REFRACTORY ANEMIA AND PANCYTOPENIA AS PRESENTATIONS OF FALCIPARUM MALARIA IN POPULATION OF KHYBER PAKHTUNKHWA, PAKISTAN

Background: Falciparum malaria is a common disease in our area. Apart from its classical presentation, at times it may present with refractory anemia or pancytopenia. The aim of this study was to determine the refractory anemia and pancytopenia as complications of falciparum malaria and apart from peripheral blood smears the significance of rapid antigen tests and bone marrow examination in the diagnosis of falciparum malaria. Material & Methods: The descriptive study included 200 consecutive cases of fever and refractory anemia or pancytopenia from 2011 to 2014. Stratification of patients according to the clinical scenario included Group-A having fever with refractory anemia and Group-B with fever and pancytopenia. A detailed history, thorough clinical examination, and pertinent laboratory tests were performed. All patients were treated with antimalarial drugs and followed-up for eight weeks. The pre and post treatment hematologic parameters were compared. Results: Among the 200 patients, 85 were males and 115 females. The age ranged from 15 to 55 years. Stratification of patients on clinical scenario revealed 175(87.5%) patients with fever and refractory anemia (Group-A). Among these, 125(62.5%) patients were reported smear positive for P. falciparum. In the remaining 50 smear negative patients rapid antigen tests were performed and all were reported positive. In 25 patients of Group B with fever and pancytopenia, the peripheral smear for malaria was positive only in 5 patients. In the remaining 20 cases both the peripheral blood smears and rapid antigen tests were reported negative. Bone marrow examination was planned to confirm the bone marrow suppression as the cause of peripheral pancytopenia, to exclude leukemia and to identify P. falciparum. The bone marrow examination revealed P. falciparum in all these cases. All the patients had a dramatic response to treatment with antimalarials in terms of disappearance of fever and correction of anemia and bone marrow rescue with reversal of pancytopenia to normal counts. Conclusion: Plasmodium falciparum should be considered in all cases of prolonged fever with refractory anemia or pancytopenia in malaria endemic areas, even with negative smear and rapid antigen tests. Bone examination is mandatory for the diagnosis in such cases. There is dramatic response of such patients to treatment with antimalarial drugs and hematinics.

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A Useful Flow Cytometry Panel To Exclude Myelodysplastic Syndrome.

Blood ◽

10.1182/blood.v108.11.4848.4848 ◽

2006 ◽

Vol 108 (11) ◽

pp. 4848-4848

Author(s):

Ling Zhang ◽

Jean R. Lopatequi ◽

Sharron E. Kelly ◽

Tobi Neer ◽

Stephen Lee

Keyword(s):

