University of the Sciences in Philadelphia. Q. Faesul, MD: "Discount Alli express".

Contain again for hemostasis generic alli 60mg without a prescription weight loss pills that are fda approved, relate a bladder CD000154 6 best order alli weight loss 05 kg per week. Intrauterine devices catheter and a vaginal bale for almost and intrauterine systems proven 60 mg alli weight loss pills yahoo answers. Cyclical progestogens REFERENCES for dreary menstrual bleeding purchase alli weight loss images. Clinical workout guidelines on menorrhagia: manage- Evaluation of menstrual blood injury in patients com- ment of peculiar uterine bleeding forward of menopause purchase pamelor 25 mg mastercard. Br J Obstet Gynaecol 1977;84: Eur J Obstet Gynecol Reprod Biol 2010;152:133-7 763-8 2 order 25mg clozaril fast delivery. A decade of hysterectomy in Directors of extraordinary uterine bleeding in low- and a tertiary hospital in urban Niger-Delta region of high-resource settings: caring of cultural issues discount cefixime on line. Nigerian J Clin Pract 2008;11:359-63 Semin Reprod Med 2011;29:446-58 232. Kolk INTRODUCTION the hindrance with all these figures is that in low-resource settings, the registration of women Ectopic pregnancy is defined as a pregnancy in having an ectopic pregnancy is -off from complete. Multifarious women the two fallopian tubes or, more almost never, in the abdo- 1 with an ectopic pregnancy last wishes as vulnerable, and thus minal hollow or the cervix. Ectopic pregnancy is not call in a hospital; after tubal abortion, blood reduction one of the usual emergencies encountered in and symptoms may stop. The quantity of un- obstetrics and gynecology and is a normal condi- detected ectopic pregnancy is consequence uninvestigated. It is worthy to bear Only a reduced integer of women choice be gifted (fitting at least a central insight about this quarters and to divers factors) to reach a health alacrity and to see its symptoms. When an ectopic preg- will be diagnosed correctly and in heyday with having nancy ruptures it is a medical danger and is an ectopic pregnancy. Women who in the worst a life-threatening adapt. Hence originally diagnosis, prior to breaking and According to the Universe Health Organization hemorrhage, is extremely important. Ideally united (WHO), degree in the developing world varies should perceive every ectopic pregnancy first it between unified ectopic pregnancy per 50 200 preg- 3,4 ruptures and becomes a life-threatening requisite. A muse about conducted in Ghana showed the most important fixation is to victual in mind that a degree rates as great as a person ectopic pregnancy in 5 strife with unerring complaints might demand an every 44 deliveries. Ectopic pregnancy is a critical ectopic pregnancy and needs to be seen urgently away cause of maternal death there the existence, with a health professional in a clinic preferably with a holder fatality rates in the developing universe (hospital- 4 stagecraft and a skilled doctor who can perform a based figures) of 1 4%. In some Early detection is of without a doubt important to pre- countries, up to 9% of all nurturing deaths are caused 4,6,7 mofette tender destruction (Outline 1). An extra- primarily if her fertility is significantly reduced after uterine pregnancy is 50 times more right to evolve 1 an ectopic pregnancy. Skeleton key points Ectopic pregnancy is an difficulty proviso. Intrauterine stratagem It is a critical agent of tender cessation. As any contraceptive method reduces the entire It is notable to admit it at an early lap. However, when a woman with an IUD tion and appropriate treatment is absolutely outstanding. There might should always merit in consider castigate that there are several be a bit higher unexpected of getting an ectopic after endanger factors contributing to developing an ectopic the smoke of an IUD in the old times15. The main chance factors are shown in ducted in Lagos showed an increased chance of scarcely Eatables 12,8 11. Whilom STIs and unwanted pregnancies a credible infection with Chlamydia trachomatis was much number of ectopic pregnancies can be prevented. Other studies also showed a relationship propagative tutelage at all ages starting at a callow length of existence is with an infection with Neisseria gonorrhoeae. Majority, marital/socioeconomic importance and fleshly partners, above ectopic pregnancy, parity were not noteworthy gamble factors since ectopic sterilization and previous induced abortion. Nevertheless, an advanced length of existence of procreative launch Ectopic pregnancy is linked to STIs. SIGNS AND SYMPTOMS In one chew over, the chance factors payment an ectopic to sunder were a previous history of ectopic preg- the signs and symptoms of an ectopic pregnancy nancy and analogy13. Other enquiry found that can be veiled or exceptionally acute in the the truth of a ruptured higher ОІ-human chorionic gonadotropin (hCG) ectopic pregnancy, depending on the amount of 116 Ectopic Pregnancy internal hemorrhage. You can set up a difference in spirit fee) with a harassing abdomen which can show an keen and a subacute image. This differ- signs of an dangerous abdomen: guarding and bounce ence is caused in most cases next to the items that there is tenderness. If you do desire to polish off a vaginal a ruptured or unruptured ectopic pregnancy. In exam (see Chapter 1 on how to do this), do it care- most cases it means the rest between investi- fully, because it can issue an unruptured ectopic to gating the patient more absolutely with more splitting. You may find cervical wave tenderness extensive diagnostic procedures (if tenable) or the with a soft minute uterus and adnexal tenderness. As the perplexed the pretended decidual cast (decidualized endo- patient is stable there is hour to polish off diagnostic metrium that is now expelled in ectopic preg- tests (speak with Chapter 9).

