Turk J Hematol: 25 (2)

Volume: 25 Issue: 2 - 2008

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REVIEW
1.	A Concise Review on the Classification and Nomenclature of Stem Cells Alp Can Pages 57 - 59 K�k h�cresi biyolojisi ve onar�msal t�p g�rece yeni alanlard�r. Buna kar��n, son y�llarda �e�itli hastal�klarda tedavi amac�yla kullan�labilme potansiyelleri nedeniyle k�k h�crelerine ola�an�st� bir ilgi art�� vard�r. Klasik tan�m�yla k�k h�cresi, kendini yenileme ad� verilen mekanizmayla farkl�la�madan kendini �o�altan veya bir dizi farkl�la�ma a�amas�ndan ge�erek olgun h�crelere d�n��ebilen h�crelerdir. �ok kabul g�ren bu tan�mlamaya kar��n, k�k h�crelerin s�n�fland�rmas� karma��k olup alan�n uzmanlar�nca bile �o�u zaman kavram karga�as�na neden olmaktad�r. Bu k�sa derlemenin amac�, morula a�amas�ndaki totipotent embriyonik k�k h�crelerinden ba�lay�p dokuda yerle�ik olan ve dokuya �zg� k�k h�cresi olarak adland�r�lan unipotent h�crelere varan bir yelpazade k�k h�crelerini s�n�fland�rmada kullan�lan kriterleri kavramsal olarak �zetlemektir. Stem cell biology and regenerative medicine is a relatively young field. However, in recent years there has been a tremendous interest in stem cells possibly due to their therapeutic potential in disease states. As a classical definition, a stem cell is an undifferentiated cell that can produce daughter cells that can either remain a stem cell in a process called self-renew�al, or commit to a specific cell type via the initiation of a differentiation pathway leading to the production of mature progeny cells. Despite this acknowledged definition, the classification of stem cells has been a perplexing notion that may often raise misconception even among stem cell biologists. Therefore, the aim of this brief review is to give a conceptual approach to classifying the stem cells beginning from the early morula stage totipotent embryonic stem cells to the unipotent tissue-resident adult stem cells, also called tissue-specific stem cells. Abstract \| Full Text PDF

2.	The evolving treatment paradigm of multiple myeloma: From past to present and future Meral Beksa�, Michel Delforge, Paul Richardson Pages 60 - 70 Multipl Miyeloma bilindi�i kadar�yla 19.Y�zy�l�n ortalar�ndan beri tan�nan bir hastal�kt�r. Tedavi y�ntemleri listesinin �ok uzun olmas�na ra�men, tedavi ba�ar�s� ancak son zamanlarda hastal�� kontrol alt�na alabilecek d�zeye ula�abilmi�tir. �ifa konusu ise hala belirsizlik ta��maktad�r. Hastal��n karma��k yap�s�, ki�isel farkl�l�klar ve bu alanda s�regelen klinik ara�t�rmalar�n varl��, bilgi�lerin devaml� g�ncellenmesini gerektirmektedir. Bu derleme bug�ne kadar ula��lan ba�ar� d�zeyini, tedavideki sorunlar� �zetlerken gelecekte bunlar�n ��z�mlerine y�nelik olas�l�klar� da i�ermektedir. Multiple myeloma has been recognized since at least the middle of the 19 th century. The list of therapies used in the treat�ment of myeloma is long but only recently has therapeutic success approached a level commensurate with disease con�trol, although cure remains elusive. The complexity of the disease, invidual variations and very active ongoing clinical research warrants continous updating of current information. This review not only summarizes the level of success that has been achieved during the past years but also points to the drawbacks in the current treatment strategies giving emphasize to the potential solutions in the future. Abstract \| Full Text PDF

