Hydrogen therapy may be an effective and specific novel treatment for aplastic anemia

Medical Application of Hydrogen in Hematological Diseases

Hydrogen gas has been reported to have medical efficacy since the 1880s. Still, medical researchers did not pay much attention to hydrogen gas until the 20th century. Recent research, both basic and clinical, has proven that hydrogen is an important physiological regulatory factor with antioxidative, anti-inflammatory, and antiapoptotic effects. In the past two decades, more than 1000 papers have been published on the topic, including organ ischemia-reperfusion injury, radiation injury, diabetes, atherosclerosis, hypertension, or cancer. We have previously hypothesized and proven the therapeutic effects of hydrogen gas in graft-versus-host disease following stem cell transplantation. In the current manuscript, we present the clinical advances of hydrogen gas in hematological disorders.

Aplastic Anemia and Risk of Incident Atrial Fibrillation - A Nationwide Cohort Study

BACKGROUND

This retrospective cohort study sought to follow up patients with aplastic anemia (AA) to evaluate their risk of developing atrial fibrillation (AF).Methods and Results:From the National Health Insurance Research Database of Taiwan, this study identified an AA cohort (n=3,921), a general population cohort (n=17,617,843) and a propensity score-matched none AA cohort (PSM non-AA cohort in brief, n=15,684) in 2000-2010. By the end of 2011, the incident AF was higher in the AA cohort than in the general population and PSM non-AA cohorts (8.94 vs. 1.14 and 6.47 per 1,000 person-years, respectively). The adjusted hazards ratio of AF for the AA cohort was 2.12 (95% confidence interval 1.46-3.08) compared with the PSM non-AA cohort, after controlling for covariates. However, after further controlling for the competing risk of death, adjusted subhazard ratio was 1.21 (95% CI 0.97-1.50). Among those who developed AF, the AA cohort had a higher mortality rate (83.7 vs. 51.1 per 100), but a lower rate of incident stroke (26.0 vs. 41.5 per 100), compared with the PSM non-AA cohort.

CONCLUSIONS

Patients with AA could have an elevated risk for AF. The mortality risk increased further for those who develop AF.

Aplastic anemia and risk of deep vein thrombosis and pulmonary embolism: A nationwide cohort study

OBJECTIVES

Deep vein thrombosis (DVT) and pulmonary embolism (PE) constitute venous thromboembolism (VTE), which is not fully known in aplastic anemia (AA). Therefore, we investigated the incidence and risk of VTE in AA patients.

METHODS

We conducted a nationwide cohort study to investigate the risk of DVT and PE in patients with AA. We identified patients with newly diagnosed AA as the AA cohort between 2000 and 2010 from the National Health Insurance Research Database (NHIRD). The initial admission date for AA diagnosis was set as the index date. For each patient with AA, 4 patients without a history of AA, frequency matched by sex, age (every 5-y span), and year of index date, were the non-AA cohort. All patients were followed from the index date to the date of DVT or PE diagnosis, withdrawal from the NHIRD, or the end of 2011. Cox models were used to evaluate the risk of developing DVT and PE in the AA cohort.

RESULTS

We included 4001 and 15,998 patients in the AA and non-AA cohorts, respectively, and the overall incidence densities of VTE were significantly higher in the AA cohort than in the non-AA cohort (42.3 vs 10.2 per 10,000person-years). The AA cohort had a 2.56-fold higher risk of VTE (95% confidence interval [CI]=1.81-3.63) than did the non-AA cohort.

CONCLUSION

This nationwide cohort study indicated that AA is associated with increased incidence and risk of VTE.