RE: Bone Marrow Procedures

[Guest guest]

Hi Lottie,

Many thanks for the article on the new technique for doing bone marrows. I

wonder how long it will be before it filters down to our labs.

One thing that they mentioned in the article was the morbidity associated

with the procedure. They didn't give any statistics, but I think that one

would be too many.

I thought that my oncologist was great. He would be in and out within 5

minutes. This technique is done in one minute. WOW!!!

Using this technique I don't think you will be seeing patients avoiding the

procedure or asking for sedation.

Zavie

[ ] Bone Marrow Procedures

CLEVELAND CLINIC'S PROCEDURE NOW STANDARD (September 1, 2010)

" For many years, the standard methods of performing bone marrow procedures

in patients with varying bone densities have remained unchanged. This is

despite the fact that the manual method of performing bone trephine biopsies

has significant limitations, including patient discomfort, needle-related

adverse events, and operator dependence.

" The new and developing field of intraosseous medicine is finally bringing

much-needed change to bone marrow procedures. Intraosseous (IO) vascular

access was commonly used by World War II medics to resuscitate soldiers

dying from hemorrhagic shock. The technique of infusing fluids and drugs

into patients in trauma and resuscitative situations via IO space fell out

of favor once the war ended. But in the 1980s, a pediatrician from the

Cleveland Clinic observed IO being used during a cholera epidemic in India,

and the technique became standard in pediatric advanced life support. "

Please note that entire article can be seen at the following website:

http://tinyurl.com/25j344p

___________________________

August 10, 2010 GLEEVEC WILL BECOME GENERIC DRUG IN 2015

" Imatinib (Gleevec), the first-line standard of care in chronic myeloid

leukemia, will become a generic drug in 2015, so the race is on to find a

second generation of tyrosine kinase inhibitors (TKIs) that can do the job

just as well. Dasatinib (Sprycel) and nilotinib (Tasigna) have demonstrated

benefits as second-line therapies, but could they be frontrunners as

first-line therapy as well? New studies would seem to support that theory,

although longer patient follow-up and, of course, cost considerations will

ultimately determine whether dasatinib and nilotinib are up to the task.

" Imatinib has changed the treatment of CML, " said Hagop Kantarjian, MD, a

professor and chair of the leukemia department at the M.D. Cancer

Center in Houston. " However, there are about 2% to 4% of patients every year

who develop resistance or toxicities that require different therapies, and

this is where the new generation of TKIs [could] have a significant role: in

managing imatinib failure. "

" Dr. Kantarjian led a study that evaluated the efficacy and safety of

dasatinib compared with imatinib. A second study, the ENESTnd trial,

compared nilotinib with imatinib (see " CML patients' molecular response to

nilotinib continues to deepen over time " ). For the dasatinib study, 519

patients with newly diagnosed CML were randomized to dasatinib (100 mg) or

imatinib (400 mg) for one year.

" Complete cytogenetic response (CCyR) and major molecular response (MMR)

were used to evaluate efficacy. The primary endpoint was confirmed CCyR,

defined as CCyR on two consecutive analyses (ASCO 2010 abstract LBA6500; N

Engl J Med 362:2260-2270, 2010). " There is always more at:

http://tinyurl.com/22q7zep

Did you know that over 1 billion URL's are transformed into tiny URL's every

month? Just go to www.tinyurl.com and it is transposed in less than a

minute.

___________________________________

HAND HYGIENE (can never be stressed enough and not practiced by some medical

professionals. They should wash their hands upon entering and existing the

patient's room or office visit.

" Hand hygiene has proven to be one of the most effective ways to prevent the

transmission of infection. Friese and Lee nicely review the significance of

hand hygiene as well as the appropriate hand-washing technique. Hand hygiene

cannot be emphasized enough, however; despite the knowledge that

hand-washing decreases the risk of infection, clinicians are not always

compliant in washing their hands before and after patient contact.

Furthermore, most oncology patients are outpatient and it is critical that

nurses educate patients about the importance of hand hygiene for themselves

and their close contacts. "

http://tinyurl.com/25ymq6w

_____________________________

FOOD BORNE ILLNESSES LAX IN INSTITUTIONS

" In the 1970s, research established that foods, particularly fresh fruits

and vegetables, contain Escherichia coli, Pseudomonas aeruginosa, and other

gram-negative bacilli.[6] These observations led to the implementation of

dietary restrictions for neutropenic cancer patients, commonly referred to

as a low microbial or " neutropenic " diet. Nearly all healthcare institutions

surveyed in the 2000s recommended a neutropenic diet to their patients, and

the most common recommendation was to avoid uncooked fruits and vegetables. "

" In one study, 30% of 23 outpatients were noncompliant with the neutropenic

diet and infection rates were similar in compliant and noncompliant

patients.[12] Another small trial showed no difference in the rate of

febrile neutropenia between patients who were randomly assigned to a US Food

and Drug Administration. " -

http://tinyurl.com/25ymq6w

__________________________

fyi,

Lottie Duthu

[Guest guest]

I read the article, but maybe I am blind, or something, I did not understand or

read how the new procedure was done.  and I have had over 50, have never had a

really BAD one. But I welcome another way to do it, explain how it is done

please. Bobby

a ( Bobby ) Doyle, dob 12/17/29

DX 5/1995

Interferon 9 weeks/Hydroxyurea 5 years

02/2000 to 06/2002 Gleevec trial, OHSU

06/2002 Gleevec/Trisenox Trial, OHSU

06/2003 Gleevec/Zarnestra Trial, OHSU

04/2004 Sprycel Trial, MDACC, CCR in 10 months

04/2008 XL228 Trial, U of Mich.

