CD34 and p53 Immunohistochemical Stains Differentiate Hypocellular Myelodysplastic Syndrome (hMDS) from Aplastic Anemia and a CD34 Immunohistochemical Stain Provides Useful Survival Information for hMDS

BACKGROUND: The presence of significant dysplasia in bone marrow (BM) aspirates helps to distinguish between hypocellular myelodysplastic syndrome (hMDS) and aplastic anemia (AA). Occasionally, diluted BM aspirates make it difficult to recognize dysplastic changes and can also negatively affect the detection of cytogenetic abnormalities in hMDS. We evaluated the usefulness of CD34 and p53 immunoreactivity for discriminating between hMDS and AA and for estimating survival outcomes in hMDS patients. METHODS: BM clot section (BMC) or BM biopsy (BMB) specimens were obtained from 64 hMDS/AA patients (33 with hMDS and 31 with AA) and seven controls. Immunohistochemical (IHC) staining for CD34 and p53 was performed by using the EnVision detection system (Dako, Denmark). We compared the results of IHC staining, BM findings, and chromosomal analyses, and determined overall survival outcomes. RESULTS: The number of CD34- and p53-positive BM cells was higher among the patients with hMDS than among the patients with AA (P<0.001 and P=0.001, respectively). hMDS patients with increased CD34-positive cells had significantly poorer survival outcomes compared with those with normal number of CD34-positive cells (P=0.013). CONCLUSIONS: CD34 and p53 IHC stains of BMC or BMB provide useful information for differentiating between hMDS and AA. CD34 IHC staining of BMC or BMB also provides useful information for estimating survival outcomes in hMDS patients.

Terapia de oxigenación hiperbárica en el tratamiento de pacientes con osteorradionecrosis: revisión de la literatura / Hyperbaric oxygen therapy in the treatment of patients with osteoradionecrosis: a review of the literature

El diagnóstico de los casos de cáncer en la región bucal son de particular interés para el odontólogo, la radioterapia se considera un instrumento para el tratamiento de estos tumores cuyo objetivo es erradicar a los mismos con la m¡nima cantidad de efectos adversos. Una consecuencia de la radioterapia es la osteorradionecrosis que es una lesión que se asienta en tejidos postirradiados en los que existe un serio compromiso hipóxico. Los protocolos de radioterapia de los tumores que se asientan en el piso de la boca, lengua y cuello, son muy agresivos, lo que aumenta la posibilidad de que provoquen la necrosis del hueso ( huesos maxilares) y tejidos adyacentes. En pacientes que presentan osteorradionecrosis existe un tratamiento que acelera el proceso de cicatrización y mejora la biodisponibilidad de los antibióticos a nivel local denominada oxigenación hiperbárica que actúa aumentando la oxigenación de los tejidos hipóxicos. El tratamiento con oxígeno hiperbárico consiste en administrar oxígeno al 100 por ciento a un individuo al que ha sometido a una presión ambiental superior a las 1,3 atmósferas absolutas, lo que se consigue en un recinto cerrado denominado cámara hiperbárica. Mediante este procedimiento terapéutico y en asociación con otras técnicas medico quirúrgicas, puedan tratarse diversas afecciones agudas y crónicas. El oxígeno hiperbárico u oxígeno administrado en ambiente presurizado, actúa como un auténtico fármaco, produciendo diferentes respuestas en función de las dosis y tiempo de administración

In the cases of cancer diagnosis in oral cavity, radiotherapy has a particular interest for the dentist as an instrument for tumor treatment therapy which main objective is to eradicate these tumors with the minimum of adverse effects. On of the consecuences of the radiotherapy is osteoradionecrosis which is an injure laying in post-irradiated tissues where there is a serious hypoxic engagement. The tumors radiotherapy protocols laying on floor of the mouth, tongue and neck are highly aggressive, this increases the possibilities of causing bone necrosis ( maxillary bones) and surround tissues. There is, for patients presenting osteoradionecrosis, a treatment which accelerates the healing process and improves the antibiotics bio-availability at a local level named hyperbaric oxygenation which acts raising oxygenation in hypoxic tissues. The hyperbaric oxygen treatment consist in administrating a 100 percent oxygen to an individual who has previously been exposed to a environmental pressure over 1,3 absolute atmospheres, this can be achieved in sealed room named hyperbaric chamber. Through this method and alongside with other medical surgical techniques several severe affections can be treated. The hyperbaric oxygen or oxygen administrated under a pressure environment work as an actual medicine (drug) producing different answers according to the dose and time administration

Hypoplastic Acute Leukemia / 대한임상병리학회지

BACKGROUND: Hypoplastic acute leukemia is rare and most cases reported were of older age group. We reviewed our cases of hypoplastic acute leukemia and their hematologic and clinical findings. METHOD: The bone marrow biopsy slides and the reports of patients diagnosed as having acute leukemia during recent ten years were reviewed. The medical records of patients who had blast cells of greater than 30% and marrow cellularity less than or equal to 50% were reviewed. RESULTS: Of 308 patients analyzed, 17 (5.5%) fulfilled the above mentioned criteria. Ten patients were women and seven men. The median age was 44 with a range of 18-71. Chief complaints were fever, headache, general weakness and abdominal pain. Two patient presented hepatomegaly. One patient was diagnosed as granulocytic sarcoma. Ten patients were pancytopenic with median leukocyte count of 1,500/ L, hemoglobin of 8.3 g/dL, and platelet count of 27,000/ L. Circulating blast cells were 0-76%. FAB classification revealed one to be M0, three M1, seven M2, three M4, one M5, one M6 and one L1. Seven patients were not followed, and three were treated conservatively. Of seven patients receiving chemotherapy, four achieved durable complete remission. One achieved complete remission by using G-CSF. CONCLUSION: Most cases of reported hypoplastic acute leukemia were acute myelogenous leukemia of older age but our cases included leukemia of younger age and one acute lymphoblastic leukemia. Of seven patients who received chemotherapy, four achieved complete remission and one showed complete remission only by G-CSF.