Annals of Hematology

, Volume 97, Issue 9, pp 1727–1729 | Cite as

Re-treatment versus extended treatment strategy of systemic bevacizumab in hereditary hemorrhagic telangiectasia: which is better?

  • Narendranath EpperlaEmail author
  • Ariel Kleman
  • Matthew Karafin
  • Patrick Foy
Letter to the Editor

Dear Editor,

Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant vascular disorder characterized by a multisystem vascular dyscrasia leading to severe and recurrent epistaxis and gastrointestinal (GI) hemorrhages from mucocutaneous telangiectases and development of arteriovenous malformations (AVM), most commonly in the lung, liver, brain, and spine [1, 2, 3, 4]. In patients with HHT, vascular endothelial growth factor (VEGF) levels in circulation are elevated [4] forming the basis for utilization of bevacizumab, a VEGF inhibitor, in this disease state. Intravenous (IV) administration of bevacizumab has been shown to be effective in improving epistaxis and telangiectasias, reducing the need for red blood cell (RBC) transfusions, and improvement in the high output cardiac failure [5, 6, 7, 8]. However, it is unclear as to the optimal dosing strategy of IV bevacizumab in patients with HHT. Hence, we aimed to determine whether re-treatment strategy or extended dosing...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Division of HematologyThe Ohio State UniversityColumbusUSA
  2. 2.Division of Hematology and OncologyMedical College of WisconsinMilwaukeeUSA
  3. 3.Department of MedicineMedical College of WisconsinMilwaukeeUSA
  4. 4.Department of PathologyMedical College of WisconsinMilwaukeeUSA
  5. 5.Medical Sciences InstituteBloodCenter of WisconsinMilwaukeeUSA

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