Publications by authors named "John M Sloan"

Venous thromboembolism (VTE) risk is increased in patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A key question was whether increased intensity of anticoagulation would help prevent VTE and improve patient outcomes, including transfer to the intensive care unit (ICU) and mortality. At the start of the coronavirus disease-19 (COVID-19) pandemic, our institution, Boston Medical Center, instituted a VTE risk stratification protocol based on patients' initial D-dimer levels, medical history, and presence of thrombosis to determine whether they should receive standard-dose prophylaxis, high-dose prophylaxis, or therapeutic anticoagulation.

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Patients with systemic light chain (AL) amyloidosis undergoing treatment with high-dose melphalan and autologous stem cell transplantation (HDM/SCT) may develop renal and cardiac toxicities potentially exacerbated by the co-solvent propylene glycol in conventional melphalan formulations. We investigated the safety and efficacy of propylene glycol-free melphalan (PGF-Mel) during HDM/SCT in patients with AL amyloidosis (ClinicalTrials.gov identifier NCT02994784).

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Article Synopsis
  • There is little existing guidance on how to choose tyrosine kinase inhibitors (TKIs) for patients with short bowel syndrome (SBS), with factors like absorption issues, toxicity, and drug interactions needing careful consideration.
  • A 57-year-old man with SBS and recently diagnosed chronic myeloid leukemia (CML) was treated with dasatinib, starting at 100 mg daily after a thorough evaluation of his medical history and medications.
  • Following this treatment, the patient quickly responded well—showing complete hematological response in two weeks and major molecular response at three months—without experiencing any adverse effects, supporting the choice of dasatinib for such cases.
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Background: Patients with cancer undergoing cytotoxic chemotherapy face an elevated risk of developing serious infection as a consequence of their treatment, which lowers their white blood cell count and, more specifically, their absolute neutrophil count. This condition is known as neutropenia. Neutropenia accompanied by a fever is referred to as febrile neutropenia, a common side effect of chemotherapy with a high mortality rate.

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Human T cell lymphotropic virus types 1 and 2 (HTLV-1/2) are delta retroviruses. HTLV-1 may lead to complications, including adult T cell leukemia-lymphoma (ATLL) and HTLV-1-associated myelopathy. Immunosuppression may result in progression from an asymptomatic carrier state to ATLL.

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Primary pulmonary extra-nodal marginal zone lymphoma of mucosa-associated lymphoid tissue (MALT lymphoma), also known as bronchus-associated lymphoid tissue (BALT lymphoma), is the most common primary pulmonary lymphoma but is rare (<1%) among all non-Hodgkin lymphomas and among pulmonary neoplasms in general. We herein report the case of a 59-year-old male who presented with stable exertional dyspnoea and persistent lung infiltrates who was referred to our hospital for further assessment. A computed tomography (CT)-guided core biopsy was performed showing a dense lymphoid infiltrate, with further testing revealing the diagnosis of pulmonary MALT lymphoma.

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  • A 38-year-old man with symptoms like fever, groin swelling, and anal bleeding was diagnosed with Fournier gangrene, which led to further investigation.
  • Initial tests indicated he had low blood counts and unusual cells in his blood, raising concerns for acute promyelocytic leukaemia (APML).
  • Treatment with All-trans retinoic acid (ATRA) and arsenic trioxide (ATO) resulted in complete remission, with no signs of APML after a month and complete healing of the wound in two months.
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A history of malignancy is often considered a contraindication for kidney transplantation. While the desire to transplant a 'cancer-free' patient is understandable, the current approach neglects the heterogeneity in the natural history of cancers, even within a given tumor type. The information used to formulate current guidelines are dated and fail to reflect the vast resource of modern oncology clinical trials data that should more accurately predict the expected overall survival and recurrence risk of cancer patients.

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AL amyloidosis and transthyretin (ATTR) amyloidosis are the most frequent forms of systemic amyloidosis diagnosed in the United States. Macroglossia is considered to be a pathognomonic feature of AL amyloidosis. We report on two cases of systemic amyloidosis with macroglossia that defied routine clinical diagnosis, in which the deposits were typed as ATTR in one case and AL in the other using immunoelectron microscopy.

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