ABSTRACT
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.
ABSTRACT
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. .