Bone Marrow ◽

Flow Cytometry ◽

Test Group ◽

Bone Marrow Examination ◽

Normal Group ◽

P Value ◽

Aberrant Expression ◽

Cd10 Expression ◽

Group A ◽

Group B

Abstract Background: Myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic disorders, which can be difficult to diagnose based only on morphologic bone marrow examination. Karyotyping can be useful in diagnosing borderline cases. However, only 40% of patients with MDS have an abnormal karyotype. Flow cytometry(FCM) approaches have been described but not clearly defined in MDS due to use of different criteria. We devised a 10-parameter FCM panel, mainly including myeloid and erythroid maturation markers, to differentiate MDS marrows from normal marrows. Design: Bone marrow from 91 patients with cytopenia(s) or anemia were included in the study(10/2005–7/2006). Cases were divided into 3 groups: normal, not morphologically suspicious for MDS, 46 cases, equivocal, morphologically suggestive but not diagnostic of MDS, 20 cases, morphologically diagnostic of MDS, 25 cases. 10 FCM paremeters were performed and scored: hypogranularity,aberrant expression of CD56,lack of CD10 expression,decreased CD64 expression,&lack of CD13 or CD33 expression,&abnormal CD13/CD16 or CD16/CD11b pattern,increase of CD 34 expression gating on all cells excluding erythrocytes,decreased expression of CD71/Glycophorin gating on erythroid precursors. Karyotypings were analyzed. Results: and (see Table 1 and 2). Karyotyping were anlayzed in 86 cases. Cytogenetic abnormalities were found in 2.2% (1/44) of normal group, 5.3% (1/19) of equivocal group and 34.8% (8/43) of MDS group. In MDS group 7 of 8 patients (87.5%) who had both morphologic and cytogenetic diagnosis of MDS were scored >=3 of 8 FCM parameters. Conclusions: Study showed the 8-parameter FCM panel was more predictive of MDS than 10-parameters one. Both CD13/CD16 & CD16/CD11b patterns were considered to be non-specific. In 8-parameter panel, zero score tended to rule out MDS, while score >=3 suggested MDS. The most specific FCM parameters were hypogranularity, CD34, aberrant expression of CD56 or lack of CD10 expression by mature granulocytes. CD71/Glycophorin A might be useful in identifying dysplasia in erythroid lineage. Table 1. Comparison of FCM Parameters in Patients with/without MDS Parameters/Group Normal Group(A)(n=46) Equivocal Group(B)(n=20) MDS Group(C)(n=25) CHITEST(P value)(GRoup A vs C) * These two parameters were deleted in the 8-parameter panel due to their high frequency seen in normal group. Hypogranularity 4 (8.7%) 6 (30%) 18 (72%) 0.0001 CD56 0 (0.0%) 1 (5%) 6 (24%) 0.0005 CD10 7 (15.2%) 7 (35%) 15 (60%) 0.0001 CD64 6 (13.1%) 2 (10%) 6 (24%) 0.2396 CD13 0 (0.0%) 0 (0.0%) 2 (8.0%) 0.0516 CD33 0 (0.0%) 2 (10 %) 0 (0%) 0 CD13/CD16* 23 (50.0%) 7 (35%) 21 (84%) 0.0047 CD34 8 (17.4%) 7 (35%) 13 (52%) 0.0026 CD71 2 (4.3%) 5 (25%) 12 (48%) 0.0001 CD16/CD11b* 27 (58.7%) 8 (40%) 22 (88%) 0.0107 Table 2. Scoring with 8 FCM Parameters in Patients with/without MDS Score/Group Normal Group (A)* (n=46) Equivocal Group (B)* (n=20) MDS Group (C)* (n=25) * Fish Exact T Test: Group A vs C: p<0.0001, A vs B: p=0.0006, B vs C: p=<0.0001 Score=0 21 (45.7%) 3 (15%) 0 (0.0%) Score=1–2 25 (543 %) 14 (70%) 8 (32 %) Score>3 0 (0.0%) 3 (15%) 17 (68%) *Mean score +/− SD 0.65+/−1.06 1.55+/−1.54 2.8+/−1.65

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CLINICAL ASSESSMENT OF PANCYTOPENIA IN PERIPHERAL BLOOD SMEARS IDENTIFIED IN PATIENTS FROM BIHAR REGION

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v3i8.573 ◽

2019 ◽

Vol 3 (8) ◽

Author(s):

Dr. Vivek Kumar ◽

Dr. Jaideo Prasad

Keyword(s):

Bone Marrow ◽

Peripheral Blood ◽

Megaloblastic Anemia ◽

Bone Marrow Aspiration ◽

Peripheral Blood Smear ◽

Bone Marrow Examination ◽

Peripheral Smear ◽

Blood Smears ◽

Function Test ◽

Peripheral Blood Smears

The severity of pancytopenia and the underlying pathology determine the management and prognosis. [3] Thus, identification of exact cause will help in implementing appropriate therapy. The major diagnostic problems occur when there are no specific features in the peripheral smear to point the cause. In India the causes of pancytopenia are not well defined, so the present study has been undertaken to evaluate the various causes and to correlate the peripheral blood smear findings. The present study was planned in Department of Pathology, Anugrah Narayan Magadh Medical College, Gaya, Bihar from july 2017 to Dec 2017. Total 50 cases of the clinical suspicion of a hematological disorder and demonstrating pancytopenia in the peripheral blood smears were enrolled in the present study. All participants underwent a detailed history, clinical examination and investigations which included complete blood picture with red cell indices and peripheral smear, liver function test, renal function test, ultrasound abdomen and bone marrow examination in all cases. Cause of pancytopenia was ascertained and data was analysed on SPSS on the basis of etiology, clinical and haematological findings. The data generated from the present study concludes that systematic and thorough workup is required in patients presenting with pancytopenia, so that elimination of the cause is needed to treat the condition. Among them, megaloblastic anaemia and infections are early treatable and reversible. Keywords: Pancytopenia, Bone Marrow Aspiration, Megaloblastic Anemia, Hypo plastic Marrow, etc

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Effects of spaceflight on rat erythroid parameters

Journal of Applied Physiology ◽

10.1152/jappl.1996.81.1.117 ◽

1996 ◽

Vol 81 (1) ◽

pp. 117-122 ◽

Cited By ~ 21

Author(s):

Z. Allebban ◽

L. A. Gibson ◽

R. D. Lange ◽

T. L. Jago ◽

K. M. Strickland ◽

...

