Publications by authors named "Christopher J Patriquin"

Complement C5 inhibitor treatment with ravulizumab or eculizumab for paroxysmal nocturnal hemoglobinuria (PNH) improves outcomes and survival. Some patients remain anemic due to clinically significant extravascular hemolysis (cs-EVH: hemoglobin [Hgb] ≤9.5 g/dL and absolute reticulocyte count [ARC] ≥120×109/L).

View Article and Find Full Text PDF
Article Synopsis
  • - Neutralizing antibodies (Abs) against SARS-CoV-2 vary widely among individuals recovering from the virus, with higher levels found in those with severe COVID-19 cases.
  • - Heat inactivation of convalescent serum significantly reduces its neutralization activity by inactivating complement proteins, which play a major role in the body’s immune response against the virus.
  • - The study highlights that the complement pathway is crucial for effective viral neutralization and that its contribution can be more than 50% of the neutralizing effect in untreated serum.
View Article and Find Full Text PDF
Article Synopsis
  • - PNH is a serious condition that leads to blood issues, and pegcetacoplan is a new therapy that targets a specific part of the immune system to help treat it; clinical trials show it works well and is safe for patients.
  • - In a follow-up study (307 OLE), 137 patients who received pegcetacoplan showed significant improvements in hemoglobin levels and reduced fatigue, with most not needing blood transfusions over the study period.
  • - Results indicated 40.2% of patients achieved hemoglobin levels above 12 g/dL, and while some experienced hemolysis, there were no major complications like blood clots or infections reported.
View Article and Find Full Text PDF
Article Synopsis
  • Paroxysmal nocturnal hemoglobinuria (PNH) is a rare blood disorder that leads to anemia, increased risk of blood clots, and organ damage, with a high mortality rate when only supportive care is provided.
  • The introduction of targeted therapies like eculizumab and newer options such as ravulizumab and pegcetacoplan have significantly improved patient outcomes by increasing hemoglobin levels and reducing complications.
  • Despite advances in treatment, challenges remain, including managing breakthrough hemolysis and infection risks, as well as ensuring patient adherence to therapies that are increasingly self-administered and complex.
View Article and Find Full Text PDF

Objectives: Data from the International PNH Registry (NCT01374360) were used to estimate the overall survival and first occurrence of thromboembolic events/major adverse vascular events (TEs/MAVEs) for eculizumab-treated patients with paroxysmal nocturnal hemoglobinuria (PNH) compared with a contemporaneous untreated cohort.

Methods: Patients enrolled in the Registry from March 16, 2007, to February 14, 2022, were included. Treated patients received eculizumab for >35 days; untreated patients did not receive eculizumab at any time.

View Article and Find Full Text PDF

The objective of this analysis was to identify risk factors for thromboembolic events (TE) in patients with paroxysmal nocturnal hemoglobinuria (PNH) who were not treated with C5 inhibitors. Patients with PNH and a history of ≥ 1 TE at enrollment in the International PNH Registry (NCT01374360; registration date, January 2011) were each matched with up to 5 patients without TE. Multivariable analysis was performed with the following variables: percentage glycosylphosphatidylinositol (GPI)-negative cells, high disease activity (HDA), non-TE major adverse vascular event history, and recent anticoagulation.

View Article and Find Full Text PDF

Patients with alloimmune platelet refractoriness can present complex clinical conundrums. Herein we describe a case of platelet refractoriness in the setting of combined HLA and HPA alloimmunization in a patient with acute myeloid leukemia and life-threatening bleeding. We discuss causative antibodies and compare prevailing therapeutic modalities.

View Article and Find Full Text PDF
Article Synopsis
  • Therapeutic plasma exchange (TPE) and red blood cell exchange (RBCX) are critical procedures used in urgent medical situations, with data from CritiCall Ontario analyzing 85 cases referred from 2013 to 2018.
  • * The average time for patients to reach the treatment center was about 243 minutes, with the longest delay occurring after patient acceptance.
  • * Improving factors like communication among physicians and reducing distances between hospitals could significantly decrease wait times and improve patient outcomes.
View Article and Find Full Text PDF

The American Society for Apheresis (ASFA) Journal of Clinical Apheresis (JCA) Special Issue Writing Committee is charged with reviewing, updating, and categorizing indications for the evidence-based use of therapeutic apheresis (TA) in human disease. In the Ninth Edition, the JCA Special Issue Writing Committee has incorporated systematic review and evidence-based approaches in the grading of evidence and categorization of apheresis indications to make recommendations on the use of apheresis in a wide variety of diseases and conditions. This edition has largely maintained the general layout and concept of a fact sheet introduced in the Fourth Edition (2007).

