Publications by authors named "Jmi Vos"

Background: Transfusion reactions occur at an estimated incidence of 2 per 1.000 transfused products. Anaphylactic transfusion reactions are rarer, and seen in 1 per 10.

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  • - Daratumumab, a targeted therapy, shows promise for managing severe angioedema that doesn't respond to standard treatments.
  • - This condition is linked to a deficiency in the C1-inhibitor protein, often seen in patients with monoclonal gammopathy.
  • - The treatment could offer relief and improve the quality of life for patients facing this serious health issue.
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  • Cold agglutinin disease (CAD) is a rare autoimmune condition causing anemia, and sutimlimab, which inhibits a key part of the immune system, showed effectiveness in reducing symptoms like hemolysis and fatigue in the CADENZA Part A study.
  • In Part B of the CADENZA study, 32 out of 39 patients continued treatment for about 99 weeks, showing sustained improvements in hemoglobin, bilirubin levels, and quality of life measures, with no severe adverse effects reported.
  • Despite the promising results, stopping sutimlimab led to a return of disease symptoms, indicating that while the treatment is effective, continuous management is necessary to maintain its benefits.
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Introduction: During the last decades, the pathogenesis of cold agglutinin disease (CAD) has been well elucidated and shown to be complex. Several documented or investigational therapies have been made available. This development has resulted in major therapeutic advances, but also in challenges in choice of therapy.

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Autoimmune hemolytic anemia (AIHA) is a rare autoantibody-mediated disease. For steroid and/or rituximab-refractory AIHA, there is no consensus on optimal treatment. Daratumumab, a monoclonal antibody targeting CD38, could be beneficial by suppression of CD38+ plasma cells and thus autoantibody secretion.

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Cold agglutinin disease is a rare autoimmune hemolytic anemia characterized by complement pathway-mediated hemolysis. Riliprubart (SAR445088, BIVV020), a second-generation classical complement inhibitor, is a humanized monoclonal antibody that selectively inhibits only the activated form of C1s. This Phase 1b study evaluated the safety, tolerability, and effect on hemolysis of riliprubart in adult patients with cold agglutinin disease.

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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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  • Autoimmune hemolytic anemia (AIHA) is a complex disorder where the body's immune system mistakenly attacks red blood cells, leading to varying degrees of severity in patients, from mild to life-threatening.
  • There are no established predictors for severe cases, but certain risk factors like need for hospitalization or blood transfusions can help identify those at greater risk.
  • Ongoing research and emerging therapies, including novel complement inhibitors, are necessary to improve treatment options and develop better prediction models for managing severe AIHA.
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  • A study screened 534 patients with monoclonal IgM disorders over nine years, revealing that 134 had type I cryoglobulinaemia, predominantly associated with Waldenström macroglobulinaemia (76%).
  • Coexisting clinically relevant disorders were found in 31% of patients, with a significant prevalence in those with IgM monoclonal gammopathy of undetermined significance (MGUS) compared to Waldenström macroglobulinaemia or non-Hodgkin lymphoma.
  • Half of the patients experienced active symptoms related to cryoglobulins, and after a median follow-up of three years, 77% had not required treatment for cryoglobulinaemia, with age being the main factor influencing overall survival.
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Bing-Neel syndrome is a rare manifestation of Waldenström macroglobulinemia (WM), which is caused by infiltration of the malignant lymphoplasmacytic cells in the central nervous system. Patients can present with a diverse range of neurologic symptoms, and differentiation with other comorbidities seen in WM, such as immunoglobulin M-related polyneuropathy, can be challenging. Both the rarity of this disorder and the heterogeneity of the clinical presentation often cause a significant diagnostic delay with the risk of permanent neurologic damage.

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The consensus panel 2 (CP2) of the 11th International Workshop on Waldenström's macroglobulinemia (IWWM-11) has reviewed and incorporated current data to update the recommendations for treatment approaches in patients with relapsed or refractory WM (RRWM). The key recommendations from IWWM-11 CP2 include: (1) Chemoimmunotherapy (CIT) and/or a covalent Bruton tyrosine kinase (cBTKi) strategies are important options; their use should reflect the prior upfront strategy and are subject to their availability. (2) In selecting treatment, biological age, co-morbidities and fitness are important; nature of relapse, disease phenotype and WM-related complications, patient preferences and hematopoietic reserve are also critical factors while the composition of the BM disease and mutational status (MYD88, CXCR4, TP53) should also be noted.