RESEARCH ARTICLE
3.	Patterns of pancytopenia in Yemen Gamal Abdul Hamid, Safa A. R. Shukry Pages 71 - 74 AMA�: Bu �al��man�n amac�, pansitopeninin cinsiyet ve ya�a ba�l� insidans�n� belirlemek ve pansitopenik hastalarda pan�sitopeninin nedenlerine g�re geli�en klinik belirtilerin anla��lmas�yd�. Y�NTEMLER: Bu �al�ma, 1 Ocak�31 Aral�k 2005 tarihleri aras�nda Aden�deki Al-Gamhouria E�itim Hastanesi Hematoloji-Onkoloji poliklini�ine kabul edilen veya tedavi g�rmekte olan pansitopenili t�m hastalar�n dahil edildi�i prospektif tan�mlay�c� bir �al�mad�r. BULGULAR: Pansitopeninin en s�k g�r�len nedeni, hastalar�n %45�inden fazlas�nda g�r�len s�tma ve hipersplenizm olarak belirlendi. Bunlar�, %14.7�lik oranla megaloblastik anemi ve her birinin %13.3�l�k g�r�lme s�kl�� ile aplastik anemi ve akut l�semi izledi. Mevcut �al�mada belirlendi�i �zere pansitopeninin di�er nedenleri, %8�lik oranla myelodisplazi, %4�l�k oran�la miyelofibroz, ve %1.3 oranla demir eksikli�i idi. En yayg�n bulgu, hastalar�n %86.7�sinde g�r�len y�ksek ate�ti. Solukluk ve splenomegali en yayg�n fiziksel bulgulard�. SONU�: Hipersplenizm ve s�tman�n, pansitopeninin en yayg�n nedenleri oldu�u g�zlendi. Bunu megaloblastik anemi, aplas�tik anemi ve akut l�semi izledi. OBJECTIVE: The aim of this study was to determine the incidence of pancytopenia in relation to sex and age and to become aware of the clinical manifestations of pancytopenic patients according to the causes of pancytopenia. MATERIALS-METHODS: This was a prospective descriptive study that included all patients with pancytopenia admitted to or attending the Hematology-Oncology Department in Al-Gamhouria Teaching Hospital, Aden, during the period 1 January�31 December 2005. RESULTS: The most common causes of pancytopenia were malaria and hypersplenism in > 45% of patients, followed by megaloblastic anemia in 14.7%, and aplastic anemia and acute leukemia in 13.3% each. The other causes as determined in the present study were myelodysplasia in 8.0%, myelofibrosis in 4.0% and iron deficiency anemia in 1.3%. The most common symptom was fever in 86.7% of patients. Pallor and splenomegaly were the most common physical findings. CONCLUSIONS: Hypersplenism and malaria were the most common causes of pancytopenia followed by megaloblastic anemia, aplastic anemia and acute leukemia. Abstract \| Full Text PDF

4.	Lymphomas of Waldeyer's ring: Clinical features, management and prognosis of eleven adult patients Abdullah Hac�hanefio�lu, P�nar Tarkun, Emel Gonullu, Ozlem Vardar Pages 75 - 78 Lenfoma, yass� h�creli karsinomadan sonra boyun b�lgesinin en s�k g�r�len ikinci t�m�rleridir. Ba� ve boyun b�lgesini tutan lenfomalar�n �o�u non � hodgkin lenfomalard�r. Hodgkin lenfomalar Waldeyer halkas�nda nadirdir. 1999 ve 2006 tar�ihleri aras�ndaki t�bbi ve patolojik kay�tlar�m�zdan daha �nce tedavi almam��, yeni tan�l� Waldeyer halkas� lenfomal� eri�kin hastalar�n bilgilerini geriye y�nelik olarak g�zden ge�irdik. Patolojik �rnekler D�nya Sa�l�k �rg�t� (WHO ) histolojik s�n�fland�rmas�na g�re uyarland�. T�m hastalar hikaye ve fizik muayene, rutin hematolojik ve biyokimyasal tetkikler, g��s r�ntgeni, ba� � boyun, g��s, kar�n ve pelvik tomografilerle evrelendirildi. Hastalar tedavi �emas�n�n bitiminden yakla��k bir ay sonra hastal�k kal�nt�lar� a��s�ndan tekrar evrelendirildi. B�l�m�m�ze kay�tl� toplam 11 hasta vard�. Alt� hastada tam yan�ta, �� hastada k�smi yan�ta ula��ld�. Bir hastada yan�t sa�lanamad�. Anaplastik b�y�k h�creli lenfomas� olan bir hasta tedavisi s�rerken kaybedildi. On hastam�z halen poliklini�imizin takibindedir. Lenfoma hastalar�n�n seyirleri hastal��n evresi ve histolojik t�r� ile yak�n ili�kilidir. Burada eri�kin hastalar�m�z�n klinikopatolojik �zellikleri ve sonu�lar� �zetlenmi�tir. Bu hastal�ktaki verilerimiz sa�kal�m�n nispeten iyi oldu�unu g�stermektedir. Sonu�lar�n anlaml� olabilmesi i�in daha fazla has�tan�n de�erlendirilmesi gereklidir. Lymphoma is the second most common neoplasm of the head and neck after squamous carcinoma. The majority of lym�phomas involving the head and neck are non-hodgkin�s lymphomas. Hodgkin�s lymphoma is rare in Waldeyer�s ring. Between 1999 and 2006, the medical records and pathology data of all newly diagnosed, previously untreated adult patients with Waldeyer�s ring lymphomas were retrospectively reviewed. Pathologic specimens were adopted according to WHO his�tologic classification. All patients were clinically staged with history and physical examination, routine hematologic and bio�chemical profiles, chest X-ray, and computerized tomography of the head and neck, chest, abdomen and pelvis. All patients were treated with chemotherapy. Approximately one month after the end of the scheduled initial management, patients were restaged for evidence of residual disease with physical examination, laboratory profiles and relevant radiologic studies. Total patient number was 11 in our institution. Complete remission was achieved in 6 patients and partial remission in 3 patients; 1 patient did not achieve remission and 1 patient with anaplastic large cell lymphoma died. Patients who are alive are still being followed in our institution. The progression of patients with lymphoma is closely associated with the diagnosis, stage and histologic grade of the disease. This series characterized the clinicopathologic features and outcomes of adult patients. Our data have shown that there is relatively good survival in these diseases but more patients must be evaluated for mean�ingful results. Abstract \| Full Text PDF

