While supply chain resilience has been touched upon frequently, research remains (with the exception of often repeated anecdotal examples) relatively disparate on what disruptions actually are. This research aims to advance theoretical and managerial understandings around the management of supply chain disruptions. A two-stage researchprocess is used which focuses first on polling academic experts. This stage is followed by the extraction of insights from practitioners in the automotive, electronics and food industries. Our findings coalesce around: (1) the types of disruptions that respondents are most concerned about; (2) the associated strategies suggested to cope with disruptions; and, (3) how resilience can be measured. It is apparent that there are some areas where academics and practitioners agree and others where they agree to a lesser extent. Both sets of actors tend to agree on how resilience can be quantified, with recovery time the preferred indicator. However, there is a discrepancy around how resilience is achieved within the supply chain. Academics emphasise the importance of redundancy while practitioners refer more to flexibility. Also, they disagree around what constitutes 'key 2 disruptions': academics suggested high-profile events while practitioners are more concerned with day-to-day problems.
Acquired hemophilia A (AHA) is a rare bleeding disorder caused by the development of specific autoantibodies against factor VIII (FVIII). Immunotherapy is a recent therapeutic option that targets the patient’s self-tolerance against tumor cells. Because therapeutic effects of the immune checkpoint inhibitors (ICIs) are mediated by enhancing the immune response to restore antitumor immunity, autoimmune-related adverse effects can be seen in up to 80% of patients during treatment and after treatment. A rare hematologic ICIs-related adverse event is AHA. Hereafter we report two cases of AHA developed during anti-PD-1 immunotherapy for advanced melanoma: one secondary to treatment with nivolumab and one secondary to pembrolizumab. Both patients were treated with activated FVII (Novoseven®, Novo Nordisk, Bagsværd, Denmark) as hemostatic treatment combined with the eradication of antibodies anti-FVIII obtained with rituximab. In the last few years these drugs have significantly improved the therapeutic armamentarium for the management of AHA. Indeed, while FVIIa has proven to be an effective and safe tool for the treatment of acute bleeding related to FVIII autoantibodies, rituximab is a promising alternative for the autoantibodies’ elimination and the restoration of normal hemostasis. Our finding supports the use of this combination even in AHA secondary to ICIs treatment.
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