MODALITY OF TREATMENT IN ESSENTIAL THROMBOCYTHEMIA

Essential thrombocytosis (ET) is clonal chronic myeloproliferative disorder which originates from abnormality of a multipotent hematopoietic stem cell.It is characterized by an increased platelet count, megakaryocytic hyperplasia and by hemorrhagic or thrombotic tendency. Symptoms and signs may include weakness, headaches, paresthesias, bleeding, splenomegaly, and digital ischemia. ET patients showed equal or slightly shorter survival than age- and sex-matched healthy population. Major causes of death were thrombotic and hemorrhagic complications or malignant progression due to both the natural history of the disease and, possibly, the use of chemotherapeutic agents.Diagnostic criteria for essential thrombocythemia were proposed in 2005 by the PVSG and demand diagnosis of exclusion.Myelosuppressive therapy to lower the platelet count usually consists of hydroxyurea, interferon alpha or anagrelide. Hydroxyurea is the most commonly used treatment, because of its efficacy, low cost and rare acute toxicity. Interferon alpha is a biological response modifier. It is not known to be teratogenic and does not cross the placenta, and is often the treatment of choice during pregnancy. Anagrelid suppresses bone marrow megakaryocytes by interfering with the maturation process and decreasing platelet production without affecting other blood cell lines. Low-dose aspirin may be used to control microvascular symptoms.Recommendations for management of patients with essential thrombocythemia were given by ASH. From a treatment standpoint, hydroxyurea is now confirmed to be the drug of choice for high-risk patients with essential thrombocythemia. Interferon alpha and anagrelide are reasonable second-line agents. Low-risk patients should receive low-dose aspirin alone. For the intermediate-risk patients, a consensus could not be reached on a recommendation for platelet-lowering treatment

MEDIASTINAL MASS AS A PROGNOSTIC FACTOR OF HODGKIN LYMPHOMA – CASE REVIEW

Many studies have researched the prognostic factors of Hodgkin disease. Up date, seven most important prognostic factors have been defined.Among them, as an important negative prognostic factor, the dissemination of the disease at the moment of diagnosis stands out. The aim of this study was to determine the influence of the presence of mediastinal mass greater than a third of the chest diameter in Hodgkin lymphoma on the disease outcome. In this study, an 18-year-old patient P.A. was presented. At the time of diagnosis, the patient had Bulky disease. Mediastinal mass was observed by radiography, computed tomography, ultrasound of the heart.The patient was treated with ABVD, GDP, BEACOPP, miniBEAM protocol and mediastinal radiation. In this patient, the mediastinal mass persisted in spite of the therapy.The course of disease deteriorated due to the presence of resistant pericardial effusion, and the patient died three years after