Keyword(s):

Bone Marrow ◽

Life Sciences ◽

Lower Number ◽

Ground Control ◽

Colony Forming Unit ◽

Human Erythropoietin ◽

Group A ◽

Group B ◽

First Time ◽

Group D

Hematologic studies were performed on 21 ground control rats and 21 rats flown during the Spacelab Life Sciences-2 14-day mission. Group A (n = 5) was used to collect blood in flight and 9 days postflight, group B (n = 5) was injected with recombinant human erythropoietin (rhEpo), group C (n = 5) received saline as a control, and group D (n = 6) was killed in flight and tissues were collected. Results indicated no significant changes in peripheral blood erythroid elements between flight and ground control rats. The nonadherent bone marrow on flight day 13 showed a lower number of recombinant rat interleukin-3 (rrIL-3)-responsive and rrIL-3 + rhEpo-responsive blast-forming unit erythroid (BFU-e) colonies in flight rats compared with ground control rats. On landing day, a slight increase in the number of rhEpo + rrIL-3-responsive BFU-e colonies of flight animals compared with ground control rats was evident. Nine days postflight, bone marrow from flight rats stimulated with rhEpo alone or with rhEpo + rrIL-3 showed an increase in the number of colony-forming unit erythroid colonies and a decrease in BFU-e colonies compared with ground control rats. This is the first time that animals were injected with rhEpo and subsequently blood and tissues were collected during the spaceflight to study the regulation of erythropoiesis in microgravity.

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Impact of megatherapy on survival after relapse from stage 4 neuroblastoma in patients over 1 year of age at diagnosis: a report from the European Group for Bone Marrow Transplantation.

Journal of Clinical Oncology ◽

10.1200/jco.1993.11.12.2330 ◽

1993 ◽

Vol 11 (12) ◽

pp. 2330-2341 ◽

Cited By ~ 31

Author(s):

R Ladenstein ◽

C Lasset ◽

O Hartmann ◽

D Frappaz ◽

A Garaventa ◽

...

Keyword(s):

Bone Marrow ◽

Proportional Hazards ◽

Bone Marrow Involvement ◽

Marrow Transplant ◽

Cox Proportional Hazards ◽

Age At Diagnosis ◽

Conventional Dose ◽

Stage 4 ◽

Group A ◽

Group B

PURPOSE Relapse from stage 4 neuroblastoma usually carries a poor prognosis. A retrospective study using the European Bone Marrow Transplant (EBMT) Solid Tumor Registry was undertaken to define the role of megatherapy (MGT) in relapsed patients. PATIENTS AND METHODS After relapse, 33 boys and 15 girls with previous stage 4 neuroblastoma received intensification by MGT followed by either autologous (n = 42) or allogeneic (n = 6) bone marrow rescue in 11 European institutions. The median age at diagnosis was 47 months (range, 14 to 134) and the median interval from diagnosis to relapse was 16 months (range, 4 to 94). Thirty patients had received only conventional-dose primary treatments (group A), whereas 18 patients had previously received intensification with MGT (group B). The median follow-up time of the total group is 95 months (range, 25 to 185). RESULTS The actuarial overall survival rate at 2 years after MGT for relapse is 27% for group A and 0% for group B (P = .02). Three adverse, independent prognostic factors were confirmed by multivariate analysis using the Cox proportional hazards regression model: an interval of less than 12 months between diagnosis and relapse (P < .0001), nonresponding or untreated relapse (P = .0002), and previous MGT during primary treatments (P = .055). None of the other variables analyzed, such as sex, age, bone or bone marrow involvement at diagnosis or at relapse, and type of MGT at relapse, influenced outcome in this patient cohort. CONCLUSION Responding patients who relapse more than 12 months from diagnosis who had not received previous MGT appear to benefit from consolidation MGT. Relapse patients who do not fulfill these criteria gain no advantage from this cost-intensive procedure and should be treated differently.

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Bone Marrow Transplantation or G-CSF Treatment Can Accelerate Recovery of Injured Spinal Cord in Mice.

