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News & Press: JTH

New SSC Recommendations and Guidelines Released by JTH

Tuesday, March 3, 2015   (0 Comments)
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The Journal of Thrombosis and Haemostasis (JTH) has accepted the following articles on recommendations from the Scientific and Standardization Committee (SSC) Subcommittees of the ISTH: 

Diagnosis and Treatment of Incidental Venous Thromboembolism in Cancer Patients
Modern computer tomography (CT) with its higher sensitivity and resolution has increased the detection of incidental venous thromboembolism (VTE) in the venous and pulmonary vasculature during routine imaging for cancer staging and response assessment. As a result, up to half of all VTEs diagnosed in oncology centers are incidental. Although widely accepted, the diagnosis of incidental VTE is made without using the standard imaging studies required for confirming the presence of symptomatic VTE (i.e. compression ultrasonography for deep vein thrombosis [DVT] and CT pulmonary angiography [CTPA] or ventilation/perfusion lung scan for pulmonary embolism [PE]). The accuracy and reliability of staging imaging in making a diagnosis of DVT or PE have not been established. 

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Establishment of the WHO 1st International Standard ADAMTS13, plasma (12/252)
ADAMTS13 (A Disintegrin And Metalloprotease with ThromboSpondin type 1 motifs 13), also known as “von Willebrand factor (VWF) cleaving protease” is responsible for modulating the size of VWF multimers in the circulation. Acquired or congenital deficiency of ADAMTS13 is associated with the circulation of ultra-large multimers of VWF which can lead to thrombotic thrombocytopoenic purpura (TTP) characterised by disseminated platelet aggregation and thrombosis in the microcirculation, severe platelet deficiency, red cell haemolysis and organ damage [1,2]. Measurement of ADAMTS13 activity in plasma is an important component in the diagnosis and treatment of TTP and numerous methods, both commercial and “in house”, are available for the estimation of ADAMTS13 activity and antigen [3]. However, there is currently no internationally accepted unitage to support harmonisation of measurement between laboratories hence the development of the World Health Organisation 1st International Standard (WHO IS) for ADAMTS13 in plasma.

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Recommendations for the Use of NOD/SCID Mouse Model in Autoimmune- and Drug-Induced Thrombocytopenia
Human platelet survival studies have been hampered due to the lack of a suitable animal model. Transfusion of human platelets into immune competent animals leads to the rapid destruction of these platelets by naturally occurring xenoantibodies. The NOD/SCID mouse lacks T and B cells and therefore lack natural antibodies that could destroy infused human platelets. Because of this property, human platelets given to the mouse intravenously circulate for several days, permitting the model to be used for testing the ability of human antibodies to cause platelet destruction in vivo. Preliminary studies have demonstrated the usefulness of NOD/SCID mouse model to monitor the survival and immune destruction of human platelets. However, differences exist between the research groups regarding the method of PLT injection, the amount and route of antibody injection and the preparation of blood samples collected from the animal making the results poorly comparable.

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