NEWS | |
1. | ISH 2014 World Congress Report of the Chair of Council Emin Kansu Kansu Page I |
REVIEW | |
2. | Diagnosis of Invasive Fungal Diseases in Hematological Malignancies: A Critical Review of Evidence and Turkish Expert Opinion (TEO-2) Sevtap Arıkan Akdağlı, Alpay Azap, Figen Başaran Demirkazık, Beyza Ener, Sibel Aşcıoğlu Hayran, Özlem Özdemir Kumbasar, Gökhan Metan, Zekaver Odabaşı, Ömrüm Uzun, Hamdi Akan doi: 10.4274/tjh.2014.0218 Pages 342 - 356 One of the most problematic issues in hematological malignancies is the diagnosis of invasive fungal diseases. Especially, the difficulty of mycological diagnosis and the necessity of immediate intervention in molds have led to the adoption of “surrogate markers” which does not verify, but strongly suggests fungal infection. The markers commonly used are galactomannan (GM), beta-glucan and imaging methods. Although there are numerous studies on these diagnostic approaches, none of these markers serve as a support for the clinician, as is in human immunodeficiency virus (HIV) or cytomegalovirus (CMV) infections. This paper has been prepared to explain the diagnostic tests and show the clinician how the available resources can be used. As moleculer tests have not been standardized and not used routinely in the clinics, they will not be mentioned here. |
RESEARCH ARTICLE | |
3. | The Relationship between P-Selectin Polymorphisms and Thrombosis in Antiphospholipid Syndrome: A Pilot Case-Control Study Nilüfer Alpay, Veysel Sabri Hançer, Burak Erer, Murat İnanç, Reyhan Diz Küçükkaya doi: 10.4274/tjh.2013.0091 Pages 357 - 362 OBJECTIVE: The selectins are cell adhesion molecules that mediate the interactions among leukocytes, activated platelets, and endothelial cells. We aimed to investigate whether P-selectin polymorphisms are associated with thrombosis in patients with antiphospholipid syndrome (APS). METHODS: The diagnosis and classification of APS were based on the report of an international workshop. Genomic DNA was extracted from citrated blood samples of all subjects. Three single nucleotide polymorphisms associated with the P-selectin coding region (S290N, c.1087G>A; N562D, c.1902G>A; T715P, c.2363A>C) were assessed. RESULTS: There were 26 APS (65%) patients with thrombosis. The number of patients without thrombosis was 14 (35%). The frequency of the N562D-DN genotype was significantly higher in patients with APS than in healthy controls (p=0.003). The frequency of this genotype was significantly higher in patients with APS with thrombosis compared with patients with no thrombosis (p=0.03). The N562D-NN genotype was found at a higher frequency in patients with APS than in healthy controls (p=0.004). CONCLUSION: Our results suggest that the N562D polymorphism of the DN genotype of P-selectin is associated with an increased risk of thrombosis in patients with APS. |
4. | Serum Bcl-2 Levels in Patients with β-Thalassemia Minor: A Pilot Study İrfan Yavaşoğlu, Gökhan Sargın, Gürhan Kadıköylü, Aslıhan Karul, Zahit Bolaman doi: 10.4274/tjh.2013.0152 Pages 363 - 366 OBJECTIVE: Anti-apoptotic proteins such as Bcl-2 and Bcl-xL may play a role in the survival of erythroid progenitor cells. Information about these proteins in patients with β-thalassemia minor is limited. We aimed to determine the levels of serum Bcl-2 in patients with β-thalassemia minor. METHODS: Ninety-seven patients (60 females and 37 males with mean age of 29±21 years) with β-thalassemia minor were enrolled in this study. The diagnosis of β-thalassemia minor was based on whole blood counts, family history, and HbA2 levels estimated by high-performance liquid chromatography. The control group compromised 23 healthy adults (17 females and 6 males with mean age of 58±9 years) without anemia. The levels of serum Bcl-2 were measured by enzyme-linked immunosorbent assay. Mann–Whitney U tests were used in statistical evaluation and p< 0.05 was accepted as statistically significant. RESULTS: Although there was no statistically significant difference between patients with β-thalassemia minor and the control group for the level of serum Bcl-2 (p>0.05), these levels were higher in β-thalassemia minor patients than controls. CONCLUSION: There are damaged beta chains in β-thalassemia minor. Therefore, it is expected that premature death of red blood cells may occur due to apoptosis. The mean age of the control group was higher than that of the β-thalassemia minor group; this may be why Bcl-2 levels were higher in the β-thalassemia minor group. It is known that older age constitutes a risk for increased apoptosis. Other proteins (Bad, Bax, etc.) and pathways [CD95 (Fas) ligand] associated with apoptosis should be evaluated in future studies including more patients. |
