12th Congress of the European Hematology ... - Haematologica

12 th Congress of the European Hematology Association
negatively with haemoglobin levels (r=-0.335, p=0.017). No statistical
differences were found between responders and non-responders to rhE-
PO therapy, concerning tPA and PAI-1 levels. However, the D-dimer
level is significantly higher in non-responder group [137.25 (68.50-
266.94) vs 214.75 (139.76-547.56), p=0.032]. Our results showed an
altered haemostasis in CRF patients based on D-dimer plasma level,
which is used as an index of fibrin turnover and intravascular thrombogenesis.
The increased levels of this fibrinolytic marker in CRF patients,
particulary in non-responders patients, associated to its correlation with
haemoglobin levels and rhEPO doses suggest a relationship between
abnormal haemostasis and resistance to rhEPO therapy. Moreover, as
tPA is decreased in CRF patients, it is reasonable to assume that the
higher levels of D-dimers are primarily a result of increased fibrin formation
and that this increased thrombogenic state may be related to
increased susceptibility to vascular disease in these patients, particularly
in non-responders to rhEPO therapy.
Acknowledgments: this study was supported by a PhD grant
(SFRH/BD/27688/2006) attributed to E. Costa by FCT and FSE.
1172
CA 15-3 : CAN USED TO DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS
OF MEGALOBLASTIC ANEMIA ASSOCIATED WITH VITAMIN B12 DEFICIENCY?
V. Aslan, 1 H. Yavuz, 1 B. Durak, 2 F. Cehiz Sagir1 1 2 Yunusemre State Hospital, ESKISEHIR; Osmangazi University Medical Faculty,
ESKISEHIR, Turkey
Background. The CA 15-3 is glycoprotein used to diagnose breast cancer
and gastrointestinal carcinoma, to define their prognosis and to monitor
of the treatment. However in some diseases like NHL and liver cirrhosis;
the CA15-3 levels may increase slightly. A disease different from
breast cancer that increase 15-3 level, is also a megaloblastic anemia associated
with serum vitamin B12 deficiency. Aims. In this study the diagnostic
value of CA15-3 at the megaloblastic anemia with vitamin B12
deficiency and its role at the differential diagnosis of disease presented
with macrocytic anemia, are investigated. Methods. Eighty-nine patients
with MCV higher than 96 fl were included in this study. Sixty-two of
them had megaloblastic anemia with vitamin B12 deficiency, 9 patients
had MDS, 10 patients had chronic liver disease and 8 patients had
hypothyroidism. CBC, serum vitamin B12, folic acid, CA15-3 testing,
thyroid hormones, liver enzymes, HbsAg, Anti HCV Ab testing, reticulocyte
counting, abdominal ultrasonography and gastroscopy were
applied to all patients. To eliminate breast cancer, mammography was
applied to all women patients. Bone marrow biopsy and cytogenetic
examination was made to the patients with MDS. Bone marrow aspiration
is applied to the patients with megaloblastic anemia. Other reasons
of macrocytosis were eliminated for patients with MDS; chronic liver disease
and hypothyroidism. 1000 µg vitamin B12 was injected IM to the
patients with vitamin B12 deficiency , per day for 10 days and then once
a month. Post-treatment analysis for these patients had been constructed
when the hemoglobin and MCV values decreased to normal levels.
Results. In patients with megaloblastic anemia associated with vitamin
B12 deficiency, Post-treatment hemoglobin and MCV values have been
obtained as 13,0±0,9 g/dL, 87,3±11,8 fl while these values are 8,4±2,5
g/dL and 114±10,8 fl. respectively for the pretreatment case (p< 0,0001).
Serum CA 15-3 values are obtained as 92,4 U/mL (N:0-25 U/mL) and
19,6 U/mL (p