E-ISSN: 1308-5263
Turkish Journal of Hematology - Turk J Hematol: 30 (2)
Volume: 30  Issue: 2 - 2013
REVIEW
1. Physiopathology, Etiologic Factors, Diagnosis, and Course of Polycythemia Vera as Related to Therapy According to William Dameshek, 1940-1950
Jan Jacques Michiels, Goodheart Institute & Foundation, Freedom Of Science And Education Thrombocythemia Vera Study Group, Tvsg And European Working Groups On Myeloproliferative Neoplasms: Ewg.mpn
doi: 10.4274/Tjh.2013.0029  Pages 102 - 110
According to Dameshek, true polycythemia (polycythemia vera: PV) is a chronic myeloproliferative disorder of the total bone marrow without any evidence of invasiveness, in which erythrocytosis, leukocytosis, and thrombocytosis are all simultaneously present. A possible hereditary or transmitted tendency may be present, but actual familial polycythemia is rare. As to the etiology, Dameshek proposed 2 highly speculative possibilities in 1950: the presence of excessive bone marrow stimulation by an unknown factor or factors, and a lack or a diminution in the normal inhibitory factor or factors. Dameshek’s hypothesis was confirmed in 2005 by Vainchenker in France by the discovery of the acquired JAK2V617F mutation as the cause of 3 phenotypes of classical myeloproliferative neoplasms: essential thrombocythemia, PV, and myelofibrosis. The JAK2V617F mutation induces a loss of inhibitory activity of the JH2 pseudokinase part on the JH1 kinase part of Janus kinase 2 (JAK2). This leads to enhanced activity of the normal JH1 kinase activity of JAK2, which makes the mutated hematopoietic stem cells hypersensitive to the hematopoietic growth factors thrombopoietin, erythropoietin, insulin-like growth factor-1, stem cell factor, and granulocyte colony-stimulating factor, resulting in trilinear myeloproliferation. In retrospect, the situation observed by Dameshek where all “stops” to blood production in the bone marrow are pulled in PV is caused by the JAK2V617F mutation.
Dameshek considered PV patients as fundamentally normal and therefore the treatment should be as physiologic as possible. For this reason, a systematic phlebotomy/iron deficiency method of treatment was recommended; the use of radioactive phosphorus is reserved for refractory cases and cases of major thrombosis. If the patient lives long enough and does not succumb to the effects of thrombosis or other complications, the marrow will gradually show signs of diminished activity. The blood smear shows nucleated red cells, increased polychromatophilia, and immature granulocytes of various types. With increasing reduction of erythropoietic tissue, myelofibrosis becomes more of an organized mass of fibrous tissue. There is prominent extramedullary hematopoiesis in the spleen, which becomes extraordinarily large and in some cases occupies almost the entire abdominal cavity. The enlarged spleen is made up largely of metaplastic marrow tissue in primary myeloid metaplasia of the spleen.

COMMENTARY
2. Clinical Trials in Turkey
Hilal İlbars
doi: 10.4274/Tjh.2013.0045  Pages 111 - 114
Abstract |Full Text PDF