5.	Treatment of thalassemia-induced osteoporosis with intermittent pamidronate infusions: Two-year follow up T�rkan Pat�ro�lu, Yasemin Altuner Torun, Mustafa Kula, Musa Karak�k�� Pages 79 - 82 Bu �al��man�n amac� 7-14 ya�lar�nda Talasemi major tan�s� alan 23 hastan�n kemik mineral dansitesini ve iki y�ll�k takip sonras� kemik dansitesindeki de�i�iklikleri de�erlendirmektir. Lumber vertebra ve femoral boyun KMD Dual enerji X-ray absorbsiyometri (DXA) ile ba�lang��ta, tedaviden 12 ay ve 2 y�l sonra de�erlendirildi. Pamidronat tedavisi (15mg/doz, bir y�l s�reyle 3 ayda bir) 23 osteoporotik (Z skoru �2,5 alt�nda) ve osteopenik (Z skoru �1 ile �2,5 aras�) hastaya verildi. Tedaviden 12 ay sonra t�m hastalara sadece kalsiyum ve vitamin D verildi. �ki y�l sonra lumber vertebra ve femur KMD�si DXA ile �l��ld�. Pamidronat verilmesi femur boyun KMD�sinde �nemli bir art�� sa�lad�. Lumber vertebra KMD�si pamidronat grubunda ba�lang�� grubuna g�re hafif y�ksekti ama bu istatistiksel olarak anlaml� de�ildi. �ki y�l sonra femur boynu ve lumber vertebra KMD�sinde art�� vard�. Bu bulgular do�rultusunda, uzun d�nem tedaviyi belirlemek i�in daha uzun d�nem takip �al��malar�na ihtiya� vard�r. AMA�: Bu �al��man�n amac� 7-14 ya�lar�nda talasemi major tan�s� alan 23 hastan�n kemik mineral dansitesini ve iki y�ll�k takip sonras� kemik dansitesindeki de�i�iklikleri (KMD) de�erlendirmektir. Y�NTEM: Lumber vertebra ve femoral boyun Dual enerji X-ray absorbsiyometri (DXA) ile ba�lang��ta, tedaviden 12 ay ve 2 y�l sonra de�erlendirildi. Pamidronat tedavisi (15mg/doz, bir y�l s�reyle 3 ayda bir) 23 osteoporotik (Z skoru -2,5 alt�nda) ve osteopenik (Z skoru -1 ile -2,5 aras�) hastaya verildi. Tedaviden 12 ay sonra t�m hastalara sadece kalsiyum ve vitamin D verildi. �ki y�l sonra lumber vertebra ve femur KMD�si DXA ile �l��ld�. BULGULAR: Pamidronat verilmesi femur boyun KMD�sinde �nemli bir art�� sa�lad�. Lumber vertebra KMD�si pamidronat grubunda ba�lang�� grubuna g�re hafif y�ksekti ama bu istatistiksel olarak anlaml� de�ildi. �ki y�l sonra femur boynu ve lum�ber vertebra KMD�sinde art�� vard�. SONU�: Bu bulgular do�rultusunda, uzun d�nem tedaviyi belirlemek i�in daha uzun d�nem takip �al��malar�na ihtiya� vard�r. Abstract \| Full Text PDF

