ABSTRACT
BACKGROUND: The evaluation of engraftment after BMT may be effectively accomplished by the analysis of genomic polymorphism, such as variable number of tandem repeat (VNTR). Discrimination potential (PD) and allelic profile of VNTR locus might be varied widely between races and geographic areas. Thus PCR-based VNTR loci to establish test panel useful in evaluating engraftment status of Korean patients after BMT were analyzed. MATERIAL AND METHODS: Thirty normal adults (15 males and 15 females), and each patient with acute lymphoblastic leukemia and severe aplastic anemia who had undergone allogeneic BMT were tested. Genomic DNAs extracted from peripheral blood lymphocytes or hair follicles were subjected to three PCR long tandem repeats (LTRs) and fifteen PCR short tandem repeats (STRs) loci analysis using silver-stain mode of detection. RESULTS: The PCR sensivity of VNTR system tested, and detection limit of minor component in mixing experiment, were 100 pg and 0.1%, respectively. The most informative marker was ACTBP2 with 93.2% of PD, and 98.0% of actual PD (APD). The most informative test panel was ACTBP2, D3S2386 and D1S1768 loci-combination with 99.6% of PD and 100.0% of combined APD. CONCLUSIONS: STRs, especially combination of ACTBP2, D3S2386, and D3S11768, were thought to be very useful screening markers for evaluating engraftment status in nonsibling allogeneic BMT. But most of allogeneic BMT are carried out between siblings, who have similar genetic marker each other, so further evaluation is need in sibling-BMT.
Subject(s)
Adult , Humans , Male , Anemia, Aplastic , Bone Marrow Transplantation , Bone Marrow , Racial Groups , Discrimination, Psychological , DNA , Genetic Markers , Hair Follicle , Limit of Detection , Lymphocytes , Mass Screening , Microsatellite Repeats , Minisatellite Repeats , Polymerase Chain Reaction , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Siblings , Tandem Repeat SequencesABSTRACT
Although occasional patients with chronic myeloid leukemia (CML) have chromosomal changes other than Philadelphia chromosome early in the disease, in typical cases the 9;22 translocation remains the sole abnormality throughout the disease course in chronic phase. When disease progression occurs, however, 75-80% develop additional chromosome aberrations. These secondary changes sometimes precede the more aggressive manifestations hematologically and clinically and thus may serve as valuable prognostic indicators. ider (9) (q10)t (9;22) (q34;q11.2) is very rare and a recurrent chromosomal abnormality associated with acute lymphoblastic leukemias (ALL) and lymphoblastic crisis of CML. And ider (9) (q10)t (9;22) (q34;q11.2) is a lymphoid-specific rearrangement and the patients with this abnormality are of older age on average. They commonly show pre-B cell lineage immunophenotype and L2 morphology. We report a case of ider (9) (q10)t (9;22) (q34;q11.2) as secondary aberration in a patient with lymphoblastic crisis of CML.
Subject(s)
Humans , Blast Crisis , Chromosome Aberrations , Disease Progression , Leukemia , Leukemia, Myelogenous, Chronic, BCR-ABL Positive , Philadelphia Chromosome , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Precursor Cells, B-LymphoidABSTRACT
The diagnosis of acute undifferentiated leukemia is made when the leukemic cells cannot be classified using morphologic and cytochemical analyses, and do not express myeloid or lymphoid antigens. Trisomy 13 is a rare primary chromosomal abnormality in acute leukemia and associated with lineage inconsistency and poor prognosis. We report a rare case of acute undifferentiated leukemia showing negativity in periodic acid-Schiff (PAS) and myeloperoxidase (MPO) without any lineage-specific cell surface marker expression and having trisomy 13. The patient was a 72- year-old male who visited our hospital because of anemia and general weakness. On examination, leukocytosis with proliferated blasts (76%) in peripheral blood was noted. Bone marrow aspirate showed blast proliferation (74%) with morphologically hand-mirror type. The blast expressed CD34 (96%) and HLA-DR (76%) in immunophenotyping. Cytogenetic study of bone marrow cells showed 46,XY,+13,-21[15]/46,XY[5]. Induction chemotherapy was failed and differentiation to monocytic series was noted.
