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  • 1
    Online Resource
    Online Resource
    IOP Publishing ; 2022
    In:  Journal of Radiological Protection Vol. 42, No. 3 ( 2022-09-01), p. 031001-
    In: Journal of Radiological Protection, IOP Publishing, Vol. 42, No. 3 ( 2022-09-01), p. 031001-
    Abstract: A major radiological or nuclear emergency may, apart from causing a substantial loss of life and physical damage, also put a substantial strain on affected societies with social, economic and political consequences. Although such emergencies are relatively uncommon, it is now being increasingly recognised that their subsequent psychosocial impact can be widespread and long lasting. Mental health effects, such as depression, anxiety and post-traumatic stress disorder, are highly represented in a population affected by a radiation disaster. In order to reach the majority of the people affected by radiation accidents, we need to be aware of how to distribute relevant and accurate information related to both short- and long-term medical effects. Effective risk communication is associated with improved compliance with any given recommendations. It is important to protect the public from physical radiation damage, but it is also essential to take into account the social and mental health effects that radiation disasters may induce. This article provides a brief review of recent reporting on the psychological consequences after a major radiation emergency.
    Type of Medium: Online Resource
    ISSN: 0952-4746 , 1361-6498
    Language: Unknown
    Publisher: IOP Publishing
    Publication Date: 2022
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    SSG: 11
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  • 2
    Online Resource
    Online Resource
    IOP Publishing ; 2022
    In:  Journal of Radiological Protection Vol. 42, No. 1 ( 2022-03-01), p. 014004-
    In: Journal of Radiological Protection, IOP Publishing, Vol. 42, No. 1 ( 2022-03-01), p. 014004-
    Abstract: The major immediate and severe medical consequences in man following exposure to high doses of ionising radiation can be summarised within the concept of the acute radiation syndrome (ARS). In a dose-dependent fashion, a multitude of organ systems can be affected by such irradiation, presenting considerable medical challenges to treating physicians. Accidents or malevolent events leading to ARS can provoke devastating effects, but they occur at a low frequency and in a highly varying manner and magnitude. Thus, it is difficult to make precise medical predictions and planning, or to draw conclusive evidence from occurred events. Therefore, knowledge from on-going continuous developments within related medical areas needs to be acknowledged and incorporated into the ARS setting, enabling the creation of evidence-based guidelines. In 2011 the World Health Organization published a first global consensus on the medical management of ARS among patients subjected to nontherapeutic radiation. During the recent decade the understanding of and capability to counteract organ damage related to radiation and other agents have improved considerably. Furthermore, legal and logistic hurdles in the process of formally approving appropriate medical countermeasures have been reduced. We believe the time is now ripe for developing an update of internationally consented medical guidelines on ARS.
    Type of Medium: Online Resource
    ISSN: 0952-4746 , 1361-6498
    Language: Unknown
    Publisher: IOP Publishing
    Publication Date: 2022
    detail.hit.zdb_id: 2010389-X
    SSG: 11
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  • 3
    In: Cell Death Discovery, Springer Science and Business Media LLC, Vol. 8, No. 1 ( 2022-06-11)
    Abstract: The antibody conjugate gemtuzumab ozogamicin (GO; Mylotarg ® ) provides targeted therapy of acute myeloid leukemia (AML), with recent approvals for patients with CD33-positive disease at diagnosis or relapse, as monotherapy or combined with chemotherapeutics. While its clinical efficacy is well documented, the molecular routes by which GO induces AML cell death warrant further analyses. We have earlier reported that this process is initiated via mitochondria-mediated caspase activation. Here we provide additional data, focusing on the involvement of caspase-2 in this mechanism. We show that this enzyme plays an important role in triggering apoptotic death of human AML cells after exposure to GO or its active moiety calicheamicin. Accordingly, the caspase-2 inhibitor z-VDVAD-fmk reduced GO-induced caspase-3 activation. This finding was validated with shRNA and siRNA targeting caspase-2, resulting in reduced caspase-3 activation and cleavage of poly [ADP-ribose] polymerase 1 (PARP-1). We previously demonstrated that GO-induced apoptosis included a conformational change of Bax into a pro-apoptotic state. Present data reveal that GO-treatment also induced Bid cleavage, which was partially reduced by caspase-2 specific inhibition while the effect on GO-induced Bax conformational change remained unaltered. In mononuclear cells isolated from AML patients that responded to GO treatment in vitro, processing of caspase-2 was evident, whereas in cells from an AML patient refractory to treatment no such processing was seen. When assessing diagnostic samples from 22 AML patients, who all entered complete remission (CR) following anthracycline-based induction therapy, and comparing patients with long versus those with short CR duration no significant differences in baseline caspase-2 or caspase-3 full-length protein expression levels were found. In summary, we demonstrate that GO triggers caspase-2 cleavage in human AML cells and that the subsequent apoptosis of these cells in part relies on caspase-2. These findings may have future clinical implications.
