Nikita Mepani

The key person I relied on Dr Ailsa Hart BA (Hons) BMBCh FRCP PhD Trained in medicine at Oxford University. We have to trust our Doctors "I have been feeling really unwell and am scheduled to fly, what is wrong with me, should I cancel?" Test that would have saved Nikita. 1. Bone Marrow 2. PET Scan

Miss Nikita Mepani 30th July 1992 - 20th July 2012. Past away before her time.

nature publishing group T-Cell Non-Hodgkin ’ s Lymphomas Reported to the FDA

WHAT IS CURRENT KNOWLEDGE Risk of lymphomas is higher with the use of TNF- α inhibitors used in combination with thiopurines or thiopurines alone. Hepatosplenic T-cell lymphoma (HSTCL) is a rare but lethal form of T-cell non-Hodgkin ’ s lymphoma (NHL) reported with the use of thiopurines alone and in combination with TNF- α inhibitors. WHAT IS NEW HERE T-cell NHLs are most commonly reported with TNF- α-inhibitor exposure when used in combination with thiopurines. Mycosis fungoides / Sezary syndrome are also commonly reported with TNF- α-inhibitor exposure. Reported risk of T-cell NHL is higher with TNF- α inhibitor used in combination with thiopurines and not when used alone.

Tumor Necrosis Factor Blockers and Malignancy in Children

Forty-eight reports of malignancy in children were identified: 31 following infliximab use, 15 following etanercept use, and 2 following adalimumab use. Half of the malignancies reported were lymphomas and included both Hodgkin’s and non-hodgkin’s lymphoma.

Long-term treatment with infl iximab in infl ammatory bowel disease: safety and tolerability issues

Other safety issues, such as the risk of malignancy or lymphoma, are still under investigation to better understand the relationship between the disease itself, the treatment and the adverse outcome.

The risk of cancer in patients with rheumatoid arthritis

Conclusion: These findings suggested that RA patients taking TNF-α antagonist are associated with a lower risk of cancer, but not for hematologic cancers, than RA patients taking nbDMARDs alone.

Azathioprine: Association with Therapy-related Myelodysplastic Syndrome and Acute Myeloid Leukemia

The observations implicate azathioprine as a leukemogenic agent. It will be prudent to review the need for azathioprine therapy when unexpected cytopenias occur and prescription has been prolonged.

Inflammatory Bowel Disease and Leukemia

The Association of Inflammatory Bowel Disease and Leukemia-Coincidence or Not?

Toxicity of infliximab in the course of treatment of Crohn’s disease

Patients who develop symptoms of infection should be aggressively treated and considered for hospitalisation, as therapy with infliximab alters the host defence mechanism.

Started Remicade (Infliximab) NHS Chelsea Westminister

Adding infliximab (Remicade) to azathioprine increases the risk of lymphoma dramatically, and because of the risk, many physicians are using azathioprine or infliximab as single therapy, not in combination. Nikita was given both at the sametime.

Start of Reoccurring Infections NHS Queen Alexandra Chelsea Westminister

Infections can occur because of a shortage of normal white blood cells (a condition called leukopenia) or a shortage of normal neutrophils (called neutropenia). Neutrophils are a type of white blood cell needed to fight infections from bacteria. Patients with AML can get infections that don’t seem to go away or may get one infection after another. Fever often goes along with the infection.

Diagnosed - Ulcerative Colitis NHS Chelsea Westminister

Start of illness and medications

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