5. | Duffy and Kidd Genotyping Facilitates Pretransfusion Testing in Patients Undergoing Long-Term Transfusion Therapy Diana Remeikiene, Rasa Ugenskiene, Arturas Inciura, Aiste Savukaityte, Danguole Raulinaityte, Erika Skrodeniene, Renata Simoliuniene, Elona Juozaityte doi: 10.4274/tjh.2013.0075 Pages 367 - 373 OBJECTIVE: Conventional serologic typing of red blood cell systems other than ABO and RhD can be inaccurate and difficult to interpret in patients who have recently undergone blood transfusion. While molecular-based assays are not used routinely, the usefulness of genotyping was investigated in order to determine patients who may benefit from this procedure. METHODS: Blood samples were taken from 101 patients with haemato-oncological, chronic renal, or gastroenterological diseases and from 50 donor controls; the samples were tested for Fya and Fyb by applying serologic and genetic methods. All patients had received 3 or more units of RBCs during the last 3 months. An average of 6.1 RBC units were transfused per patient. The average length of time from transfusion until blood sampling was 24.4 days. The haemagglutination test was applied for serological analysis, and the restriction length polymorphism assay was used for genotyping. RESULTS: In total, 33 (32.7%) patients showed positive reactions with anti-Fya or anti-Fyb while being negative genetically. False-positive Fya results were found in 23 samples, and false-positive Fyb in 10 specimens. During the last 3 months, significantly more RBC units were transfused to patients with discrepant results than to those with accurate phenotyping/genotyping results: median of 5 (mean±SE: 6.85±0.69) versus median of 4 (mean: 5.71±0.51), respectively (p=0.025). The median length of time after the last transfusion was 25 days (mean: 28.72±2.23 days) in the group with accurate phenotyping/genotyping results versus a median of 14 days (mean: 15.52±1.95 days) in the group with discrepant results (p=0.001). Phenotypes and genotypes coincided in all donor samples. CONCLUSION: Genotyping assays for the Duffy system should be considered if the patient underwent blood transfusion less than 3 or 4 weeks before the sample collection. If the time frame from RBC transfusion exceeds 6 weeks, Duffy phenotyping can provide accurate results. |
6. | Bone-Specific Alkaline Phosphatase Levels among Patients with Multiple Myeloma Receiving Various Therapy Options Güven Çetin, Ahmet Emre Eşkazan, M. Cem Ar, Şeniz Öngören Aydın, Burhan Ferhanoğlu, Teoman Soysal, Zafer Başlar, Yıldız Aydın doi: 10.4274/tjh.2013.0004 Pages 374 - 380 OBJECTIVE: This study aimed to investigate the impact of the different therapy regimens used in multiple myeloma (MM) on bone-specific alkaline phosphatase (BALP) levels. METHODS: One hundred and thirteen patients with MM were included in the study. Patients were grouped according to the regimens they received, as follows: group 1, melphalan and prednisolone (MP); group 2, vincristine, adriablastin, and dexamethasone (VAD); group 3, thalidomide plus dexamethasone; and group 4, bortezomib plus dexamethasone. BALP levels were measured before treatment and at the third and sixth months of treatment. A fifth group consisted of patients in the post-treatment remission period at study entry (no-treatment group). RESULTS: The BALP levels at the third and sixth months of the treatment were significantly higher than the pre-treatment levels in the bortezomib and the no-treatment groups, whereas no significant difference was observed in the MP, VAD, and thalidomide groups. CONCLUSION: Considering that BALP is a surrogate marker of bone formation, our study suggests that bortezomib more efficiently leads to the improvement of bone disease in myeloma than other treatment options. |