6.	Aspirin resistance frequency in healthy males D�nd� �sk�dar Cansu, Olga Meltem Akay, Zerrin Cant�rk, Zafer G�lba� Pages 83 - 86 G�R��: Aspirinin herbir bireyde farkl� antitrombosit aktivitesi oldu�u g�sterilmi�tir. �nceki �al��malar aspirinin antitrombosit etkisinin populasyonun %5-45�inde yeterli ba�ar� sa�lamad��n� g�stermi�tir ve tedaviye ra�men hala iskemik olaylar g�r�lmektedir. AMA�: Bu �al��mada sa�l�kl� erkeklerde aspirin direncinin s�kl��n� ara�t�rmay� ama�lad�k. Y�NTEM: Prospektif olarak ya�lar� ≥19 olan 175 sa�l�kl� erkek �al��maya al�nd� ve 100 mg/g�n aspirin ≥7 g�n �al��ma �nce�si verildi. Demografik bilgiler ve laboratuvar verileri topland�. Aspirin direnci yayg�n olarak kabul g�ren bir y�ntem olan ade�nozin difosfat (ADP) ve ara�idonik asitin (AA) kullan�ld�� optik trombosit aggregometri ile saptand�. BULGULAR: Aspirin direnci %28, aspirin yar�duyarl�l�� %62 ve aspirin duyarl�l�� %10 olarak saptand�. Aspirin direnci olanlar yar�duyarl� olan bireylerden daha ya�l� idi (p<0.01), eritrosit sedimentasyon h�zlar� yar�duyarl� olanlardan (p<0.01) ve duyarl� bireylerden (p<0.01) daha y�ksek idi. SONU�: Bizim �al��mam�z, ara�t�rma grubumuzda saptad��m�z y�ksek aspirin direnci s�kl��n� g�z�n�ne ald��m�zda bu klinik durumun �nemini g�stermi�tir. Yayg�n olarak kullan�lan bir antitrombotik ila� olan aspirinin biyolojik etkisi t�m bireylerde ayn� de�ildir. INTRODUCTION: Aspirin has been shown to have variable antiplatelet activity in individuals. Previous studies have estimated that 5% to 45% of the population do not achieve an adequate antiplatelet effect from aspirin and still suffer ischemic events despite therapy. AIM: In this study, we aimed to evaluate aspirin resistance in healthy males. METHOD: We prospectively enrolled 175 healthy males who were ≥19 years old and taking 100 mg of aspirin daily ≥7 consec�utive days before study entry. Demographic information and laboratory data were collected. Aspirin resistance was detected by optical platelet aggregometry, a widely accepted method using adenosine diphosphate (ADP) and arachidonic acid (AA). RESULT: 28% of the participants were aspirin-resistant, 62% were aspirin-semi-responders and 10% were aspirin-sensitive. The aspirin-resistant individuals were older than the semi-responders (p<0.01), and had higher erythrocyte sedimentation rate than the semi-responders (p<0.01) and sensitive individuals (p<0.05). CONCLUSION: Our study demonstrates aspirin resistance to be particularly important given its high frequency in our study population. The biological effects of aspirin, which is widely used as an antithrombotic drug, are not similar in all individuals. Abstract \| Full Text PDF

