Background: Thrombosis is one of the leading causes of death in cancer patients. Anti-angiogenic inhibitors like bevacizumab, a humanized monoclonal antibody targeting vascular endothelial growth factor, increase the risk of thrombosis. Thromboprophylaxis must be provided to patients receiving bevacizumab. Methods: An up-to-date, comprehensive literature search using PubMed for studies performed on bevacizumab from January 2003 to the present was performed. Key words searched included bevacizumab, avastin, thromboprophylaxis, and anticoagulation in cancer patients. Results: Thrombosis risk is increased with bevacizumab therapy. Anticoagulation therapy with bevacizumab may increase bleeding risks; however, these risks are generally low and for minor bleeding. Current guidelines approve thromboprophylaxis in a subset of cancer patients; however, they are not specific for patients receiving anti-angiogenesis therapy. Conclusion: Thromboprophylaxis should be considered for patients receiving bevacizumab, as the benefits outweigh the small risk of adverse effects such as bleeding.

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Plasma and its components are prepared from whole blood or collected using apheresis. They represent important clinical transfusion products that contribute to the management of a variety of clinical cases. In addition, plasma is used by the fractionation industry to prepare many medicinal products. As with any medicinal product, safety, efficacy, and availability are essential elements that contribute to the support of patients who need plasma and its components. Good manufacturing practice is essential for the preparation of plasma and its components. To maximize benefits and reduce hazards, adherence to practice guidelines, which are developed from evidence-based medicine, is essential. Mini-pool solvent detergent pathogen inactivation with a single-use Conformité Européenne-marked medical device that can be used in local blood establishments and its validation are discussed in this review as new technology for making safe plasma and its products accessible to the developing as well as the developed world.

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The need for blood is increasing universally while the sources of blood donation have not increased in kind. Voluntary, unpaid donors are the only current hope for acquiring an adequate source of safe blood. Because voluntary unpaid donors are the heroes and "owners" of blood banks, special attention should be given to donors, the process of blood donation, and blood donation centers. The staff working in a blood donation center must be certified professionals for the job, socially and scientifically. The donor must feel that he belongs to that place, as he is the 'owner', and staff should treat him as a VIP. World Blood Donor Day (WBDD) must be an international event celebrated much like the New Year's Day. Officials in every country should give special attention to WBDD to make it a prominent international commemoration. Advertising about and motivation to donate blood must reach a level at which everyone is asked and encouraged to ask others: How many units did you donate this year? When was the last time you donated blood? When will you next donate blood?

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After discussing the need for iron-chelating therapy with b-thalassemia major patients and their families, we describe the advantages and disadvantages of available chelators-subcutaneous desferrioxamine (DFO), oral deferiprone (DFP), and deferasirox (DFX)-so that a genuinely informed decision can be made. At present, the most frequent choices are either oral DFP or DFX. patient information about the number of previous transfusions and the rate of ongoing transfusion and arrange for hepatic transverse relaxation rate measurements, magnetic resonance imaging evaluation of cardiac T2*, and echocardiographic and electrocardiographic studies. Auditory and ophthalmic testing, including slit-lamp and fundus examinations, are also performed. Laboratory tests include a complete blood count with a differential count and measurement of serum creatinine, protein/creatinine ratio, serum aminotransferases, bilirubin levels, and iron indexes. After transfusing 10-12 units of blood, or reaching a hepatic iron concentration between 3 and 7 mg/g, we prescribe either once-daily oral DFX therapy (20 mg/kg) or DFP (75 mg/kg/d) in escalating doses. Monitoring efficacy and adverse events is valuable. Ideally, iron-chelating therapy should be initiated on a prophylactic basis before clinically significant iron accumulation has occurred. Patients who have already undergone repeated transfusion without sufficient chelation can also be treated successfully.

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Immune thrombocytopenic purpura (ITP) is an autoimmune disorder characterized by a low circulating platelet count caused by the destruction of antibody-sensitized platelets in the reticuloendothelial system. ITP can be classified as childhood or adult, acute or chronic, and primary or secondary. The persistence of ITP beyond 12 months defines the chronic form of the disorder. Essential data in ITP patients included demographic data, disease onset, course and duration, treatment modalities, and patient response to treatment according to the definition of Rodeghiero et al. ¹ Previously published guidelines for the diagnosis and management of primary ITP require updating largely owing to the introduction of new classes of therapeutic agents and a greater understanding of disease pathophysiology. Treatment-related decisions still depend principally on clinical expertise or patient preference, however, rather than high-quality clinical trial evidence. This consensus document aims to report new data and provide consensus-based recommendations relating to the diagnosis and treatment of ITP in adults, children, and pregnancy. ² The secondary causes of ITP, which include collagen vascular disorders, immune deficiencies, and some chronic infections, are less common in children than in adults. This review focuses on the diagnosis and management of children who have chronic ITP. Emphasis is placed on areas of controversy and new therapies. Predictors of chronic ITP were similar to those in western studies; the gradual onset of symptoms over >2 weeks, initial platelet count >20×10 ⁹ /L, and age >10 years at presentation were the major predictors, whereas negative history of preceding febrile illness and less frequent mucosal bleeding were minor predictors in a subset of patients prone to the development of chronic ITP. ³

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The World Federation of Hemophilia (WHF) is an international not-for-profit organization based in Montreal, Canada, that has been active in the field of hemophilia care for the last 49 years. The WFH currently has a membership of 118 countries and this number is expected to reach 123 in 2012. The WFH brings together the expertise of different disciplines and specialties in order to establish, develop, and execute successful hemophilia care programs in developing countries where great needs for such programs exist.

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Patients/family and significant others are entitled to safe, quality health care at all times while receiving chemotherapy. The most common forms of cytotoxic drugs are known as antineoplastic agents, and sometimes these terms are used interchangeably. Chemotherapy drugs are also known to be carcinogenic, mutagenic, and teratogenic. Chemotherapy drugs kill both normal and malignant cells. Various categories of staff are involved in handling these drugs, from the manufacturing unit to administration and waste disposal, and they are potentially exposed to the hazards of cytotoxic drugs. Therefore, it is essential that all healthcare workers, employees, and employers maintain a safe environment in the chemotherapy unit to prevent hazards to self, patients, and family.

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Acute leukemia (AL) is a complex disease with considerable phenotypic and morphologic heterogeneity. The phenotype is often assessed by multiparameter flow cytometry ideally on aspirated bone marrow. These leukemia associated phenotypes (LAPs) are crucial for disease monitoring. In addition, there are more than 100 recurring cytogenetic abnormalities encountered in acute myeloid leukemia (AML) and similarly, multiple acquired genetic abnormalities are responsible for aberrant proliferation and differentiation arrest seen in acute lymphoblastic leukemia (ALL). WHO requires a combination of both immunophenotypic and cytogenetic studies to definitively classify AL. Outgrowth of minimal residual disease (MRD) in AL is responsible for the occurrence of relapses. These are cells present in the bone marrow after treatment and these can be monitored by molecular, biologic and or immunophenotypic detection methods. Defining MRD is thought to be crucial in defining patient-tailored post remission therapy which might reduce the risk of relapse or diminish morbidity and mortality in AL. This may also allow detection of impending relapses for early intervention. Immunophenotyping by flow cytometry (FC) is a cost effective and fast tool for detection of MRD. Essentially all cases of AL possess a unique phenotype with multiple aberrancies which tend to remain stable during the course of relapses. By defining these LAPs on malignant cells at diagnosis, flow cytometry can be highly reliable in MRD parameter assessment at different stages AL, consequently predicting survival and forthcoming relapses.

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