Alteraciones hematológicas en trabajadores expuestos ocupacionalmente a mezcla de benceno- tolueno-xileno (BTX) en una fábrica de pinturas / Blood disorders among workers exposed to a mixture of benzene-toluene-xylene (BTX) in a paint factory

Objetivos. Evaluar las tres series celulares sanguíneas e identificar la presencia de hipocromía, macrocitosis, leucopenia, linfocitopenia y trombocitopenia en un grupo de trabajadores expuestos a la mezcla de benceno-tolueno-xileno (BTX). Materiales y métodos. Estudio transversal donde se incluyó a 97 trabajadores de una empresa de pinturas de México a los que se les realizó una biometría hemática convencional y les fue estimada la exposición a través de la dosis diaria potencial acumulada para vapores de BTX. Resultados. Del total de trabajadores, 19,6%, mostró macrocitosis, 18,6%, linfocitopenia, 10,3% hipocromía, 7,2% trombocitopenia y 5,2% leucopenia. La asociación cruda de macrocitosis con exposición a dosis alta de mezcla de BTX fue la única significativa (OR:3,6; IC95%: 1,08 - 13,9; p=0,02) y en la que se estructuró un modelo de regresión logística (OR:6,7; IC95%: 1,33 - 13,55; p:0,02) ajustada por edad, consumo de alcohol y tabaquismo. Conclusiones. Todos los componentes citohemáticos analizados mostraron cambios leves; que podrían estar asociados con la exposición a la mezcla de BTX. De ellos, la macrocitosis podría constituirse en una manifestación precoz que merece ser vigilada.

Objectives. Evaluate the three blood cell series and identify the presence of hypochromia, macrocytosis, leucopenia, lymphopenia, and thrombocytopenia in a group of workers exposed to the mixture of benzene-toluene-xylene (BTX). Materials and methods. A cross-sectional study which included 97 workers from a paint factory in Mexico. The participants underwent conventional blood count and tests for potential cumulative daily dose of BTX fumes, to estimate exposure. Results. From the total of workers, 19.6% showed macrocytosis, 18.6%, lymphopenia, hypochromia 10.3%, 7.2% and 5.2% thrombocytopenia leukopenia. The crude association of macrocytosis with exposure to high doses of BTX mixture was the only with statistical significance (OR: 3.6, 95% CI 1.08 to 13.9, P = 0.02), and the base for a logistic regression model (OR: 6.7, 95% CI 1.33 to 13.55, P = 0.02) adjusted for age, alcohol consumption, and smoking. Conclusions. All blood cytological components analyzed demonstrated mild changes, potentially associated with exposure to the mixture of BTX. Macrocytosis could constitute an early manifestation worthy for surveillance.

Niveles séricos de eritropoyetina en sujetos sanos estudiados en el valle de México / Erythropoietin seric levels in healthy student subjects in the Valley of Mexico

La eritropoyetina (EPO) es el factor humoral directamente resposable de la eritropoyesis, y su secreción se relaciona con el grado de oxigenación tisular. En altitudes por arriba del nivel del mar; las concentraciones de oxígeno son menores, lo que podría influir en los niveles séricos de EPO y de esta manera explicar el aumento de las cifras de hemoglobina y hematócrito. Por otro lado, la determinación de sus niveles sanguíneos es de gran importancia tanto en el diagnóstico diferencial de las anemias, como en el estudio de la eritrocitosis, en especial la policitemia rubra vera, enfermedad en que sus niveles son normales o bajos. Por tal motivo estimamos conveniente determinar las cifras que podrían ser consideradas como valores de referencia en población residente en la ciudad de México. Se estudió un total de 220 sujetos sanos, 168 hombres y 52 mujeres. Los niveles de EPO sérica, determinados por radioinmunoanálisis resultaron, en todo el grupo, con una mediana (Md) de 7.5 mU/ml, con un intervalo percentilar, (IP) de 1 a 18; en el sexo masculino la Md fue de 7.6 con un IP de 1 al 18 y en el sexo femenino Md de 7.5 con un IP de 1 a 16.9

Cytogenetic findings in 303 mexican patients with de novo acute myeloblastic leukemia

In this report we show the chromosomal changes seen in a group of 303 Mexican patients with de novo Acute myeloblastic Leukemia (AML). Two hundred forty-two patients were diagnosed and treated at two hospitals affiliated with the Instituto Mexicano del Seguro Social (IMSS). These are the Centro Medico Nacional Siglo XXI and Centro Medico La Raza Hospitals; the remaining 61 patients were diagnosed and treated at the Hospital General de Mexico (HGM). Clonal abnormalities were detected in 75.6 percent of the patients; this result agrees with what has been reported in other large series of AML studies. The incidence of changes per hospital was similar in patients from the IMSS hospitals (72-75 percent), while an increase was seen in patients from the HGM (85.2 percent). The cromosomal changes seen in this study in order of frequency were: t(15;17)[18.8 percent], t(9;22)[9.2 percent], miscellaneous chromosomal changes (mainly rearrangementa of chromosomes 1,2,3,12 y 17) [8.2 percent], abnormalities of 16q22 [7.3 percent], t(8;21)[6.3 percent], -7/del(7q)[5.6 percent], t(6;9)[5.3 percent), and abnormalities of 11q23 [4.6 percent]. We reported an increase in the indicidence of certain types of chromosomal changes seen in cases of AML, in comparison with reports from other countries. These differences must not be disregarded. We support this finding when comparing distribution of changes in the population of patients seen in the IMSS hospitals with those from the HGM; the main difference lies in the socioeconomic level

Treatment results of 23 cases of severe aplastic anemia with lymphocytapheresis

We report the results of 23 patients with aplastic anemia (AA) treated with a program of 14 lymphocytapheresis (LC). Treatments were performed with apheresis machines, models Haemonetics 30-S and Baxter CS3000, using the standard program. This procedure was done because AA in many cases appears as a result of the action of a T cell population that inhibits hematopoiesis. Theorically, removal of this clonal population would produce hematopoietic recovery. Of the total of 23 patients, 9 were excluded for final evaluation of treatment results because 7 died during or shortly after treatment (0.7-3 months); one patient abandoned treatment after three LC and another died 7 months later because of transformation to acute leukemia. The ramaining 14 patients were included in the final evaluation of treatment; seven females and seven males, average age 46.1 years (range 22-69); 13 with severe, and one with moderate AA; 11 with recently diagnosed, and 3 with chronica AA; 12 without previous treatment and two treated before with antilymphocyte globulin + oxymetholone (OXN) + cyclosporine A (CsA) with transiet partial remission (PR). Besides lymphocytapheresis, 13 patients received OXM; 4 of them GM-CSF ad one low dose CsA. Four patients had complete remission lasting >59.5 months (range 42-78); eight PR (average duration of >38.6 months), and two minimal remission (>37 and 29 months). Platelet, reticulocyte and granulocyte counts increased on average at 48.7, 73.3 and 91.4 days, respectively. In cocnlusion, 14 (60.8 perecent) of 23 patients with AA showed an improvement related to LC treatment, with a survival probability of 63 percent from the fourth month, the latter with and added beneficial effect of the other therapies used. Larger numbers of patients have to be treated with LC to determine its real usefulness, mechanism of action and the best conditions for its use