7.	Allogeneic hematopoietic stem cell transplantation (allo-HSCT) in acute myeloblastic leukemia (AML): A single center experience Osman �lhan, Pervin Top�uo�lu, Mutlu Arat, Ender A. Soydan, Meltem K. Yuksel, �nder Arslan, Muhit �zcan, G�nhan G�rman, Taner Demirer, Hamdi Akan, Nahide Konuk, Ak�n Uysal Pages 87 - 93 AMA�: AML tan�s� ile HLA-�zde� karde� vericiden allojeneik transplantasyon yap�lan 145 hastada transplantasyon �ncesi ve sonras� de�i�kenlerin transplantasyon sonu�lar�na etkisini geriye d�n�k olarak de�erlendirdik. BULGULAR: Kullan�lan k�k h�cre kayna�� kemik ili�i (K�) (% 36.6) veya periferik kan (PK) (% 63.4)� d�. N�trofil ve trombosit engraftman� ortanca 14.g�nlerdeydi. PK grubunda engraftman K� grubuna g�re daha k�sa s�rede oldu (p<0.0001). Ciddi akut graft versus host hastal�� (aGvHH) hastalar�n % 27,9�unda g�zlenirken, kronik(k) GvHH % 61,2�inde geli�ti. PK kul�lan�m� daha ciddi aGvHH geli�imine neden oldu. On y�ll�k l�semisiz sa�kal�m (LSK) ve genel sa�kal�m (GSK) olas�l�� s�rayla % 43,4�% 5,2 and % 52,7�% 4.6 idi. SONU�: Hem tek hem de �ok de�i�kenli istatistiksel analizde transplantasyondaki hastal�k durumu ve akut GvHH geli�imi hem LSK hem de GSK �zerine etkileyen ba��ms�z risk fakt�rleri oldu�u saptand�. OBJECTIVE: We retrospectively analyzed the impact of pre- and post-transplant variables on the outcome of transplanta�tion in 145 consecutive patients with acute myeloblastic leukemia (AML) allografted from their HLA-identical siblings in our single center cohort. RESULTS: The stem cell source used was bone marrow (BM) (36.6%) or peripheral blood (PB) (63.4%). Both neutrophil and platelet engraftments were observed on the median 14th day. Engraftment was faster in the PB group than in the BM group (p<0.0001). Severe acute graft versus host disease (aGvHD) was observed in 27.9% of the patients while chronic (c)GvHD developed in 61.2%. The use of PB was associated with more severe aGvHD. Estimated leukemia-free survival (LFS) and overall survival (OS) at 10 years were 43.4%�5.2% and 52.7%�4.6%, respectively. CONCLUSION: Both in univariate and multivariate analyses for LFS and OS, remission status at transplant and the presence of aGvHD were independent risk factors. Abstract \| Full Text PDF

CASE REPORT
8.	Clonal evolution of monosomy 7 in acquired severe aplastic anemia: Two cases treated with allogeneic hematopoietic stem cell transplantation �ule Mine Bakanay, Pervin Top�uoglu, Aynur U�ur Bilgin, Kanay Yararba�, Sibel Berker Kara�z�m, Muhit �zcan, Mutlu Arat, Levent �ndar, Osman Ilhan Pages 94 - 97 Aplastik anemi (AA), miyelodisplastik sendrom (MDS) ve akut miyeloblastik l�semi (AML) gibi klonal hastal�klara d�n��m g�sterebilmektedir. Monozomi 7, tedaviyle ili�kili MDS ve sekonder AML ile birlikte s�k�a g�zlenen k�t� prognostik bir kro�mozomal anomalidir. Bunun yan�s�ra AA�da l�komojenik transformasyonla da ili�kilendirilmi�tir. Burada ilk s�ra tedavi olarak imm�nsupresif tedavi alm�� ve s�ras�yla blast art��yla giden refrakter anemi (MDS-RAEB-II) ve AML�ye transforme olmu� iki a��r AA�l� olgu bildirmekteyiz. Hastalarda transformasyon s�ras�nda monozomi 7 klonunun pozitif oldu�u saptanm��t�r. Her iki hastaya da HLA uyumlu vericilerinden (akraba d�� ve karde�) allojeneik hematopoietik k�k h�cre transplantasyonu yap�lm��t�r. Aplastic anemia (AA) may evolve into clonal diseases like myelodysplastic syndrome (MDS) and acute myeloblastic leuke�mia (AML). Monosomy 7 is a poor prognostic chromosomal abnormality commonly associated with therapy related MDS and secondary AML. It has also been associated with leukomogenic transformation in AA. We present here two adult ma�le patients with acquired severe AA. Both patients had received immunosuppressive therapy (IST) as first line treatment and had monosomy 7 positive clone at transformation to MDS with refractory anemia and excess of blast (RAEB-II) and AML, respectively. Both patients have undergone allogeneic hematopoietic stem cell (HSC) transplantation from their HLA identical donors (unrelated and sibling). Abstract \| Full Text PDF