Thigh-length versus below-knee stockings initiated in the next 24 hours if the VTE occurred in the pattern 12 an eye to the waves venous thrombosis prophylaxis after beat: a randomized probationary order 60mg alli otc weight loss pills for breastfeeding mothers. In r‚sum‚ cheap 60mg alli mastercard weight loss las vegas, as our knowledge of the verifiable risks of pharmacopro- 15 purchase 60 mg alli fast delivery weight loss running. Effectiveness of spasmodic phylaxis in pregnancy and VTE danger stratification in pregnancy has pneumatic compression in reduction of risk of deeply streak thrombosis in evolved order alli online weight loss kidney disease, we have developed a clearer spit of who should and patients who be struck by had a dash (CLOTS 3): a multicentre randomised who should not come into pharmacoprophylaxis to prevent pregnancy- controlled distress order on line malegra fxt plus. Pradax Artefact Disquisition: Dabiga- this information to deliver the settle offset in preventing pregnancy- tran Etixilate Capsules; 2009 discount meldonium 250 mg without prescription. Xarelto Effect Treatise cheap avana 200 mg fast delivery, Rivaroxaban Tablet; 2008. VTE, thrombophilia, Disclosures antithrombotic remedy, and pregnancy: Antithrombotic Remedy and Conflict-of-interest disclosure: the founder declares no competing Obviation of Thrombosis, 9th ed: American College of Trunk Physi- financial interests. Off-label drug use: LMWH to balk VTE in cians Evidence-Based Clinical Realistically Guidelines. Gamble in return heparin-induced thrombocytopenia with unfractionated and low-molecular-weight heparin thromboprophy- Correspondence laxis: a meta-analysis. Marc Rodger, Chief, Allotment of Hematology, Chief Scientist, 20. Osteoporotic fractures and the recurrence of thromboem- Ottawa Hospital Analysis Institute, Ottawa Medical centre, General bolism during pregnancy and the puerperium in 184 women undergoing Campus, 1812-E Box 201, 501 Smyth Road, Ottawa, ON, Canada thromboprophylaxis with heparin. Long-term dalteparin in pregnancy not associated with a decrease in bone mineral density: References substudy of a randomized controlled trial. Simpson EL, Lawrenson RA, Nightingale AL, Agriculturist RD. Chance stratification and additional chance factors from a London perinatal database. Venous thromboembolism mortality in the United States, 1998 to 2005. Antepartum dalteparin Reviewing fond deaths to get to motherhood safer: 2006-2008: the versus no antepartum dalteparin for the prevention of pregnancy Eighth Piece of the Confidential Enquiries into Understanding Deaths in the complications in loaded women with thrombophilia (TIPPS): a Collective Principality. Aspirin advantage heparin or versus no antepartum dalteparin for the fending of pregnancy aspirin unescorted in women with repetitious non-fulfilment. An ultrasound think over of gesta- Intervention Den: a multicentre randomised controlled inquisition of dirty tional and postural changes in the abstruse venous system of the leg in molecular substance heparin and low prescribe aspirin in women with continual pregnancy. Huhle G, Geberth M, Hoffmann U, Heene DL, Harenberg J. The value of family life as a danger for recompense venous ment of heparin-associated thrombocytopenia in pregnancy with subcu- thrombosis. Comparing profound vein thrombosis and pulmonary embolism during pregnancy or multiple competing interventions in the absence of randomized trials dispatch partum: a population-based, case-control study. Jeopardize factors for first venous factors of venous thrombosis: a hospital-based case-control chew over. J thromboembolism roughly pregnancy: a population-based wing study Thromb Haemost. Prophylaxis with venous thrombosis in carriers of dour inherited thrombophilia. Thromb low-dose low-molecular-weight heparin during pregnancy and postpar- Haemost. Jacobsen AF, Dahm A, Bergrem A, Jacobsen EM, Sandset PM. J Thromb Hae- returning early-onset pre-eclampsia in women with inheritable thrombo- most. Conard J, Horellou MH, Van DP, Lecompte T, Samama M. Above moreover of enoxaparin to aspirin and pregnancy in congenital deficiencies in AT III, protein C or protein pro the indirect restraining of placental vascular complications in S: contemplate of 78 women. Thromb heparin in replete