Role of daratumumab in the frontline management of multiple myeloma: a narrative review.

Introduction: The prevalence of multiple myeloma (MM) has gradually increased over the last few decades in India due to growing population, better disease awareness, and improved diagnostic procedures. Despite such advances, MM remains an incurable and relapsing disease due to its heterogeneity and genomic instability. With the inclusion of monoclonal antibodies, especially daratumumab in the frontline regimen, the management landscape of MM has improved significantly resulting in better disease control and patient outcomes.

Rare Case of Hemolytic Anemia and Distal Renal Tubular Acidosis in an adult due to Homozygous Mutation.

In this case study, we report an adult patient presenting with generalized weakness, marked anemia, spherocytosis, and no features of thalassemia. The patient was treated for suspicion of autoimmune hemolytic anemia but was recalcitrant to treatment. Genetic analysis revealed the patient to be homozygous for c.

Enoxaparin Induced Skin Lesions in Pregnancy: A Rare But Clinically Recognizable Association.

We report the case of a 29 year old pregnant female who experienced itching with erythematous plaques on prophylactic enoxaparin for recurrent fetal losses. These lesions generalized on rechallenge but erythema and itching gradually resolved after 4 weeks of discontinuation. Cutaneous adverse events with heparin have been reported (Villanueva et al.

Reversal agents for NOACs: Connecting the dots.

Objective: The objective of this review is to provide an overview on the current development of the specific reversal agents for Non-vitamin K Oral Anticoagulants (NOACs).

Methods: We conducted a systematic literature search strategy to identify potential studies on Medline, Embase, and the Cochrane register.

Conclusions: These new reversal agents for NOACs, will help address the unmet need for the management of major or life threatening bleeds, and the management of emergency surgical procedures in patients taking NOACs.

The Indian consensus guidance on stroke prevention in atrial fibrillation: An emphasis on practical use of nonvitamin K oral anticoagulants.

The last ten years have seen rapid strides in the evolution of nonvitamin K oral anticoagulants (NOACs) for stroke prevention in patients with atrial fibrillation (AF). For the preparation of this consensus, a comprehensive literature search was performed and data on available trials, subpopulation analyses, and case reports were analyzed. This Indian consensus document intends to provide guidance on selecting the right NOAC for the right patients by formulating expert opinions based on the available trials and Asian/Indian subpopulation analyses of these trials.

Tc 99m Sestamibi Scanning in Multiple Myeloma--a New look with SPECT-CT.

Unlabelled: A variety of diagnostic tools including biochemistry, radiological imaging bone marrow studies and recently metabolic imaging with FDG PET are used for assessment of disease extent in myeloma.

Aim: To evaluate the role of metabolic imaging with Tc99m Sestamibi (Mibi) SPECT-CT in Multiple myeloma.

Materials And Methods: Patients in various stages of Myeloma were scanned after 20mCi Tc99m Sestamibi was injected i/v.

Unusual immunophenotype of T-cell large granular lymphocytic leukemia: report of two cases.

Large granular lymphocytes (LGL) leukemias are commonly of the T-cell or NK-cell type. T-cell LGL leukemia is typically a disorder of mature CD3, CD8 and T-cell receptor TCR (TCR - T cell receptor)-αβ positive cytotoxic T-cells. Rare variants include TCRγδ+ variants and CD4 + TCRαβ+ cases.

Warfarin therapy--why one dose does not fit all!

We report an Indian adult female patient with Deep Vein Thrombosis (DVT), in whom it was difficult to achieve and maintain target INR on warfarin (oral anticoagulant) by conventional doses. Pharmacogenomics study for warfarin revealed that she had Homozygous mutant for CYP2C9 *3(CYP2C9 *3/*3) and Heterozygous mutant for VKORC 1(1639G >A) {genetic polymorphism double defect}. This conferred a greater sensitivity to her warfarin therapy in an otherwise conventional dose regime used in most patients, making her management challenging.

Refractory anaemia in an immunocompromised patient--what is it?

Anaemia is common among human immunodeficiency virus (HIV)-infected patients. It may be directly attributable to the virus or may be caused by opportunistic infections, neoplasms or drugs that cause either bone marrow suppression or haemolysis. Pure red cell aplasia (PRCA) is an uncommon haematological disorder that causes severe transfusion dependant anaemia.

Hb Koln [β98(FG5) [GTG → ATG, Val → Met]: the first report from India.

Background: The group of unstable hemoglobins are associated with congenital non-spherocytic hemolytic anemia due to instability of the hemoglobin molecule. They often lead to formation of the characteristic inclusion bodies or Heinz bodies.

Aim: To identity the cause of mild anemia, reticulocytosis, and hepatosplenomegly in a case of non-spherocytic hemolytic anemia.