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

12 th Congress of the European Hematology Association
disorders, such as MDS. An increased sensitivity of lymphocytes from
HIV-infected patients to lysis by complement has been directly correlated
with a decreased expression of CD55 and CD59. The aim of this
study was to evaluate the presence of CD55 and/or CD59 deficient erythrocytes
in HIV patients and explore possible correlations with clinical
parameters. Patients and Methods. CD55 and CD59 expression was evaluated
in erythrocytes surface of 37 patients (30M/7F; median age 39
years) with HIV infection. Twenty five of them were hemophilia
patients. At the time of evaluation, all patients were under antiretroviral
therapy. The detection of CD55- and CD59-deficient red cells was
performed using the sephacryl gel microtyping system (DiaMed-ID
MicroTyping System PNH test, Cressier-sur-Morat, Switzerland). The
presence of the deficient red cell populations was blindly scored by two
independent observers and expressed semiquantitatively as 100%, 75%,
50%, 25% and 10%. In all samples with CD55- or CD59-negative populations
Ham and sucrose lysis tests were also performed. Eight patients
with PNH and 121 healthy subjects were also studied as control populations.
Results. Anemia was present in 14/37 (37.8%) HIV patients. Interestingly,
we found that all HIV patients had erythrocyte populations
with CD55 and/or CD59 deficiency. More specifically, deficient red cell
populations for both CD55 and CD59 antigens were detected in 8
patients (21.6%): in seven of them erythrocytes were deficient for both
antigens at a proportion of 10%, while one patient had erythrocytes
with 25% of CD55 deficiency and 10% of CD59 deficiency. Isolated
CD55 negativity was observed in 29/37 patients (78.3%): 26 had red
cells with 10% CD55 deficiency and only 3 had erythrocytes with 25%
CD55 deficiency. Isolated CD59 deficiency was not detected. Among
121 normal subjects, two of them (1.6%) had red cells with double negativity
for CD55 and CD59, while 3 others (2.4%) had erythrocytes
with an isolated CD55 or CD59 deficiency; these red cells were counted
for not more than 10% of the total. All patients with PNH had a
simultaneous CD55 and CD59 deficiency. Positive Ham and sucrose
tests were found only in patients with PNH. There was no correlation
between the percentage of red cell population with CD55 and/or CD59
deficiency and the type or length of antiretroviral therapy, the CD4 +
counts, the plasma viral load or the concomitant hepatitis C infection.
Summary and conclusions. Our study provides evidence supporting the
presence of erythrocytes with CD55 and/or CD59 deficiency in patients
with HIV. Further studies using molecular techniques will be required
for clarifying the exact role of this deficiency to the increased susceptibility
of these populations in complement lysis and the subsequent
development of anemia in these patients.
0204
PREVENTION OF OVARIAN DAMAGE DURING CHEMOTHERAPY BY GONADOLIBERINE
ANALOGUES ADMINISTRATION
L. Smardova
University Hospital, BRNO, Czech Republic
Background. Frequent negative consequence of chemotherapy is ovarian
damage and premature ovarian failure (POF). The risk of POF onset
depends mainly on women’s age and foliculogenesis status in ovary,
chemotherapy regimen used and cumulative dose of single cytotoxic
agents. Aims. Aim of this prospective case-control study is evaluation of
gonadoliberine analogues (GnRH-a) administration to patients with
Hodgkin´s lymphoma (HL) during chemotherapy and prevention of
ovarian damage depending upon chemotherapy dose and regimen.Methods.
Study group consists of 72 patients in fertile age (28.4±4.1 years)
with HL diagnosis treated in 2004-2005 by curative chemotherapy
together with GnRH-a administration according standardized protocol.
Patients were divided to 3 groups according clinical stage of disease and
risk factors and treated by three types of chemotherapy regimens with
increased cytotoxicity (German Hodgkin Study Group protocols): group
A - ABVD regimen, group B - baseline BEACOPP and ABVD regimen in
combination, group C - dose-escalated BEACOPP regimen. Ovarian
function of all patients was assessed by gonadotrophins levels (FSH, LH)
analysis from peripheral blood before treatment and also 6 and 12 month
after it. Number of women with POF after chemotherapy in study
groups was compared with control group (n=45, age 26.8±4.6) of
patients treated in 2002-2003 according the same protocol, but without
protective GnRH-a application. In statistical evaluation two sample binomial
test with α/α=0.05 was adopted together with adjustment of level
of statistical significance by Bonferroni correction for multiple tests.
Results. In study group with GnRH-a administration during chemotherapy
there was statistical significantly (p50.000/mcL), the number of febrile episodes, the rate of empiric antifungal
therapy, the duration of hospitalisation, and the number of G-CSF
administrations in the control group. Results. There was no significant
difference between the patients receving or not receiving pegylated G-
CSF in terms of PMN recovery (median 10 vs 11 days), platelet recovery
(14 vs 14 days), hospitalisation (17 vs 17 days) or empiric antifungal
therapy; the median duration of treatment in the G-CSF group was eight
days (range 6-30). There was a significant between-group difference in
the number of febrile episodes (p