7. | The Relationship of T Helper-2 Pathway Components Interleukin-4, Interleukin-10, Immunoglobulin E, and Eosinophils with Prognostic Markers in Non-Hodgkin Lymphoma: A Case-Control Study Nil Güler, Engin Kelkitli, Hilmi Atay, Dilek Erdem, Hasan Alaçam, Yüksel Bek, Düzgün Özatlı, Mehmet Turgut, Levent Yıldız, İdris Yücel doi: 10.4274/tjh.2013.0328 Pages 381 - 387 OBJECTIVE: Increased risk for non-Hodgkin lymphoma (NHL) is associated with infections and environmental agents. We hypothesized that these factors chronically trigger the T helper-2 (Th2) pathway and result in lymphoma. We investigated the role of the Th2 pathway by exploring the relationships between components of the Th2 pathway, interleukin (IL)-10, IL-4, immunoglobulin E (IgE), and eosinophils, and prognostic markers of NHL. METHODS: Thirty-one NHL patients and 27 healthy controls were enrolled. IL-10, IL-4, IgE, and eosinophils were measured. IL-4 and IL-10 were analyzed with the enzyme amplified sensitivity immunoassay method. RESULTS: High IL-10 levels were correlated with several poor prognostic features, short early survival, and lymphopenia. There was a positive correlation between albumin and IL-4 levels and a negative correlation between IL-10 and albumin. There was no relationship related with eosinophils and IgE. We found remnant increased IL-4, which could be a clue for the triggering of the Th2 pathway in the background. CONCLUSION: There is a need for differently designed studies to detect the place of the Th2 pathway in NHL. |
8. | The Association of HLA Class 1 and Class 2 Antigens with Multiple Myeloma in Iranian Patients Arezou Sayad, Mohammad Taghi Akbari, Mahshid Mehdizadeh, Elham Roshandel, Soheila Abedinpour, Abbas Hajifathali doi: 10.4274/tjh.2013.0098 Pages 388 - 393 OBJECTIVE: Multiple myeloma (MM) is a B-cell malignancy characterized by the clonal proliferation of malignant plasma cells. According to results of some studies, it has been suggested that the HLA class 1 and 2 genes have susceptibility effects on MM. Studies of different populations have reported different HLA class 1 and 2 alleles that affect MM. In this study, we assessed the association of HLA class 1 and class 2 antigens with MM in Iranian patients METHODS: We performed a case-control genotyping study with 105 Iranian MM patients that were selected from the bone marrow transplantation department of Taleghani Hospital and 150 controls using single specific primerpolymerase chain reaction with the HLA-Ready Gene ABDR Kit. RESULTS: Our results demonstrated that 21% of patients versus 12% of controls and 11% of patients versus 3% of controls carried HLA-A*03 and HLA-B*18, respectively. The MM patients had a significant increase in the frequency of HLA-A*03 and HLA-B*18 alleles in comparison to control subjects (p=0.039, OR=2.057 and p=0.013, OR=3.567, respectively). CONCLUSION: Our findings suggested that the HLA-A*03 and HLA-B*18 alleles have significant susceptibility effects on MM in the Iranian population. However, compared to other populations, the above-mentioned alleles had different statuses. Since there are not many studies evaluating and calculating this association among ethnic groups, further studies among other populations are needed to explain the exact association of the HLA genes with MM. |
