BackgroundPatients with Ph-negative myeloproliferative neoplasms (MPN), such as polycythemia vera (PV), essential thrombocythemia (ET), and primary myelofibrosis (PMF), are at increased risk for thrombosis/thromboembolism and major bleeding. Due to the morbidity and mortality of these events, antiplatelet and/or anticoagulant agents are commonly employed as primary and/or secondary prophylaxis. On the other hand, disease-related bleeding complications (i.e., from esophageal varices) are common in patients with MPN. This analysis was performed to define the frequency of such events, identify risk factors, and assess antiplatelet/anticoagulant therapy in a cohort of patients with MPN.MethodsThe MPN registry of the Study Alliance Leukemia is a non-interventional prospective study including adult patients with an MPN according to WHO criteria (2008). For statistical analysis, descriptive methods and tests for significant differences as well as contingency tables were used to identify the odds of potential risk factors for vascular events.ResultsMPN subgroups significantly differed in sex distribution, age at diagnosis, blood counts, LDH levels, JAK2V617F positivity, and spleen size (length). While most thromboembolic events occurred around the time of MPN diagnosis, one third of these events occurred after that date. Splanchnic vein thrombosis was most frequent in post-PV-MF and MPN-U patients. The chance of developing a thromboembolic event was significantly elevated if patients suffered from post-PV-MF (OR 3.43; 95 % CI = 1.39–8.48) and splenomegaly (OR 1.76; 95 % CI = 1.15–2.71). Significant odds for major bleeding were previous thromboembolic events (OR = 2.71; 95 % CI = 1.36–5.40), splenomegaly (OR = 2.22; 95 % CI 1.01–4.89), and the administration of heparin (OR = 5.64; 95 % CI = 1.84–17.34). Major bleeding episodes were significantly less frequent in ET patients compared to other MPN subgroups.ConclusionsTogether, this report on an unselected “real-world” cohort of German MPN patients reveals important data on the prevalence, diagnosis, and treatment of thromboembolic and major bleeding complications of MPN.

We describe a four-year experience with bone marrow transplantation involving closely HLA-matched unrelated donors and 55 consecutive patients with hematologic disease who were seven months to 48.6 years old (median, 18 years). An intensive pretransplantation conditioning regimen and graft-versus-host disease (GVHD) prophylaxis with CD3-directed T-cell depletion and cyclosporine were employed. Durable engraftment was achieved in 50 of 53 patients who could be evaluated (94 percent; 95 percent confidence interval, 83 to 98 percent). Acute GVHD of Grade II to IV developed in 46 percent of the patients (confidence interval, 27 to 66 percent). The incidence and severity of acute GVHD were increased in recipients of HLA-mismatched marrow as compared with recipients of phenotypically matched marrow (incidence of 53 percent [confidence interval, 37 to 68 percent] vs. 17 percent [confidence interval, 5 to 45 percent]; P less than 0.05). Extensive chronic GVHD and deaths not due to relapse also tended to be more frequent when HLA-mismatched marrow was used, but not significantly so. With a median follow-up of more than 19 months (range, greater than 9 to greater than 39), the actuarial disease-free survival of transplant recipients with leukemia and a relatively good prognosis (acute leukemia in first remission and chronic myelogenous leukemia in chronic phase) was 48 percent (confidence interval, 24 to 73 percent), and that of recipients with more aggressive leukemia was 32 percent (confidence interval, 18 to 51 percent); the actuarial survival of recipients with non-neoplastic disease was 63 percent (confidence interval, 31 to 86 percent). We conclude that marrow transplantation with closely HLA-matched unrelated donors can be effective treatment for neoplastic and non-neoplastic diseases. Although transplants from phenotypically HLA-matched unrelated donors appear to be most effective, transplants with limited HLA disparity can also be successful in some patients.

JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org. . Allen Press and Society for Range Management are collaborating with JSTOR to digitize, preserve and extend access to Journal of Range Management. A. 1976. Theory and application of the linear model. Duxbury Press, North Scituate, Mass. Jacoby, P.W., and C.H. Meadors. 1983. Triclopyr for control of honey mesquite (Prosopisjuliflora var. glandulosa). Weed Sci. 31:681-685. Jacoby, P.W., C.H. Meadors, and M.A. Foster. 1981. Control of honey mesquite (Prosopisjulifiora var. glandulosa) with 3,6-dichloropicolinic acid. Weed Sci. 29:376-378. Kempthorne, 0. 1979. The design and analysis of experiments. Robert E. Krieger Publishing Co., Huntington, New York. Meyer, R.E., and R.W. Bovey. 1979. Control of honey mesquite (Prosopis juliflora var. glandulosa) and Macartney rose (Rosa bracteata) with soil-applied herbicides. Weed Sci. 27:280-284. Meyer, R.E., and R.W. Bovey. 1980. Hexazinone and other herbicides on Texas woody plants. Weed Sci. 28:358-362. Peach, M. 1965. Hydrogen-ion activity. p. 914-926. In: C.A. Black et. al. (eds.) Methods of Soil Analysis, Part 2. Agron. Monogr. No. 9. Amer. Soc. of Agron., Madison. Wis. Scifres, C.J. 1980. Brush management. Texas A&M Univ. Press, College Station, Texas. Scifres, C.J. 1982. Woody plant control in the post oak savannah of Texas with hexazinone. J. Range Manage. 35:401-404. Scifres, C.J., A. Rasmussen, J.L. Mutz, and B.H. Koerth. 1984. Susceptibility of selected woody plants to hexazinone on South Texas rangelands. Weed Sci. 32:482-488. Scifres, C.J., J.L. Mutz, and C.H. Meadors. 1978. Response of range vegetation to grid placement and aerial application of karbutilate. Weed

5-FU CI is superior to 5-FU bolus in terms of tumor response and achieves a slight increase of overall survival. The hematologic toxicity is much less important in patients who receive 5-FU CI, but hand-foot syndrome is frequent in this group of patients.

The feces of the Shasta ground sloth (Nothrotheriops shastense), preserved by the arid climate of the lower Grand Canyon, were collected at various levels and examined by microhistological analyses to identify and quantify plant taxa in the diet. Over 500 pieces of different Shasta sloth coprolites were examined. Sloth dung from the nearby Muav Caves was examined and compared with that from Rampart Cave.Seventy-two genera of plants were identified in the sloth dung deposited discontinuously from over 40,000 to about 11,000 yr BP. The major plant taxa in the Rampart Cave sloth diets were desert globemallow (Sphaeralcea ambigua = 52%), Nevada mormontea (Ephedra nevadensis = 18%), saltbushes (Atriplex spp. = 7%), catclaw acacia (Acacia greggii = 6%), Cactaceae spp. (= 3%), common reed (Phragmites communis = 5%), and yucca (Yucca spp. = 2%).Six of the most abundant plants in sloth diets were collected in the environs of Rampart Cave and were analyzed for their energy, fiber and nutrient values. The simulated diets of Rampart Cave sloths averaged 1679 cal/g in digestible gross energy and 7.9% for digestible protein. Apart from a substantial increase in digestible energy and in mormontea there was no unusual change in the sloth diet immediately prior to the time of their extinction.The ecological role of Nothrotheriops shastense is less dramatically different from that of extant desert herbivores than was previously believed.