Subject(s)
Humans , Male , Anemia , Bone Marrow , Bone Marrow Cells , Chromosome Aberrations , Cytogenetics , Diagnosis , HLA-DR Antigens , Immunophenotyping , Induction Chemotherapy , Leukemia , Leukocytosis , Peroxidase , Prognosis , TrisomyABSTRACT
Vibrio metschnikovii is worldwidely distributed in the aquatic environment and human infections are very rarely associated, such as septicemia, urinary tract infection, wound infection, and peritonitis. V. metschnikovii is negative in nitrate reduction and oxidase reaction, and these findings are different from other vibrio species. V. metschnikovii was isolated from the ascitic fluid and blood of a patient with peritonitis, sepsis and renal insufficiency. This patient was a 41-year old man who suffered from post-necrotic liver cirrhosis, chronic hepatitis B, gastric ulcer, esophageal varix bleeding, and alcoholism. He had neither history of ingestion of seafoods nor exposure to seawater before onset of illness. He was successfully treated with antimicrobial agents. This is the first case report of septicemia and peritonitis by V. metschnikovii in Korea.
Subject(s)
Adult , Humans , Alcoholism , Anti-Infective Agents , Ascitic Fluid , Eating , Esophageal and Gastric Varices , Hemorrhage , Hepatitis B, Chronic , Korea , Liver Cirrhosis , Oxidoreductases , Peritonitis , Renal Insufficiency , Seafood , Seawater , Sepsis , Stomach Ulcer , Urinary Tract Infections , Vibrio , Wound InfectionABSTRACT
BACKGROUND: Platelets can be stored for 3days at 22degrees C in conventional plastic bags plasticizer with di-(2-ethylhexyl)phthalate(DEHP). However, with such a short interval for storage, platelets could not be made easily available for thrombocytopenic patients. In vitro platelet function during 5 days of storage at 22degrees C was studied in a new plastic bag (second generation bag) which contained as plasticizer a tri (2-ethylhexyl)trimellitate and developed in Korea (Boin Medica Co.). METHODS: In vitro function (mean platelet volume, platelet distribution width, pH, platelet aggregation, platelet morphology and swirling phenomenon) was evaluated in 20 units of platelet concentrate at day 0, 2, 5 while mixing in 60 rpm platelet rotator at 22degrees C. RESULTS: At day 5, platelet count, mean platelet volume, platelet distribution width, pH, platelet aggregation, platelet morphology and swirling phenomenon were well maintained. pO2, pCO2 and HCO3- were 65.6mmHg, 43.4mmHg and 12.3mmol/L at day 5, respectively. CONCLUSION: The data indicate that the use of the new platelet storage container will permit satisfactory storage for at least 5 days at 22degrees C.
Subject(s)
Humans , Blood Platelets , Hydrogen-Ion Concentration , Korea , Mean Platelet Volume , Plastics , Platelet Aggregation , Platelet CountABSTRACT
A 36-year-old pregnant woman with gestational diabetes mellitus and anemia was found to have an abnormal Hb (comprising 18.7%) in the automated midget low pressure cation- exchange chromatography (DiaSTATTM, Bio-Rad, USA) for Hb A1c assay. The abnormal Hb revealed an abnormal peak emerged slightly later than normal Hb A1 in DiaSTATTM chromatogram, subsequently confirmed by cellulose acetate membrane electrophoresis and isoelectric focusing. This hemoglobinopathy with high isoelectric point was noted and abnormal chain globin was prepared by chromatography. Family study was carried out and this chain variant was also found in four other family members, and all of them had no clinical abnormalities, except well controlled diabetes. As the results from peptide mapping, amino acid analysis and sequencing, abnormal Hb of the patient was finally identified as Hb Queens[ 34 (B15)Leu-->Arg] without clinical abnormalities.