9. | New Insights on Iron Study in Myelodysplasia Noha M. El Husseiny, Dina Ahmed Mehaney, Mohamed Abd El Kader Morad doi: 10.4274/tjh.2012.0154 Pages 394 - 398 OBJECTIVE: Hepcidin plays a pivotal role in iron homeostasis. It is predominantly produced by hepatocytes and inhibits iron release from macrophages and iron uptake by intestinal epithelial cells. Competitive ELISA is the current method of choice for the quantification of serum hepcidin because of its lower detection limit, low costs, and high throughput. This study aims to discuss the role of hepcidin in the pathogenesis of iron overload in recently diagnosed myelodysplasia (MDS) cases. METHODS: The study included 21 recently diagnosed MDS patients and 13 healthy controls. Ferritin, hepcidin, and soluble transferrin receptor (sTFR) were measured in all subjects. RESULTS: There were 7 cases of hypocellular MDS, 8 cases of refractory cytopenia with multilineage dysplasia, and 6 cases of refractory anemia with excess blasts. No difference was observed among the 3 MDS subtypes in terms of hepcidin, sTFR, and ferritin levels (p>0.05). Mean hepcidin levels in the MDS and control groups were 55.8±21.5 ng/mL and 19.9±2.6 ng/ mL, respectively. Mean sTFR was 45.7±8.8 nmol/L in MDS patients and 31.1±5.6 nmol/L in the controls. Mean ferritin levels were significantly higher in MDS patients than in controls (539.14±83.5 ng/mL vs. 104.6±42.9 ng/mL, p<0.005). There was a statistically significant correlation between hepcidin and sTFR (r=0.45, p=0.039). No difference in hepcidin levels between males and females was observed, although it was lower in males in comparison to females (47.9±27.6 vs. 66.7±35.7, p>0.05). CONCLUSION: Hepcidin may not be the main cause of iron overload in MDS. Further studies are required to test failure of production or peripheral unresponsiveness to hepcidin in MDS cases. |
CASE REPORT | |
10. | Severe Myelotoxicity Associated with Thiopurine S-Methyltransferase*3A/*3C Polymorphisms in a Patient with Pediatric Leukemia and the Effect of Steroid Therapy Burcu Fatma Belen, Turkız Gursel, Nalan Akyurek, Meryem Albayrak, Zühre Kaya, Ülker Kocak doi: 10.4274/tjh.2013.0082 Pages 399 - 402 Myelosuppression is a serious complication during treatment of acute lymphoblastic leukemia and the duration of myelosuppression is affected by underlying bone marrow failure syndromes and drug pharmacogenetics caused by genetic polymorphisms. Mutations in the thiopurine S-methyltransferase (TPMT) gene causing excessive myelosuppression during 6-mercaptopurine (MP) therapy may cause excessive bone marrow toxicity. We report the case of a 15-year-old girl with T-ALL who developed severe pancytopenia during consolidation and maintenance therapy despite reduction of the dose of MP to 5% of the standard dose. Prednisolone therapy produced a remarkable but transient bone marrow recovery. Analysis of common TPMT polymorphisms revealed TPMT *3A/*3C. |
11. | Intravascular Large B-Cell Lymphoma Diagnosed on Prostate Biopsy: A Case Report Nazan Özsan, Banu Sarsık, Asu Fergün Yılmaz, Adnan Şimşir, Ayhan Dönmez doi: 10.4274/tjh.2013.0090 Pages 403 - 407 Intravascular large B-cell lymphoma (IVLBCL) is a very rare type of non-Hodgkin lymphoma, usually affecting elderly patients and characterized by selective infiltration of neoplastic cells within blood vessels’ lumina. IVLBCL diagnosed with prostatic involvement is extremely rare. We report a patient of 65 years old, having mostly neurological complaints but diagnosed with IVLBCL upon histopathological examination of transurethral prostate resection material, which revealed large neoplastic cell infiltration totally limited within the lumens of small vessels. By immunohistochemistry, neoplastic cell infiltration was positive with MUM1, bcl-6, and bcl-2 and negative with ALK1, CD10, and CD30, with a high Ki-67 proliferation index. CD34 and CD31 staining showed expression in endothelial cells, highlighting the intravascular nature of neoplastic infiltrate. The patient unfortunately refused to receive treatment and died of the disease 8 months after the diagnosis. IVLBCL, though very rare, should be considered in differential diagnosis of all organ biopsies with intravascular infiltration. Further improvements in the understanding of the pathogenesis and biology of this rare type of lymphoma are mandatory. |
