scholarly journals An Unusual Case of Aplastic Anemia Caused by Temozolomide

2010 ◽  
Vol 2010 ◽  
pp. 1-2 ◽  
Author(s):  
Gazi Comez ◽  
Alper Sevinc ◽  
Ozlem Nuray Sever ◽  
Taner Babacan ◽  
Ibrahim Sarı ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Adjuvant Therapy ◽  
Aplastic Anemia ◽  
Adjuvant Treatment ◽  
Unusual Case ◽  
English Literature ◽  
Bone Marrow Aspiration ◽  
High Grade Glioma ◽  
High Grade ◽  
Life Threatening

Radiotherapy and concomitant/adjuvant therapy with temozolomide are a common treatment regimen for children and adults with high-grade glioma. Although temozolomide is generally safe, it can rarely cause life-threatening complications. Here we report a case of a 31-year-old female patient who underwent surgical resection followed by radiotherapy plus concomitant temozolomide. She developed pancytopenia after adjuvant treatment with temozolomide. A bone marrow aspiration and biopsy showed hypocellularity with very few erythroid and myeloid cells, consistent with aplastic anemia. In the English literature, aplastic anemia due to temozolomide is extremely rare.

Vitamin B12 Deficiency an Unusual Cause of Fever: A Case Report

2019 ◽  
Vol 4 (02) ◽  
Author(s):  
Shyama . ◽  
P. Kumar ◽  
Surabhi .
Keyword(s):  
Bone Marrow ◽  
Vitamin B12 ◽  
Unusual Case ◽  
Vitamin B12 Deficiency ◽  
Bone Marrow Aspiration ◽  
Microcytic Anemia ◽  
Peripheral Smear ◽  
Erythroid Hyperplasia ◽  
B12 Deficiency ◽  
Vitamin B12 Supplementation

Introduction: An unusual case of a 19 year old female, presenting with fever, pallor and hepatosplenomegaly for one month. She had microcytic anemia on peripheral smear examination but her bone marrow aspiration & biopsy revealed a hypercelluar marrow with megaloblastic erythroid hyperplasia. Resolution of fever within 48 hours of Vitamin B12 supplementation, initiated in view of the megaloblastic bone marrow picture & low serumVitamin B12 level, suggests a causal association. Conclusion: Vitamin B12 deficiency seems to be an unusual cause of PUO (Pyrexia of unkown origin) which should be ruled out in every case of PUO.

scholarly journals Pancytopenia: A Clinico Hematological Study

2011 ◽  
Vol 3 (01) ◽  
pp. 015-020 ◽  
Author(s):  
Gayathri B N. ◽  
Kadam Satyanarayan Rao
Keyword(s):  
Bone Marrow ◽  
Megaloblastic Anemia ◽  
Hematological Parameters ◽  
Disease Process ◽  
Bone Marrow Aspiration ◽  
Drug Induced ◽  
Male Predominance ◽  
Bone Marrow Hypoplasia ◽  
Life Threatening ◽  
A Prospective Study

ABSTRACT Background: Pancytopenia is a relatively common hematological entity. It is a striking feature of many serious and life-threatening illnesses, ranging from simple drug-induced bone marrow hypoplasia, megaloblastic anemia to fatal bone marrow aplasias and leukemias. The severity of pancytopenia and the underlying pathology determine the management and prognosis. Thus, identification of the correct cause will help in implementing appropriate therapy. Objectives: To study the clinical presentations in pancytopenia due to various causes; and to evaluate hematological parameters, including bone marrow aspiration. Materials and Methods: It was a prospective study, and 104 pancytopenic patients were evaluated clinically, along with hematological parameters and bone marrow aspiration in Hematology Unit, Department of Pathology, JJMMC, Davanagere, during the period of September 2005 to September 2007. Results: Among 104 cases studied, age of patients ranged from 2 to 80 years with a mean age of 41 years, and male predominance. Most of the patients presented with generalized weakness and fever. The commonest physical finding was pallor, followed by splenomegaly and hepatomegaly. Dimorphic anemia was the predominant blood picture. Bone marrow aspiration was conclusive in all cases. The commonest marrow finding was hypercellularity with megaloblastic erythropoiesis. The commonest cause for pancytopenia was megaloblastic anemia (74.04%), followed by aplastic anemia (18.26%). Conclusion: The present study concludes that detailed primary hematological investigations along with bone marrow aspiration in cytopenic patients are helpful for understanding disease process and to diagnose or to rule out the causes of cytopenia. These are also helpful in planning further investigations and management.