RESEARCH ARTICLE
3. Cardiogenic and Myogenic Gene Expression in Mesenchymal Stem Cells After 5-Azacytidine Treatment
Aungkura Supokawej, Pakpoom Kheolamai, Kuneerat Nartprayut, Yaowalak U-pratya, Sirikul Manochantr, Methichit Chayosumrit, Surapol Issaragrisil
doi: 10.4274/Tjh.2012.0161  Pages 115 - 121
OBJECTIVE: 5-Azacytidine is a hypomethylating agent that is used for the treatment of myelodysplastic syndrome. This histone modifier is widely employed and plays a nonspecific role in influencing the differentiation capability of stem cells. The ability of bone marrow mesenchymal stem cells to differentiate into cardiomyocyte- and myocyte-like cells after exposure to 3 different doses of 5-azacytidine has been evaluated and compared. The aim of the study was to optimize the effective dose of 5-azacytidine for promoting the cardiomyocyte and myocyte differentiation capabilities of human mesenchymal stem cells (MSCs).
METHODS: Human bone marrow aspirations were collected from healthy donors. MSCs were used for the study of mesodermal differentiation. MSCs were cultured to promote osteoblast differentiation and adipocyte differentiation. The evaluation of osteogenic or adipogenic properties was then performed through immunocytochemical staining. BMMSCs were trypsinized into single-cell suspensions and then prepared for flow cytometric analysis. The MSCs were treated with 5, 10, or 15 μM 5-azacytidine for 24 h and then cultured for 3 weeks. Total RNA was extracted from untreated and 5-azacytidine–treated cells. Troponin T and GATA4 antibodies were used as cardiogenic markers, whereas myogenin and MyoD antibodies were used as myocyte markers.
RESULTS: The morphology and growth rate of MSCs that were treated with any of the 3 doses of 5-azacytidine were similar to the morphology and growth rate of control MSCs. An immunofl uorescence analysis examining the expression of the cardiac-specifi c markers GATA4 and troponin T and the skeletal muscle-specifi c markers MyoD and myogenin revealed that cells treated with 15 μM 5-azacytidine were strongly positive for these markers. Real-time RT-PCR results were examined; these amplifi cations indicated that there were higher expression levels of cardiac- and skeletal muscle-specifi c mRNAs in MSCs treated with 15 μm 5-azacytidine than in MSCs that had either been treated with lower doses of 5-azacytidine or left untreated.
CONCLUSION: MSCs treated with 5-azacytidine demonstrated the capacity to differentiate into both cardiomyocytes and skeletal myocytes, and 15 μM 5-azacytidine could be the optimal dose of this drug. Other promoting factors should be examined to investigate the possibility of promoting the differentiation of MSCs into specific cell types.

4. High Throughput FISH Analysis: A New, Sensitive Option For Evaluation of Hematological Malignancies
Hakan Savlı, Seda Eren, Nilüfer Üzülmez, Zeynep İlkay, Duygu Yavuz, Deniz Sünnetçi, Abdullah Hacıhanifioğlu, Naci Çine
doi: 10.4274/Tjh.2012.0033  Pages 122 - 128
OBJECTIVE: The aim of this study was to determine the efficiency of the high throughput FISH analysis (HTFA) method for detecting genetic alterations in hematological malignancies, which is a new bacterial artificial chromosome array-based approach.
METHODS: We performed a HTFA study of bone marrow aspiration and peripheral blood samples of 77 cases (n=19 myelodysplastic syndrome, n=17 acute lymphoblastic leukemia, n=9 chronic myeloid leukemia, n=32 acute myeloid leukemia) with hematological malignancies during the periods of initial diagnosis, treatment, and/or follow-up.
RESULTS: Both numerical and structural abnormalities were detected by HTFA. We observed aberrations in 88% of our acute lymphoblastic leukemia patients, 25% of acute myeloid leukemia patients, and 31% of myelodysplastic syndrome patients. In chronic myeloid leukemia cases, aberration was not detected by HTFA.
CONCLUSION: Our results showed that HTFA, combined with other methods, will gradually take a place in the routine diagnosis of hematologic malignancies.

5. Prognostic Impact of Nucleophosmin 1 (NPM1) Gene Mutations in Egyptian Acute Myeloid Leukemia Patients
Magda Zidan, Howyda Shaaban, Doaa El Ghannam
doi: 10.4274/Tjh.2012.0048  Pages 129 - 136
OBJECTIVE: Somatic mutations of the nucleophosmin gene (NPM1), which alter the subcellular localization of the product, are the most frequent mutations in patients with acute myeloid leukemia. The aim of the study was to assess the prevalence and prognostic impact of NPM1 gene mutations in adult AML patients.
METHODS: Polymerase chain reaction and single-strand conformation polymorphism (PCR-SSCP) were used to screen 55 AML patients for mutations of NPM1 gene.
RESULTS: NPM1 mutations were found in 12 (21.8%) of 55 patients, significantly associated with higher total leukocytie count, marrow blast percentage (p=0.03 and p=0.02, respectively), and M5 subtype (p<0.001). Patients with NPM1 mutations had significantly higher complete remission rates (p=0.003) and a trend to lower rates of mortality, relapse and refractory disease (p=0.28, p=0.45 and p=0.08, respectively). Survival analysis showed significantly longer disease-free survival (mean 18.635±1.229 versus 11.041±1.250 months, p=0.044) and overall survival (mean 19.810±1.624 versus 12.063±1.244 months, p=0.041) in patients with NPM1 mutations compared with those without. Multivariate analyses confirmed NPM1 mutation as a significant independent predictor for disease-free survival (HR=0.066, p=0.001) and overall survival (HR=0.125, p=0.002).
CONCLUSION: NPM1 mutation is a prognostic factor for a favorable outcome in Egyptian population. This finding is of major clinical importance since it strongly suggests that NPM1 mutations may allow one to divide the heterogeneous patient group of AML into prognostically different subgroups.

