Hepatitis B-Associated Symptomatic Iron Overload, with Complete Resolution after Nucleoside Analogue Treatment.

Symptomatic iron overload and hyperferritinemia are rarely mentioned as complications of chronic hepatitis B infection. We report a case of a 70-year-old woman who presented with symptoms of iron overload including aches in the calves, fatigue, poor appetite, and low mood. Laboratory results showed a serum ferritin of 2449 µg/L and transferrin saturation of 74%. Her symptoms completely resolved with hepatitis B antiviral treatment. Serum ferritin and transferrin saturation also normalized. Symptomatic iron overload is a rare yet clinically important complication that can result from chronic hepatitis B infection.

Influence of family income and medical insurance coverage on health-related quality of life and optimism in cancer patients at a Hong Kong private hospital: A cross-sectional study.

OBJECTIVE: Health-related quality of life (HRQL) and optimism are important health domains that express the physical, emotional, and psychological well-being of cancer patients. Previous studies have explored income and medical insurance coverage as predictors of their well-being with the aim to better understand their financial needs. The primary objective of this study was to examine the associations in the private health sector in Hong Kong. METHODS: The study was conducted cross-sectionally with a structured questionnaire in traditional Chinese. HRQL was assessed with the RAND 12-item Health Survey, and optimism was assessed with the Life Orientation Test. The two primary predictors were family income and medical insurance coverage. The associations were tested using logistic regression, controlling for other sociodemographic and clinical covariates. RESULTS: A total of 428 questionnaires were used in the regression model. After adjusting for other covariates, no significant association was observed with family income as the predictor. Medical insurance coverage was a significant and positive predictor of optimism with odds ratio of 2.30 and 95% confidence interval of 1.30 to 4.05 for the group with the most coverage with little to no coverage as the reference group. CONCLUSIONS: The significant association between medical insurance coverage and optimism might be an indication that the medical cost was a financial burden to many cancer patients in Hong Kong. In addition to their medical needs, cancer support organization and health care practitioners must be able to recognize and assist with the financial needs of the cancer patients.

Treatment of elderly patients with acute myeloid leukemia with azacitidine results in fewer hospitalization days and infective complications but similar survival compared with intensive chemotherapy.

AIMS: Azacitidine has been shown to prolong overall survival (OS) compared with best supportive care in elderly patients with acute myeloid leukemia (AML) with low blast counts but it is unknown if azacitidine has a similar efficacy in patients with blast counts of >30%. It is also unknown if azacitidine is comparable to intensive chemotherapy in terms of survival and morbidity. METHODS: Differences between the outcomes of elderly AML patients who received intensive chemotherapy, azacitidine-based therapy or best supportive care are studied in this retrospective review. Patients 60 years or older diagnosed with AML between January 2009 and June 2011 were included. Those who passed away within less than 2 weeks of diagnosis were excluded. RESULTS: At a median follow-up of 7.2 months (range: 0.5-26.4 months), estimated median OS for patients who received azacitidine-based therapy was 9.8 months (range: 2.4-22.5 months) compared with 8.9 months (range: 0.9-26.4 months) for patients who received intensive chemotherapy (P=0.89). Compared with azacitidine-based therapy, intensive chemotherapy is associated with more inpatient days and episodes of febrile illness requiring inpatient stay or intravenous antibiotics. CONCLUSIONS: Compared with intensive chemotherapy in elderly patients with AML, azacitidine-based therapy is associated with similar median survival but lower number of hospitalization days and infective episodes.

Maintenance therapy with imatinib appears necessary despite molecular remission in FIP1L1-PDGFRA fusion gene positive hypereosinophilic disorder.

Patients with primary hypereosinophilic disorders who are positive for the FIP1L1-PDGFRA fusion gene mutation are highly responsive to therapy with imatinib mesylate. A 35-year-old man with FIP1L1-PDGFRA positive hypereosinophilic syndrome and cardiac involvement, was treated with imatinib 100 mg daily. Hematologic and molecular remission and reversal of end-organ damage was achieved. He was then lost to follow up for 19 months. Imatinib successfully reinduced hematologic and molecular remission but worsening cardiac involvement was not reversed. Our experience and a review of limited literature suggest that imatinib maintenance therapy is necessary despite molecular remission of the FIP1L1-PDGFRA mutation.