Uncontrolled Complement Activation and the Resulting Chronic Hemolysis As Measured by LDH Serum Level At Diagnosis As Predictor of Thrombotic Complications and Mortality in a Large Cohort of Patients with Paroxysmal Nocturnal Hemoglobinuria (PNH),

Blood ◽  
2011 ◽  
Vol 118 (21) ◽  
pp. 3166-3166 ◽  
Author(s):  
Jong Wook Lee ◽  
Jun Ho Jang ◽  
Jin Seok Kim ◽  
Sung-Soo Yoon ◽  
Je-Hwan Lee ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Aplastic Anemia ◽  
Complement Activation ◽  
Independent Predictor ◽  
Significant Risk ◽  
Premature Mortality ◽  
Clinical Complications ◽  
Life Threatening ◽  
Complications And Mortality ◽  
Bone Marrow Disorders

Abstract Abstract 3166 Introduction: Paroxysmal nocturnal hemoglobinuria (PNH) is a progressive, systemic, and life-threatening disease characterised by chronic uncontrolled terminal complement activation and hemolysis. Uncontrolled complement activation leads to red blood cell (RBC) hemolysis, platelet activation and subsequently thromboembolism (TE), renal and other organ impairment, pain, severe fatigue, poor quality of life and early mortality. Lactate dehydrogenase (LDH) serum level of ≥1.5x the upper limit of normal (LDH ≥1.5x) is a marker of uncontrolled complement activation that has been used in multinational PNH clinical trials. TE is the leading cause of death in PNH and carries a significant mortality risk, accounting for 46% of deaths in Korean PNH patients. The aim of this clinical research project is to evaluate whether uncontrolled complement activation as measured by LDH ≥1.5x at diagnosis is a suitable predictor of TE and mortality. Methods: A retrospective analysis of the national PNH data registry (301 patients) in South Korea was performed. 224 patients who had reported LDH level at diagnosis were analyzed. Results: PNH patients with LDH ≥1.5x at diagnosis had a 4.8-fold greater mortality rate compared to the age and gender matched general population (AGMGP; P<0.001). In contrast, patients with LDH <1.5x had a similar mortality rate as the AGMGP (P=0.824). Other factors that could be associated with increased mortality (age, gender or coexistence of aplastic anemia/other bone marrow disorders) did not differ significantly between the LDH ≥1.5x and LDH <1.5x populations of PNH patients. Using logistic regression analysis, LDH ≥1.5x at diagnosis was significantly associated with premature mortality compared to LDH <1.5x (univariate odds ratio 5.0; 95% CI (1.15, 21.70); p=0.009). In a multivariate logistic regression with mortality as the response variable, which contained LDH ≥1.5x at diagnosis, age, gender, and aplastic anemia/other bone marrow disorders as explanatory variables, LDH ≥1.5x at diagnosis was shown to be an independent predictor of mortality (OR=10.57, 95% CI: (1.36, 81.93), P=0.024). We performed a sensitivity analysis which identified that, unlike the LDH 1.5x threshold, consideration of an LDH threshold higher than 1.5x was not a significant predictor of premature mortality compared to the population of patients with LDH less than these respective higher thresholds: LDH ≥3.0x (OR 1.8; 95% CI (0.78, 4.09); p=0.162), and ≥5.0x (OR 2.0; 95% CI (0.91, 4.32); p=0.082). Furthermore, using LDH ≥1.5x at diagnosis as the threshold detected 96% of patients with TE, which is one of the multiple severe clinical complications in PNH and itself a risk factor for premature mortality. We performed a sensitivity analysis which identified that, unlike the LDH 1.5x threshold, consideration of an LDH threshold higher than 1.5x, similar to the lack of significant predictor of premature mortality, also missed approximately 50% of the life-threatening TE population compared to the 1.5x LDH threshold (only 67% detection with LDH ≥3.0x and only 47% with LDH ≥5x). Conclusion: This evidence demonstrates that uncontrolled complement activation as measured by LDH ≥1.5x the upper limit of normal at diagnosis is a strong and independent predictor of clinical complications and mortality in PNH independent of age, gender or the coexistence of aplastic anemia/other bone marrow disorders. LDH ≥1.5x clearly identifies a population of PNH patients with a high risk of life-threatening complications and premature mortality (4.8-fold) from the remaining population of PNH patients that has a survival rate similar to AGMGP. Applying higher thresholds of LDH at diagnosis does not identify a population at significant risk for premature mortality and also does not further concentrate patients at risk, but on the contrary, would miss more than 50% of PNH patients at significant risk for life-threatening complications and consequences. Thus, early therapeutic intervention in PNH patients with LDH ≥1.5x ULN at diagnosis is imperative to prevent TE and other life-threatening complications caused by uncontrolled complement activation and hemolysis, such as kidney disease and pulmonary hypertension, as well as premature mortality. Disclosures: Lee: Novartis: Honoraria; Alexion: Honoraria. Chung:Novartis: Research Funding.

