Hematology Reports

3 pages, 648 KiB

Open AccessCase Report

Pulmonary Extramedullary Hematopoiesis Involving the Pulmonary Artery

by Varun Monga and Margarida Silverman

Hematol. Rep. 2015, 7(1), 5714; https://doi.org/10.4081/hr.2015.5714 - 24 Mar 2015

Cited by 12 | Viewed by 326

Extramedullary hematopoiesis (EMH) occurs as a complication of hematologic disorders such as myelofibrosis, sickle cell anemia and thalassemia. The extramedullary tissue usually involves liver, spleen and lymph nodes, less frequently the chest. We present a recent case of a man with myeloproliferative neoplasm [...] Read more.

Extramedullary hematopoiesis (EMH) occurs as a complication of hematologic disorders such as myelofibrosis, sickle cell anemia and thalassemia. The extramedullary tissue usually involves liver, spleen and lymph nodes, less frequently the chest. We present a recent case of a man with myeloproliferative neoplasm who developed pulmonary hemorrhage secondary to EMH in the lung and pulmonary artery. Radiation therapy was considered the best approach, but it didn’t work and the patient died a week after radiation therapy was completed. We also review herein the present literature. Full article

2 pages, 519 KiB

Open AccessCase Report

Acute Iatrogenic Polycythemia Induced by Massive Red Blood Cell Transfusion during Subtotal Abdominal Colectomy

by David Chiapaikeo and Pejman Rohani

Hematol. Rep. 2015, 7(1), 5638; https://doi.org/10.4081/hr.2015.5638 - 23 Mar 2015

Cited by 2 | Viewed by 384

Abstract

A 46 year old man was transfused ten units of packed red blood cells during subtotal colectomy after intraoperative point-of-care testing values demonstrated hemoglobin values less than seven grams per deciliter (g/dL). A post-operative hemoglobin analyzed in a standard hematologic laboratory revealed a [...] Read more.

A 46 year old man was transfused ten units of packed red blood cells during subtotal colectomy after intraoperative point-of-care testing values demonstrated hemoglobin values less than seven grams per deciliter (g/dL). A post-operative hemoglobin analyzed in a standard hematologic laboratory revealed a hemoglobin value of 27.8 g/dL. He underwent emergent red blood cell depletion therapy which decreased his hemoglobin to 7.5 g/dL. The physiologic consequences of iatrogenic polycythemia caused by massive transfusion during major abdominal surgery must take into account the fluid shifts that interplay between the osmotic load, viscosity of blood, and postoperative third spacing of fluid. Treatment of acute iatrogenic polycythemia can be effectively accomplished by red blood cell depletion therapy. However, fluid shifts caused by massive transfusion followed by rapid red cell depletion produce a unique physiologic state that is without a well-described algorithm for management. Full article

4 pages, 712 KiB

Open AccessCase Report

Complex Karyotype with Novel Translocation in Pure Erythroid Leukemia Patient

by Mansour Aljabry

Hematol. Rep. 2015, 7(1), 5674; https://doi.org/10.4081/hr.2015.5674 - 16 Mar 2015

Cited by 5 | Viewed by 327

Abstract

Pure erythroid leukemia (PEL) is rare hematopoietic neoplasm characterized by uncontrolled proliferation of immature erythroid precursors—mainly abnormal proerythroblasts—comprising at least 80% of bone marrow cells. In this paper, I present a case of 48 years old patient, who presented with pancytopenia and circulating [...] Read more.

Pure erythroid leukemia (PEL) is rare hematopoietic neoplasm characterized by uncontrolled proliferation of immature erythroid precursors—mainly abnormal proerythroblasts—comprising at least 80% of bone marrow cells. In this paper, I present a case of 48 years old patient, who presented with pancytopenia and circulating erythroblast in peripheral blood after long history of alcohol abuse. Bone marrow examination revealed hypercellular marrow which is markedly infiltrated with immature erythroid precursors. An expanded panel of immunophenotyping markers has confirmed the diagnosis of PEL. Cytogenetics analysis detected a complex karyotype with multiple chromosomal abnormalities and a novel translocation, t(8;9) (p11.2;q12), which has not been reported in acute myeloid leukemia (AML) in the past. The patient was treated with standard AML chemotherapy but he did not show an optimal response and passed away. An updated and short review about various aspects of PEL has been made with special focus on immunophenotyping and genetic studies. Full article