women with a history of venous thromboembolism: Haemost. Activated protein C tive, randomized, multicenter, controlled clinical judicial proceeding. Prothrombin gene G20210A recurrence of placental-mediated complications of pregnancy in women mutation and obstetric complications. Thromboprophylaxis and polymorphisms and pregnancy outcomes in nulliparous women. Obstet pregnancy: two randomized controlled steer trials that used low- Gynecol. Burrows RF, Gan ET, Gallus AS, Wallace EM, Burrows EA. Trends in the degree of after caesarean element: a shepherd over. Tengborn L, Bergqvist D, Matzsch T, Bergqvist A, Hedner U. Repetitious thrombosis and pulmonary embolism: the Worcester mull over. Principal Intern thromboembolism in pregnancy and puerperium.

Syndromes

• Pain
• Retrograde ejaculation
• Abdominal CT scan
• Scarring
• Bleeding
• Fever and chills
• Post-streptococcal GN
• Eye and nose irritation (burning, tearing, redness, or runny nose)
• Checking it as often as instructed by your diabetes health care provider and keeping a record of your numbers so you know the things that affect your level

The 1 lawsuit that evaluated simvastatin compared to fixed-dose ezetimibe/simvastatin 295 coalition (10 mg/40 mg) demonstrated no change in high-density lipoprotein cholesterol buy alli 60 mg visa weight loss xbox 360 games. We conducted a random-effects meta-analysis of placebo-controlled trials reporting the transmute from baseline in high-density lipoprotein cholesterol levels in children with familial 285-289 purchase alli 60mg online weight loss 9 weeks, 291 order genuine alli on-line weight loss for kids, 292 hypercholesterolemia (Idol 3) purchase alli amex weight loss pills stars use. Seven trials contributed text to the meta-analysis discount 5 mg escitalopram with mastercard, representing 472 patients compelling a statin and 320 taking a placebo buy risperidone 3mg with mastercard. Blanket discount sildalis 120mg amex, the pooled result indicated that statins increased high-density lipoprotein cholesterol alongside 3% (95% CI, 0. Total the discrete statins, single pravastatin significantly increased high-density lipoprotein cholesterol, with a 5% change (95% CI, 0. The without fail difference from placebo was nonsignificant with a view the other statins. How do statins and fixed-dose association products containing a statin and another lipid lowering antidepressant bear in their skill to ease up on the risk of nonfatal myocardial infarction, coronary condition (angina), coronary sentiment blight mortality, all-cause mortality, tittle, hospitalization for unstable angina, or necessary for revascularization (coronary artery go implantation, angioplasty, or stenting)? Ornate assessment Nonfatal myocardial infarction, coronary blight (angina), coronary soul cancer mortality, all- call mortality, touch, hospitalization for unpredictable angina, or destitution for revascularization (coronary artery go corruption, angioplasty, or stenting) are outcomes that manifest itself pre-eminently in adults. There were no studies in children that had sufficient backup to upon the clout of treatment with statin or fixed-dose consortium products containing a statin and another lipid- lowering drug on the danger of these outcomes. As a surrogate end-point, trials drink demonstrated the power of statins on intima-medial thickness, arterial stiffness, and endothelial 289 function. Are there differences in effectiveness of statins and fixed-dose coalition products containing a statin and another lipid lowering slip someone a mickey finn in another demographic groups or in patients with comorbid conditions. Summary of findings No trials arrange evaluated statins in children with diabetes or bulk. A given scrutiny demonstrated 21% reduction in low-density lipoprotein with simvastatin in children with neurofibromatosis 1. Circumstantial assessment We identified no trials of statins and fixed-dose alliance products in children with diabetes or rotundity. One about of simvastatin compared to placebo in children with neurofibromatosis 1 demonstrated a reduction in low-density lipoprotein cholesterol (21% looking for simvastatin; low- density lipoprotein reduction for the duration of placebo group not reported) but no coins in high-density 296 lipoprotein. Statins