[Acute myeloid leukemia and pregnancy]

This is a rare clinical entity estimated to affect one in 100,000 pregnancies. The challenge is to provide a beneficial therapeutic regimen for the mother while limiting toxic effects to the fetus. Patient 27 year pregnant by 32 weeks gestation, presents a complete bone marrow failure syndrome. Laboratory tests have objectified an acute myelogenous leukemia type 2. The course of action was the initiation of vaginal delivery under cover of red cell transfusion and platelet giving birth to a healthy newborn. Chemotherapy as AML03 protocol allowed a complete remission of the disease. Pregnancy does not affect the development of acute myelogenous leukemia. The rate of remission and survival rates at 6 and 12 months were comparable among women of childbearing age, whether they are pregnant or not. The treatment is the same as that used in patients not pregnant. Leukemia, it has consequences on pregnancy. The number of delayed intrauterine growth, miscarriage and spontaneous preterm birth is higher in patients untreated. Hematological addition treatments, beneficial for the mother, are teratogenic. During the first trimester, termination of pregnancy should be discussed due to effects of chemotherapy on the fetus. While in the second or third trimester may be administered without interruption of pregnancy

Etiological profile of pancytopenia in adults in Marrakesh, Morocco

This retrospective study evaluated the frequency of different causes of pancytopenia in all adult patients with pancytopenia presenting to the Department of Haematology of Mohamed VI Hospital, Marrakesh from 1 January 2008 to 31 December 2010. A total of 118 cases of pancytopenia were found [average of 39 cases per year]. The mean age of patients was 52 years [range 18-82 years] and 52.5% were male. The main clinical signs were pallor [100%], asthenia [100%] and fever [30.5%]. Mean haemoglobin was 6.5 g/dL [range 2.9-9.2 g/dL], mean white blood cell count was 2360/mm[3] [range 840-3360/mm[3]] and platelet count 66 000/mm[3] [range 3000-123 000/mm[3]]. Bone marrow aspiration was performed in 112 patients; megaloblastosis was found in 32.2% and marrow blasts in 23.7%. Anaemia due to vitamin B[12] deficiency [32.2%], acute leukaemia [23.7%] and aplastic anaemia [15.2%] were the main causes of pancytopenia. Given the incidence of acute leukemia among our cases, patients presenting with pancytopenia require urgent diagnosis and treatment

[Systemic lupus erythematosus and Epstein-Barr virus]

We determined the prevalence of antibodies to Epstein-Barr virus [EBV] in 44 patients with systemic lupus erythematosus [SLE] and 44 healthy blood donors matched for sex and age as controls. Of the cases, 39 were women; mean age was 33 years. Four cases [9%] and 5 controls [11%] were positive for IgM anti-viral capsid antigen [VCA] [P = 0.9]. All the cases were positive for IgG anti-VCA compared with 91% of the controls [P = 0.12]. The mean immunity ratio for this antibody was 2.341 in cases and 1.873 in controls [P = 0.068]. Forty [91%] cases were positive for IgG anti-EBNA1 [EB nuclear antigen1] compared with 42 [95%] controls [P = 0.6]