2 pages, 513 KiB

Open AccessCase Report

Emergency Management of Major Bleeding in a Case of Maxillofacial Trauma and Anticoagulation: Utility of Prothrombin Complex Concentrates in the Shock Room

by Alessandro Morotti and Mauro Felice Frascisco

Hematol. Rep. 2015, 7(1), 5656; https://doi.org/10.4081/hr.2015.5656 - 09 Mar 2015

Cited by 4 | Viewed by 253

Abstract

Life-threatening bleeding in anticoagulation with Warfarin is an emergency challenging issue. Several approaches are available to treat bleeding in either over-anticoagulation or propeanticoagulation, including vitamin K, fresh frozen plasma and prothrombin complex concentrates (PCC) administration. In coexisting trauma-induced bleeding and anticoagulation, reversal of [...] Read more.

Life-threatening bleeding in anticoagulation with Warfarin is an emergency challenging issue. Several approaches are available to treat bleeding in either over-anticoagulation or propeanticoagulation, including vitamin K, fresh frozen plasma and prothrombin complex concentrates (PCC) administration. In coexisting trauma-induced bleeding and anticoagulation, reversal of anticoagulation must be a rapid and highly effective procedure. Furthermore the appropriate treatment must be directly available in each shock rooms to guarantee the rapid management of the emergency. PCC require a simple storage, rapid accessibility, fast administration procedures and high effectiveness. Here we report the utility of PCC in management of a craniofacial trauma in proper-anticoagulation. Full article

4 pages, 764 KiB

Open AccessCase Report

A Rare Cause of Acquired Immune Deficiency Syndrome Related Pancytopenia

by Su Bin Kim, Makeardhwaj Sarvadaman Shrivastava and Marianna Strakhan

Hematol. Rep. 2015, 7(1), 5475; https://doi.org/10.4081/hr.2015.5475 - 09 Mar 2015

Cited by 4 | Viewed by 305

Abstract

A 21-year-old male with acquired immune deficiency syndrome, not on highly active antiretroviral treatment (HAART) was admitted after complaining of headache and intermittent diarrhea, found to have Cryptococcal meningitis. During the course of his hospitalization, patient developed pancytopenia. Anemia panel, serologies including Epstein [...] Read more.

A 21-year-old male with acquired immune deficiency syndrome, not on highly active antiretroviral treatment (HAART) was admitted after complaining of headache and intermittent diarrhea, found to have Cryptococcal meningitis. During the course of his hospitalization, patient developed pancytopenia. Anemia panel, serologies including Epstein barr virus, cytomegalovirus, and parvovirus were negative. Patient then developed high grade fever with elevated liver enzymes. Blood cultures, urine cultures, stool cultures, and repeat cerebrospinal fluid cultures remained negative. Patient subsequently developed skin lesions which on biopsy showed Kaposi’s sarcoma, and upon endoscopy, noted to have gastrointestinal Kaposi’s sarcoma involvement. Human herpes virus 8 was positive. Bone marrow biopsy revealed hemophagocytic lymphohistiocytosis. Despite having a concern for patient developing immune reconstitution syndrome which may worsen his meningitis, HAART was initiated and patient’s symptoms improved including resolution of fevers and hematological as well as liver abnormalities. Kaposi’s sarcoma improved as well. Full article

3 pages, 561 KiB

Open AccessCase Report

Central Neurotoxicity of Immunomodulatory Drugs in Multiple Myeloma

by Urmeel H. Patel, Muhammad A. Mir, Jeffrey K. Sivik, Divisha Raheja, Manoj K. Pandey and Giampaolo Talamo

Hematol. Rep. 2015, 7(1), 5704; https://doi.org/10.4081/hr.2015.5704 - 03 Mar 2015

Cited by 21 | Viewed by 532

Abstract

Immunomodulatory drugs (IMiDs) currently used in the treatment of multiple myeloma, are thalidomide, lenalidomide and pomalidomide. One of the most common side effects of thalidomide is neurotoxicity, predominantly in the form of peripheral neuropathy. We report 6 cases of significant central neurotoxicity associated [...] Read more.