6. Gene Expression of VEGF-A and VEGF-C in Peripheral Blood Mononuclear Cells of Iranian Patients with Acute Myeloid Leukemia
Mohammad Reza Aliparasti, Shohreh Almasi, Zohreh Sanaat, Aliakbar Movasaghpoor, Reza Khalili Dizaji, Homaun Sadeghi Bazargani
doi: 10.4274/Tjh.2011.0023  Pages 137 - 143
OBJECTIVE: The crucial role of angiogenesis in the pathophysiology of acute myeloid leukemia (AML) has been proposed. One of the key regulators of angiogenesis is the vascular endothelial growth factor (VEGF). Among the VEGF family, it has been observed that VEGF-A and VEGF-C are expressed by AML cells and mediate leukemic cell proliferation, survival, and resistance to chemotherapy. Emerging evidence, however, suggests that elevated levels of VEGF or a proangiogenic phenotype may impede, rather than promote, early tumor development and progression. As the significance of VEGF-A and VEGF-C levels in the pathogenesis of AML has not been clarified well, the aim of this study is to evaluate gene expression of these angiogenesis promoters and its possible prognostic value in peripheral blood mononuclear cells of Iranian patients with AML.
METHODS: We investigated the mRNA expression of VEGF-A and VEGF-C in peripheral blood mononuclear cells of 27 patients with newly diagnosed AML and 28 healthy controls by quantitative real-time PCR.
RESULTS: Expression of VEGF-C mRNA was significantly lower in AML patients than in healthy controls (p<0.001). However, there was no significant decrement in expression of VEGF-A mRNA of AML patients compared to the control group (p=0.861). VEGF-A and VEGF-C expression were not able to predict clinical outcome.
CONCLUSION: Our data showed that AML is associated with a decreased expression of VEGF-C mRNA. However, expression levels did not influence the clinical outcome in our study. It seems that angiogenesis is affected by different cytokines other than VEGF-C or VEGF-A, and VEGF is also affected by different cytokines. Taken together, these findings help to provide new insights into the investigation of other angiogenic factors and cytokines that may play roles in the pathogenesis of AML.

7. Effects of Zinc Sulfate Supplementation in Treatment of Iron Defi ciency Anemia
Meltem Gülşan, Barış Malbora, Zekai Avcı, Nilüfer Bayraktar, İkbal Bozkaya, Namik Özbek
doi: 10.4274/Tjh.2012.0043  Pages 144 - 152
OBJECTIVE: In this study, we aimed to compare the effect(s) of zinc sulphate on growth and serum iron variables when it is given with ferrous sulphate in iron deficiency anemia (IDA).
METHODS: Patients (n=79) were randomly divided into two groups. In one group (n=40) 4 mg/kg/d ferrous sulfate was given orally. In the other group (n=39), in addition to ferrous sulfate, 5 mg/d oral zinc sulfate was given.
RESULTS: Compared to the initial values statistically significant increase in mean height, weight, and head circumference has been observed in both groups after 3 months. However, there was no statistical difference between two groups concerning mean height, weight, and head circumference at the beginning (83.43±11.3 cm vs 84.62±12.77 cm; 12.36±3.08 kg vs 12.72±3.87 kg; 47.33±2.15 cm vs 47.26±2.73 cm, respectively), at the first month, (84.82±10.97 vs 85.97±12.28; 12.78±3.09 vs 13.09±3.87; 47.76±2.10 vs 47.61±2.67, respectively), and at the third month, (86.4±11.12 vs 87.69±12.13; 12.9±3.06 vs 13.35±3.81; 48.22±1.89 vs 48.07±2.45, respectively). There were no statistical differences between mean hematological parameters of the groups at the beginning, at the first month, and at the third month, either (mean hb of Group 1: 8.78±1.12 g/dL; 11.27±1.09 g/ dL; 12.05±1.00 g/dL respectively and of Group 2: 9.10±1.07 g/dL; 11.12±0.85 g/dL; 11.80±0.79 g/dL, respectively). Mean ferritin and zinc values of the groups were statistically insignificant at the beginning (Mean ferritin: 4.96±4.03 μg/dL vs 4.52±2.94 μg/dL, zinc: 88.64±15.35 ng/mL vs 86.84±17.34 ng/mL). Their increase was statistically significant at the third month (mean ferritin: 15.91±9.57 μg/dL vs 15.25±10.47 μg/dL; zinc: 88.02±15.10 ng/mL vs 95.25±16.55 ng/mL).
CONCLUSION: In our study neither positive nor negative effect of zinc administration on IDA treatment was demonstrated. Therefore, in the treatment of IDA zinc together with iron should be used at different times if there is coexistent zinc deficiency.