9.	A patient with extramedullary acute myeloid leukaemia involving the brachial plexus: Case report and review of the literature Cheung Richard Yiu, Lai Heng Lee, Prakash M Kumar, Gee Chuan Wong Pages 98 - 100 Akut miyeloid l�seminin (AML) bir par�as� olarak ekstramed�ller l�semik tutulum nadir bir durum de�ildir. Ancak AML�ye ba�l� infiltratif periferik n�tropati nadiren bildirilmi�tir. Burada, relaps AML�li bir hastada brakiyal pleksusun ekstramed�ller l�semik infiltrasyonu vakas�n� sunuyoruz. Extramedullary leukaemic involvement is not uncommon as part of the presentation in acute myeloid leukaemia (AML). However, infiltrative peripheral neuropathy due to AML was rarely reported. We report a case of extramedullary leukaemic infiltration of the brachial plexus in a patient with relapsed AML. Abstract \| Full Text PDF

LETTER TO EDITOR
10.	Diffuse alveolar hemorrhage due to donor lymphocyte infusion in a case of acute lymphoblastic leukemia G�lsan Sucak, Zeynep Arzu Yegin, M�nci Ya�c�, Nurdan K�kt�rk Pages 101 - 103 Diff�z alveolar hemoraji, hematopoetik k�k h�cre al�c�lar�nda %60-100 oran�nda mortalite ile sonu�lanabilen bir akci�er komplikasyonudur. Temmuz 2003 �te prek�rs�r B akut lenfoblastik l�semi tan�s� alm�� 34 ya��ndaki bir erkek hastaya tam uyumlu karde� vericisinden allojeneik periferik k�k h�cre nakli yap�ld�. Takibinde geli�en hematolojik relaps nedeniyle 2x107/kg CD3 pozitif h�creden olu�an don�r lenfosit inf�zyonu uygulanan hastada inf�zyondan 4 g�n sonra ate�, nefes dar�l�� ve hipoksemi geli�ti. Klinik, radyolojik ve bronkoskopik veriler ile desteklenen diff�z alveolar hemoraji tan�s� ile hastaya y�k�sek doz metil prednizolon tedavisi ba�land�. Steroid tedavisinin ikinci g�n�nden itibaren hastada belirgin klinik d�zelme sa�land�. Diff�z alveolar hemoraji, transplant sonras� ge� d�nemde ortaya ��kabilen, don�r lenfosit inf�zyonunun da tetikleyebil�di�i bir komplikasyondur. Diffuse alveolar hemorrhage, with a mortality rate between 60-100%, is a life-threatening complication in hematopoietic stem cell transplant recipients. A 34-year-old man, with precursor B acute lymphoblastic leukemia diagnosed in July 2003, relapsed after allogeneic peripheral blood hematopoietic stem cell transplantation from his human leukocyte antigen- iden�tical brother in July 2005. He received a donor lymphocyte infusion of 2 x 107/kg CD3 positive cells. He developed fever, dyspnea and hypoxemia four days after donor lymphocyte infusion. The patient was diagnosed as diffuse alveolar hem�orrhage based on the clinical, radiological and bronchoscopic data. He was immediately started on high-dose methylpred�nisolone. Two days after the onset of the steroid therapy, he recovered with significant improvement in oxygenation. Diffuse alveolar hemorrhage can be a late-onset transplant complication that could also be associated with a recent donor lymphocyte infusion. Abstract \| Full Text PDF

CASE REPORT
11.	Development of zona zoster during bortezomib treatment in patients with Relapsed/Refractory multiple myeloma Ahmet Ifran, Cengiz Beyan, K�r�at Kaptan Pages 104 - 105 Abstract \| Full Text PDF

LETTER TO EDITOR
12.	Idiopathic thrombocytopenic purpura (ITP) in childhood �inasi �zsoylu Pages 106 - 107 Abstract \| Full Text PDF

13.	The correlation between soluble endothelial protein c receptor (sEPCR) and tumor necrosis factor-alpha (TNF-α) levels in vivo Arzu Ulu, Yonca Egin, Nejat Akar Pages 108 - 109 Abstract \| Full Text PDF

IMAGES IN HEMATOLOGY
14.	The bone marrow in hereditary cystinosis Ne�e Yaral�, Ali Bay, Pamir I��k, ��kr� G�ng�r, G�lay Demircin Page 110 Abstract \| Full Text PDF

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