Hamad H.,John Stroger Jr. Hospital of Cook County |
Adab K.,Section of Hematology Oncology |
Shah M.,Section of Hematology Oncology
International Journal of Clinical and Experimental Medicine | Year: 2016
Tyrosine kinase inhibitors (TKIs) are targeted molecular therapies widely used for different types of cancer. Their toxicity profile involves multiple organ systems, and the most common hematological toxicity is myelosuppression. Erythrocytosis is an uncommonly reported side effect of TKIs. We report here a case of erythrocytosis in response to the TKI Sunitinib in a patient with metastatic renal cell carcinoma that resolved with the discontinuation of the medication. The patient remained disease free with normal hemoglobin after three years of follow up. While the mechanism of this side effect remains anecdotal, our case reflects some of the different suggested mechanisms to explain it, including both erythropoietin (EPO) dependent and independent pathways. Further research aimed to reveal these pathways could lead to a general better understanding of the mechanisms governing red cell production and also can be used to gauge and monitor response to treatment with TKIs. © 2016, E-Century Publishing Corporation. All rights reserved.
Albrecht J.,John Stroger Jr. Hospital of Cook County |
Werth V.P.,Philadelphia Medical Center |
Werth V.P.,University of Pennsylvania
Lupus | Year: 2010
Cutaneous lupus erythematosus (CLE) is a clinically heterogeneous group of rare skin diseases that only rarely have been subjected to controlled clinical trials. This may have been partly due to a lack of suitable validated outcome instruments. Recently, the Food and Drug Administration (FDA) mandated that organ-specific trials for lupus erythematosus need to use a combination of different outcome measures. The patients condition needs to be assessed in terms of quality of life, the patients global response, and organ-specific instruments that measure activity of the disease as well as damage due to the disease. For the skin, the only formally validated and published instrument is currently the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). This paper discusses the background of the development of the CLASI as well as issues related to its use and interpretation in the context of clinical research of CLE. © The Author(s), 2010.