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Published in: Annals of Hematology 12/2016

01-12-2016 | Letter to the Editor

Improvement in hereditary hemorrhagic telangiectasia after treatment with the multi-kinase inhibitor Sunitinib

Authors: Freya Droege, Kruthika Thangavelu, Stephan Lang, Urban Geisthoff

Published in: Annals of Hematology | Issue 12/2016

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Excerpt

Dear Editor, (Table 1).
Table 1
Retrospective assessment of epistaxis severity before medication with Sunitinib, during treatment with Sunitinib, and during the off treatment period (dose of Sunitinib—37.5 mg for 4 weeks followed by 2 weeks off treatment)
 
Before Sunitinib
During Sunitinib treatment
During off-treatment period
Observational period
Several years
5 monthsa
2 weeksa
Epistaxis frequency (times/month)
30
2
4
Average duration [min]
30
3
3
Longest duration [min]
90
3
3
Intensityb
10
1
2
Time lost per day due to nosebleeds [min]c
30
3
3
Subjective impedimentd
Crippled
None
None
Method used to collect the blood
Fully soaked handkerchief
Slightly stained handkerchief
Slightly stained handkerchief
Estimated blood loss [ml]
50
<5
<5
Normalized Epistaxis Severity Score (ESS)
7.46
1.41
1.92
Interpretation suggested by ESS
Severe
Mild
Mild
CTCAEe
2
1
1
min minute
a4 weeks of Sunitinib intake followed by 2 weeks off-treatment
bIntensity measured on a visual analogue scale from 0 to 10 (1 = few drops, 10 = gushing like a tap)
cDuration of minutes per day the nosebleed prevents the patient from doing other activities of daily living
dSubjective impediment by the patient measured on a scale from none, minor, moderate, crippled
eCommon Terminology Criteria for Adverse Events (CTCAE), version 4,03, epistaxis: 1 = mild symptoms, intervention not indicated; 2 = moderate symptoms, medical intervention indicated (e.g., nasal packing, cauterization, topical vasoconstrictors)
Literature
1.
go back to reference Dupuis-Girod S, Bailly S, Plauchu H (2010) Hereditary hemorrhagic telangiectasia: from molecular biology to patient care. J Thromb Haemost 8(7):1447–1456CrossRefPubMed Dupuis-Girod S, Bailly S, Plauchu H (2010) Hereditary hemorrhagic telangiectasia: from molecular biology to patient care. J Thromb Haemost 8(7):1447–1456CrossRefPubMed
3.
go back to reference Hoag JB, Terry P, Mitchell S et al (2010) An epistaxis severity score forhereditary hemorrhagic telangiectasia. Laryngoscope 120(4):838–843CrossRefPubMed Hoag JB, Terry P, Mitchell S et al (2010) An epistaxis severity score forhereditary hemorrhagic telangiectasia. Laryngoscope 120(4):838–843CrossRefPubMed
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go back to reference Robinson K, Gatehouse S, Browning GG (1996) Measuring patient benefit from otorhinolaryngological surgery and therapy. Ann Otol Rhinol Laryngol 105(6):415–422CrossRefPubMed Robinson K, Gatehouse S, Browning GG (1996) Measuring patient benefit from otorhinolaryngological surgery and therapy. Ann Otol Rhinol Laryngol 105(6):415–422CrossRefPubMed
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go back to reference Mendel DB, Laird AD, Xin X et al (2003) In vivo antitumor activity of SU11248, a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor and plateletderived growth factor receptors: determination of a pharmacokinetic/pharmacodynamic relationship. Clin Cancer Res 9:327–937PubMed Mendel DB, Laird AD, Xin X et al (2003) In vivo antitumor activity of SU11248, a novel tyrosine kinase inhibitor targeting vascular endothelial growth factor and plateletderived growth factor receptors: determination of a pharmacokinetic/pharmacodynamic relationship. Clin Cancer Res 9:327–937PubMed
6.
go back to reference Kanellopoulou T, Alexopoulou A (2013) Bevacizumab in the treatment of hereditary hemorrhagic telangiectasia. Expert Opin Biol Ther 13(9):1315–1323CrossRefPubMed Kanellopoulou T, Alexopoulou A (2013) Bevacizumab in the treatment of hereditary hemorrhagic telangiectasia. Expert Opin Biol Ther 13(9):1315–1323CrossRefPubMed
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Metadata
Title
Improvement in hereditary hemorrhagic telangiectasia after treatment with the multi-kinase inhibitor Sunitinib
Authors
Freya Droege
Kruthika Thangavelu
Stephan Lang
Urban Geisthoff
Publication date
01-12-2016
Publisher
Springer Berlin Heidelberg
Published in
Annals of Hematology / Issue 12/2016
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI
https://doi.org/10.1007/s00277-016-2796-6

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