Two cases of disseminated tuberculosis associated with the myelodysplastic syndrome / 대한임상병리학회지

Tuberculosis can be superimposed on many hematologic disorders. Numerous hematologic abnormalities are also associated with tuberculosis, especially disseminated form. With this controversy, when the patient has tuberculosis and hematologic abnormalities, it is important to differentiate tuberculosis from primary hematologic disorder. Especially, most patients with tuberculosis and pancytopenia have been reported to have underlying hematologic disorder. We present two rare cases in which patients with myelodysplastic syndrome had disseminated tuberculosis involving the bone marrow.

A mixed cerebral infection of vivax and falciparum malaria / 대한임상병리학회지

Mixed falciparum-vivax infection accounts for 5% of all malaria cases seen in endemic region. However, a larger proportion of mixed malaria cases develop cerebral complication. We report one case of mixed infection resulted in cerebral malaria.

Significance of trilineage myelodysplasia in de novo acute myeloid leukemia / 대한임상병리학회지

BACKGROUND: The findings of dysplastic features in haemopoietic cells in de novo acute myeloid leukemia(AML) is defined as AML with trilineage myelodysplasia(AML/TMDS). These cases have been reported accounting for 10-5% of de novo AML. The rate of complete remission(CR) in AML/TMDS to conventional chemotherapy is poor and relapse occur much earlier than in patients without dysplastic features. TMDS features are also observed during remission and termed this de novo AML with myelodysplastic remission marrow(AML/MRM). Recent report described that TMDS during remission was more closely related to prognosis than dysplastic features at diagnosis. We investigated the incidence of AML/TMDS and AML/MRM and evaluated the impending role of dysplasia in prognosis. METHOD: Ninety-ive patients with de novo AML from March 1994 to December 1998 were enrolled according to the FAB classifiction. To determine AML/TMDS and AML/MRM, we used Brito-abapulle's criteria and Kazuhiro's criteria. Prognosis was aalysed by the means of disease free survival(DFS) and overall survival(OS). RESULTS: Nine(9.5%) patients had AML/TMDS and it was 7.7%, 17.2%, 50% of patients with M2, M4 and M6. CR rate was 44.4% for TMDS patients compared to 76.7% for patients without TMDS(p<0.05). AML/TMDS also showed significantly shorter DFS and OS. The incidence of AML/MRM was higher in the group of AML/TMDS(44.4%) compared to AML without TMDS(8.1%) but was not related to prognosis. CONCLUSION: We concluded that the presence of TMDS in de novo AML exerts a negative effect on the ability to achieve CR and in the prognosis. But the MRM has no significance to predict poor prognosis and early relapse.

Significance of trilineage myelodysplasia in de novo acute myeloid leukemia / 대한임상병리학회지

BACKGROUND: The findings of dysplastic features in haemopoietic cells in de novo acute myeloid leukemia(AML) is defined as AML with trilineage myelodysplasia(AML/TMDS). These cases have been reported accounting for 10-5% of de novo AML. The rate of complete remission(CR) in AML/TMDS to conventional chemotherapy is poor and relapse occur much earlier than in patients without dysplastic features. TMDS features are also observed during remission and termed this de novo AML with myelodysplastic remission marrow(AML/MRM). Recent report described that TMDS during remission was more closely related to prognosis than dysplastic features at diagnosis. We investigated the incidence of AML/TMDS and AML/MRM and evaluated the impending role of dysplasia in prognosis. METHOD: Ninety-ive patients with de novo AML from March 1994 to December 1998 were enrolled according to the FAB classifiction. To determine AML/TMDS and AML/MRM, we used Brito-abapulle's criteria and Kazuhiro's criteria. Prognosis was aalysed by the means of disease free survival(DFS) and overall survival(OS). RESULTS: Nine(9.5%) patients had AML/TMDS and it was 7.7%, 17.2%, 50% of patients with M2, M4 and M6. CR rate was 44.4% for TMDS patients compared to 76.7% for patients without TMDS(p<0.05). AML/TMDS also showed significantly shorter DFS and OS. The incidence of AML/MRM was higher in the group of AML/TMDS(44.4%) compared to AML without TMDS(8.1%) but was not related to prognosis. CONCLUSION: We concluded that the presence of TMDS in de novo AML exerts a negative effect on the ability to achieve CR and in the prognosis. But the MRM has no significance to predict poor prognosis and early relapse.

Analysis of Factors Associated with Platelet Refractoriness / 대한수혈학회지

BACKGROUND: Platelet refractoriness is associated with immune and nonimmune factors. It has been shown that the incidence of platelet refractoriness caused by HLA alloimmunization is decreased by using of leukocyte-depleted blood components. The purpose of this study was to determine the incidence of platelet refractoriness in relation to the use of leukocyte removal filter and the relative importance of immune and nonimmune factors. METHODS: One hundred and eighty-five patients with thrombocytopenia, treated with multiple transfusion were classified into three groups according to use of leukocyte removal filters (group I: no filter, II: Asahi filter, III: Pall filter). Patients were considered to be refractory when the 20-hour posttransfusion corrected count increment (CCI) was less than 4.5 x 109/L on three subsequent platelet transfusions. Nonimmune factors analyzed were fever, sepsis, disseminated intravascular coagulation, splenomegaly, bone marrow transplantation, and administration of amphotericin-B. RESLUTS: The overall incidence of platelet refractoriness was 45% in group I, 44% in group II, and 47% in group III. In more than 90%, platelet refractoriness was associated with the presence of nonimmune factors. The incidence of platelet refractoriness presumably caused by alloimmunization was less than 5% and is much higher in aplastic anemia than in leukemia. Patients with pregnancy history developed platelet refractoriness with an increased incidence compared to patients without pregnancy history. CONCLUSION: This study revealed that nonimmune factors were predominant causes of platelet refractoriness regardless of transfusion of leukocyte-depleted blood components.