8. Clinical Significance of Reticulocyte Hemoglobin Content in the Diagnosis of Iron Deficiency Anemia
Mustafa Karagülle, Eren Gündüz, Fezan Şahin Mutlu, Meltem Olga Akay
doi: 10.4274/Tjh.2012.0107  Pages 153 - 156
OBJECTIVE: The aim of this study was to evaluate the clinical significance of reticulocyte hemoglobin content (CHr) in the diagnosis of iron deficiency anemia (IDA) and to compare it with other conventional iron parameters.
METHODS: A total of 32 female patients with IDA (serum hemoglobin <120 g/L and serum ferritin <20 ng/mL) and 18 female patients with iron deficiency (serum hemoglobin > 120 g/L and serum ferritin <20 ng/mL) were enrolled.
RESULTS: CHr was 24.95±3.92 pg in female patients with IDA and 29.93±2.96 pg in female patients with iron deficiency. CHr showed a significant positive correlation with hemoglobin, mean corpuscular volume, mean corpuscular hemoglobin, mean corpuscular hemoglobin concentration, serum iron, and transferrin saturation and a significant negative correlation with transferrin and total iron-binding capacity. The cut-off value of CHr for detecting IDA was 29 pg.
CONCLUSION: Our data demonstrate that CHr is a useful parameter that can be confidently used in the diagnosis of IDA, and a CHr cut-off value of 29 pg predicts IDA.

9. WITHDRAWN: Inhibition of MicroRNA miR-92a Inhibits Cell Proliferation in Human Acute Promyelocytic Leukemia
Mohammadreza Sharifi, Rasoul Salehi, Yousof Gheisari, Mohammad Kazemi
doi: 10.4274/Tjh.2012.0171  Pages 157 - 162
Objective: This article has been withdrawn due to the fact that it is published in three different journals.
Materials and Methods:
Results:
Conclusion:

10. Trends in Transfusion Transmitted Infections Among Replacement Blood Donors in Karachi, Pakistan
Syed Mohammad Irfan, Jamal Uddin, Hasan Abbas Zaheer, Sadia Sultan, Amjad Baig
doi: 10.4274/Tjh.2012.0132  Pages 163 - 167
OBJECTIVE: To determine the prevalence of Hepatitis-B, Hepatitis-C and Human Immunodeficiency infections in replacement blood donors.
METHODS: From January 2004 to December 2011, 108,598 apparently healthy donors donated blood at our Blood Bank. Screening was done by Microparticle Enzyme Immuno Assay (MEIA) method on Axsym System (Abbott Diagnostic, USA) and in year 2011 by Chemiluminescent Immunoassay (CIA) method on Architect i2000 (Abbott Diagnostic, USA). From 2010 onward, HIV reactive donors were advised for confirmatory tests and reported back with the results.
RESULTS: Of the 108,598 total donors, 108,393 (99.8%) were replacement donors with a mean age of 28.92 (17-55) years. Of this, only 164 (0.15%) were females. Among the replacement donors, 4,906 (4.5%) were found to be reactive for Hepatitis-B, C and Human Immunodeficiency Virus. All the reactive patients, except one, were males. HbsAg was positive in 2,068 (1.90%) and anti-HCV in 2832 (2.61%) donors, while 111 (0.10%) were positive for Human Immunodeficiency Virus. Co-infectivity was observed in 103 (0.09%) cases. The prevalence appeared to be higher in younger age group (17-30 yrs). Only 16.6% cases should be patients returned with results of the confirmatory tests for HIV and were found positive.
CONCLUSION: Hepatitis-B and C sero-prevalence in our series of replacement donors appears high compared to most studies from neighboring countries and relatively low in comparison to earlier studies from Pakistan. Prevalence of HIV, however, appears low and turn out of HIV positive cases for confirmatory tests is low.

