ABC of Clinical Haematology by Drew Provan

By Drew Provan

Masking hematological elements of components comparable to pathology, molecular technology, melanoma, and normal drugs, this consultant turns out to be useful as a reference for common perform and medical institution employees, hematologists and trainees in hematology. This moment version displays advances within the knowing of the molecular biology of disorder because the first variation was once released in 1998. Provan teaches within the division of Hematology at Queen Mary's institution of medication and Dentistry.

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Thrombocytopenia may present as spontaneous bruising, menorrhagia, bleeding from venepuncture sites, gingival bleeding, or prolonged nose bleeds. A common presenting feature resulting from organ infiltration in childhood acute lymphoblastic leukaemia is bone pain, but acute lymphoblastic leukaemia can also present with superficial lymphadenopathy, abdominal distension due to abdominal lymphadenopathy and hepatosplenomegaly, respiratory embarrassment due to a large mediastinal mass, testicular enlargement, or a meningeal syndrome.

Bleeding episodes in all the congenital thrombocytopenias and platelet function disorders require filtered HLA-compatible platelet transfusions to secure haemostasis, though in minor episodes in the dysfunctional syndromes desmopressin (DDAVP) given intravenously or intranasally with antifibrinolytics (tranexamic acid) may be sufficient. There is increasing evidence that in selected patients with congenital disorders recombinant factor VIIa may be of use in the treatment or prevention of bleeding.

Treatment directed at the central nervous system The treatment or prevention of leukaemic cells in the central nervous system is part of all treatment protocols in childhood leukaemia and adult acute lymphoblastic leukaemia, but not in adults with acute myeloid leukaemia unless they have symptoms or blasts are present in the cerebrospinal fluid. Treatment directed at the central nervous system generally comprises regular intrathecal chemotherapy (usually methotrexate), high dose intravenous methotrexate, or cranial irradiation.

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