REVIEW | |
1. | Thromboembolism in Patients with Cancer Abdullah Büyükçelik, Hakan Akbulut Page 0 One hundred and forty years ago, Armand Trousseau described phlegmasia alba dolens as a sign of internal malignancy. Nowadays, it is commonly believed that the presence malignant tumaor increases the risk of venous thromboembolism (i.e deep vein thrombosis and pulmonary embolism) However, cancer is usually associated with other factors such as old age, extensive surgery,immobility, etc., which may predispose to thromboembolism. The majority of thrombotic events occur in the venous system; the incidence of arterial thrombosis is much lower.Recurrent thromboembolism in cancer patients frequently and diminishes the quality of life of the patients.Furthermore, if the thromboembolism is massive, destipte of early and aggressive treatment, it may result in death. In this article, we review thromboembolic complications in cancer patients. |
RESEARCH ARTICLE | |
2. | Therapeutic Angiogenesis by Autologous Transplantation of Bone Marrow Mononuclear Cells for Buerger's Patients with Retractable Limb Ischaemia: A Preliminary Report Rüçhan Akar, Serkan Durdu, Mutlu Arat, Neyyir Tuncay Eren, Öder Arslan, Tümer Çorapçıoğlu, Tanzer Sancak, Burcu Uzun, Metin Kİr, Osman İlhan, Ümit Özyurda Pages 13 - 21 Bone marrow implantation into ischaemic limbs could enhance angiogenesis by supplying endothelialprogeniter cells and angiogenic cytokinesot factors. We investigated efficacy and safety of autologousimplantation of bonemarrow-mononuclearcells (BMMC)in patients with ischaemic limbs due to Buerger's disease. We commence daciinical study to test cell therapy with autologous BMMC in patients with ischaemic limbs at the University of Ankara School of Medicine. In order for the patients to qualify for BMMC implantation, they should have critical limb ischaemia define das ischaemic rest painin a limb with or without non healing ulcers, should not respond to previous iloprost infusions and smoking cessation six months prior to evaluation and should not be candidates for nonsurgicalor surgical revascularisation. Primaryend points were safety andfeasibility of the treatmentand total healing of the most importantlesion. Secondary endpoints were total relief of rest pain without the need for analgesies,change in peak walkingtime (PWT)at 12 weeks, improvements in ankle-brachial pressure index(ABI), transcutaneous oxygen saturation using pulse oximetry(SaO2),angiographic evidence of newcollatera lvesselformation, tissue perfusion in the affected extremity using Thallium perfusions cintigraphyW. hilepatients(meanage46.7: !: 10.3years)were undergeneraal naesthesiaw, eharvested bonemarrow(519: t 45.5mUfromtheposteridilriacspineA. fterredbloodcell(RBCd) epletiaannd volumereduction using a continuous flow cell separator,we achieved 91% RBC depletian and concentrated /~MMC to a final volume and concentration of 51.5: t io.1 mLand7.04: t 1.9 x ioe7/mL total nucleated cells, respectively W.eimplantedBMMC (mean12.16: t 4.3 x ioe8) within three hours after marrow aspiration by intramuscular injection into the gastrocnemiusmuscle of ischaemic legs. Isotonic saline were injected into the other extremityin as similar fashion as control. 13 Unilateral intramuscular administration of BMMC was not associated with any complications. The primary efficacy end point, total healing of the most importantlesion, was achieved in three patients. All patients were followed up for at least four weeks. The secondary measures; change in PWT(LlPWT)at 12 weeks, total relief of rest pain without the need of analgesics improved in three patjents. These improvements were sustained for 24 weeks in the first two patients. Digital subtraction angiographic studies before and 3 months after the BMMC implantation showed the presence of a new vascular collateral network across the affected arteries in three patients. Preliminary results of the presentedstudy are promising. Thus, bone marrow maybe a potential source of cells for Buerger'spatients with end-stage Iimbischaemia refractory to other medical treatment modalities. |
3. | Rapid Detection of the Apoptosis Related Genes (BCL-2, BAD, BAX) in 12 Hours 1,25 (OH)2D3 Treated HL-60 Cells Using Real-Time Quantitative RT-PCR Hakan Savlı, Saadet Özdemir, Balint Nagy Pages 23 - 26 HL-60 cell line offers an interesting model to study apoptosis. Our aim was to detect the expressions of three apoptotic genes (BCL-2, BAD and BAX) using Real-Time quantitative polymerase chain reaction (PCR). HL-60 cells were incubated with 1,25 (OH)2D3 (5 x 10-8 M). RNA portions were isolated and LightCycler analysis were performed on cDNA samples. 1,25 (OH)2D3 incubated cell portions were compared to nontreated portions. We observed down-regulated levels of three genes at the end of the 12 hours. Gene expression ratios were 0.98 for BAX, 0.41 for BAD, 0.81 for BCL-2. For the first time, this study represents the expression levels of these three apoptosis related genes together during early phase (12 hours) of 1,25 (OH)2D3 treatment of HL-60 cells. Data indicate that expression differences of these apoptosis genes take place so early in exposure to 1,25 (OH)2D3. This optimised strategy would be used in rapid understanding of similar apoptotic deregulations. |