11. Screening Bleeding Disorders in Adolescents and Young Women with Menorrhagia
Suar Çakı Kılıç, Nazan Sarper, Emine Zengin, Sema Aylan Gelen
doi: 10.4274/tjh.2011.0048  Pages 168 - 176
OBJECTIVE: Chronic menorrhagia causes anemia and impairment of life quality. In this study the aim was the screening of bleeding disorders in adolescents and young women with menorrhagia.
METHODS: The study was performed prospectively by pediatric hematologists. A form including demographic characteristics of the patients, bleedings other than menorrhagia, familial bleeding history, characteristics of the menorrhagia, and impairment of life quality due to menorrhagia was filled out by the researcher during a face-to-face interview with the patient. A pictorial blood assessment chart was also used for evaluation of blood loss. All patients underwent pelvic ultrasound sonography testing and women also received pelvic examination by gynecologists. Whole blood count, peripheral blood smear, blood group, serum transaminases, urea, creatinine, ferritin, PFA-100, PT, aPTT, INR, TT, fibrinogen, VWF: Ag, VWF: RCo, FVIII, and platelet aggregation assays were performed. Platelet aggregations were studied by lumiaggregometer.
RESULTS: Out of 75 patients enrolled, 60 patients completed the study. The mean age was 20.68±10.34 (range: 10-48) years and
65% (n=39) of the patients were younger than 18 years. In 18 (46%) of the adolescents, menorrhagia subsided spontaneously.
In 20% (n=12) of the patients, a bleeding disorder was detected (1 case of type 3 von Willebrand disease, 2 patients with low
VWF: Ag, 1 case of probable von Willebrand disease, 3 cases of Bernard-Soulier syndrome, 2 cases of Glanzmann thrombasthenia, 2 cases of immune thrombocytopenic purpura, 1 case of congenital factor VII deficiency).
CONCLUSION: In patients with menorrhagia, at least complete blood count, peripheral smear, aPTT, PT, VWF: Ag, VWF: RCo, FVIII, and fibrinogen assays must be performed. When there is history of nose and gum bleeding, platelet function assay by lumiaggregometer must also be performed. In nearly 50% of adolescents, menorrhagia is dysfunctional and transient. Detailed coagulation assays can be postponed in adolescents if bleeding history other than menorrhagia and/or family history of bleeding and/or parental consanguinity is absent. All subjects with menorrhagia must consult with gynecologists and hematologists.

CASE REPORT
12. Successful Management of Hydroxyurea-induced Leg Ulcers in Essential Thrombocythemia: Report of 3 Cases
Jihane Abou Rahal, Rim S. Ishak, Zaher K. Otrock, Joseph E. Maakaron, Samer Ghosn, Ali T. Taher
doi: 10.4274/Tjh.2012.0134  Pages 184 - 187
Essential thrombocythemia is one of the myeloproliferative neoplasms with a plethora of thrombohemorrhagic complications. Hydroxyurea has been proven to be an effective treatment for this condition. However, it is not without side effects. We herein report 3 patients with essential thrombocythemia treated with hydroxyurea who developed refractory leg ulcers, and we outline their successful management. We also review the literature to shed light on the mechanism of this toxicity. Awareness of this important treatment complication is important to avoid the pitfall of futile invasive interventions.