Persistence of disseminated tumor cells (DTC) in bone marrow (BM) of breast cancer patients predicts increased risk for relapse—Results of pooled European data

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 10083-10083 ◽  
Author(s):  
W. J. Janni ◽  
G. Wiedswang ◽  
T. Fehm ◽  
J. Jueckstock ◽  
E. Borgen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Bone Marrow ◽  
Adjuvant Therapy ◽  
Cancer Patients ◽  
Adjuvant Treatment ◽  
Prognostic Significance ◽  
Primary Diagnosis ◽  
Nodal Status ◽  
Breast Cancer Patients ◽  
Increased Risk

10083 Background: The prognostic significance of DTC in the BM of breast cancer patients at the time of primary diagnosis has recently been confirmed by a large pooled analysis. If the persistence of DTC after adjuvant therapy confers a similar risk for relapse, there might be an indication for secondary adjuvant treatment. Methods: We analyzed BM aspirates of 697 patients from academic breast cancer units in Oslo (n=356), Munich (n=228) and Tuebingen (n=113) during recurrence-free follow-up at a median interval of 32.4 months (standard deviation [std] 19.4 mon) after primary diagnosis of breast cancer pT1–4, pN0–3 pM0. Carcinoma cells were detected using a standardized immunoassay with the monoclonal antibodies A45-B/B3 (Munich, Tuebingen), or AE1 and AE3 (Oslo), directed against cytokeratin (CK). Patients were followed for a median of 54.2 months (std 24.5 mon) after primary diagnosis. Results: Persistent DTC in the BM were detected in 15.6% of the patients (n=109). The Kaplan-Meier estimate for mean distant relapse-free survival estimate was 155.6 mon (142.4 - 168.9 95%CI) in patients with negative and 102.3 mon (93.6 - 111.0, 95% CI, p< .0001, log rank test) in patients with positive BM status. Patients without evidence of persistent DTC had a significantly longer overall survival (164.4 [155.6 - 173.3]), than patients with positive BM status (101.7 mon [89.4 - 113.9], p< .0001). In multivariate Cox regression analysis, allowing for bone marrow status, tumor size, nodal status, histopathological grading and hormone receptor status, DTC was of higher independent prognostic significance for subsequent reduced breast cancer specific survival (RR 5.9, 2.8 - 12.8, 95% CI, p< .0001), than nodal status at time of primary diagnosis (RR 1.2, 1.0 - 1.3, 95% CI, p=.014). Conclusion: Evidence of persistent DTC in breast cancer patients indicates an increased risk for subsequent relapse, and may serve for monitoring in future clinical trials. Such trials might investigate the benefit of individualized secondary adjuvant treatment or extended adjuvant therapy of patients with DTC. No significant financial relationships to disclose.

scholarly journals O5.09 * VENTRICULAR HIGH GRADE GLIOMA: NEUROENDOSCOPY AND ADJUVANT THERAPY

