Platelet E-News: February 23, 2012

This e-newsletter is a monthly publication of the Platelet Disorder Support Association. The information in this newsletter is for educational purposes only. For advice on your unique medical condition, please consult a health care professional.

Contents:

ITP and Platelet Disorders Research and Treatments

Hospitals, Insurance, and Medical Care

General Health and Medicine

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ITP and Platelet Disorders Research and Treatments

 

Rituximab Blocks Vaccine Response

None of the 67 lymphoma patients vaccinated for H1N1 within six months of being treated with rituximab (Rituxan®) developed antibodies to H1N1, which would protect them against the virus. However 82% of the controls given the vaccine achieved antibody protection. Rituximab depletes B-cells, a type of white blood cell involved in developing antibodies against foreign substances, including vaccine contents. According to the study authors rituximab may impair the antibody response to vaccines in other diseases treated with that agent.

Yri OE et al. “Rituximab blocks protective serologic response to influenza A (H1N1) 2009 vaccination in lymphoma patients during or within 6 months after treatment.” Blood. 2011 Dec 22;118(26):6769-71. http://www.ncbi.nlm.nih.gov/pubmed/22058114

Eltrombopag Doesn’t Alter Platelet Function

The platelets of people with ITP are more reactive and form clots more easily than those without the disease. These reactive platelets can help prevent bleeding symptoms but they can also lead to unwanted blood clots such as deep vein thrombosis or heart attacks (thromboembolic events). Because some thromboembolic events have been recorded in studies of ITP patients given eltrombopag (Promacta ®), researchers looked at chemical markers of platelet function in people with ITP to see if that treatment increased platelet reactivity. When they reviewed the test results, they didn’t find difference in platelet function between those with ITP treated with eltrombopag (whether they responded or not) and those in good health.

Psaila B, et al. “In vivo effects of eltrombopag on platelet function in immune thrombocytopenia: no evidence of platelet activation.” Blood. 2012 Jan 31. [Epub ahead of print] http://www.ncbi.nlm.nih.gov/pubmed/22294727

Thrombopoietin Production Varies Between Night and Day

Most physiological processes (ex. breathing and temperature) vary between day and night, termed circadian rhythm.   Now researchers discovered that the production of thrombopoietin, the protein that stimulates the megakaryocytes in bone marrow to produce platelets, can also vary depending on the time.  The researchers measured a protein associated with regulating the body’s circadian rhythms (CLOCK) in mice and in human cell lines at different times and compared it to the production of thrombopoietin.  When the CLOCK protein was present TPO production was cyclical.  When the protein was silenced TPO production was constant.

Tracey CJ. “Diurnal expression of Thrombopoietin is regulated by Clock.” J Thromb Haemost. 2012 Jan 27 doi: 10.1111/j.1538-7836.2012.04643.x. [Epub ahead of print]
http://www.ncbi.nlm.nih.gov/pubmed/22284746

Dr. Gernsheimer Explains ITP on Youtube

In an interview at the recent American Society of Hematology (ASH) meeting, Dr. Terry Gernsheimer, a PDSA medical advisor, describes the prevalence, diagnosis, and treatments of ITP.  This 14-minute clip, now posted on YouTube, also includes Dr. Gernsheimer’s comments on her involvement with the discovery of platelet production problems in people with ITP and how this and the discovery of thrombopoietin led to new treatment options for the disease.  The interview was sponsored by Seattle Cancer Care Alliance and conducted by Andrew Schorr, founder and host of Patient Power.

See the interview at: http://www.youtube.com/watch?v=OxiuIvpMaeQ

You can learn more about the latest research reported at ASH in the January e-news and the Winter and upcoming Spring issue of The Platelet News
http://www.pdsa.org/products-a-publications/newsletters.html.

You can find more YouTube clips at http://www.youtube.com/user/PDSAorg

 

Hospitals, Insurance, and Medical Care

Healthcare Plans Have New Transparency Rules

Health insurance companies must provide a four-page, easy-to-understand summary of their policies according to final rules issued by President Obama, implementing Section 2715 of the Affordable Care Act.  This summary must include what each policy covers and doesn’t, the cost of co-payments, co-insurance, and deductibles, plus a standardized glossary of insurance and medical terms.  The final rules, based on the recommendations of a working group of the National Association of Insurance Commissioners, require insurers to provide this information by September 23, 2012 for individuals seeking coverage.  Employers must provide the new summary information 30 days prior to plan renewal or within seven days if there is a plan change. 