    Type of Medium: Online Resource
    ISSN: 2058-7716
    Language: English
    Publisher: Springer Science and Business Media LLC
    Publication Date: 2022
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  • 4
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2011
    In:  Molecular Cancer Therapeutics Vol. 10, No. 11_Supplement ( 2011-11-12), p. A24-A24
    In: Molecular Cancer Therapeutics, American Association for Cancer Research (AACR), Vol. 10, No. 11_Supplement ( 2011-11-12), p. A24-A24
    Abstract: Acute myeloid leukemia (AML) is characterized by uncontrolled expansion of immature leukocytes. It is the predominant leukemia among adults and is generally treated with high dose chemotherapy. This normally results in an initial normalization of the blood- and bone marrow-cell composition (complete remission; CR). Yet, most patients relapse within 1–2 years. Conventional chemotherapy is also associated with severe and at times lethal side effects. Thus, it would be valuable to find both biomarkers capable of predicting treatment response and novel treatment strategies. Here we address both these issues. Identification of biomarkers to predict CR was analyzed by gene expression analysis of AML patient cells. To further understand the potential of gemtuzumab ozogamicin (GO) as targeted agent for AML, profiling of apoptotic signaling in AML patient derived cells and cell lines was performed. Cellular signaling was compared to the conventional drug Daunorubicin. For the biomarker study, gene expression profiling (Affymetrix U133A) was made on leukemic blast cells isolated from AML patients (n=42) with long ( & gt; 6 months).or short ( & lt; 6 months) CR time. Candidate genes were validated using real time quantitative PCR in patient cohorts and individual samples. Ingenuity pathway analysis was applied to sort out critical signaling components involved. The molecular studies of GO response were focused on caspase-2. The AML cell line HL60 was treated in vitro with GO or Daunorubicin with or without caspase-2 inhibitor z-VDVAD. Patient derived blasts were treated in vitro with GO or were untreated. Caspase-2 expression and processing was analyzed using western blotting. Caspase-3, Bak/Bax-activation assays and cell cycle profiling was analyzed using FACS. We found major discrepancies in gene expression when comparing AML patients with long or short CR time. RUNX1T1 is frequently translocated with RUNX1 to produce the characteristic fusion gene (t8;21) in AML and is blocking hematopoietic differentiation. Here we found the transcription factor RUNX1T1 (ETO) to be highly over expressed in patients with short CR duration. Examples of other up-regulated genes in patients with short CR were TKTL1, NUDT4 and CHD3. A number of genes that were lower expressed in patients with short CR were ANXA1, FLRT3 and TLR8. We have molecularly dissected the role of caspase-2 in GO-induced apoptotic signaling and compared its mechanisms of action to Daunorubicin. We found processing of caspase-2 in both GO- and Daunorubicin-induced apoptotic signaling in AML cells and after GO-treatment in patient derived leukemic blasts. A critical role of caspase-2 in GO-induced apoptosis was found as the caspase-2 inhibitor z-VDVAD-fmk reduced both caspase-3 activation and apoptotic morphology with about 50% yet having no effect on GO-induced Bak and Bax activation. These results suggest that caspase-2 is located upstream of caspase-3, in this signaling cascade. In order to further understand the clinical relevance of our findings, we are currently analyzing expression levels of caspase-2 and caspase-3 in patient cells. In conclusion, our gene expression profiling suggest RUNX1T1 to be a marker of CR duration in AML and our molecular profiling suggest caspase-2 to have a critical role in CT response of AML. Thus both these analyzes highlight possible CT resistance mechanisms in AML which warrants further studies. Citation Format: {Authors}. {Abstract title} [abstract]. In: Proceedings of the AACR-NCI-EORTC International Conference: Molecular Targets and Cancer Therapeutics; 2011 Nov 12-16; San Francisco, CA. Philadelphia (PA): AACR; Mol Cancer Ther 2011;10(11 Suppl):Abstract nr A24.