Page 76 of 128 Final Boom Update 5 Drug Effectiveness Magazine Project Main Question 5. Are there differences in the harms of statins or fixed-dose claque products containing a statin and another lipid lowering medicate when in use accustomed to in the regular people of children? Summary of findings Adverse events were variably reported; methods of detection and assessment of adverse events were often not specified. Detailed assessment Communication on harms of statins and fixed-dose set products in children was obtained from randomized-controlled trials, controlled clinical trials, non-controlled dispute series, and action reports. Evidence on adverse events from clinical trials is variably reported; methods representing detection and assessment of the adverse events were ordinarily not specified. Several studies reported that aspartate aminotransferase and alanine aminotransferase remained underneath twice or 3 times the upper limit of normal. This was unwavering an eye to 24-48 weeks of 286, 287 291 treatment lovastatin, 28 weeks of simvastatin, and 12 weeks to 2 years of treatment with 288, 289, 297 285 pravastatin. Reports of elevations in transaminases occurred with atorvastatin, 295 simvastatin-ezetimibe combinations, and rosuvastatin (in a tribulation that included both adults and 293 children with homozygous familial hypercholesterolemia). In studies that reported increased transaminase levels during statin treatment, these levels returned to regular with treatment 285, 291, 295 lacuna or discontinuation of the statin. Similarly, multiple studies reported no meaningful elevations in creatine kinase once more the 285-287, 289, 293 study interval. Another on reported a single descendant with creatine kinase prominence (>10 times the upper limit of natural) without muscled symptoms, which occurred with concomitant government of simvastatin and erythromycin and returned to normal after finish of the antibiotics, and 2 children with increases in creatine kinase (>5- 292 go bust the characters upper class limit of normal) that returned to routine in reproduce tests. Several studies also cited no significant or no serious adverse events, or impartial no 286, 291, 298 adverse events. Such statements in these studies need rigorous definitions of the methods familiar to trace in support of and identify adverse events. Other studies stated that the prevalence of 287, reporting any adverse events was equivalent between the treatment and steer (placebo) groups 288, 291 285, 292, 295 or reported the extent of adverse events to evince that locale. Treatment- 286 cognate adverse effects were reported as 8. Are there differences in the harms of statins or fixed-dose array products containing a statin and another lipid lowering medicate when hand-me-down in special populations or with other medications (drug-drug interactions)? Outline of findings One inquiry of fluvastatin in children with token variation glomerulonephritis demonstrated shrink in whole cholesterol and reported no side effects. Detailed assessment Harmonious ruminate on of children with littlest change-over glomerulonephritis (MCGN) assigned 36 patients to 299 20 mg of fluvastatin or dipyridamole instead of 2 years. The dominant lessons outcome was bone mineral density, after which there was no revolution beyond the despatch of the investigation. Hematuria decreased significantly, and creatinine allowance, total protein, and albumin increased compared to baseline in the statin bring, but not the dipyridamole gather. The authors observed no side effects in any of the patients over the treatment days. BRIEF Edibles 15 summarizes the level and course of bear witness in support of each key certainly. Epitome of the support nigh key matter Soundness of Legend proposition beyond the shadow of a doubt data Conclusion ADULTS 1. How do statins and fixed-dose Benign the acme haunt would be a double-blind, intention-to-treat colloid products containing a randomized judicial proceeding in which equipotent doses of different statin and another lipid-lowering statins were compared with attention to to low-density cure correspond in their cleverness to lipoprotein-lowering, withdrawals, and adverse effects. No shorten low-density lipoprotein studies met these stringent criteria.

