[Impact of early lymphopenia on the risk of febrile neutropenia and hematological toxicity]

Background: Hematologic toxicity is a severe complication of chemotherapy. The objective of our study is to evaluate the impact of early lymphopenia on the risk of occurrence of febrile neutropenia and hematological toxicity after aggressive chemotherapy for Hodgkin lymphoma or high grade non-Hodgkin lymphoma

Methods: This prospective study involved 42 patients who received 193 cycles of chemotherapy in 2009. We assessed the impact of lymphopenia on day 1 and 8 on the risk of occurrence of febrile neutropenia. We also investigated the relation between the occurrence of hematologic toxicity after the first cycle and the subsequent cycles

Results: Febrile neutropenia was observed in 25% of cycles. Grade 3/4 hematologic toxicity occurred in 63% of cycles. Growth factors were used in 79% of cycles. Lymphopenia

Conclusion: Our results confirmed the impact of early lymphopenia on the occurrence of febrile neutropenia and hematologic toxicity after aggressive chemotherapy for Hodgkin lymphoma or high grade non Hodgkin lymphoma

[Adult lymphocytosis classification by flow cytometry]

Positive and differential diagnosis of chronic lymphocytic leukemia [CLL] is based on immunophenotyping analysis. CLL is searched whenever a persistent lymphocytosis is found. To evaluate the performance of flow cytometry in etiologic diagnosis of lymphocytosis. Could it allow us to distinguish CLL from other causes of lymphocytosis? Blood samples from 104 adult patients having a rate of lymphocytes> 5000 ele/mm[3] persisting more than three months were analyzed using a large panel of monoclonal antibodies in three colors and Cell Quest software. Lymphoproliferative B disorder was retained in 83 cases, including 50 cases of typical CLL with Matutes score >/= 4 and 12 cases of atypical CLL with Matutes score = 3. Diagnosis of hairy cell leukemia and follicular lymphoma were guided by the respective specific antigen expression CD103 and CD10. Large granular T lymphoma [LGL-T] was the most common etiology of lymphoid T proliferation. Unusual cases of Natural Killer [NK] and NK/T proliferations were found. The Flow cytometry is a powerful tool to establish lymphocytosis etiological diagnosis; it avoids invasive investigations in a large number of cases

[Splenectomy in hereditary hemolytic anemia: 82 Tunisian cases]

Splenectomy is frequently advised in hereditary hemolytic anemia.Severe complications could occur after splenectomy. To provide the indication and benefit of splenectomy clinical and biological patterns were performed in a retrospective study of 82 patients: 17 homozygous beta thalassemia, 17 thalassemia intermedia, 33 heterozygote HbS I beta thalassemia and 15 hereditary spherocytosis. Splenectomy was performed for: Hypertransfusion in homozygous thalassemia, hereditary spherocytosis; hypersplenism in Thalassemia intermedia and splenic sequestration in heterozygote HbS/beta thalassemia.The benefit of splenectomy was proved in hereditary spherocytosis [100%], heterozygote HbS/beta thalassemia [90%] and thalassemia intermedia [75%];nevertheless in homozygous beta thalassemia.Post splenectomical complication are often thrombocytosis, thrombosis and infections. Splenectomy should be performed in hereditary hemolytic anemia to reduce and avoid transfusion