    Type of Medium: Online Resource
    ISSN: 1535-7163 , 1538-8514
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2011
    detail.hit.zdb_id: 2062135-8
    SSG: 12
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  • 5
    In: Experimental Hematology, Elsevier BV, Vol. 37, No. 6 ( 2009-06), p. 755-766
    Type of Medium: Online Resource
    ISSN: 0301-472X
    RVK:
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2009
    detail.hit.zdb_id: 2005403-8
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  • 6
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 5041-5041
    Abstract: Gemtuzumab ozogamicin (GO) is a novel targeted therapy with promising clinical activity in acute myeloid leukaemia (AML). Consisting of a monoclonal CD33 antibody coupled to the toxin calicheamicin, GO enters the cell after binding to the CD33 antigen and releases the toxin intracellularly, resulting in site-specific DNA double-strand breaks (dsb). The more precise cellular and molecular mechanisms behind the clinical response, and resistance to GO remain however incompletely known. With the final aim to identify potential applicable biomarkers related to clinical outcome of GO treatment, we have investigated in vitro effects of GO and of calicheamicin alone, on primary cells isolated from AML patients and on AML cell lines. Cell incubations with GO or calicheamicin at clinically relevant concentrations (10 to1000 and 0.3 to 30 ng/ml, respectively) during 24 to 72 h revealed clear dose and time dependent effects by both drugs on CD33-positive primary cells isolated from an AML patient at diagnosis and on HL-60 cells. A maximum decrease in cell viability of 60% and 80%, respectively, as compared to untreated cells, was noted at 72 h at the highest drug concentrations used (MTT assay). In contrast, GO-induced toxicity was clearly lower in cells obtained from an AML patient in clinically resistant relapse and only minute, even at the highest drug concentrations, in KG1a AML cells. Expression of CD33 (as examined by FACS) appeared to influence the response to GO administered at low to intermediate, but not at higher doses. Thus, GO at 100 ng/ml did not affect viability of CD33-negative HL60 cells, while this dose induced a more than 60% survival reduction amongst CD33-positive HL60 cells. At a higher GO concentration (1000 ng/ml), however, viability was markedly decreased in both cell populations. In contrast, cytotoxicity elicited by calicheamicin appeared independent of CD33-expression at all concentrations tested. These findings support the present notion, that the clinical effect of GO administered to AML patients at sufficiently high doses is not clearly linked to the degree of CD33-positivity of the individual leukemic cell population. Since the active part of GO, calicheamicin, causes site specific DNA dsbs, which may induce apoptosis through the intrinsic apoptotic pathway, we examined activation of the mitochondrial pathway after GO adminstration. GO and calicheamicin were both found to cause mitochondrial depolarization followed by caspase-3 activation in a dose- and time-dependent way in GO-sensitive HL60 cells, and to some extent activation of caspase-3 in the GO-sensitive primary AML patient cells. In contrast, GO failed to induce any of these events in the KG1a cells. When exposed to another DNA damage-inducing cytotoxic substance, etoposide, also KG1a cells showed reduced viability and activation of caspase-3. DNA damage-induced apoptosis has been linked to a sustained activation of the stress-activated protein kinases (SAPKs) such as p38. We observed an increased level of phosphorylated p38 in GO-sensitive HL60 cells as well as in sensitive primary AML cells upon GO-treatment. In contrast, in GO-resistant KG1a cells this GO-induced activation of p38 was not observed, suggesting that activation of p38 is an essential part of GO response. In conclusion, our results from GO-treated primary AML cells and AML cell lines pinpoint the importance, not only of CD33-expression but also of SAPK activation with subsequent initiation of mitochondrial depolarization and caspase-3 activation, as molecular determinants for clinical GO responsiveness.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
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  • 7
    Online Resource
    Online Resource
    American Society of Hematology ; 2008
    In:  Blood Vol. 112, No. 11 ( 2008-11-16), p. 4854-4854
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 4854-4854