Blood ◽

10.1182/blood.v104.11.4181.4181 ◽

2004 ◽

Vol 104 (11) ◽

pp. 4181-4181

Author(s):

Damianos Sotiropoulos ◽

Eleni Siotou ◽

Evangelia Athanasiou ◽

Christos Kalpouzos ◽

Panayotis Kaloyannidis ◽

...

Keyword(s):

Spinal Cord ◽

Bone Marrow ◽

Bone Marrow Cells ◽

Control Group ◽

Significant Difference ◽

Cord Injury ◽

Group A ◽

B Mice ◽

The Mean ◽

Group B

Abstract Mice, unlike rats and humans, have a self recovery mechanism of spinal cord injury. Whether the hematopoietic system is involved in this mechanism is under investigation. In this study we tested whether bone marrow cells transplanted or mobilized by a growth factor in mice with spinal cord injury, can accelerate the recovery. C57bl/6 female mice 10 to 12 weeks of age underwent spinal cord incision in an open operation. The injury was performed as a complete transection including the dura mater and the whole circumference of the cord at the T10-T11 intervertebral space with a micro scalpel (No 11). Group A mice received 200μg/kg/day G-CSF subcutaneously for 7 days, starting 24 hours after operation. Group B mice received 106 light density bone marrow cells from C576bl/6 donor mice intravenously 24 hours after operation. Control group mice received no treatment. Histological evaluation was performed at 48 hours, 1 week, 3 weeks and 5 weeks postoperatively. Paraffin embedded longitudinal samples of spinal cord were cut as serial sections. Spinal cord damage was estimated by measuring the maximum diameter of the area of axonal damage and disruption of astrocytic network using immunostaining for neurofilaments and GFAP. Antibodies against CD68 were applied to identify macrophage aggregations. All measurements were performed by morphometric photo analysis. The volume of fibroblastic infiltration was estimated using a grading system (0–7), based on Van Gieson stain for connective tissue. Functional deficits and recovery over time were evaluated by testing hind limb reflex and coordinated motor function (Kuhn and Wrathal functional tests, modified by Seki et al, 2002). All tests have been videotaped. Outcome scores at 48 hours, 1 week, 3 weeks and 5 weeks postoperatively for the control group, group A and group B mice were analyzed with the Mann-Whitney U test. 48 hours post operatively all mice in all groups were paralyzed in both hind limbs. Gradual improvement was observed in all groups. At week 3 there was a significant difference between the mean scores of functional tests for both treated groups (A and B) compared with the mean scores of the control group. Statistically significant difference (p<0,05) was observed in 5 out of 7 tests for group A and in 3 out of 7 tests for group B. Same difference between Group A mice and control group mice was observed by 5 weeks, while group B had no statistically significant difference. No animal in any of the groups had a complete recovery 5 weeks postoperatively. Spinal cord in control group mice showed a gradually increase of fibroblastic infiltration until 5 week which entirely separated the two ends of the cord. In group A and group B mice a significant decrease of fibroblastic infiltration was observed at week 5 compared with week 3. Macrophage aggregations were evident at weeks 1 and 5 but not at week 3 in all groups. In conclusion our results indicate that light density bone marrow transplanted cells or G-CSF treatment can accelerate spinal cord injured mice recovery. It is possible that this is associated with a decrease in fibroblastic infiltration of spinal cord. Macrophage aggregation may also play an important role in the mechanism of recovery in mice, while in rats a different reaction including cavitation and delayed demyelination prohibits neurological recovery.

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Clonality in Granulocytes Detected by an Improved HUMARA Assay: A Good Prognostic Marker in Bone Marrow Failure Patients Exhibiting Chromosomal Abnormalities of Indefinite Significance.

