Publications by authors named "Erfan Nur"

Sickle cell retinopathy (SCR) is a complication of sickle cell disease (SCD) and can drastically impair visual acuity. Screening for SCR is therefore recommended, but evidence for optimal screening frequency on an individual level is lacking. This scoping review mapped the current evidence on risk factors for SCR and sickle cell maculopathy (SCM).

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Cyclosporine A combined with mycophenolate mofetil (CsA/MMF) has become an established regimen for the prevention of graft-versus-host disease (GVHD) following non-myeloablative (NMA) allogeneic hematopoietic stem cell transplantation (alloHSCT). However, the optimal duration of immunosuppression (IS) has not yet been defined and overtreatment is of concern. We hypothesized that time-restricted IS with CsA/MMF would increase the proportion of patients with non-severe GVHD compared to standard-duration IS, thereby resulting in reduction of the relapse rate and improvement of progression-free survival (PFS) and overall survival (OS).

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Article Synopsis
  • Silent cerebral infarcts (SCIs) are common in patients with severe forms of sickle cell disease (SCD) and thalassemia, although the underlying causes are not fully understood.
  • This study compared cerebral blood flow, oxygen metabolism, and SCI lesions in severe and mild SCD patients, thalassemia patients, and healthy controls before and after a vasodilatory challenge.
  • Findings showed that while severe SCD and thalassemia patients had higher blood flow, their oxygen consumption was lower; this suggests that anemia rather than cerebral blood flow may play a key role in the development of SCIs, especially in milder forms of SCD.
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Sickle cell disease (SCD) is complicated by silent cerebral infarcts (SCIs), for which anemia is an important risk factor. Despite normal oxygen delivery (OD), cerebral vascular reserve (CVR), and cerebral metabolic rate of oxygen (CMRO) are diminished in SCD, possibly causing the formation of SCIs. Voxelotor inhibits polymerization by increasing the hemoglobin oxygen binding, ameliorating hemolytic anemia.

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Background: Acute myeloid leukemia (AML) is a heterogenous and complex blood cancer requiring aggressive treatment. Early identification and prediction of the complications following treatment is vital for effective disease management.

Aims: We explored associations between plasma protein levels and fever- and infection-related complications in 26 AML patients during chemotherapy-induced neutropenia.

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Purpose: To assess the self-reported oral health and oral health-related quality of life of patients diagnosed with hemato-oncological disease.

Patients And Methods: Data was collected through a digital questionnaire in collaboration with the Dutch patient organization Hematon. The questionnaires EORTC-QLQ-C30, EORTC-QLQ-OH15, shortened Xerostomia Inventory (XI), and the OHIP-14 were used.

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  • * A total of 249 eyes from 137 patients were examined; results showed significant macular thinning and variations in vessel density, though no clear association with the severity of SCR.
  • * Despite the prevalence of macular issues, they did not lead to visual impairment, and OCTA imaging proved ineffective in predicting SCR risk in these patients.
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  • Crovalimab is a new C5 inhibitor that can be self-administered every four weeks and is being tested in a phase 3 trial against another treatment, eculizumab, for patients with paroxysmal nocturnal hemoglobinuria (PNH).
  • The trial's focus shifted from efficacy to safety due to not meeting recruitment goals, and exploratory endpoints included various measures of patient health and satisfaction.
  • Results showed that while both treatments had adverse events, crovalimab showed sustained effectiveness and 85% of patients preferred it over eculizumab, suggesting it might be a more manageable treatment option for long-term PNH care.
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Nonmyeloablative, matched sibling donor hematopoietic stem cell transplantation with alemtuzumab/total body irradiation (TBI) conditioning is a curative therapy with low toxicity for adults with sickle cell disease (SCD). However, relatively low donor chimerism levels and graft rejection remain important challenges. We hypothesized that adding azathioprine/hydroxyurea preconditioning will improve donor chimerism levels and reduce graft failure rate.

