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

12 th Congress of the European Hematology Association
micrometastasis in breast cancer patients has been emphasized, as it
will improve tumor staging and subsequent plan of management. It also
helps in monitoring the effectiveness of chemotherapy and the detection
of contaminated bone marrow grafts to be re-infused after high
dose chemotherapy. Aim. To assess the HER-2/neu mRNA expression in
bone marrow, peripheral blood in HER-2/neu mRNA positive breast tissues
of female breast cancer patients. To correlate between the level of
the HER-2/neu mRNA over-expression in bone marrow and the established
risk factors for metastatic breast cancer. Type of the study: a cross
sectional study. Study population: 38 female breast cancer patients, diagnosed
with fine needle histo-pathological assessment were included. A
control group of 5 female patients with benign breast conditions were
included. Methods. All individuals included in the study were subjected
to: breast tissue fine needle aspiration biopsy & grading according to
Scarf, Bloom and Richardson, Chest X-ray, abd. ultrasonography, bony
scan, complete blood count, assessment of stained bone marrow smear.
Molecular assessment: For detection of HER-2/neu mRNA over-expression
in breast tissue specimens, bone marrow and peripheral blood.
After RNA extraction carried out using the MagNA Pure LC RNA and
isolation Kit for blood/bone marrow. Quantitative assessment of HER-
2/neu mRNA was carried out using the Light-Cycler and the HER-2/neu
mRNA quantification kit from Roch-Molecular diagnostics. Results. HER-
2/neu mRNA over-expression positivity was detected in: 16/38 (42.1%)
breast cancer tissues cases, in 7/16 (43.7%) bone marrow & and in 6/16
(35.5%) peripheral blood samples of the breast cancer HER-2/neu
mRNA tissues positive cases. A significant difference was detected
between HER-2/neu mRNA tissue positivity and tumor size (P value:
=0.032) & lymph node metastasis (P value =0.014), between HER-2/neu
mRNA bone marrow positivity and lymph node status (P value = 0.036),
between HER-2/neu mRNA marrow positivity and tumor grade. (P value
= 0.011), between bone marrow and peripheral blood HER-2/neu
mRNA positivity in the tissue positive patients (P value = 0.001): highly
significant. Recommendations: assessment of HER-2/neu mRNA in
bone marrow and/or peripheral blood for the detection of disseminated
tumor cells should be carried out for all patients with HER-2/neu
mRNA tissue positive breast cancer patients either for assessment or for
follow up. The Bone marrow microscopic examination is valueless for
the detection of micrometastasis, as all cases that showed HER-2/neu
mRNA bone marrow positivity were free of any malignant disseminated
cells on microscopic examination.
1515
BIOLOGICAL PROFILE OF BLAST CRISIS OF CHRONIC MYELOID LEUKEMIA: ANALYSIS
OF CLINICAL RELEVANCE AND PROGNOSTIC SIGNIFICANCE
A. Vidovic, 1 G. Jankovic, 1 M. Colovic, 1 D. Tomin, 1 V. Djordjevic, 1
N. Kraguljac, 1 J. Bila, 1 V. Djurasinovic, 1 O. Markovic, 2 D. Boskovic1 1 2 Institute of Hematology, BELGRADE, Serbia; Clinical Center „Bezanijska
Kosa„, BELGRADE, Serbia
Background. The blast crisis (BC) of chronic myeloid leukemia (CML)
represents terminal and infaust phase of CML, with average duration of
3-9 months. The mechanisms responsible for progression of CML to
BC are still unknown. Genomic instability, i.e. presentation of new cytogenetic
abnormalities other than Ph chromosome is significant pathogenetic
factor, as well, as activation of some oncogenes. Aim. To define
and correlate clinical, immunophenotypic, cytogenetic and laboratory
characteristics of BC in CML with duration of BC phase. Methods. The
study included 31 patients (pts) with BC of CML (median age 51; range
19-72 years; M/F ratio 18/13). The median duration of BC was 4 months
(range 1-12 m). The immunophenotypic analysis of bone marrow (b.m.)
aspirates of 26 pts was performed by flow citometry (EPICS-C, Counter
of FACScalibur, Becton, Dickinson). In 5 pts, b.m. biopsies were analyzed
by immunohystochemistry in order to define a type of blast cells.
The kariotype of pts was analyzed on metaphases from b.m. aspirates
by conventional cytogenetic analysis. Furthermore, the study included
analysis of laboratory data (Hb, WBC, pletelet count, percentage of blast
and basophills, LDH) as well as degree of splenomegaly, and degree of
reticulin fibrosis in the b.m. biopsies. Results. The type of BC was as follows:
in 16 pts myeloblastic, in 7 pts lymphoblastic, in 6 pts megakarioblastic
and in 2 pts biphenotypic. Thrombocytosis was found in
4/31pts, 6/31 pts had normal platelets, and in 21/31 pts existed low
platelet count. Twenty-six pts were anemic; and in 20pts leukocytosis
upper than 20×10 9 /l was detected. Twelve pts evolve additional karyotypic
abnormalities; 9/12 pts had one or two additional abnormalities
and 3/12 pts show myltiple karyotypic anomalies. A grade III or IV
myelofibrosis was present in 17/31 pts. The serum activity of LDH was
elevated in all pts (med 1159U/L). Splenomegaly more than 5cm below
538 | haematologica/the hematology journal | 2007; 92(s1)
left costal margin was found in 19/31 pts. There was no correlation
between clinical, immunophenotypic, cytogenetic features, type of BC
and duration of disease. Conclusions. The studies performed on a molecular
level in the large cohort of patients are need to define basic biologic
event that lead CML from chronic to BC phase, which is refractory
to all known type of therapy.
1516
PREDICTIVE VALUE OF DISCRIMINATION INDICES IN DIFFERENTIAL DIAGNOSIS OF
IRON DEFICIENCY ANEMIA AND β-THALASSEMIA TRAIT
C. Beyan, K. Kaptan, A. Ifran
Gulhane Military Medical Academy, ANKARA, Turkey
Background. Iron deficiency anemia (IDA) and β-thalassemia trait (B-
TT) are most common causes of hipochromic microcytic anemias. Many
indices have been defined to quickly discriminate these similar entities
via parameters obtained from automated blood count analyzers. Aims.
The purpose of the study is to evaluate the predictive value of these
indices in differential diagnosis of IDA and B-TT in adult cases. Methods.
This study consists of 45 IDA cases, 36 women and 9 men, whose
mean age is 33,87±11,59 (mean±SD) (range 17-57 years) and 66 B-TT
cases, 41 women and 25 men, whose mean age is 33,26±13,36
(mean±SD) (range 14-74 years). IDA cases with Hb value