12. | Primary Splenic Angiosarcoma Revealed by Bone Marrow Metastasis Soumaya Anoun, Sofia Marouane, Asmae Quessar, Said Benchekroun doi: 10.4274/tjh.2013.0049 Pages 408 - 410 Primary splenic angiosarcomas are the most common malignant non-hematopoietic tumors of the spleen. Metastatic diseases were found in 69% of patients in a reported series but the incidence of bone marrow involvement is unclear. We report a rare case of a 25-years-old Moroccan woman with unsuspected primary splenic angiosarcoma revealed by bone marrow metastasis. She presented with serious anemia and splenomegaly. Bone marrow biopsy revealed proliferating spindle cells. Computed tomography scanning showed an enlarged spleen with heterogeneous lesions. Splenectomy was performed and retrospective histological study of the spleen confirmed the diagnosis. She died 1 year after splenectomy. |
13. | Aplastic Anemia Associated with Oral Terbinafine: A Case Report and Review of the Literature Bülent Kantarcıoğlu, Hüseyin Kemal Türköz, Güven Yılmaz, Funda Pepedil Tanrıkulu, Işık Kaygusuz Atagündüz, Cafer Adıgüzel, Tülin Fıratlı Tuğlular doi: 10.4274/tjh.2013.0119 Pages 411 - 416 Onychomycosis (OM) is a common fungal infection of the toenails and/or fingernails that is highly prevalent in the general population and also responsible for significant morbidity. OM is caused by dermatophytes, nondermatophytic molds, or yeast. Today systemic antifungal agents are considered as the gold standard for all types of OM. Here we report a case of aplastic anemia associated with oral terbinafine use and a review of the literature on hematological toxicities associated with terbinafine. |
LETTER TO EDITOR | |
14. | Significant Differences in Thymic Index of Thalassemia Major Patients Yeşim Oymak, Bülent Güzel, Hüseyin Gümüş, Erdem Dağlıoğlu, Ali Ayçiçek, Ahmet Koç, Derya Özyürük doi: 10.4274/tjh.2014.0150 Pages 417 - 419 Abstract | |
15. | c.761C>T Mutation Linked Hyper IgM Syndrome Presenting with Hypertransaminasemia and Arthritis Mehmet Halil Çeliksoy, Stephan Borte, Aydan İkincioğulları, Meltem Ceyhan Bilgici, Filiz Karagöz, Ayhan Gazi Kalaycı, Alişan Yıldıran doi: 10.4274/tjh.2014.0081 Pages 420 - 421 Abstract | |
16. | Blastic Plasmacytoid Dendritic Cell Neoplasm: Single-Center Experience with Two Cases in One Year Alexandra Agapidou, Sophia Vakalopoulou, Dimitra Markala, Christina Chadjiaggelidou, Maria Tzimou, Theodosia Papadopoulou, Vasileia Garypidou doi: 10.4274/tjh.2013.0404 Pages 422 - 423 Abstract | |
17. | Mogamulizumab Treatment in a Hemodialysis Patient with Adult T-Cell Leukemia/Lymphoma Mari Yoshihara, Yasushi Kubota, Makoto Fukuda, Tomoya Kishi, Yuji Ikeda, Shinya Kimura doi: 10.4274/tjh.2014.0166 Pages 424 - 425 Abstract | |
18. | Chediak-Higashi Syndrome: A Case Report of a Girl Without Silvery Hair and Oculocutaneous Albinism Presenting with Hemophagocytic Lymphohistiocytosis Murat Elevli, Halil Uğur Hatipoğlu, Mahmut Civilibal, Nilgun Selçuk Duru, Tiraje Celkan doi: 10.4274/tjh.2014.0049 Pages 426 - 427 Abstract | |
19. | Gaucher Cells or Pseudo-Gaucher Cells: That’s the Question Deniz Gören Şahin, Hava Üsküdar Teke, Mustafa Karagülle, Neslihan Andıç, Eren Gündüz, Serap Işıksoy, Olga Meltem Akay doi: 10.4274/tjh.2014.0019 Pages 428 - 429 Abstract | |
20. | Quilty Effect after Extracorporeal Photopheresis in a Patient with Severe Refractory Cardiac Allograft Rejection Özgür Ulaş Özcan, Tamer Sayın, Gürbey Soğut, Aylin Heper, Hüseyin Göksülük, Veysel Kutay Vurgun, Cansın Tulunay Kaya, Elif Ezgi Üstün, Osman İlhan, Çetin Erol doi: 10.4274/tjh.2014.0052 Pages 430 - 431 Abstract | |
21. | A Pediatric Patient with Intravenous Cyclosporine Anaphylaxis Who Tolerated the Oral Form Pamir Işık, Namik Özbek, Emine Dibek Mısırlıoğlu, Turan Bayhan, Suna Emir, Fatih Mehmet Azık, Bahattin Tunç doi: 10.4274/tjh.2014.0206 Pages 432 - 433 Abstract | |
22. | Acquired Hemophilia Şinasi Özsoylu doi: 10.4274/tjh.2014.0252 Page 434 Abstract | |
IMAGES IN HEMATOLOGY | |
23. | Generalized Necrobiotic Xanthogranuloma in a Patient with Multiple Myeloma María Jimenez, José Verdú, Francisco De Paz, Fabián Tarín doi: 10.4274/tjh.2013.0364 Pages 435 - 436 Abstract | |
24. | Aggressive Multiple Myeloma with Unusual Morphology Mehmet Sönmez, Hasan Mücahit Özbaş, Nilay Ermantaş, Ümit Çobanoğlu doi: 10.4274/tjh.2013.0104 Pages 437 - 438 Abstract | |
NONE | |
25. | Subject Index Pages 439 - 443 Abstract | |
26. | Author Index Pages 444 - 447 Abstract | |