Subject(s)
Adult , Female , Humans , Pregnancy , Anemia , Cellulose , Chromatography , Diabetes, Gestational , Electrophoresis , Globins , Glycated Hemoglobin , Hemoglobinopathies , Isoelectric Focusing , Isoelectric Point , Membranes , Peptide Mapping , Pregnant WomenABSTRACT
BACKGROUND: The combination of Philadelphia chromosome (Ph) and monosomy 7(-7) was rarely observed in acute lymphoblastic leukemia (ALL). With the results from immunophenotyplc and molecular analysis, Philadelphia chromosome positive ALL with monosomy 7[Ph(+)/-7] has been considered that it may be derived from neoplastic transformation at the pluripotent stem cell level. We compared the clini-cal, laboratory, and hematological findings between 5 cases of Ph(+)/-7 and 5 cases of Ph(+) without monosomy 7 [Ph (+) /N7]. METHODS: During the period from January, 1995 to December, 1996, total 72 cases of ALL were confirmed among 259 cases of hematologic malignancy with bone marrow cytogenetic analysis. Among 72 ALL cases, 5 cases of Ph(+)/-7(monosomy 7 or 7q abnormalities) were compared with Ph only or Ph without monosomy 7(ph(+)/N7] on the hematological, immunophenotypic, other laboratory, clinical findings and event ree survival (EFS) The karyotyping of the bone marrow specimens was analysed byshort-term unsynchronized culture methods such as overnight colcemid treatment and 24 hours incubation following ethidium bromide treatment. RESULTS: The mean age of Ph(+)/-7 was 30.6+/-12.8 years, and it was significantly different from that of Ph(+)/N7 (p=0.009), Four cases of Ph(+)/-7 were classified as ALL L2 subtype, and 2 cases revealed CNS involvements. Immunophenotyping was positive in CD10, CDl9, CD2O, CD22 and HLA-DR. But one case revealed e-B-lymphoid lineage with positivity in CD34, CDl3, and CD33. The response to chemotherapy and EFS was very poor in Ph(+)/-7 group, and the mean EFS was 3.2+/-1.9 months(p=0.014). All of cases showed induction on failure in chemotherapy, relapsed with bone marrow, CNS and extramedullary involvements, and expired due to sepsis. CONCLUSIONS: Ph(+)/-7 ALL had very Poor clinical course with being resistant to chemotherapy and unfavorable prognosis, revealed L2 subtype by FAB classification, and was slightly older in ages compared with Ph(+)/N7 ALL.
Subject(s)
Bone Marrow , Classification , Cytogenetic Analysis , Demecolcine , Drug Therapy , Ethidium , Hematologic Neoplasms , HLA-DR Antigens , Hydrogen-Ion Concentration , Immunophenotyping , Karyotyping , Monosomy , Philadelphia Chromosome , Pluripotent Stem Cells , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Prognosis , SepsisABSTRACT
The t(3;21) (q26;q22) is associated with chronic myelogenous leukemia in blast crisis, leukemia evolving from therapy-related myelodysplasia, and with leukemia following other hematopoietic proliferative diseases. The t(3;21) is rare secondary aberration in blast crisis of Philadelphia(Ph)-positive chronic myeloid leukemia, which may be restricted to patients entering myeloid blast crisis. We report here in one case of chronic myeloid leukemia in blast crisis which reveals both t(9;22) (q34;q11), and t(3;21) (q26 ;q22). A 62-year-old male was diagnosed as chronic myeloid leukemia 5 years ago, received hydroxyurea therapy, and admitted because of gingival bleeding and fever. On examination, splenomegaly and leukocytosis with proliferated blasts(91%) in peripheral blood were noted. Bone marrow aspirate showed hypercellularity with severe blast proliferation(92.5%) which revealed all negative in peroxidase and PAS stain. Cytogenetic study of bone marrow cells showed the karyotype 46, XY, t(3;21) (q26;q22), t(9;22) (q34;q11), which might be suspected as myeloid blast crisis. Above finding was confirmed by the result of immunophenotyping(CD13 43.6%, CD34 68.2%, HLA-DR 91.6%). He received intensive chemotherapy, but still sustained proliferation of blasts was noted . The follow up cytogenetic study was as follows: 46, XY, 4(3;21) (q26:22), t(9;22) (q34;q11)/46, XY, t(3;21)(q26;q22), del(8) (q22), t(9:22) (q34,q11)/46, XY (16/3/1). He died soon from severe pancytopenia and sepsis.