2014 ◽  
Vol 16 (suppl 2) ◽  
pp. ii11-ii11
Author(s):  
P. A. Oppido ◽  
F. Cattani ◽  
C. M. Carapella ◽  
V. Villani
Keyword(s):  
Adjuvant Therapy ◽  
High Grade Glioma ◽  
High Grade

scholarly journals Haemophagocytic Lymphohistiocytosis: A Case Report

2019 ◽  
Vol 11 (2) ◽  
pp. 89-90
Author(s):  
Mohammad Shameem Montasir Hossen ◽  
SM Mahbubul Alam ◽  
AKM Abu Yousuf ◽  
Md Moshiur Rahman
Keyword(s):  
Bone Marrow ◽  
Lower Abdominal Pain ◽  
Bone Marrow Aspiration ◽  
Armed Forces ◽  
High Grade ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Medical College ◽  
Total Hysterectomy ◽  
Erythematous Skin ◽  
Laboratory Investigations

A 60 years old lady, a diagnosed case of hypertension and hypothyroidism, admitted in CMH Dhaka with the complaints of high grade continuous fever, headache, vomiting and lower abdominal pain following total hysterectomy about two weeks back. On general and physical examination, she was found febrile, mildly anaemic, pitting oedema over both legs and erythematous skin rash over face, trunk and extremities. Relevant laboratory investigations were done including bone marrow aspiration which revealed haemophagocytic lymphohistiocytosis. Journal of Armed Forces Medical College Bangladesh Vol.11(2) 2015: 89-90

scholarly journals Leukemia and Exposure to X-Ray: A Report of 6 Cases

Blood ◽  
1959 ◽  
Vol 14 (10) ◽  
pp. 1137-1142 ◽  
Author(s):  
WILLIAM C. MOLONEY
Keyword(s):  
Bone Marrow ◽  
Aplastic Anemia ◽  
Bone Marrow Aspiration ◽  
Ionizing Irradiation ◽  
Acute Leukemias ◽  
X Ray ◽  
Radiation Induced ◽  
Complete Detail

Abstract 1. Six cases of leukemia occurring in patients exposed to varying doses of x-ray are reported in this article. 2. The difficulties in evaluating the dosage of radiation is well illustrated in most of these cases. 3. Latent periods were variable and difficult to estimate accurately. It is pointed out that the latent periods in radiation-induced leukemia usually are from three to 10 years in length. 4. All cases in this group were acute leukemias; in four the onset simulated aplastic anemia and diagnosis was verified only after bone marrow aspiration or biopsy. 5. The difficulties in establishing criteria for the diagnosis of radiation-induced leukemia in the present inadequate state of our knowledge are pointed out. In all cases of leukemia attributed to ionizing irradiation it is urgently necessary to publish all information in as complete detail as possible.

Obstetric Outcome in a Patient with Aplastic Anemia

2017 ◽  
Vol 9 (2) ◽  
pp. 127-128
Author(s):  
Anuja Nanda ◽  
Vineeta Gupta ◽  
Prachi Maheshwari ◽  
Archna Tandon
Keyword(s):  
Bone Marrow ◽  
Aplastic Anemia ◽  
Pluripotent Stem Cells ◽  
Treatment Options ◽  
Suppressive Therapy ◽  
Obstetric Outcome ◽  
Child Treatment ◽  
Mother And Child ◽  
Immune Suppressive Therapy ◽  
Life Threatening

ABSTRACT Aplastic anemia is a rare disease caused by destruction of pluripotent stem cells in bone marrow. The etiology may be radiation exposure, chemotherapy, environmental toxins or it could be autoimmune. During pregnancy it can be life threatening for both mother and child. Treatment options are erythrocytes and platelet transfusions and immune suppressive therapy. We report a series of obstetric events in the life of a woman whose pregnancy was complicated due to aplastic anemia but her subsequent obstetric outcome improved after successful bone marrow transplantation. How to cite this article Gupta V, Maheshwari P, Tandon A, Nanda A. Obstetric Outcome in a Patient with Aplastic Anemia. J South Asian Feder Obst Gynae 2017;9(2):121-122.

Sign in / Sign up

Export Citation Format

Share Document