4. | Anti-D and Intravenous Immunoglobulin Treatments in Chronic Idiopathic Thrombocytopenic Purpura Çağatay Ünsal, Emel Gürkan, Birol Güvenç, Fikri Başlamışlı, Abdullah Canataroğlu Pages 27 - 32 The aim of this prospective study was to evaluate the data from 29 patients diagnosed as chronic refractory idiopathic thrombocytopenic purpura (ITP) treated with anti-D immunoglobulin and intravenous immunoglobulin G (IVIG). We used anti-D and IVIG in 11 and 18 patients respectively in whom the previous treatments including corticosteroids and splenectomy had been unsuccessful. The complete response rates were significantly higher in IVIG arm (55.5% to 18.1%) with a duration of 8 weeks. The overall efficacy of IVIG in the chronic ITP is similar to previous data, however we found lower platelet responses in patients treated with anti-D that can be attributed to the lower sucess in the splenectomized patients. |
CASE REPORT | |
5. | Report of a Family with Fanconi Anemia and Ataxia-Telangiectasia Türkan Patıroğlu, Selmin Murataldı, Yusuf Özkul, Esat Köklü Pages 33 - 37 We diagnosed two boys with two different chromosomal instability disorders such as Fanconi anemia (FA) and ataxia-telangiectasia (AT) in the same family. The phenotype of the first sibling supports the diagnosis of ataxia-telangiectasia. He had ataxia, telangiectasias on bulbar conjunctivas, a high level of alpha-fetoprotein, low levels of IgA and IgE, and a defective cell-mediated immunity. Cytogenetic studies of the peripheral lymphocytes revealed a chromosomal sensitivity to ionizing radiation. His 8-years-old brother had pancytopenia but had no ataxia and telangiectasia. He had a normal level of immunoglobulins and alpha-fetoprotein. His cell-mediated immunity was also normal. Cytogenetic studies showed no evidence spontaneus chromosome aberrations; however, there was a mild increase in the rate of diepoxybutane (DEB) and also an increased chromosome aberrations in the mitomycin C (MMC) treated samples than the control. The parent of the boys and 5th child were healty. The first child had normal hematological and immunological features, but he had a mild increase in the rate of DEB. The 4th child had an increased rate of DEB-induced chromosome aberrations. To our knowledge, this is the first family with FA and AT in Turkey and it is reported because of its rarity. |
6. | Primary Uterine Lymphoma: A Rare Cause of Postmenopausal Bleeding Cem Dane, Banu Dane, Emine Kalli, Murat Erginbaş, Ahmet Çetin Pages 39 - 43 Although uterus and cervix infiltration is a frequent finding in the later stages of lymphomatous disease, non-Hodgkin’s lymphoma (NHL) of the female genital tract is extremely rare. We present the case of a 63-years- old woman diagnosed with postmenopausal bleeding, Ann Arbor stage IE, primary, diffuse, large B-cell NHL of the uterus. Disease status was monitored with physical examination and imaging studies. We administered chemotherapy according to CHOP protocol (cyclophosphamide, adriamycin, vincristine, and prednisone). Primary pelvic NHL may present symptoms like other more common gynecologic cancers. It should be considered in the differential diagnosis of gynecologic malignancy. Our case emphasizes the importance of chemotherapy that can provide a control of the distant microscopic metastases. |
7. | A Case with Chronic Eosinophilic Leukaemia Resulting in Blastic Transformation Abdullah Hacıhanefioğlu, Muharrem Akkaş, Pınar Tarkun, A. Turgut Karakaya, Cengiz Erçin Pages 45 - 48 Chronic eosinophilic leukaemia is a rare myeloproliferative disease different from the chronic myeloid leukaemia. It is a haematologic malignancy that must be considered separately from other causes of eosinophilia due to its remarkable clonal eosinophilia. Here, we describe a case with chronic eosinophilic leukaemia which was initially hypereosinophilic (eosinophil count: 85.4 x 109/L) and displayed blastic transformation after a 9 months follow up. We suggest the invasion of spleen, probable invasion of the liver and the blastic transformation of this case must be discerned as a different entity rather than the other causes of eosinophilia. |
IMAGES IN HEMATOLOGY | |
8. | Images in Hematology Mehmet Ali Özcan, Özden Pişkin, İnci Alacacıoğlu, Yusuf Savran, Hayri Güner Özsan Page 49 Abstract | |
LETTER TO EDITOR | |
9. | Microorganisms Isolated from Blood Cultures of Febrile Neutropenic Patients in İbn-i Sina Hospital Kürşat Kaptan, Cengiz Beyan Page 51 Abstract | |
10. | Horizontal Pigmented Nail Bands During Daunorubicin Treatment Murat Soker, Orhan Ayyıldız, Abdurrahman Işıkdoğan, Murat Çelik Page 53 Abstract | |