Piercing basophilic leukemia ЎThree or more chromosome abnormalities in the scarcity of united of the WHO- Acute panmyelosis with myelofibrosis (also known as grave designated recurring translocations or inversions: t(15;17) purchase alli once a day weight loss newborn, t(8;21) purchase alli pills in toronto weight loss juice cleanse, inv(16) or myelofibrosis; sudden myelosclerosis) t(16;16) order alli with visa weight loss pills gnc reviews,t(9;11) discount alli 60mg online weight loss 6 week plan,t(v;11)(v;q23) purchase exelon 6mg line,t(6;9) prilosec 40 mg without prescription,inv(3) cheap plavix 75 mg with visa,ort(3;3). Myeloid sarcoma (also known as extramedullary myeloid tumor, granulocytic sarcoma, chloroma) Diagnostic work-up/disease classification Myeloid proliferations allied to Down syndrome Based on the revised Age Health Systematizing (WHO) publica- Transient peculiar myelopoiesis (also known as fleeting tion WHO Classification of Tumors of Hematopoietic and Lymphoid myeloproliferative fracas) Tissues,7 a amount to of 7 entities are defined within the subgroup AML Myeloid leukemia associated with Down syndrome with returning genetic abnormalities. All other entities in ABL1 Conflicting phenotype intense leukemia with t(v;11q23); MLL rearranged this category require the companionship of at least 20% BM blasts at Varied phenotype alert leukemia, B/myeloid, NOS diagnosis based on morphology. Two probationary entities defined not later than Adulterated phenotype discriminating leukemia, T/myeloid, NOS the carriage of gene mutations were added to this type: AML Pro tem thing: Basic killer stall lymphoblastic leukemia/lymphoma with mutated NPM1 and AML with mutated CEBPA. The variety AML with mutated NPM1 is at hand far the largest subgroup defined ForadiagnosisofAML,aBMblastcountof 20%isrequired,exceptforAMLwith by way of genomics, with a consequential degree in both young and older AML the intermittent genetic abnormalities t(15;17), t(8;21), inv(16), or t(16;16) and some 8-10 casesoferythroleukemia. Howsoever, the association with cooperating genetic NOSindicatesnototherwisespecified. The favorable prognostic strike of mutant CEBPA eage dysplasia; AND non-attendance of both ex cytotoxic cure for different illness that was demonstrated in the old days in a variety of studies can be attrib- and aforementioned recurring genetic abnormalities; cytogenetic abnormalities uted to the subtype of AML with CEBPAdm. In patients with cytogenetically healthy (CN) AML, agents,ionizingradiationtherapy,topoisomeraseIIinhibitors,andothers. Hematology 2013 325 Interestingly, RUNX1 mutations are wellnigh mutually exclusive of Tabular 3. Categorization and frequency of gene mutations according other disease-defining genetic aberrations such as NPM1, CEB- to functional properties based on next-generation sequencing in PAdm, CBFB-MYH11, RUNX1-RUNX1T1, and PML-RARA. PML-RARA CBFB-MYH11 RUNX1-RUNX1T1 A late-model critical leaflet next to the Cancer Genome Atlas PICALM-MLLT10 Scrutinization Network on the genomic and epigenomic landscapes of NPM1 mutations 27% full-grown de novo AML reported results from next-generation sequenc- Tumor suppressor genes 16% ing performed in 200 AML patients (n 50 whole-genome sequenc- TP53 ing, n 150 whole-exome sequencing). The median platoon of mutated DNA methylation 44% genes in coding sequences was 13 (range, 0-51). The investigators DNMT3A proposed a classification of gene mutations into 9 categories based DNMT3B on their biological act as, with 199 of the 200 analyzed patients DNMT1 having at least identical transmuting in 1 of these categories (Columnar list 3). These TET1 TET2 findings intent to all intents influence the time to come condition classification IDH1 system. IDH2 Activated signaling 59% Prognostication of response to induction psychoanalysis FLT3 the acquirement of CR after induction therapy is a commonly GEAR accepted indispensable for long-term survival and nostrum. CR rates diverge Other tyrosine kinases thoroughly in the diverse prognostic groups (Table 1), from 80% to Serin-threonine kinases 95% in the favorable peril platoon to solitary 32. In this position, Other myeloid transcription factors molecular and cytogenetic markers may alleviate to manage patients and Chromatin modifiers 30% their families through the risks and benefits of induction MLL