Kofman M Corlette S “New Transparency Rules For Health Plans: A Huge Win For Consumers” Health Affairs Blog, February 10, 2012.
http://healthaffairs.org/blog/2012/02/10/new-transparency-rules-for-health-plans-a-huge-win-for-consumers/

Physician Honesty and Openness Questioned

In a 2009 survey of 1,891 physicians nationwide, the majority of physicians agreed that they should fully inform patients of the risks and benefits of interventions.  However, one-third did not agree that they should disclose serious medical errors to patients, nearly 20% did not agree that they should never tell a patient something that was not true, about 40% didn’t feel they needed to disclose financial relationships they had with drug or device companies, and just over 10% said they had told a patient something that was not true within the last year.  The survey authors conclude, “Our findings raise concerns that some patients might not receive complete and accurate information from their physicians, and doubts about whether patient-centered care is broadly possible without more widespread physician endorsement of the core communication principles of openness and honesty with patients.”

Iezzoni L et al., “Survey Shows That At Least Some Physicians Are Not Always Open or Honest With Patients.” Health Aff (Millwood). 2012 Feb;31(2):383-91.
http://www.ncbi.nlm.nih.gov/pubmed/22323169

 

General Health and Medicine

Bacon Stops Nosebleeds

Two potentially fatal nosebleeds in a girl with Glanzmann thrombasthenia, a rare bleeding disorder, were successfully stopped with rolled up raw bacon packed in the nasal cavity.  In the 1940s and 1950s, doctors often used cured, salted pork to stop the occasional nosebleed.  However, the study authors speculate that the practice was discontinued because of concerns of bacterial and parasitic complications, as well as the availability of other treatments,

Gann C. “Bacon — a New Cure for Nosebleeds.” ABC News January 25, 2012.
http://abcnews.go.com/blogs/health/2012/01/25/bacon-a-new-cure-for-nosebleeds/

Humphreys I, et al. “Nasal packing with strips of cured pork as treatment for uncontrollable epistaxis in a patient with Glanzmann thrombasthenia.” Ann Otol Rhinol Laryngol. 2011 Nov;120(11):732-6.  http://www.ncbi.nlm.nih.gov/pubmed/22224315

PFCS In the Air Get In the Blood

Polyfluorinated compounds (PFCs), found in many homes and offices, can damage the immune system.  Recently researchers determined that circulating PFCs can enter a person’s blood stream.  They measured the PFCs in the air of 31 office buildings in Boston and in the blood of people who worked there.  They found the highest levels of PFCs in the blood of workers in office buildings with the highest amounts of PFCs circulating in the air, for the first time linking air-borne and blood PFC levels.   PFCs make materials stain, oil, and water resistant and are given off by carpets, paint, flooring, and other construction materials, so it is not surprising that the highest amounts of PFCs in the blood were from workers in newly constructed buildings.

In addition to construction materials PFCs are used in non-stick cookware, fast-food packaging (ex. microwave popcorn and pizza boxes), anything treated with Scotchgard, and more.  See http://www.inspirationgreen.com/perfluorinated-compounds.html for a list.

Fraser AL. “Polyfluorinated Compounds in Serum Linked to Indoor Air in Office Environments” Environ. Sci. Technol.2012, 46 (2), pp 1209–1215.
http://pubs.acs.org/doi/abs/10.1021/es2038257

Dewitt JC, “Immunotoxicity of Perfluorinated Compounds: Recent Developments.” Toxicol Pathol. 2011 Nov 22.
http://www.ncbi.nlm.nih.gov/pubmed/22109712

 

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This e-newsletter is published by the Platelet Disorder Support Association, 133 Rollins Avenue, Suite 5, Rockville, MD 20852, phone 1-87-Platelet, fax: 301-770-6638, web: http://www.pdsa.org, e-mail: pdsa@pdsa.org

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