    Abstract: Most patients with acute myeloid leukemia (AML) display an initial response to high dose chemotherapy but a majority develops resistance and relapse within 1–2 years. The targeted drug gemtuzumab ozogamicin (GO) has shown promising clinical effects. Consisting of a monoclonal CD33 antibody coupled to a toxin, calicheamicin, GO enters the cell after binding to the CD33 antigen, preferentially expressed on myeloid cells. Calicheamicin is then released from the antibody and causes multiple signaling effects resulting in cell death. We have previously shown that GO-induced apoptotic signaling in AML cells involves activation of the Bcl-2 proteins Bax and/or Bak. In this study we aimed to clarify if altered DNA repair or DNA damage signaling are molecular determinants of GO-sensitivity in AML. Moreover, attempts were made to connect the upstream DNA double stranded break (dsb) signaling to GO-induced activation of Bax and Bak. Therefore, we analyzed GO-induced DNA damage signaling in GO responsive (HL60) and resistant (KG1a) AML cells. We can show that GO-resistant cells display a higher basal activity of γH2AX and DNA-PKcs and hence a higher DNA repair capacity. Moreover, by treating AML cells with clinically relevant doses of GO we have observed an increased level of both γH2AX and phosphorylated DNA-PKcs which indicates the prevalence of DNA dsbs. This activation was observed in HL60 as well as in KG1a cells, in vitro. Thus, our data suggest that resistance to GO is not due to lack of DNA dsbs induction, but is rather influenced by the DNA dsbs signaling to the downstream apoptotic components. Key activators downstream of DNA-PK but upstream of Bak/Bax, including c-Abl, caspase-2, Bid, Bad, Bim, Bcl-2 and Bcl-xL, are therefore currently being analyzed. In conclusion, we show that GO induced DNA dsbs in both GO sensitive and GO resistant AML cells in vitro, and that resistance to GO treatment is at least in part due to factors downstream of DNA-PK but upstream of Bak/Bax activation.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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  • 8
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2009
    In:  Molecular Cancer Therapeutics Vol. 8, No. 12_Supplement ( 2009-12-10), p. B25-B25
    In: Molecular Cancer Therapeutics, American Association for Cancer Research (AACR), Vol. 8, No. 12_Supplement ( 2009-12-10), p. B25-B25
    Abstract: The aim of this study was to identify essential signaling molecules involved in apoptotic cell death in acute myeloid leukemia (AML) cells after treatment with the targeted drug gemtuzumab ozogamicin (GO). New effective therapeutic drugs are highly desirable in the treatment of AML. Although a majority of treated patients initially respond to conventional treatment, most patients will relapse within 1–2 years. Also, the treatment is associated with severe off-target effects. GO is a novel therapeutic approach, consisting of a monoclonal CD33 antibody coupled to a DNA damaging toxin, calicheamicin. GO enters the cell after binding to the CD33 antigen, preferentially expressed on myeloid cells, and cause DNA double strand breaks (DSB). We have previously demonstrated that activation of Bak and Bax is critical for GO-induced apoptotic signaling, followed by downstream mitochondrial depolarization and caspase-3 activation. As a continuation, we have now examined potential proapoptotic signaling events induced by GO upstream of mitochondria in HL60 AML cells in vitro. We identified caspase-2 and the pro-apoptotic BH3-only protein Bid as two candidates. By analyzing caspase-2 by western blotting after GO treatment we found that GO caused cleavage of caspase-2 after 24h, which was prior to mitochondria-mediated signaling. At the same time, full-length Bid was cleaved to its truncated, active form tBid. The importance of caspase-2 activation in the signaling cascade after GO treatment was demonstrated using z-VDVAD-fmk, a caspase 2 inhibitor. Preincubation with this inhibitor reduced caspase-3 activation with around 50%, suggesting that caspase-2 is an important molecule, located upstream of caspase-3, in the signaling between DNA double stranded breaks and apoptosis signaling in AML cells. In conclusion, we demonstrate that GO, at clinically applicable concentrations (100–1000ng/ml), induce pro-apoptotic signaling which involve activation of caspase-2, and cleavage of the BH3-only protein Bid to the truncated, active protein tBid. Blocking caspase-2 activity reduced caspase-3 activation to only half. This suggests multiple signaling pathways capable of activating caspase-3. The caspase-2 pathway appears central for downstream caspase-3 activity, after GO treatment in AML. Our findings may highlight possible resistance mechanisms in AML, which might have profound therapeutic implications. Citation Information: Mol Cancer Ther 2009;8(12 Suppl):B25.
