Accuracy of leukocyte alkaline phosphatase score to predict JAK2 V617F mutation

Granulocyte activation parameters have been described in patients with myeloproliferative disorders (MPD). We have evaluated the accuracy of leukocyte alkaline phosphatase (LAP) score to predict JAK2 V617F mutation. LAP score was obtained using a cytochemical reaction in granulocytes of patients’ peripheral blood with MPD

The Latin American experience of allografting patients with severe aplastic anaemia: real-world data on the impact of stem cell source and ATG administration in HLA-identical sibling transplants

We studied 298 patients with severe aplastic anaemia (SAA) allografted in four Latin American countries. The source of cells was bone marrow (BM) in 94 patients and PBSCs in 204 patients. Engraftment failed in 8.1% of recipients with no difference between BM and PBSCs (P = 0.08). Incidence of acute GvHD (aGvHD) for BM and PBSCs was 30% vs 32% (P = 0.18), and for grades III–IV was 2.6% vs 11.6% (P = 0.01). Chronic GvHD (cGvHD) between BM and PBSCs was 37% vs 59% (P = 0.002) and extensive 5% vs 23.6% (P = 0.01). OS was 74% vs 76% for BM vs PBSCs (P = 0.95). Event-free survival was superior in patients conditioned with anti-thymocyte globulin (ATG)-based regimens compared with other regimens (79% vs 61%, P = 0.001) as excessive secondary graft failure was seen with other regimens (10% vs 26%, P = 0.005) respectively. In multivariate analysis, aGvHD II–IV (hazard ratio (HR) 2.50, confidence interval (CI) 1.1–5.6, P = 0.02) and aGvHD III–IV (HR 8.3 CI 3.4–20.2, Po0.001) proved to be independent negative predictors of survival. In conclusion, BM as a source of cells and ATG-based regimens should be standard because of higher GvHD incidence with PBSCs, although the latter combining with ATG in the conditioning regimen could be an option in selected high-risk patient

Células de Reed- Sternberg en impronta de ganglio axilar

The detection of Reed- Sternberg cells in lymph node biopsy is a very important diagnostic tool for Hodgkin´s Lymphoma. However, its visualization in intraoperative nodal touch imprints is not a common practice despite being a technique that allows a quick etiological orientation.La detección de células de Reed- Sternberg en las biopsias ganglionares constituye una herramienta diagnóstica de gran importancia para el Linfoma de Hodgkin. Sin embargo su visualización en improntas ganglionares no es una práctica habitual, pese a ser una técnica que permite orientación etiológica con mayor rapidez

Trypanosoma cruzi in Persons without Serologic Evidence of Disease, Argentina

Current diagnosis of chronic Chagas disease relies on serologic detection of specific immunoglobulin G against Trypanosoma cruzi. However, the presence of parasites detected by polymerase chain reaction (PCR) in patients without positive conventional serologic testing has been observed. We determined the prevalence and clinical characteristics of persons with seronegative results for T. cruzi DNA detected by PCR in a population at high risk for chronic American trypanosomiasis. We studied a total of 194 persons from two different populations: 110 patients were recruited from an urban cardiology clinic, and 84 persons were nonselected citizens from a highly disease-endemic area. Eighty (41%) of persons had negative serologic findings; 12 (15%) had a positive PCR. Three patients with negative serologic findings and positive PCR results had clinical signs and symptoms that suggested Chagas cardiomyopathy. This finding challenges the current recommendations for Chagas disease diagnosis, therapy, and blood transfusion policies

Application of the revised International Prognostic Scoring System for myelodysplastic syndromes in Argentinean patients