fusions chemotherapy. MLL-PTD NUP98-NSD1 Genetic mutations also aid in predicting response. NPM1 mutations, ASXL1 one of the most frequent gene mutations (occurring in 25%-35% of EZH2 all adults with AML)23 procure uniformly been reported as a KDM6A favorable prognostic cause in the direction of CR realization, with CR rates of Other 90% and higher in younger patients either as a one marker or as Cohesin complex* 13% combined genotype, NPM1-mut/FLT3-ITDneg. The uniting of all-trans retinoic acid to intensified induction remedy24 and the TP53 alterations including mutations and losses are found in intensification of daunorubicin within a ordinary 7 3 regimen25 approximately 70% of AML with complex karyotype. Whether FLT3-ITD adds value in prognostication been shown to be an independent sterile prognostic fact centre of the of CR rate on the unnoticed of NPM1 is flat a event of reflection. Whether more novel Schneider et al showed no smashing of FLT3-ITD on CR rates in either agents, such as the demethylating agents, may overhaul the sad NPM1-mutated or NPM1 wild-type AML. Such markers comprehend mutations of the DNMT3A (incidence adult AML and the frequency decreases with increasing age. Prognostication of rejoinder to induction treatment CR sort Years 60 y; Life-span 60 y; Period 60 y; exhaustive induction intensive induction nonintensive treatment Reference(s) Favorable marker RUNX1-RUNX1T1 80% 90% 70% 80% N/A 1 CBFB-MYH11 80% 90% 70% 80% N/A 1 NPM1-mut 80% 90% 80% 90% 50% 1,24,25,26 CEBPAdm 80% 90% N/A N/A 11 14 Unfavorable marker Monosomal 30% 35% 30% 35% N/A 1,20 karyotype TP53 every other 25% 30% 25% 30% N/A 28 inv(3) or t(3;3) 31% N/A N/A 21 N/Aindicatesnotavailable. Prognostication of relapse and OS Transplantation (EBMT) scores (Table 5). Although allo-HSCT is considered as the PRT with ITDneg, and CEBPAdm were grouped into the good-risk division, the strongest antileukemic carry out, the benefit of allo-HSCT on OS whereas AML with monosomal karyotype, abn(3q), and those with may be compromised during nonrelapse treatment-related mortality. Based on the integrated HSCT, (2) treatment-related mortality of allo-HSCT, and (3) determined come near, allo-HSCT represents the most appropriated PRT in and transplant-specific parameters such as comorbidity, donor type, patients with low HCT-CI and EBMT scores in the categories and age reflected by the hematopoietic apartment transplantation comorbid- medial, wiped out, and danged hard up. No matter what, the recommendations ity index (HCT-CI) and European Body In return Blood and Marrow become more complex, above all in the intermediate- and poor-risk Table 5. Hematology 2013 327 groups, with rising HCT-CI and EBMT scores. Two principal shortcom- constant impression on survival indecisive points in the whole assortment. In the following, these Generally two-thirds of RUNX1 mutations are base in 2 aspects are highlighted according to gamble arrange proposed past the CN-AML and cause been associated with a extraordinarily unfavorable ELN AML Working Side. Consequently, the question arises whether the In patients with seed binding factor (CBF) AML, GEAR mutations 23,38 appearance of RUNX1 mutations should in the tomorrow be categorized as secure been associated with an increased going back gauge (Tabular 5). How in the world, before long, merited to the inconsistencies in 37 offered an allo-HSCT if a CR is achieved. TP53 alterations are the within reach figures, cooperating gene mutations in CBF-AML should closely associated with a complex and in express also with a not be acquainted with to direct treatment decisions. In AML exhibiting the 28 monosomal karyotype, so the adulthood are already categorized in genotype NPM1-mut/FLT3-ITDneg two reports from cooperative the very-poor-risk group. Anyhow, if a CR is achieved, allo-HSCT study groups showed a unenthusiastic colliding of cooperating IDH1/2 33,34 should be offered if practicable. Futures studies inclination be needed to mutations on relapse-free survival and OS. In contrast, Patel et dictate whether persistence therapy, such as cure with al reported on a favorable impression of the genotype NPM1-mut/FLT3- 25 hypomethylating or other blockbuster agents, may improve survival of ITDneg only if cooperating IDH1/2 mutations were present. Such those patients who are powerless to proceed to allo-HSCT.