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ABSTRACT Introduction: The myelodysplastic syndrome (MDS) represents a group of hematopoietic neoplasms that is characterized by clonal hematopoiesis, cytopenia and abnormal cellular maturation. Red cell distribution width (RDW) refers to the variation degree of erythrocyte size and it is a reflection of anisocytosis. Higher values have been linked to adverse outcomes, such as increased mortality, vascular events, kidney and liver disease and demonstrated to harbor poor prognosis in solid and hematological malignancies. The RDW value can be used as a contributing parameter for MDS diagnosis, as well as its prognosis. In this study, we essentially aimed to demonstrate the correlation between the RDW and MDS prognostic indexes. Materials and methods: Ninety-four MDS patients at the Aydın Adnan Menderes University Hematology Division were included in the study. The correlations between the RDW and laboratory values (either lactate dehydrogenase, albumin, globulin or ferritin) and the RDW prognostic scoring indexes (IPSS, WPSS, IPSS-R and LR-PSS) were investigated. The PASW for Windows, version 21.0 (SPSS Inc., Chicago, IL, USA), was used for statistical assessment. A p-value below 0.05 was the cut-off for the statistical significance. Results: The mean age of all the patients was 73 ±10 years. Patients were observed for 41.88 ± 25 months. The mean RDW value for all cases was 15.5 ± 2.39. We found a statistically significant difference of survival between RDW values below and above 15.5% (p = 0.016). A significant difference was also observed according to the prognostic scoring indexes (see below). Conclusion: An increase in RDW is probably related to dysplasia in the MDS and this constitutes a possible explanation for the poor outcome. Prognostic indexes might incorporate the RDW as a parameter in the future.
Subject(s)
Myelodysplastic Syndromes , Prognosis , ErythrocytesABSTRACT
Purpose: Splenectomy is used as the second line therapy in patients with immune thrombocytopenia (ITP). However, there is no parameter predicting splenectomy decision. Thrombopoietin is the main regulator of platelet count through its receptor c-mpl. The aim of the present study was to evaluate immune histochemical Cloned Myeloid Leukemia Virus (c-mpl) positivity in bone marrow specimens of ITP patients with or without splenectomy indications. Methods: Pre-splenectomy bone marrow was stained for c-mpl, that was taken from 24 patients with ITP and who had splenectomy as well as bone marrow samples from 30 patients with ITP who did not have splenectomy. Results: c-mpl negativity was higher in splenectomized patients (n: 23) compared to patients without splenectomy (n:18). A significant difference was found for platelet counts before and after splenectomy. Our study show that, c-mpl positivity was statistically significant in patient group who did not have splenectomy. In the patient group who had the splenectomy, c-mpl was not associated with refractory status. Conclusion: The significant level of c-mpl negativity might be the useful parameter for splenectomy indication in patients with immune thrombocytopenia.
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Nocardiosis is a gram positive bacterial infection caused by aerobicactinomycetes. It抯 nonspesific presentation and radiographic findings usually make it undiagnosed with highly fatal outcomes. The patients with intracelluler defects are prone to nocardiosis. Multiplemyelom(MM) itself is a mainly humoral deficiency disorder because of defective antibodies but recent drugs such as proteasome inhibitors and immuno modulatory drugs also cause cellular deficiency. Here we presented two definite and oneprobable pulmonary nocardiosis patients who have a diagnosis of MM, autologou shematopoetic stem cell transplant history in their past and anti myeloma therapy presently.
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Objective: CD20 expression was reported at different rates in patients with multiple myeloma. The importance of this B-cell antigen for plasma cells is still unknown. This study aimed to investigate CD20 expression of myeloma cells in bone marrow, and any relationship between the stage of disease, isotype and clinical features. Methods: Sixty-one patients who were admitted to the hematology clinic of the Adnan Menderes Medical School with the diagnosis of multiple myeloma according to the criteria of the "International Myeloma Working Group" were enrolled in this study. Age, gender, Durie-Salmon stage, history of autologous hematopoietic stem cell transplantation, and the distribution pattern and positivity of CD20 expression on multiple myeloma cells in bone marrow were evaluated. The Mann-Whitney U and chi-square tests were used for statistical analysis with a p-value < 0.05 being accepted as statistically significant. Results: Thirty patients (48.9%) had positive scores for CD20 with the distribution pattern being most likely interstitial in 55.6% of the cases. There was no statistically significant difference between immunohistochemical positivity for CD20 expression on multiple myeloma cells, immunoglobulin type, and the stage of disease. Conclusion: The combination of immunohistochemical studies with flow cytometry may reveal the importance of CD20 positivity in patients with multiple myeloma more clearly. .