of one or more cells.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

chemotherapy (KEE-moh-THAYR-uh-pee)

Treatment with drugs that kill cancer cells.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

clinical (KLIH-nih-kul)

Having to do with the examination and treatment of patients.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

condition (kun-DIH-shun)

In medicine, a health problem with certain characteristics or symptoms.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

cytotoxic (SY-toh-TOK-sik)

Cell-killing.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

etiology (EE-tee-AH-loh-jee)

The cause or origin of disease.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

familial

A phenotype or trait that occurs with greater frequency in a given family than in the general population; familial traits may have a genetic and/or nongenetic etiology.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

idiopathic (IH-dee-oh-PA-thik)

Describes a disease of unknown cause.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

leukemia (loo-KEE-mee-uh)

Cancer that starts in blood-forming tissue such as the bone marrow and causes large numbers of blood cells to be produced and enter the bloodstream.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

lymph (limf)

The clear fluid that travels through the lymphatic system and carries cells that help fight infections and other diseases. Also called lymphatic fluid.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

lymphoma (lim-FOH-muh)

Cancer that begins in cells of the immune system. There are two basic categories of lymphomas. One kind is Hodgkin lymphoma, which is marked by the presence of a type of cell called the Reed-Sternberg cell. The other category is non-Hodgkin lymphomas, which includes a large, diverse group of cancers of immune system cells. Non-Hodgkin lymphomas can be further divided into cancers that have an indolent (slow-growing) course and those that have an aggressive (fast-growing) course. These subtypes behave and respond to treatment differently. Both Hodgkin and non-Hodgkin lymphomas can occur in children and adults, and prognosis and treatment depend on the stage and the type of cancer.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

multidisciplinary (MUL-tee-DIH-sih-plih-NAYR-ee)

In medicine, a term used to describe a treatment planning approach or team that includes a number of doctors and other health care professionals who are experts in different specialties (disciplines). In cancer treatment, the primary disciplines are medical oncology (treatment with drugs), surgical oncology (treatment with surgery), and radiation oncology (treatment with radiation).

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

multiple myeloma (MUL-tih-pul MY-eh-LOH-muh)

A type of cancer that begins in plasma cells (white blood cells that produce antibodies). Also called Kahler disease, myelomatosis, and plasma cell myeloma.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

myelodysplasia (MY-eh-loh-dis-PLAY-zhuh)

Abnormal bone marrow cells that may lead to myelogenous leukemia.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

myelodysplastic syndromes (MY-eh-loh-dis-PLAS-tik SIN-dromz)

A group of diseases in which the bone marrow does not make enough healthy blood cells. Also called preleukemia and smoldering leukemia.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

nontoxic (non-TOK-sik)

Not harmful or destructive.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

platelet (PLAYT-let)

A tiny piece of a cell found in the blood that breaks off from a large cell found in the bone marrow. Platelets help wounds heal and prevent bleeding by forming blood clots. Also called thrombocyte.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

reduction (ree-DUK-shun)

A chemical reaction that takes place when a substance comes into contact with hydrogen or another reducing substance.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

resistance

Failure of a cancer to shrink after treatment.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

romiplostim (ROH-mih-PLOH-stim)

A drug used to treat patients with immune thrombocytopenic purpura (ITP) who do not get better with other forms of treatment. In ITP, platelets (cells that cause blood clots to form) are destroyed by the immune system. Romiplostim is being studied as a way to treat low platelet counts caused by chemotherapy. It binds to the thrombopoietin receptor and causes the bone marrow to make more platelets. Romiplostim is also being studied in the treatment of myelodysplastic syndromes (a group of diseases in which the bone marrow does not make enough healthy blood cells). It is a type of thrombopoietin agonist. Also called AMG 531 and Nplate.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

screening (SKREE-ning)

Checking for disease when there are no symptoms. Since screening may find diseases at an early stage, there may be a better chance of curing the disease. Examples of cancer screening tests are the mammogram (breast), colonoscopy (colon), and the Pap test and HPV test (cervix). Screening can also include checking for a person’s risk of developing an inherited disease by doing a genetic test.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

thrombocytopenia (THROM-boh-sy-toh-PEE-nee-uh)

A condition in which there is a lower-than-normal number of platelets in the blood. It may result in easy bruising and excessive bleeding from wounds or bleeding in mucous membranes and other tissues.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

thrombosis (throm-BOH-sis)

The formation or presence of a thrombus (blood clot) inside a blood vessel.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

transplantation (tranz-plan-TAY-shun)

A surgical procedure in which tissue or an organ is transferred from one area of a person’s body to another area, or from one person (the donor) to another person (the recipient).

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)

vitamin (VY-tuh-min)

A nutrient that the body needs in small amounts to function and stay healthy. Sources of vitamins are plant and animal food products and dietary supplements. Some vitamins are made in the human body from food products. Vitamins are either fat-soluble (can dissolve in fats and oils) or water-soluble (can dissolve in water). Excess fat-soluble vitamins are stored in the body’s fatty tissue, but excess water-soluble vitamins are removed in the urine. Examples are vitamin A, vitamin C, and vitamin E.

Source: The National Cancer Institute's Dictionary of Cancer Terms
(http://www.cancer.gov/dictionary)