13. Deep Vein Thrombosis Following Non-myeloablative Allogeneic Stem Cell Transplantation: Presentation of Three Cases and Literature Review
Evren Özdemir, Emin Kansu
doi: 10.4274/Tjh.92499  Pages 188 - 190
The incidence of deep vein thrombosis (DVT) after non-myeloablative (NMA) allogeneic stem cell transplantation (allo-SCT) is unknown. In addition, very few studies on the predisposing factors for DVT post SCT have been published. The incidence of DVT among patients that underwent NMA allo-SCT at our hospital was 4.1% (3 of 73) over the course of last 8 years, and to the best of our knowledge this is the first study to report the incidence of DVT following NMA allo-SCT. The present findings show that NMA allo-SCT patients may have multiple risk factors for DVT. Herein we present 3 cases of DVT following NMA allo-SCT and a literature review.

14. A Pediatric Renal Lymphoma Case Presenting with Central Nervous System Findings
Ahmet Baran, Serhan Küpeli, Ömer Doğru
doi: 10.4274/Tjh.03164  Pages 191 - 193
In pediatric patients renal lymphoma frequently presents in the form of multiple, bilateral mass lesions, infrequently as a single or retroperitoneal mass, and rarely as diffuse infiltrative lesions. In patients with apparent central nervous system involvement close attention to other physical and laboratory findings are essential for preventing a delay in the final diagnosis. Herein we present a pediatric patient with renal lymphoma that presented with central nervous system findings that caused a delay in diagnosis.

15. Megadose Methylprednisolone (MDMP) Treatment in a Patient with Autoimmune Hemolytic Anemia (AIHA) Resistant to Conventional Corticosteroid Administration: A Case Report
Şinasi Özsoylu, Henriette Wa Berenschot
doi: 10.4274/Tjh.2012.0070  Pages 194 - 197
A female in the Netherlands with severe autoimmune hemolytic anemia (AIHA) was treated with conventional corticosteroid (2 mg/kg/d in divided doses) and blood transfusions for 18 months without improvement. The presented patient responded to megadose methylprednisolone (MDMP) 30 mg/kg/d for 3 d, followed by 20 mg/kg for 4 d, and subsequently 10, 5, 2, and 1 mg/kg/d each for 1 week.

16. Langerhans Cell Sarcoma of the Axillary Lymph Node: A Case Report and Review of the Literature
Aylin Orgen Çallı, Yelda Morgül, İnci Alacacıoğlu, Sadi Bener, Bahriye Payzin
doi: 10.5152/tjh.2011.98  Pages 198 - 203
Langerhans cell sarcoma is a rare, high-grade neoplasm with overtly malignant cytological features and the Langerhans phenotype. Herein, we present a rare case of Langerhans cell sarcoma in a 65-year-old female that presented with a painless enlarging mass in her right axillary region, along with the histopathological features and diagnostic characteristics in the light of literature on Langerhans cell sarcoma.

17. Encephalitozoon intestinalis: A Rare Cause of Diarrhea in an Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) Recipient Complicated by Albendazole-Related Hepatotoxicity
Serdar Şıvgın, Bülent Eser, Leylagül Kaynar, Fatih Kurnaz, Hülya Şıvgın, Süleyman Yazar, Mustafa Çetin, Ali Ünal
doi: 10.4274/Tjh.90692  Pages 204 - 208
A 50-year-old male patient previously diagnosed with acute myelomonocytic (M4) leukemia in July 2009 underwent allogeneic hematopoietic stem cell transplantation (allo-HSCT). During the pre-transplant period complete blood count (CBC), liver and renal function tests, coagulation tests, and other parameters were normal. On the first day of transplantation teicoplanin (400 mg d–1 for the first 3 d, and then 400 mg d-1) and caspofungin (first dose was 1×70 mg d–1, followed by 1×50 mg d–1) were started intravenously due to white plaques and oropharyngeal candidiasis in the patient’s mouth and perianal erythema. On the 14th d of transplantation watery diarrhea occurred, along with abdominal discomfort, nausea, and fatigue. Stool examination was negative for findings of bleeding. Investigation of Microsporidia confirmed a rare pathogen Encephalitozoon intestinalis in the patient’s stool sample via species-specific immunofluorescence antibody (IFA) assay and albendazole treatment was started at a dose of 2×400 mg d–1. On the 5th d of albendazole treatment (d 18 of treatment) liver function test (LFT) results began to deteriorate. As LFT results continued to deteriorate, albendazole was withdrawn on the 7th d of treatment. Biopsy was performed on the 22nd d of transplantation and histopathological analysis confirmed the diagnosis of toxic hepatitis. LFT results began to decrease after withdrawal of albendazole treatment. On the 13th d of albendazole treatment all LFT values returned to normal. The presented allo-HSCT case had a rare pathogenic agent (E. intestinalis) that caused diarrhea, as well as hepatotoxicity due to albendazole treatment. This is the first reported case of E. intestinalis diagnosed via IFA in Turkey.