Blood ◽

10.1182/blood.v104.11.3702.3702 ◽

2004 ◽

Vol 104 (11) ◽

pp. 3702-3702

Author(s):

Ken Ishiyama ◽

Chiharu Sugimori ◽

Hirohito Yamazaki ◽

Akiyoshi Takami ◽

Shinji Nakao

Keyword(s):

Bone Marrow ◽

Chromosomal Abnormalities ◽

Bone Marrow Failure ◽

Bone Marrow Examination ◽

Refractory Anemia ◽

Clonal Population ◽

Dividing Cells ◽

Humara Assay

Abstract Some patients with aplastic anemia (AA) and approximately 40% of patients with refractory anemia (RA) of myelodysplastic syndrome exhibit karyotypic abnormalities in bone marrow dividing cells. Although some of the patients undergo evolution to acute myeloid leukemia (AML), others follow a clinical course similar to AA patients without chromosomal abnormalities. Except for several abnormalities such as −7 and 5q-, the clinical significance of such chromosomal abnormalities in bone marrow failure patients remains unclear. We recently developed a reliable HUMARA assay capable of detecting a clonal population in granulocytes which constitutes 30% or more of total granulocytes (Blood. 2003;102:1211–1216). Studying correlation between chromosomal abnormalities and the presence of clonality may help in understanding the pathogenetic role of chromosomal abnormalities in AA and RA. We thus analyzed 50 acquired AA and 28 RA female patients who were heterozygous for the HUMARA gene. Chromosomal abnormalities such as add(5)(q13), 9q–9q+ and del(7)(q14q22) were found in 8% of AA and 21% of RA patients. Clonality was detected in 38% of AA patients and 39% of RA patients. Incidence of chromosomal abnormalities in patients with clonality (27%) was higher than that in patients without clonality (4%, p<0.01). In two AA patients who respectively exhibited add(5)(q13) in 10% and +8 in 38% dividing cells, clonality was not detected and these abnormal clones became undetectable at the time of subsequent bone marrow examination. Clonality was detected in the other 2 AA patients respectively exhibiting 9q–9q+ in 40% and del(7)(q14q22) in 25% dividing cells, and in all 5 RA patients respectively exhibiting +8 in 10%, del(5)(q13q31), dup(1)(q32q12) in 90%, del(5)(q13), add(11)(q23), inv(9) in 65% and X,-X in 100% of dividing cells. None of the 50 AA patients including 2 patients with clonality and chromosomal abnormalities underwent evolution to AML during 2-year follow up while one of 28 RA patients who exhibited del(5)(q13q31) progressed to AML. The proportion of clonal granulocytes in total granulocytes estimated by the HUMARA assay remained unchanged in most patients with clonality except for the transformed one. These data indicate that the chromosomal abnormality in bone marrow dividing cells is not necessarily associated with presence of clonal granulocyte population in peripheral blood and that detection of clonality in granulcytes in bone marrow failure patients with chromosomal abnormalities of indefinite significance is useful in predicting prognosis of these patients.

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Study on Gene Exppression Profiling Associated with Prognosis in AML (M2a).

Blood ◽

10.1182/blood.v106.11.4360.4360 ◽

2005 ◽

Vol 106 (11) ◽

pp. 4360-4360

Author(s):

Fan Yi Meng ◽

Jiaming Tang ◽

Wenli Ma

Keyword(s):

Bone Marrow ◽

Complete Remission ◽

Mononuclear Cells ◽

Bone Marrow Mononuclear Cells ◽

Oligonucleotide Microarrays ◽

Newly Diagnosed ◽

Standard Chemotherapy ◽

Group A ◽

Group B ◽

Refractory Aml

Abstract Objective: to explore genes related to the prognosis of AML (M2a). Methods: 6 newly diagnosed AML were involved in this experiment and were divided into 2 groups. Group A: 3 AML (M2a) patients with continuous complete remission (CCR1) less than 6 months; Group B: 3 AML (M2a) patients with CCR1 more than 12 months. Bone marrow mononuclear cells were separated and mRNA was purified and labeled with Cy3 and Cy5 respectively, which were used to hybridize against the Agilent human 1B 60mer oligonucleotide microarrays. Results: in the 20173 genes tested, 22 genes were found to be expressed differently between these two groups, among them 10 genes were up-regulated in group A, and 12 genes were up-regulated in group B. Conclusion: with microarray assay, 22 genes including APP were found to be differently expressed in AML (M2a) treated with standard chemotherapy. These genes may be early indicators for the diagnosis as well as prognosis of the refractory AML.

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A Comparison of Clinical Outcomes of Non-T-Cell-Depleted (Non-TCD) Unrelated Donor Heamatopietic Stem Cell Transplantation (HSCT) and Non-TCD Haploidentical Related Donor HSCT.

Blood ◽

10.1182/blood.v108.11.5140.5140 ◽

2006 ◽

Vol 108 (11) ◽

pp. 5140-5140

Author(s):

Feng Chen ◽

De Pei Wu ◽

Aining Sun ◽

Xiao Ma ◽

Xiaowen Tang ◽

...