The International Prognostic Scoring System (IPSS) [1], the gold standard for risk assessment in Myelodysplastic syndromes (MDS), has been recently revised (IPSS-R). The authors proposed a new prognostic model including novel components: five cytogenetic prognostic subgroups with specific classification of a number of less common cytogenetic subsets [2-3]; the 2-150, 131, 51, 6, and 5 months, respectively (Fig. 1b). The proposed IPSS-R defines a new intermediate risk group mainly composed by patients from the intermediate-1 IPSS risk category (84%, 47/56) and allowed us to identify 7% (11/150) of patients that were shifted from the intermediate-1 risk group into the high IPSS-R risk group. Although limit age of 60 years did not show statistical differences for predicting survival, our results confirm that younger good risk patients have significantly better prognosis than elderly counterparts (very low/ low risk patients: 125 vs. 64 months, p=0.014), while the age at diagnosis has no impact on disease outcome for higher risk patients [1-2, 7-8]. The proposed formula for an age-adjusted categorization [2] helped us to identify 19% (28/147) of short surviving patients among low risk IPSS-R patients with a median survival of 34 months (Fig. 1d). These patients showed, among relevant parameters, a gender ratio M/F of 3.0, a median age of 81 years, 2.5% of BM blasts, 9.1g/dL of haemoglobin level, 12 (43%) presented an abnormal karyotype and 17 died, including 6 patients with previous leukemic progression. It can be concluded that the IPSS-R system is simple to use since includes accessible variables showing a good reproducibility, effectiveness in predicting clinical outcome, and a refinement of the intermediate risk category in our WHO classified series.Fil: Belli, Carolina Bárbara. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Bestach, Yesica Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Giunta, Mario. Instituto Privado de Hematología y Hemoterapia. Paraná; ArgentinaFil: Iastrebner, Marcelo. Centro Médico “San Luis”. Buenos Aires; ArgentinaFil: Santos, Isabel. Ministerio de Defensa. Ejército Argentino. Hospital Militar Central Cirujano Mayor "Dr. Cosme Argerich"; ArgentinaFil: Pintos, Noemi. Sanatorio “Julio Méndez”. Servicio de Hematología. Buenos Aires; ArgentinaFil: Arbelbide, Jorge. Hospital Italiano; ArgentinaFil: Basquiera, Ana L.. Hospital Privado de Córdoba. Córdoba; ArgentinaFil: Bengió, Raquel. Instituto de Investigaciones Hematológicas. Buenos Aires; ArgentinaFil: Larripa, Irene Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentina. Instituto de Investigaciones Hematológicas. Buenos Aires; Argentin

Prognostic relevance of cytogenetic systems in myelodysplastic syndromes

We have read with great interest the recent article by Qu et al . reporting the impacts of diff erent cytogenetic categories in the Revised International Prognostic Scoring System (IPSS-R) on the prognosis of primary myelodysplastic syndromes (MDS). Cytogenetic analysis has been recognized as an independent prognostic factor, and its inclusion within diff erent systems has contributed to improvement in assessing the prognosis of MDS.Fil: Belli, Carolina Bárbara. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Bestach, Yesica Soledad. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Correa, Walter A.. Laboratorio de Genética ; ArgentinaFil: Sakamoto, Francisco. Instituto Privado de Hematología y Hemoterapia, Paraná; ArgentinaFil: Flores, María G.. Gobierno de la Ciudad de Buenos Aires. Hospital Interzonal de Agudos Dr. C. Durand; ArgentinaFil: Basquiera, Ana L.. Hospital Privado de Córdoba; ArgentinaFil: Rivas, María M.. Hospital Universitario Austral; ArgentinaFil: Campestri, Reinaldo. Sanatorio Trinidad ; ArgentinaFil: Bengió, Raquel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Larripa, Irene Beatriz. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentin

Recomendaciones para el descarte de productos de CPH/linfocitos criopreservados: consenso del Grupo Argentino de Trasplante de Médula Ósea (GATMO)

The cryopreservation and storage of hematopoietic stem cells (HSCs) is usually required in the autologous stem cells transplant setting and, in some cases, for allogenic products. The storage of these products has a validity defined by the storage characteristics, clinical utility and security conditions of the product. Here, we present recommendations elaborated by the Argentinian Group of Bone Marrow Transplantation (GATMO).El procedimiento de criopreservación y almacenamiento (CyA) de las células progenitoras hematopoyéticas (CPH) es requerido con frecuencia para la realización de un trasplante CPH autólogo y en algunas ocasiones se requiere la CyA de productos celulares alogénicos (CPH o linfocitos). El almacenamiento de estos productos celulares tiene una validez definida por el medio en el que se almacena, la utilidad clínica del producto y las condiciones de seguridad del producto que fue almacenado. Se presentan recomendaciones emitidas por el Grupo Argentino de Trasplante sobre el descarte de productos criopreservados y almacenados.