View Article and Find Full Text PDF
Article Synopsis
  • Paroxysmal nocturnal haemoglobinuria (PNH) is a rare blood disorder that leads to severe fatigue and decreased quality of life, making effective treatment essential.
  • A post hoc analysis of the PEGASUS phase 3 trial compared the effectiveness of two treatments, pegcetacoplan and eculizumab, specifically focusing on improvements in patient-reported fatigue using the FACIT-fatigue scale.
  • Results showed that patients receiving pegcetacoplan had significantly greater improvements in fatigue and related health measures compared to those receiving eculizumab, indicating pegcetacoplan is a more effective treatment option for managing fatigue in PNH.
View Article and Find Full Text PDF
Article Synopsis
  • This research compares the safety and effectiveness of allogeneic hematopoietic stem cell transplant (HSCT) and gene therapy (GT) for treating sickle cell disease (SCD), addressing the lack of clinical trials on the subject.* -
  • A total of 56 studies involving 1,198 patients were analyzed, showing a 91% two-year survival rate for HSCT with a low mortality rate for GT but overall low quality evidence due to limited randomized trials.* -
  • The findings highlight the need for improved reporting on SCD-related complications and patient outcomes to facilitate better comparisons of HSCT and GT effectiveness.*
View Article and Find Full Text PDF

Thrombotic microangiopathy (TMA), a pathological lesion observed in a wide spectrum of diseases, is triggered by endothelial injury and/or dysfunction. Although TMA lesions are often accompanied by clinical features of microangiopathic hemolytic anemia, thrombocytopenia, and ischemic end-organ injury, renal-limited forms of TMA are not infrequently encountered in clinical practice. The presence of renal-limited manifestations can be diagnostically challenging, often delaying the initiation of targeted therapy.

View Article and Find Full Text PDF

Background: Fetal and neonatal alloimmune thrombocytopenia (FNAIT) is the most common cause of intracranial hemorrhage (ICH) in thrombocytopenic term infants. We investigated clinical and laboratory predictors of severe FNAIT in a tertiary care referral center.

Study Design And Methods: Retrospective cohort study over a 30-year period.

View Article and Find Full Text PDF

Rationale: Thrombotic microangiopathies (TMAs) are systemic disorders that often affect the kidneys and encompass a heterogeneous group of conditions, including atypical hemolytic uremic syndrome (aHUS). The complement pathway is thought to play a crucial role in the pathogenesis of aHUS, and a favorable response can be obtained through complement C5 inhibition. There is emerging evidence to suggest that the same is also true for several other forms of TMA.

View Article and Find Full Text PDF

Introduction: Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a rare autoimmune blood disorder, which presents with microangiopathic hemolytic anemia, thrombocytopenia, and microvascular thrombosis and is caused by severe deficiency of ADAMTS13. iTTP may result in both acute and chronic complications and is rapidly fatal without expedient treatment. Life-time risk of relapse is approximately 40%.

View Article and Find Full Text PDF

Immune-mediated thrombotic thrombocytopenic purpura (iTTP) is a rare, life-threatening disorder of systemic microthrombosis and organ ischemia. The etiology of chronic cerebrovascular outcomes in iTTP survivors is largely unknown. In this pilot study, we measured blood-brain barrier (BBB) permeability in patients with iTTP at the start of remission and 6 months later.

View Article and Find Full Text PDF
Article Synopsis
  • A 78-year-old man with metastatic melanoma experienced a rare immune-related adverse event called complement-mediated thrombotic microangiopathy (CM-TMA) after receiving immune checkpoint inhibitors (ICIs).
  • After treatment with nivolumab and ipilimumab, he developed symptoms including anemia and thrombocytopenia, leading to a diagnosis of CM-TMA.
  • Following the cessation of immunotherapy and treatment with steroids, the patient recovered and showed no signs of melanoma or CM-TMA six months later, highlighting the importance of recognizing CM-TMA in similar patients.
View Article and Find Full Text PDF

Purpose Of Review: Thrombotic microangiopathy (TMA) is suspected in patients presenting with thrombocytopenia and evidence of a microangiopathic hemolytic anemia. Patients with TMA can be critically ill, so rapid and accurate identification of the underlying etiology is essential. Due to better insights into pathophysiology and causes of TMA, we can now categorize TMAs as thrombotic thrombocytopenic purpura, postinfectious (mainly Shiga toxin-producing -induced) hemolytic uremic syndrome (HUS), TMA associated with a coexisting condition, or atypical HUS (aHUS).

View Article and Find Full Text PDF