Editorial

Welcome to the October 2012 issue of Therapeutic Advances in Hematology!

As always we aim to span the full spectrum of malignant and nonmalignant hematology; this issue brings you multiple works covering nonmalignant hematology, therapeutics for immune thrombocytopenia, iron overload in thalassemia, and prevention and treatment of thrombosis. First, however, we open with a malignant hematology review from Monika Joshi, MD and colleagues from Penn State / Hershey Medical Center, PA and Thayer School of Engineering at Dartmouth, NH, USA. This comprehensive review covers the heterogeneous group of marginal zone lymphomas, including splenic and nodal marginal zone lymphomas and the unique mucosa-associated lymphoid tissue (MALT) lymphomas. They review the biology and pathogenesis and major treatment advances including anti-CD20 therapy (rituximab), nucleoside analog options, and the role of Helicobacter pylori eradication for gastric MALT lymphoma. They then conclude with a comprehensive review of novel agents under investigation for this family of lymphomas.

The issue then turns to nonmalignant hematology, first with a review from Nichola Cooper, MD from the Hammersmith Hospital and colleagues from Barts / Queen Mary’s School of Medicine and Dentistry, London, UK, on the treatment of chronic idiopathic thrombocytopenic purpura (ITP) with romiplostim, a thrombopoiesis-stimulating Fc-peptide fusion protein. They nicely review all of the clinical development including initial phase II and subsequent phase III trials and touch upon the relevant issues with longer follow up, including titration for chronic administration, thromboembolic risk and reticulin fibrosis observed with use. Next you will find an excellent review by Saumya S. Jamuar and Angeline H. Meeng Lai from Boston Children’s Hospital MA and KK Hospital, Singapore, respectively, on the oral iron chelation therapy option of deferiprone for thalassemia. They explain measures of morbidity of iron overload such as cardiac MRI and liver iron concentration and then cover key side effects warranting close observation for during therapy with deferiprone.

Continuing with nonmalignant hematology, this issue next has a review by Alexander G.G. Turpie, MD from Hamilton Health Sciences, McMaster Clinic, Hamilton, ON, on rivaroxaban, an oral factor Xa inhibitor studied for multiple indications including thromboembolism prevention during surgery, treatment and prevention of deep vein thrombosis and pulmonary embolism, stroke prevention in atrial fibrillation, and prevention of acute coronary syndrome. They rightly tout the oral administration and predictable pharmacokinetics as advantages over historic vitamin K antagonists and describe the dosing for various clinical settings where the drug is used. They then cover the array of studies (all with catchy acronyms) of rivaroxaban, including the RECORD, MAGELLAN, EINSTEIN, and ATLAS trials and the findings therein. They summarize the safety and efficacy of this broadly applicable agent and ease of use with minimal consideration for patients with renal impairment and the practical risk of bleeding with anticoagulation.

We close with a letter from Kassem Harris, MD and colleagues from Staten Island University Hospital, NY describing a unique case of ovarian vein thrombosis in a nonpregnant woman and reviewing this rare but serious condition generally triggered by pelvic disease or pregnancy.

And I close indebted once again to my colleagues for their submissions, my editorial colleagues for their thoughtful reviews, the editorial staff of the journal and you, the readers, for your support and interest. Enjoy!