Etiologic Evaluation of 1012 Patients Admitted with Thrombocytopenia.

Introduction: Thrombocytopenia is the situation where the number of thrombocytes is less than 150.000/ μL. This may result due to decreased thrombocyte production, increase in the destruction of thrombocytes and differentiation in distribution of thrombocytes. Hereditary and acquired diseases both contribute to the condition, but the acquired reasons are more common in older patients. In this study we aimed to present the patients’ data with thrombocytopenia in the eastern Turkey and the underlying diseases that cause thrombocytopenia in order to contribute to literature. Material and Methods: In this study, we retrospectively aimed to evaluate the etiology of thrombocytopenia at 1012 patients who admitted to Inonu University Medical Faculty Turgut Ozal Medical Center Hematology outpatient clinic, hematology service, emergency department and the ones who were consulted from other departments in the hospital. We collected data of patients for whom we searched the aetiology of thrombocytopenia as Department of Hematology. Results: Total of 1012 patients, of whom 508 were female and 504 were male, were included to the study. The mean age was 51±20 years. The mean number of the thrombocytes was 64.28±43.05 /mL. The mean number of leucocytes was 13.89±32.71 /μL. The mean level of hemoglobin was 11.22±3.03 g/dL. Leukaemia, infections and the immune thrombocytopenias represented most of the cases, and the other reasons of thrombocytopenia were drugs, chronic liver diseases, megaloblastic anemias, pseudothrombocytopenia, thrombotic microangiopathies and other diseases. Conclusion: The reasons of thrombocytopenia may differ according to geographic distribution and step level of health centers. It’s an expected situation for thrombocytopenia reasons that the high rate of infections can be accused in developing countries and malignant diseases to be the first reason in developed countries.

unexpected complication of bone marrow aspiration and trephine biopsy: arteriovenous fistula

To report a case of arteriovenous fistula [AVF] following bone marrow aspiration and trephine biopsy. Clinical Presentation and Intervention: A 76-year-old man was diagnosed with acute myeloblastic leukemia. Pain and hematoma were detected in his left leg and hip 4 days after bone marrow aspiration and trephine biopsy. A pelvic arteriography was performed, and a diagnosis of AVF was made. This case shows that clinicians should be aware of AVF, especially in cases with refractory bleeding after bone marrow aspiration and trephine biopsy despite normal blood coagulation parameters

Clinicopathologic characteristics and therapeutic outcomes of primary gastrointestinal non-Hodgkin's lymphomas: 10 years of experience from a single center in Eastern Anatolia

The objective of this retrospective study was to report the clinicopathological data and the treatment outcomes in patients with primary gastrointestinal non-Hodgkin's lymphoma. We carried out a retrospective analysis of 41 patients [22 females, 18 males, median age 58 and range 18-90 years] who presented to our department with histopathological diagnosis of primary gastrointestinal non-Hodgkin's lymphoma between 1995 and 2004. The stomach was the most common extranodal site and was seen in 25 of 41 [61%] patients. At presentation 28 [68.3%] patients had gastrointestinal symptoms while 27 [65.9%] had B symptoms. The range of follow-up was 2-84 months with a median of 9 months. The overall survival rate was 3 years for 25 [61.21%] patients. The 3-year overall survival rate was better in patients with early-stage disease [stages I and II[1]] who were treated with surgery plus chemotherapy and/or radiation therapy than in those treated with chemotherapy alone [91.6 vs. 50%, p<0.05]. The disease had a significant impact on both the progression-free survival and overall survival rates. Our data showed that surgical resection prior to postoperative chemotherapy was a better option for patients with early-stage disease with better patient survival

Effects of cyanocobalamin on immunity in patients with pernicious anemia

The aim of the study was to evaluate the role of vitamin B12 in patients with pernicious anemia. This study was conducted prospectively at the Turgut ?zal Medical Center, Department of Hematology, between April and November 2002. Absolute numbers and ratio of the surface antigens of T and B lymphocyte subgroups, CD4/CD8 ratio were calculated in order to evaluate changes in leukocyte and lymphocyte numbers; natural killer [NK] cell count, serum C3, C4, and levels of immunoglobulins G, A, and M were also measured to evaluate vitamin B[12] effect on immunity. Values obtained before treatment with cyanocobalamin were compared with those found during peak reticulocyte count. In vitamin B[12]-deficient patients, absolute numbers of CD4+ and especially CD8+ lymphocytes were found to be decreased; CD4/CD8 ratio increased, and NK cell activity was depressed. After cyanocobalamin treatment, absolute numbers and percentage of lymphocyte subgroups were elevated. Increased CD4/CD8 ratio and depressed NK cell activity were restored and levels of C3, C4, and immunoglobulins were elevated. These findings suggest that vitamin B[12] has important immunomodulatory effects on cellular immunity, and abnormalities in the immune system in pernicious anemia are restored by vitamin B[12] replacement therapy

Retrospective analysis of patients with Idiopathic thrombocytopenic purpura from Eastern Anatolia

We evaluated the clinical features and the effects of various treatment modalities on the clinical course in patients diagnosed with idiopathic thrombocytopenic purpura [ITP]. Retrospective investigation of the medical records of 168 patients at our center between 1994 and 2005 was done. Of the 168 patients, 115 [68.4%] were women and 53 [31.6%] men. At initial diagnosis, the median age of the patients was 33 years [range: 15-91] and 139 [82.7%] had signs of bleeding. Follow-up was complete in 130 patients and the median follow-up was 27 months [range: 3-132]. Initial treatment with either standard or high-dose steroid as first-line therapy was begun in 123 [73.2%] of the 168 patients. Complete remission [CR] was achieved in 56% of the patients. Sixty-one [61] patients who were followed up regularly received second-line therapies. CR was achieved in 45.8% of the patients who received steroids as second-line therapy. Within a median follow-up of 7 months, 27.2% of these patients relapsed. Splenectomy was performed in 26 patients and CR was obtained in 72% of the 25 patients regularly followed up. CR obtained by splenectomy was significantly higher than that obtained by steroids [p < 0.001]. The 10-year disease-free survivals in patients who used steroids and who underwent splenectomy were 15 and 61.6%, respectively. Steroid therapy is effective both in the initial and relapse periods. Splenectomy is the treatment of choice for those ITP patients refractory to steroid therapy and younger than 40 years of age