Keyword(s):

Bone Marrow ◽

Stem Cell ◽

High Risk ◽

Acute Gvhd ◽

Peripheral Blood Stem Cell ◽

Ex Vivo ◽

Unrelated Donor ◽

Group A ◽

Related Donor ◽

Group B

Abstract Unrelated donor HSCT and haploidentical related donor HSCT have been evaluated as alternative transplant options for the approximately 70% of patients without an HLA-identical sibling donor. To compare the clinical outcomes between Non-TCD unrelated donor HSCT and Non-TCD haploidentical HSCT, we studied 55 patients with high-risk or advanced leukemia who underwent Non-TCD HSCT from unrelated or haploidentical related donors from June 2001 to May 2006. Group A including 25 patients received HLA-matched unrelated donor HSCT, group B, including the other 30 patients, received HLA-haploidentical family donor HSCT. 20 recipient/donor pairs were allele matched and 5 pairs were 1–2 alleles disparity mismatched in the group A, HLA-haploidentical family donors in the group B included mother (22 cases), sibling(5 cases) and offspring (3 cases). Patients with myeloid leukemia were conditioned with the regimen consisting of Simustine (MeCCNU) 250mg/m2×1day, Ara-c 4g/ m2×2days, busulfan (Bu) 4mg/kg×3days, and cyclophosphamide (Cy)1.8g/m2×2days, patients with lymphoblastic leukemia were conditioned with the regimen consisting of MeCCNU 250mg/m2×1day, total-body irradition(TBI) 8Gy×1day, Ara-c 4g/ m2×2days, and Cy 1.8g/m2×2days. 15 patients received Non-TCD bone marrow transplantation (BMT), and 10 patients received Non-TCD peripheral blood stem cell transplantation (PBSCT) in the group A. 17 patients received G-CSF-primed bone marrow grafts that had not been depleted ex vivo of T cells, and 13 patients received G-CSF-primed bone marrow grafts plus G-CSF-mobilized peripheral blood stem cell without ex vivo T cell depletion in the group B. Prophylaxis against GVHD was performed with cyclosporine (CSP), short-term methotrexate (MTX), and mycophenolate mofetil (MMF), some patients received the combination of CSP, MTX and MMF plus antithymocyte globulin (ATG). When GVHD developed, methylprednisolone(MP) was given at first, if the response was poor, anti-CD25 monoclonal antibody was given to the patients as quickiy as possible and CSP was replaced with tacrolimus. All patients of the group A and 29 patients of the group B were engrafted successfully. Acute GVHD grades III-IVoccurred in 10 and 11 patients in the group A and B, respectively(the cumulaitive incidence 40% vs 37.9%, P>0.05). 2 patients relapsed in each group (the actuarial probilities of relapse 8% vs 6%, P>0.05). The 2-year probabilities of event-free survival(EFS) for the group A and B were (58.7±5.9)% and (42.2±2.0)%, respectively (P>0.05). 10 patients of the group A and 17 of the group B died of transplantation- related disease. The primary causes of death included severe acute GVHD and pulmonary infection. These results suggested that both Non-TCD unrelated donor HSCT and Non-TCD haploidentical related donor HSCT are effective treatments for patients with refractory or high-risk hematologic malignancies, the high transplantation related mortality due to GVHD and infection is still a major challenge.

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Proteomics Analysis of Bone Marrow Cells of Acute Myeloid Leukemia (M2a) and Its Prognosis Significance.

Blood ◽

10.1182/blood.v108.11.4297.4297 ◽

2006 ◽

Vol 108 (11) ◽

pp. 4297-4297

Author(s):

Fan Yi Meng ◽

Shuai Tian ◽

Jia-ming Tang

Keyword(s):