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  • Sickle cell disease can cause serious issues with organs, making patients very sick, so researchers wanted to see if a treatment called stem cell transplantation helps or hurts organ function.
  • They looked at many studies and found that while some organ functions got better after the treatment, like the spleen and brain blood flow, not all problems went away, and some got worse, especially in kids.
  • Overall, while stem cell transplantation can help certain organ issues in sickle cell disease patients, it can also cause new problems, so more research is needed to find out who would benefit the most from it.
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In the setting of a learning collaborative, we conducted an international multicenter phase 2 clinical trial testing the hypothesis that nonmyeloablative-related haploidentical bone marrow transplant (BMT) with thiotepa and posttransplant cyclophosphamide (PTCy) will result in 2-year event-free survival (no graft failure or death) of at least 80%. A total of 70 participants were evaluable based on the conditioning protocol. Graft failure occurred in 8 of 70 (11.

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Factors influencing the activation of neutrophils in SCD and the potential neutrophil-mediated ameliorating effects of therapies in SCD.

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Background: To provide insight into the perspectives of children and young adults with transfusion-dependent thalassemia and sickle cell disease and their caregivers regarding the decision for hematopoietic stem cell transplantation (HSCT).

Procedure: A qualitative longitudinal multicenter study. Data collection consisted of 40 audio-recorded conversations between physicians and families and 77 interviews with patients and/or caregivers related to 27 unique cases, collected at different time points throughout the decision-making process.

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We investigated the potential of the point of sickling (PoS; the pO2 tension at which red cells start to sickle), determined by oxygen gradient ektacytometry to serve as a biomarker associated with the incidence of acute sickle cell disease-related complications in 177 children and 50 adults. In the pediatric cohort, for every 10 mmHg increase in PoS reflecting a greater likelihood of sickling, the likelihood of an individual experiencing >1 type of acute complication increased; the adjusted odds ratio (aOR) was 1.65.

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Targeting the primary pathogenic event of sickle cell disease (SCD), the polymerization of sickle hemoglobin (HbS), may prevent downstream clinical events. Mitapivat, an oral pyruvate kinase (PK) activator, has therapeutic potential by increasing adenosine triphosphate (ATP) and decreasing 2,3-diphosphoglycerate (2,3-DPG), a glycolytic red blood cell (RBC) intermediate. In the previously reported 8-week dose-finding period of this phase 2, investigator-initiated, open-label study, mitapivat was well tolerated and showed efficacy in SCD.

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Sickle cell disease (SCD) is characterized by chronic hemolytic anemia associated with impaired cerebral hemodynamics and oxygen metabolism. Hematopoietic stem cell transplantation (HSCT) is currently the only curative treatment for patients with SCD. Whereas normalization of hemoglobin levels and hemolysis markers has been reported after HSCT, its effects on cerebral perfusion and oxygenation in adult SCD patients remain largely unexplored.

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Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) is a rare heterogeneous disease in which treatment must be initiated early to prevent irreversible organ damage and death. There are several diseases that can mimic AAV, even in the presence of positive ANCA serology and/or histological evidence of vasculitis, as demonstrated in this case series. We reflect on the diagnostic approach of patients with AAV and provide an overview of AAV-mimicking diseases that can be considered in patients with atypical disease presentation or course.

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Introduction: Neutrophils promote chronic inflammation and release neutrophil extracellular traps (NETs) that can drive inflammatory responses. Inflammation influences progression of sickle cell disease (SCD), and a role for NETs has been suggested in the onset of vaso-occlusive crisis (VOC). We aimed to identify factors in the circulation of these patients that provoke NET release, with a focus on triggers associated with hemolysis.

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Article Synopsis
  • Graft-versus-host disease (GvHD) is a major complication in allogeneic hematopoietic stem cell transplants, and this study compares the effectiveness of two treatments, anti-thymocyte globulin (ATG) and post-transplant cyclophosphamide (PTCy), in patients who received transplants using matched unrelated donors (MUD) with non-myeloablative conditioning (NMC).
  • The study included 185 adult patients and found that acute GvHD occurred in 48% of those treated with ATG compared to only 21% in those treated with PTCy, indicating that PTCy is more effective at reducing acute GvHD risk.
  • Both treatments had similar
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Objectives: Pain management during a vaso-occlusive crisis (VOC) for patients with sickle cell disease (SCD) remains a major challenge and strongly depends on opioids. We developed a multimodality pain protocol for rapid, opioid-sparing pain treatment of VOC and evaluated its feasibility.

Methods: Patients were included for evaluation if they were ≥18 years, diagnosed with SCD and visited the emergency department (ED) because of VOC between July 2018 and December 2020.

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