Immunomodulatory drugs (IMiDs) currently used in the treatment of multiple myeloma, are thalidomide, lenalidomide and pomalidomide. One of the most common side effects of thalidomide is neurotoxicity, predominantly in the form of peripheral neuropathy. We report 6 cases of significant central neurotoxicity associated with IMiD therapy. Treatment with thalidomide (1 patient), lenalidomide (4 patients), and pomalidomide (1 patient) was associated with various clinical manifestations of central neurotoxicity, including reversible coma, amnesia, expressive aphasia, and dysarthria. Central neurotoxicity should be recognized as an important side effect of IMiD therapy. Full article

4 pages, 683 KiB

Open AccessArticle

Interferon α Therapy in Patients with Chronic Hepatitis C Infection: Quality of Life and Depression

by Ciro Conversano, Claudia Carmassi, Marina Carlini, Giulia Casu, Paola Gremigni and Liliana Dell’Osso

Hematol. Rep. 2015, 7(1), 5632; https://doi.org/10.4081/hr.2015.5632 - 03 Mar 2015

Cited by 18 | Viewed by 514

Abstract

Health-related quality of life was examined in 49 patients with hepatitis C virus with no psychiatric history who received interferon (IFN)-α treatment. Quality of life was assessed at baseline, at 3-time points during IFN-α therapy and at 1-6 month follow-up, using SF-36. Hepatitis [...] Read more.

Health-related quality of life was examined in 49 patients with hepatitis C virus with no psychiatric history who received interferon (IFN)-α treatment. Quality of life was assessed at baseline, at 3-time points during IFN-α therapy and at 1-6 month follow-up, using SF-36. Hepatitis C virus patients showed poorer physical functioning and better social and mental functioning than a normal population. Significant decreases from baseline SF-36 scores were observed at an early phase of treatment. Six patients developed major depression during IFN-α treatment. At baseline, they had reported more bodily pain than patients who did not develop depression during treatment. Planned contrasts revealed that worsening in some dimensions of quality of life at 2 months was greater in depressed than in non-depressed patients. Results suggest that depressive symptoms should be accurately monitored during IFN-α therapy even in patients with no psychiatric history, especially if they present with bodily pain. Full article

4 pages, 634 KiB

Open AccessCase Report

Feasibility of Romiplostim Discontinuation in Adult Thrombopoietin-Receptor Agonist Responsive Patients with Primary Immune Thrombocytopenia: An Observational Retrospective Report in Real Life Clinical Practice

by Monica Carpenedo, Silvia Cantoni, Veronica Coccini, Marilena Fedele, Enrica Morra and Enrico Maria Pogliani

Hematol. Rep. 2015, 7(1), 5673; https://doi.org/10.4081/hr.2015.5673 - 24 Feb 2015

Cited by 20 | Viewed by 552

Abstract

Thrombopoietin mimetics are new treatment options for patients with immune thrombocytopenia (ITP). Because of their mechanism of action, long-term administration was envisioned in order to maintain effective thrombopoiesis. We report on 30 romiplostim treated patients: 13/27 responders (48%) achieved stable platelet counts on [...] Read more.

Thrombopoietin mimetics are new treatment options for patients with immune thrombocytopenia (ITP). Because of their mechanism of action, long-term administration was envisioned in order to maintain effective thrombopoiesis. We report on 30 romiplostim treated patients: 13/27 responders (48%) achieved stable platelet counts on a mean romiplostim dose of 2.43 μg/kg and were able to stop romiplostim after a mean of 44.3 weeks (range 12-122) on therapy with sustained response maintained at a mean of 26 months (range 12-52). No bleeding events occurred during the observational period. No specific patient’s features nor pattern of early response seemed to predict for sustained response. However, patients achieving safe platelet counts at lower dosages are probably worth a try of therapy tapering and discontinuation. Our observations support feasibility of romiplostim safe suspension in a relevant proportion of ITP patients. Full article

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Hematol. Rep., Volume 7, Issue 1 (February 2015) – 8 articles

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