Bone Marrow ◽

Zinc Finger Protein ◽

Differentially Expressed ◽

Leukemic Cells ◽

Differentially Expressed Proteins ◽

Maldi Tof Ms ◽

Maldi Tof ◽

Group A ◽

Group B ◽

Tof Ms

Abstract Objective:The distinct proteins of leukemic cells were investigated by proteomics technology between AML-M2a patients before inductive treatments with evidently different duration of first continuous complete remission(CCR1) and AML-M2a patients at replase in order to find their relations with prognosis of AML-M2a. Methods:The bone marrow mononuclear cells(BMMNCs) from 17 cases of AML-M2a patients before inductive treatment were grouped with different duration of CCR1: group A with CCR1 duration exceeded 12 months(11 cases), group B within 6 months(6 cases), and group C was composed of 3 patients at replase among group B. The proteins of BMMNCs from all the patients were separated by two-dimensional electrophoresis, and the part of differentially-expressed proteins were identified by matrix assisted laser desorption/ionization time-of-flight mass spectrometry(MALDI-TOF-MS). Results: 6 differentially-expressed proteins were identified between group A and B by MALDI-TOF-MS: tubulin-specific chaperone B, myeloperoxidase, <TT>Solution Structure Of The Ch Domain Of Human Transgelin-2,</TT> glutathione S-transferase, RING zinc finger protein, glyceraldehyde-3-phosphate dehydrogenase.3 differentially-expressed proteins were identified in group C: NAD(P)H dehydrogenase, hypothetical protein, HES1. Conclusion: The distinct proteins of leukemic cells of AML-M2a patients before inductive treatments were involved in prognosis, and the proteins of BMMNCs from patients at replase have changed.

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Bacterial, Viral and Fungal Infections in Patients after Allogeneic Stem Cell or Bone Marrow Transplantation - A Comparison between Patients with Related and Patients with HLA-Matched Non-Related Stem Cell Donors.

Blood ◽

10.1182/blood.v110.11.4978.4978 ◽

2007 ◽

Vol 110 (11) ◽

pp. 4978-4978

Author(s):

Christina T. Rieger ◽

Johanna Tischer ◽

Helmut Ostermann

Keyword(s):

Bone Marrow ◽

Candida Albicans ◽

Stem Cell ◽

Stem Cell Transplantation ◽

Myeloid Leukemia ◽

Fungal Infections ◽

Stem Cell Source ◽

Cell Source ◽

Group A ◽

Group B

Abstract Bacterial, viral and fungal pathogens frequently cause severe, life-threatening infections in immunocompromised patients after allogeneic stem cell transplantation (SCT). We investigated whether patients with related stem cell donors (group A) developed infections less frequently than patients with HLA-matched, non-related donors (group B). Fifty-nine consecutive patients treated at our transplantation unit between April 2004 and January 2005 were included into the analysis. We documented demographic and clinical characteristics at baseline, treatment, clinical course, microbiological examinations, clinical and radiological signs of infection and mortality. Of the total 59 patients analyzed, 22 received stem cells from related and 37 from HLA-matched non-related donors. Both groups were well balanced regarding age and weight. 50% of the patients in group A and 60% in group B were male. Most frequent diagnoses were acute myeloid leukemia (30 of 59 patients [50.8%]; group A: 68.2%; group B: 40.5%), multiple myeloma (15.2%), acute lymphoblastic leukemia (11.9%) and chronic myeloid leukemia (10.2%). Bone marrow was more often the stem cell source in group A (45.5%/ 10 patients) than in group B (10.8%/ 4 patients), peripheral stem cell transplantation respectively was predominant in the unrelated group (86.5%/ 32 patients) versus the family donor group (54.5%/ 12 patients), cord blood was used as unrelated stem cell source in1 patient (2.7%). Clinically documented infections occurred in 6% in group A and in 14% in group B. Pulmonary infiltrates were observed more frequently in group A (11 patients/ 50%) than in group B (16 patients/ 43.2%). The predominant findings were atypical infiltrates (total 16 patients), followed by signs of fungal (total 7 patients) and bacterial pulmonary infiltration (total 4 patients). Microbiologically documented infections were detected in all patients. The average number of pathogens was equal in both groups. Detected pathogens were HHV-6 (48 patients), coagulase-negative Staphylocci (17 patients), EBV (14 patients) and CMV (11 patients). Three fungal infections were detected by microbiological approaches in group A (2 × Candida albicans, 1 × Pitysporum ovale) compared to nine fungal infections in group B (5 × Candida albicans, 1 × Candida glabrata, 1 × Candida parapsilosis, 2 × Geotrichum capitatum). Two years after transplantation, 55.9% of patients were alive (group A: 68.2%; group B: 48.6%). Patients with AML had a two-year survival of 50% (group A: 53.3%; group B: 46.7%). In our study, we observed no clear relation between frequency of infection and donor type, yet there was a trend towards more invasive fungal infections in the unrelated group (13% group A vs. 24% group B).

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