    Type of Medium: Online Resource
    ISSN: 1535-7163 , 1538-8514
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2009
    detail.hit.zdb_id: 2062135-8
    SSG: 12
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  • 9
    In: Blood, American Society of Hematology, Vol. 108, No. 11 ( 2006-11-16), p. 4436-4436
    Abstract: With the object to identify key proteins related to treatment response in acute myeloid leukemia (AML), and to eventually elucidate new targets for therapy, we have investigated protein spectra from diagnostic AML samples. Surface-enhanced laser desorption ionization time-of-flight mass spectrometry (SELDI-TOF MS) was used to spot proteins in the molecular weight area of 2–40 kDa. The samples were applied to two different chip surfaces (CM10 and Q10) for selective protein binding, avoiding the necessity of extensive purification and separation procedures prior to analysis. Peripheral blood samples from a total of 67 acute leukemia patients at diagnosis were analyzed. The cells were collected, frozen and stored in biobanks between 1988 and 2003. This provided a good basis for correlating detected protein peaks to a large number of clinical diagnostic and therapeutic variables and outcomes. Among the patients, aged 18 to 86 yrs, response to induction therapy was observed with complete remission (CR) durations ranging between 12 and 3701 days. The duration of first CR was used as a dichotomic variable in order to compare protein spectra from groups of patients with “good” and “bad” response, respectively, to chemotherapy. A peak detection and annotation software was developed in-house1,2 and employed. The software will be presented and a comparison to commercially available MS-spectral analysis methods will be provided. Initial results from MS profiling of the two response groups showed 18 significantly (p & gt;0.01) differently expressed peaks on anion exchange chips and 22 peaks on cation exchange surfaces. Ongoing work is focused on further development of the RS peak detection method, including the influence of normalisation and filtering of the SELDI data and supervised linear and non-linear modelling. In addition, identification of selected peaks and their relation to various clinical variables is in progress.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2006
    detail.hit.zdb_id: 1468538-3
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  • 10
    Online Resource
    Online Resource
    American Society of Hematology ; 2009
    In:  Blood Vol. 114, No. 22 ( 2009-11-20), p. 3466-3466
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 3466-3466
    Abstract: Abstract 3466 Poster Board III-354 Although high dose chemotherapy induces complete remission (CR) in a majority of treated acute myeloid leukemia (AML) patients, most of these will develop relapse within 1-2 years. Improved predictive biomarkers for response and response duration are clearly needed. We have studied peripheral blood cell samples from 58 AML patients (median age 63 yrs, range 18-86) with the intention to relate RNA and protein expression patterns to clinical outcome. The samples were obtained at diagnosis prior to therapy and stored in our biobank. All patients were treated with anthracycline and cytarabine based induction regimens and all entered CR. Median CR duration was 223 days (range 12 - 3701). The patients were stratified into two groups depending on their CR duration: 〉 6 months (“long”, n=33) and 〈 6 months (“short”, n=25). In an initial analysis of protein extracts derived from the diagnostic peripheral blood cells, using chip-based high throughput proteomics (SELDI-MS), we were able to identify a collection of 21 protein/peptide peaks significantly associated with remission duration (Forshed, J Proteome Res 2008, 7, 2332). We have now proceeded to perform global genomic profiling, using gene array (Affymetrix, Santa Clara, CA, USA), followed by pathway analysis (Ingenuity System Inc, USA) to elucidate differences in signaling networks between the two, clinically different cohorts. In cells from patients with short CR duration, as compared to those with long duration, gene array analysis revealed 10 genes to be up-regulated 〉 30 times, which was confirmed by qPCR. Among the most up-regulated genes were: 1. RUNX1T1 (part of the Runt-related transcription factor family of genes, also called core binding factor-α), up-regulated 116 fold, known to be activated in AML including the M2 subtype, chromosomal translocations involving this gene are well documented in AML. 2. TKTL1 (transketolase 1), up-regulated 53 fold, overexpression reported in various human cancers and claimed to predict a poor patient's survival. 3. U2AF1 (U2 small nuclear RNA auxiliary factor 1), up-regulated 40 fold, reported to play a critical role in both constitutive and enhancer-dependent splicing by mediating protein-protein interactions and protein-RNA interactions. Conversely, among the 10 most down-regulated (by at least 23 fold) genes in cells from patients with short, as compared to long, CR were: 1. ANXA1 (annexin 1), -58 fold, has an inhibitory effect on phospholipase A2 which is required for the biosynthesis of potent mediators of inflammation, such as prostaglandins and leukotrienes. Induction of ANXA1 expression has been proposed as a mechanism of action for the treatment of AML with HDAC inhibitors. 2. FLRT3 (member of the fibronectin leucine rich transmembrane protein family), -48 fold, has a function in cell adhesion and receptor signaling. 3. TLR8 (Toll-like receptor 8), -23 fold, plays a fundamental role in pathogen recognition and activation of innate immunity and promotes NF-kappa-B activation, cytokine secretion and inflammatory response. Synthetic agonists of TLR8 are already in anti-cancer trials as immune response enhancers and TLR8 was recently shown to increase the immunostimulatory capacity also of AML cells. Further data on protein expression of deregulated genes from Western blot and immunophenotypical characterization of cytospin preparations are pending and will be presented. In addition, data on other genes in these signaling networks will be examined and reported. Observed major protein aberrations will be validated in a larger patient cohort available at our center. In summary, comparing AML patient cohorts with short vs. long CR duration our data demonstrate major differences in the RNA-expression of genes known to be involved in important regulatory events in normal and leukemic hematopoiesis. Disclosures No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
    detail.hit.zdb_id: 1468538-3
    detail.hit.zdb_id: 80069-7
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