Datos epidemiologicos y pronósticos del Registro Argentino de Sindromes Mielodisplásicos (SMD)

Los SMD son un grupo heterogéneo de trastornos clonales. El curso clínico es variable, desde un cuadro estable a un pronto fallecimiento por transformación leucémica o por complicaciones de las citopenias. Esta variabilidad complica la decisión terapéutica, siendo fundamental la caracterización pronóstica de los pacientes previo al tratamiento.El IPSS (International Prognostic Scoring System),ampliamente utilizado, fue revisado en 2012 (IPSS-R), redefiniéndose los grupos citogenéticos,niveles de citopenias y el porcentaje de blastos en MO. El sistema del MD Anderson (MDA-S) incluyela leucemia mielomonocítica crónica mielo-proliferativa y SMD secundarios. Otros factores pronósticos están en debate. El Registro Argentino de SMD fue creado en 2008 y colaboran 17 instituciones. Los estudios descriptivos son útiles para estrategiasen salud pública, y necesarios para establecer características epidemiológicas, para validar factores pronósticos y clasificaciones internacionales, permitiendo adecuar esquemas terapéuticos. Por ende,nuestro objetivo fue evaluar las características de los pacientes de nuestro registro.Se analizaron 532 pacientes (89%: SMD primario), mediana de edad: 72 años (17-95), relación M/F: 1,3. Durante el seguimiento(mediana: 18 meses), 104 (19,5%) pacientes evolucionaron a leucemia aguda y 211 (39,7%) fallecieron. La edad, sexo, blastos en MO, nivel dehemoglobina, recuento plaquetario y de neutrófilos, cariotipo, LDH y mielofibrosis fueron variables pronósticas estadísticamente significativas. Las clasificaciones FAB y OMS, y los sistemas pronósticoIPSS, IPSS-R, WPSS según niveles de hemoglobina, MDA-S y el índice de comorbilidad de Charlson permitieron discriminar grupos con diferentes evolución (Kaplan-Meier y Long-Rank, p<0,05). Nuestros resultados confirman la utilidad de variables y sistemas pronósticos en nuestra población.Fil: Flores, Gabriela. Gobierno de la Ciudad de Buenos Aires. Hospital General de Agudos Dr. Carlos G. Durand; ArgentinaFil: Basquiera, Ana L. Hospital Privado Centro Medico de Córdoba; ArgentinaFil: Kornblihtt, Laura Inés. Universidad de Buenos Aires. Facultad de Medicina. Hospital de Clínicas General San Martín; ArgentinaFil: Sakmann, Federico. FUNDALEU; ArgentinaFil: Prates, Virginia. Hospital Italiano de La Plata; ArgentinaFil: Schutz, Natalia. Hospital Italiano; ArgentinaFil: Viñuales, S. Hospital Italiano; ArgentinaFil: Fantl, Dorotea. Hospital Italiano; ArgentinaFil: Cardenas, María Paula. Hospital Italiano; ArgentinaFil: Benasayag, Silvia. Fundagen; ArgentinaFil: Crisp, Renée. Ministerio de Salud de la Nación. Hospital Nacional Profesor Alejandro Posadas; ArgentinaFil: Pintos, Noemí. Sanatorio Dr. Julio Méndez; ArgentinaFil: Santos, Isabel. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; ArgentinaFil: Iastrebner, Marcelo. Sanatorio Sagrado Corazón ; ArgentinaFil: Belli, Carolina Bárbara. Consejo Nacional de Investigaciones Científicas y Técnicas. Instituto de Medicina Experimental. Academia Nacional de Medicina de Buenos Aires. Instituto de Medicina Experimental; Argentin