ABSTRACT
HbA1c is an established index of glycaemic control and correlates strongly with risk of chronic diabetic complications. However, the accuracy of HbA1c measurement can be affected by many factors, among which is the presence of haemoglobin (Hb) variants. The aim of the study was to determine the percentage of Hb variant detected during HbA1c monitoring in Hospital Kuala Lumpur. The study also analysed non-reportable HbA1c results in the presence of Hb variants. A cross-sectional study using retrospective data of HbA1c results over fi ve months’ period was analysed on Biorad Variant II Turbo, a high performance liquid chromatography (HPLC) assay. The Hb variants were grouped either as HbS, HbC, others (Hb variant apart from HbS or C), and a combination of HbS or C with Others. A total of 11,904 patients were included. Only 2.3% (273) had Hb variants; HbS trait (10.3%), others (89%), and the combination of HbS trait with others (0.7%). No patient with HbC variant or its combination was found. Only 2.2% of those with Hb variant had non-reportable HbA1c. Although the percentage of Hb variants detected during HbA1c analysis and non-reportable HbA1c results were low, their presence should be noted.
ABSTRACT
Clonal disorders of LGL may either be CD3+ CD56- or CD3- CD56+ phenotype and these have been designated as T-cell leukaemia (T-LGL) or natural killer cell (NK)-LGL leukaemia respectively. Clonality is usually demonstrated by clonal rearrangement of T-cell receptor gene rearrangement or identified by flowcytometry analysis. Most patients with T-LGL will have an indolent course. In this report we described an aggressiveness of disease in a patient with clonal CD3+ LGL leukaemia whose cells also co-expressed CD56 diagnosed by flowcytometry. The patient responded well to interrupt ALL standard risk protocol however succumbed to her disease while waiting for upfront stem cell transplant. This case highlights on both the classical laboratory findings of rare entity of disease as well as a review of the literature pertaining particularly on its management.
ABSTRACT
Plasma cell leukaemia (PCL) is a rare form of malignant plasma cell dyscrasia. It can occur as a primary form without prior evidence of multiple myeloma or as a secondary form which is a terminal event in multiple myeloma. It is characterised by a proliferation of plasma cells in blood and the bone marrow. The outcome of plasma cell leukemia is poor with conventional therapy. Here we illustrate a case of primary plasma cell leukemia complicated by para plegia. The patient initially responded to combination chemotherapy but succumbed to the disease two months after presentation