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

oped mild thrombocytopenia (platelet count between 50.000 and
100.000/µL) without clinical manifestations; of these, three cases were
associated with anaemia. In this series of AIDS patients we observed 11
cases of malignancy (10,2%): 6 Kaposi sarcomas (5 males, 1 female), 3
non-Hodgkin lymphomas (histologically of the diffuse large cell type),
1 Hodgkin lymphoma and 1 multiple myeloma. They were treated with
chemotherapy according to the established protocol and staging. Summary.
In our series of AIDS patients the most common hematological
complication was anemia (62%), in a few cases associated with neutropenia
or thrombocytopenia. Isolated neutropenia or thrombocytopenia
was uncommon. Kaposi sarcoma was the most frequent malignancy
observed (6 cases), followed by non-Hodgkin lymphoma (3 cases).
1314
COMBINATION OF FLUORESCENCE IMMUNOPHENOTYPING AND IN SITU
HYBRIDIZATION TO DETECT CHROMOSOMAL ABERRATIONS IN MULTIPLE MYELOMA
C. Garcia, A. López Martínez, C. Benet Campos, V. Amigo Garcia,
E. Monzó Castellano, J.R. Mayans Ferrer
Hospital Arnau de Vilanova, VALENCIA, Spain
Background. Multiple myeloma (MM) is the prototypic monoclonal Bcell
neoplasm that is derived from the autonomous proliferation of plasma
cells and associated with paraprotein production and osteolytic bone
lesions. Chromosomal abnormalities are among the most important prognostic
parameters for patients with MM. However, conventional karyotyping
has been hampered by the slow growth of MM cells in cell cultures,
and chromosomal abnormalities are often missed by this technique,
showing normal karyotypes in around 50 to 70% of cases. The importance
of chromosomal abnormalities in order to determine prognosis and evolution
of the disease justifies the need to detect these abnormalities in all
patients. Rutine FISH (fluorescent in situ hybridization) improves somewhat
this percentage showing aberrations in up to 85% of patients. Fluorescence
Immunophenotyping and interphase Cytogenetics as a Tool for
the Investigation Of Neoplasms (FICTION) is a new technique that permits
the study and counting of only plasma cell nuclei, therefore improving
the sensitivity of the FISH technique. Aims. The aim of this study is the
comparison of standard FISH technique to FICTION technique for the
detection of chromosomal abnormalities in multiple myeloma and monoclonal
gammopathy of undetermined significance (MGUS). Methods.
Bone marrow (BM) samples from 6 patients with MM, 3 patients with
MGUS, and one normal bone marrow, used as a control, were obtained.
For the detection of chromosomal aberrations, FISH on interphase nuclei
with commercially available probes for 13q14, 11q22.3, p53 gene (17p13)
and IgH rearrangements was performed. For all probes applied, 200 nuclei
were counted. Combination of fluorescence immunophenotyping, using
an anti-K?L Ig light chain antibody, and in situ hybridization was applied
to all patients, analyzing also 200 nuclei, except for two cases with specially
low percentage of plasma cell infiltration, in which, all plasma cells
present in the smear were counted.
Table 1.
Results. Median plasma cell infiltration was 25% (1-89%), of note, 6
patients presented with less than 25% of infiltration. FISH detected 5 chromosomal
aberrations in 4 cases (44%) 2 of them with less than 25% of
infiltration. FICTION was able to detect 12 chromosomal aberrations in
7 patients (77, 7%). In three patients, the FICTION revealed a genomic
aberration that hadn´t been detected with FISH (one of them with only 4%
of infiltration). FISH sensitivity was very low compared to FICTION sensitivity,
being the aberration rates 6-22% in FISH and 10-99% in FICTION
analysis. FICTION revealed that only plasma cells presented chromosomal
aberrations. Table 1 shows percentages of abnormal cells. Results
higher than 4% have been considered as positives. P:patient, F:FISH,
FC:FICTION. Conclusions. In conclusion, the combination of immunophe-
12 th Congress of the European Hematology Association
notyping and FISH on a single cell level demonstrated that only plasma
cells bore chromosomal aberrations and that combined techniques allow
us to increase the sensitivity of the specific genomic aberration.
1315
THE EFFECT OF BLOOD VISCOSITY ON ERYTHROPOIETIN SECRETION
M.L.A. Balea, 1 T. Puscariu, 2 C. Siara, 1 M.I. Balea3 1 Colentina Clonical Hospital, BUCHAREST; 2 Fundeni Institute, BUCHAREST;
3 NIP Prof. Dr. Marius Nasta, BUCHAREST, Romania
Background. Erythropoietin (Epo) is produced primarily in the adult
kidney under the control of an oxygen-sensing mechanism. Besides
hypoxia, there are several factors that modulate Epo production, such as
hypoglycemia, increased intracellular calcium, insulin release, estrogen,
androgenic steroids, and various cytokines. Aims. To demonstrate our
hypothesis that the blood viscosity modulate as well Epo production.
Methods. Considering blood viscosity’s importance for kidney function
we have evaluated the serum erythropoietin’s level in subjects with
Waldenstrom’s disease and multiple myeloma before starting the
plasmapheresis program and at 21 days after the serum viscosity was
normalized. The analyzed lot had viscosity between 4cp and 12cp and
need plasmapheresis as a regulator of their severe hyper-viscosity syndrome.
The results we obtained denoted constant decrease to the low
level of normal values and under normal limits of serum Epo concentration
for the evaluation made before plasmapheresis. We observed a high
correlation between the high level serum viscosity and the severity of
Epo’s decrease level. The reevaluation of the serum erythropoietin concentration
21 days after serum viscosity stabilizing, indicated a constant
increase of the serum Epo with 68% to 230% (referring to initial values),
the average increase being 114%. Our conclusions of this stage are: the
serum viscosity is involved in the Epo’s release regulation; the hyper-viscosity
represents an inhibitory factor of the Epo’s release.
1316
THE RELATION BETWEEN CHRONIC IDIOPATHIC THROMBOCYTOPENIC PURPURA
AND THYROID AUTOANTIBODIES
A. Altintas, 1 S. Pasa, 1 E. Parmaksiz2 1 Dicle University Medical Faculty, DIYARBAKIR; 2 Dicle University, Medical
Faculty, DIYARBAKIR, Turkey
Background and Aim. The association between thrombocytopenia and
hyperthyroidism or thyroid autoimmune diseases (TAD) has been
reported but its mechanism is unclear. Thrombocytopenia may be
observed in patients with TAD, especially those with hyperthyroidism.
We designed a prospective study to investigate the prevalence of antithyroid
and antigliadin autoantibodies in patients with idiopathic thrombocytopenic
purpura (ITP), and to determine the frequency of overlapping
autoimmune disorders. Patients and Methods. Patients admitted with
chronic ITP to the Dicle University Hematology policlinic between June
2003 and December 2006 were tested at study entry and followed for
the presence of antithyroid antibodies, antiendomisium and antigliadin
antibodies. Thyroid, endomisium and gliadin autoantibodies performed
in 68 patient with chronic ITP compared with 92 healthy individuals that
have a normal platelet counts. Results. Thyroid antithyroid autoantibody
(TATA) positivity detected in 26 (38.2%) out of 68 patients with chronic
ITP, and 3 out of 92 (3.2%) healthy controls. Thyroid antimicrosomal
autoantibody (TAMA) positivity found in 14 out of 68 (20.58%) patients
with chronic ITP, and 2 out of 92 (2.1%) healthy controls. Both antithyroid
autoantibodies are significantly different from control subjects
(p