LETTER TO EDITOR
18. Co-occurrence of Papillary and Follicular Thyroid Carcinoma in a Patient with Hodgkin’s Disease
Mehmet Aşık, Faruk Özkul, Hüseyin Toman, Ahmet Durmuş, İnan Anaforoğlu, Fahri Güneş, Erdem Akbal
doi: 10.4274/Tjh.2012.0173  Pages 209 - 210
Abstract |Full Text PDF

19. Dasatinib May Override F317L BCR-ABL Kinase Domain Mutation in Patients with Chronic Myeloid Leukemia
Ahmet Emre Eşkazan, Teoman Soysal
doi: 10.4274/Tjh.2012.0013  Pages 211 - 213
Abstract |Full Text PDF

20. DDAVP Might Reduce the Risk of Preeclampsia in Pregnant Women with VWF Defi ciency
Alireza Hamidian Jahromi, Mehran Karimi
doi: 10.4274/Tjh.2012.0044  Pages 214 - 215
Abstract |Full Text PDF

21. Imatinib-Induced Psoriasis
Figen Atalay, Ebru Kızılkılıç, R. Simin Ada
doi: 10.4274/Tjh.2012.0147  Pages 216 - 218
Abstract |Full Text PDF

22. Adsorptive Leukocytapheresis in Inflammatory Bowel Diseases: Our Preliminary Results are Encouraging
Murat Törüner, Selami Koçak Toprak, Kiraz Mızrak, Yasin Yıldırım, Meltem Bay, Erol Ayyıldız, Osman İlhan
doi: 10.4274/Tjh.2012.0186  Pages 219 - 220
Abstract |Full Text PDF

23. A Case with Hypothyrodism Following Autologous Stem Cell Transplantation
Berna Bozkurt Duman, Semra Paydaş, Mehtap Evran
doi: 10.4274/Tjh.2012.0177  Pages 221 - 222
Abstract |Full Text PDF

24. First Observation of Hb South Florida [beta 1(NA1) Val>Met] in Turkey
Ayça Dilruba Aslanger, Aynur Akbulut, Gül Tokgöz, Sakine Türkmen, Kanay Yararbaş
doi: 10.4274/Tjh.2013.0014  Pages 223 - 224
Abstract |Full Text PDF

25. Congenital Diaphragmatic Hernia and Iron Defi ciency Anemia
Şinasi Özsoylu
doi: 10.4274/Tjh.2013.0059  Page 225
Abstract |Full Text PDF

26. Huge Dose Vitamin B12 (Vit B12) Treatment for Pernicious Anemia
Şinasi Özsoylu
doi: 10.4274/Tjh.2013.0053  Page 226
Abstract |Full Text PDF

27. About Pyrimidine 5’-Nucleotidase Deficiency
Şinasi Özsoylu
doi: 10.4274/Tjh.2013.0050  Page 227
Abstract |Full Text PDF

28. Megadose Methyl-Prednisolone (MDMP) for Autoimmune Hemolytic Anemia
Şinasi Özsoylu
doi: 10.4274/Tjh.2013.0052  Pages 228 - 229
Abstract |Full Text PDF

IMAGES IN HEMATOLOGY
29. Pseudo Chediak-Higashi Anomaly
Zekai Avcı, Barış Malbora, Namık Özbek
doi: 10.4274/Tjh.2011.0010  Pages 230 - 231
Abstract |Full Text PDF

30. Myeloperoxidase Deficiency: The Secret Under the Flag of Unstained Cell
Türkan Patıroğlu, Hatice Eke Güngör, Julie Sawalle Belohradsky, Ekrem Ünal, Christoph Klein
doi: 10.4274/Tjh.2012.0012  Pages 232 - 233
Abstract |Full Text PDF