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Recent advances in the understanding of Waldenström macroglobulinemia (WM) biology have impacted the development of effective novel agents and improved our knowledge of how the genomic background of WM may influence selection of therapy. Consensus Panel 7 (CP7) of the 11th International Workshop on WM was convened to examine the current generation of completed and ongoing clinical trials involving novel agents, consider updated data on WM genomics, and make recommendations on the design and prioritization of future clinical trials. CP7 considers limited duration and novel-novel agent combinations to be the priority for the next generation of clinical trials.

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Complement-mediated (CM) autoimmune hemolytic anemia (AIHA) is characterized by the destruction of red blood cells (RBCs) by autoantibodies that activate the classical complement pathway. These antibodies also reduce transfusion efficacy via the lysis of donor RBCs. Because C1-inhibitor (C1-INH) is an endogenous regulator of the classical complement pathway, we hypothesized that peritransfusional C1-INH in patients with severe CM-AIHA reduces complement activation and hemolysis, and thus enhances RBC transfusion efficacy.

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  • Bendamustine and rituximab (BR) therapy is effective for treating Waldenström Macroglobulinemia (WM), but the optimal dose of Bendamustine and its effects in different treatment settings remain unclear.
  • In a study of 250 WM patients, response rates were significantly better in patients treated in the frontline setting compared to those with relapsed disease (91.4% vs 73.9%).
  • Achieving a complete response (CR) or very good partial response (VGPR) improved survival rates, and higher doses of Bendamustine were linked to better progression-free survival (PFS) outcomes in both frontline and relapsed patients.
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Relapsing or occurring de novo autoimmune hemolytic anemia (AIHA) during pregnancy or puerperium is a poorly described condition. Here, we report 45 pregnancies in 33 women evaluated at 12 centers from 1997 to 2022. Among the 20 women diagnosed with AIHA before pregnancy, 10 had a relapse.

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The diagnosis of Waldenström's macroglobulinemia (WM), an IgM-associated lymphoplasmacytic lymphoma, can be challenging due to the different forms of disease presentation. Furthermore, in recent years, WM has witnessed remarkable progress on the diagnostic front, as well as a deeper understanding of the disease biology, which has affected clinical practice. This, together with the increasing variety of tools and techniques available, makes it necessary to have a practical guidance for clinicians to perform the initial evaluation of patients with WM.

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Waldenström's Macroglobulinemia (WM) is a rare type of indolent non-Hodgkin lymphoma (NHL) that remains incurable. Several effective agents such as monoclonal antibodies (in combination with chemotherapy), Bruton's tyrosine kinase inhibitors, proteasome inhibitors, and BCL2 inhibitors are (becoming) available for the treatment of relapsed and refractory WM. There is however no consensus on a preferred treatment in the relapsed setting.

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Introduction: Treatment options for Waldenström's Macroglobulinemia (WM) have expanded rapidly in the last decades. However, there is no consensus on a preferred treatment. Therefore, patient preferences become increasingly important in making individualized treatment plans.

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Waldenström's macroglobulinemia (WM), a rare low-grade B-cell non-Hodgkin lymphoma (NHL), has a distinct clinical presentation and different treatment-related side effects compared with other NHL. Currently, a wide variety of therapeutic agents are available for the treatment of WM but there is no consensus on optimal treatment in first line and/or at relapse. The aim of this survey was to evaluate the current knowledge and perspectives of hematologists on diagnosis and treatment of WM.

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  • * The study found that 73% of patients receiving sutimlimab met the primary effectiveness criteria, significantly improving hemoglobin levels and reducing symptoms compared to only 15% of those on placebo.
  • * While sutimlimab showed promising results, some patients experienced more side effects, including headaches and hypertension, highlighting the need for careful monitoring in clinical use.
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