Clinicopathological analysis of myelodysplastic syndrome according to French-American-British classification

To evaluate the age of onset, gender ratio, clinical presentation of Myelodysplastic syndrome patients, and to classify these patients according to French-American-British classification on the basis of morphological features in blood and bone marrow. Case series. The department of Haematolgoy, Shaikh Zayed Hospital, Lahore, from April 2007 to March, 2007. Fifty patients of primary Myelodysplastic syndrome [MDS] were studied. The patients were classified according to French-American-British [FAB] criteria and the epidemiological, clinical and haematological features of MDS patients were evaluated. Descriptive statistics were used to describe data. There were 31 males and 19 females. The mean age was 41 years. According to FAB classification, 39 cases of retractory anaemia, 1 case of retractory anaemia with ring sideroblast, 6 cases of retractory anaemia with excess of blasts and 4 cases of refractory anaemia with excess of blasts in transformation were identified. The commonest complaint was easy fatiguablity affecting 41 cases [82%]. Anaemia was the most common finding seen in 47 patients [94%]. Pancytopenia was seen in 33 cases [66%]. Dyserythropoeisis was present in 42 [84%], dysmyelopoeisis was seen in 21 [42%] and morphologically abnormal megakaryocytes were identified in 29 [58%] of the bone marrow aspirates. Grade-III reticulosis was seen in 9 bone marrow trephine biopsies. Abnormla localization of immature precursors [ALIP] were present in 18 cases. MDS was more frequent in young males, Refractory anaemia constituted a major chunk of the disease entity

Hyper eosinophilic syndrome; a case series

Hyper eosinophilic syndrome [HES] is a subset of idiopathic eosinophilia that fulfils the criteria of a persistent [>6 months] increase in absolute eosinophil count [AEC] [>1.5x10[9]/l] associated with target organ damage. Recently it was classified into myeloproliferative and lymphoid variants. Present study is aimed to study the clinico morphological features and variants of HES and their response to various therapeutic modalities. In Pakistani population. It is a case series conducted at Haematology department, Shaikh Zayed hospital, Lahore during 4 years from Jan 2005 to Dec 2008. This study included 8 adult patients of HES diagnosed on history, clinical features and elevated absolute eosinophil count [AEC]. Seven of 8 patients were of lymphoid-HES and 1 was of myeloproliferative-HES. M: F ratio is 7:1, mean age of presentation was 37 years in lymphoid- HES and 69 years in myeloproliferative -HES. Presenting features were fatigue, weight loss, fever, SOB, paraesthesia and skin rash. Mean AEC in l-HES was 16109/l and in myeloproliferative- HES was 22.7x109/l. Organ damage was seen in cardiovascular, gastrointestinal [GIT], respiratory and nervous systems. All of the lymphoid-HES responded to steroids. In conclusion, early diagnosis and targeted therapy improve outcome in HES