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Foreword – US Hematology, 2007;1(1):5

Published Online: August 20th 2011 US Hematology, 2007;1(1):5
Authors: Louis M Aledort
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When choosing the topics to cover in a reasonable and readable space in US Hematology 2007, we had to pare down the field. Experienced hematologists were chosen to help elucidate current thinking and controversies.

When choosing the topics to cover in a reasonable and readable space in US Hematology 2007, we had to pare down the field. Experienced hematologists were chosen to help elucidate current thinking and controversies.
The field of thrombophilia and its attendant high-prevalence thrombotic disorders is frequently encountered by hematologists. The rapid expansion of our understanding of thrombotic risk factors and therapeutic implications remains an evolving state of the art. Advances in our knowledge of hemophilia, inhibitors, and thrombocytopenia and resultant hemorrhagic disorders have made possible a variety of diagnostic and therapeutic tools.
In the field of transplantation therapy, the political ‘football’ of stem cells has now become a therapeutic tool for the management of a variety of diseases, from primary hematological disorders to cardiac disease. Immunology is becoming more difficult than ever to distinguish from hematology. This is particularly true in idiopathic thrombocytopenic purpura, circulating anticoagulants, and graft-versus-host disease. The recognition that dendritic cells are the key antigen-presenting cells is receiving a great deal of attention.
Our knowledge of the existence of hemoglobinopathies and of hemophilia is old. However, advances in basic science have offered us new tools to better recognize genetic disorders. This has led to greater understanding of rare disorders such as Fanconi’s anemia and Gaucher’s disease, which may lead to better strategies in terms of prevention and therapeutic interventions.
Since the emergence of the field of transfusion therapy during World War II, transfusion has played—and continues to play— a significant role in many diseases. The challenge of iron overload in chronically transfused patients is now amenable to treatment. Transfusion has even been shown to prevent thrombosis in sickle cell disease. The exciting area of alternatives to transfusion is also addressed in this publication.
The recognition of the now most commonly diagnosed hematological disorder—myelodysplasia—has attracted much attention. Physicians face the challenge of managing anemia, thrombocytopenia, and infection, as well as the risk of progression to fibrosis and leukemia. Low-risk myelodysplastic syndrome is a challenge in terms of prognosis and therapy.
Many of these issues are addressed in US Hematology 2007. These reviews are not meant to resolve all of the issues, but rather to raise the level of awareness of new frontiers in the approach to these diseases. ■

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