01/2009 PCR 5.69

04/2009 Ariad Trial AP24534

09/2009 PCR 0.01

11/2009 PCR 0.034

02/2010 PCRU

#840 Zavie's Zero Club

From: Zavie <zmiller@...>

Subject: RE: [ ] Bone Marrow Procedures

Date: Thursday, September 23, 2010, 6:03 PM

 

Hi Lottie,

Many thanks for the article on the new technique for doing bone marrows. I

wonder how long it will be before it filters down to our labs.

One thing that they mentioned in the article was the morbidity associated

with the procedure. They didn't give any statistics, but I think that one

would be too many.

I thought that my oncologist was great. He would be in and out within 5

minutes. This technique is done in one minute. WOW!!!

Using this technique I don't think you will be seeing patients avoiding the

procedure or asking for sedation.

Zavie

[ ] Bone Marrow Procedures

CLEVELAND CLINIC'S PROCEDURE NOW STANDARD (September 1, 2010)

" For many years, the standard methods of performing bone marrow procedures

in patients with varying bone densities have remained unchanged. This is

despite the fact that the manual method of performing bone trephine biopsies

has significant limitations, including patient discomfort, needle-related

adverse events, and operator dependence.

" The new and developing field of intraosseous medicine is finally bringing

much-needed change to bone marrow procedures. Intraosseous (IO) vascular

access was commonly used by World War II medics to resuscitate soldiers

dying from hemorrhagic shock. The technique of infusing fluids and drugs

into patients in trauma and resuscitative situations via IO space fell out

of favor once the war ended. But in the 1980s, a pediatrician from the

Cleveland Clinic observed IO being used during a cholera epidemic in India,

and the technique became standard in pediatric advanced life support. "

Please note that entire article can be seen at the following website:

http://tinyurl.com/25j344p

___________________________

August 10, 2010 GLEEVEC WILL BECOME GENERIC DRUG IN 2015

" Imatinib (Gleevec), the first-line standard of care in chronic myeloid

leukemia, will become a generic drug in 2015, so the race is on to find a

second generation of tyrosine kinase inhibitors (TKIs) that can do the job

just as well. Dasatinib (Sprycel) and nilotinib (Tasigna) have demonstrated

benefits as second-line therapies, but could they be frontrunners as

first-line therapy as well? New studies would seem to support that theory,

although longer patient follow-up and, of course, cost considerations will

ultimately determine whether dasatinib and nilotinib are up to the task.

" Imatinib has changed the treatment of CML, " said Hagop Kantarjian, MD, a

professor and chair of the leukemia department at the M.D. Cancer

Center in Houston. " However, there are about 2% to 4% of patients every year

who develop resistance or toxicities that require different therapies, and

this is where the new generation of TKIs [could] have a significant role: in

managing imatinib failure. "

" Dr. Kantarjian led a study that evaluated the efficacy and safety of

dasatinib compared with imatinib. A second study, the ENESTnd trial,

compared nilotinib with imatinib (see " CML patients' molecular response to

nilotinib continues to deepen over time " ). For the dasatinib study, 519

patients with newly diagnosed CML were randomized to dasatinib (100 mg) or

imatinib (400 mg) for one year.

" Complete cytogenetic response (CCyR) and major molecular response (MMR)

were used to evaluate efficacy. The primary endpoint was confirmed CCyR,

defined as CCyR on two consecutive analyses (ASCO 2010 abstract LBA6500; N

Engl J Med 362:2260-2270, 2010). " There is always more at:

http://tinyurl.com/22q7zep

Did you know that over 1 billion URL's are transformed into tiny URL's every

month? Just go to www.tinyurl.com and it is transposed in less than a

minute.

___________________________________

HAND HYGIENE (can never be stressed enough and not practiced by some medical

professionals. They should wash their hands upon entering and existing the

patient's room or office visit.

" Hand hygiene has proven to be one of the most effective ways to prevent the

transmission of infection. Friese and Lee nicely review the significance of

hand hygiene as well as the appropriate hand-washing technique. Hand hygiene

cannot be emphasized enough, however; despite the knowledge that

hand-washing decreases the risk of infection, clinicians are not always

compliant in washing their hands before and after patient contact.

Furthermore, most oncology patients are outpatient and it is critical that

nurses educate patients about the importance of hand hygiene for themselves

and their close contacts. "

http://tinyurl.com/25ymq6w

_____________________________

FOOD BORNE ILLNESSES LAX IN INSTITUTIONS

" In the 1970s, research established that foods, particularly fresh fruits

and vegetables, contain Escherichia coli, Pseudomonas aeruginosa, and other

gram-negative bacilli.[6] These observations led to the implementation of

dietary restrictions for neutropenic cancer patients, commonly referred to

as a low microbial or " neutropenic " diet. Nearly all healthcare institutions

surveyed in the 2000s recommended a neutropenic diet to their patients, and

the most common recommendation was to avoid uncooked fruits and vegetables. "

" In one study, 30% of 23 outpatients were noncompliant with the neutropenic

diet and infection rates were similar in compliant and noncompliant

patients.[12] Another small trial showed no difference in the rate of

febrile neutropenia between patients who were randomly assigned to a US Food

and Drug Administration. " -

http://tinyurl.com/25ymq6w

__________________________

fyi,

Lottie Duthu