Assessment of platelet function and resistance to aspirin and clopidogrel in patients with peripheral arterial disease undergoing percutaneous transluminal angioplasty

Introduction: Analysis of platelet function, acetylsalicylic acid (ASA) and clopidogrel resistance in patientswith peripheral arterial disease (PAD) undergoing percutaneous transluminal angioplasty (PTA), the impact ofprocedure on this phenomenon, connection with diabetes, hypertension, smoking. Material and methods: The study included 72 patients, with a group of patients taking ASA on a permanentbasis and a group of patients in whom treatment was implemented after the procedure. Patients were alsodivided according to the antiplatelet therapy applied, either double-therapy, or ASA monotherapy. Daily doseswere 75 mg. Three methods were used for the evaluation of the platelet function: IVY bleeding time, cytometricevaluation of platelet surface antigen (CD62p and CD63) expression and hemostasis measurement by PFA-200®. Results: In the PFA-200 analysis, ASA resistance was found in 37.8% (64.7% were tobacco smokers) beforesurgery. Patients not taking ASA before, after PTA and first dose of ASA presented resistance in 63%. The firstdose of clopidogrel after surgery was associated with resistance in 73.7%. Significant differences in the expressionof CD62p and CD63 markers before and after PTA were observed. According to IVY method, aspirin resistancewas found in 40% of patients permanently receiving ASA. Conclusions: Patients with PAD who undergo PTA are resistant to ASA in 40%, smoking is associated withthis phenomenon. PTA increases the expression of CD62P and CD63, and thus the platelet activation, whichis not adequately prevented by antiplatelet drugs at a dose of 75 mg. Dual antiplatelet therapy reduces theactivation of thrombocytes more than the monotherapy of ASA

JAK2 mutation status, hemostatic risk factors and thrombophilic factors in essential thrombocythemia (ET) patients

The recently discovered JAK2 V617F point mutation, found in 50–60% of ET patients, has been reported to be associated with a higher risk of thrombotic events. In this study, we explored if JAK2 V617F mutation, or coexisting thrombophilic and hemostatic risk factors, contributed to these complications. We examined 32 patients with ET, and looked for pathogenetic JAK2 V617F mutation and prothrombotic genes mutations: factor V Leiden, prothrombin and MTHFR. We also evaluated plasma levels of fibrinogen, factors VIII and XII, AT, protein C, protein S and serum level of homocysteine. Urokinase concentration was assessed in patients’ plasma as well as platelet lysates. There was no difference in the number of thrombotic complications between ET patients with and without JAK2 mutation. However, we found a number of thrombophilic and hemostatic risk factors that could contribute to thrombotic complications in ET patients. (Folia Histochemica et Cytobiologica 2011; Vol. 49, No. 2, pp. 267–271

Evaluation of the prognostic and predictive value of free light chains in patients with chronic lymphocytic leukemia – preliminary results

Introductionκ and λ serum free light chains (sFLCs) are produced during physiological lymphopoesis by plasmocytes and B lymphocytes in a constant ratio related to heavy chains. The measurement of sFLC plays an important role in the diagnosis and monitoring of patients with multiple myeloma (MM). The first reports suggested that sFLC disturbances might have prognostic value also in patients with chronic lymphocytic leukemia (CLL). Aim of the study: The aim of the study was to evaluate the relationship between sFLC concentration and recognized prognostic factors and clinical course of CLL. Materials and methods: The sFLC concentration was measured using a latex-enhanced immunoassay in 59 patients with newly diagnosed CLL. The relationship between sFLC concentration and time to start of the treatment (TFT), the response rate to therapy (ORR) and overall survival (OS) was assessed. ResultsA significant correlation was found between sFLC κ concentration and the clinical stage of leukemia according to Rai classification, β-2 microglobulin concentration, LDH activity, CD38 expression, as well as between sFLC λlevel and β-2 microglobulin concentration and platelet count (PLT ). There was also a correlation between the values of summated κ and λ and the clinical stage of disease according to Rai classification, β-2 microglobulin concentration, CD38 expression, white blood cells count (WBC), lymphocyte count (ALC) and hemoglobin (Hgb) concentration. The κ/λ ratio (FCLR) values were significantly different in the CD38+ and CD38- population. SummarySimple and reproducible clonality index, which constitutes the sFLC concentration assessment, can be an attractive, potential prognostic marker in patients with CLL, however further studies are needed on a larger group of patients especially in relation to the predictive value of sFLC

Secondary malignancy in patients with essential thrombocythemia – case reports

Nadpłytkowość samoistna (ET; essential thrombocythemia) należy do przewlekłych chorób mieloproliferacyjnych i ma na ogół mało agresywny przebieg, jednak czas przeżycia chorych jest krótszy w porównaniu z ogólną populacją. Do niedawna za główne przyczyny skrócenia czasu życia chorych uznawano zaawansowany wiek i przebyte epizody zakrzepowe. Obecnie coraz więcej uwagi zwraca się na inny powód, jakim jest rozwój u tych chorych wtórnych nowotworów niehematologicznych.ET is a relatively indolent disease, but a shorter survival of patients has been observed. Previously the main risk factors for reduced survival time were advanced age and the history of thrombotic complications. Recently the other cause of reduced survival is put on – secondary nonhematological neoplasms

Mild hyperhomocysteinemia in patients with essential thrombocythemia (ET) and its relation with MTHFR gene mutation and folic acid concentration

In this study we assessed homocysteine level in 106 patients with ET – 80 females and 26 males, mean age 54 (23–82) and in 20 healthy persons – 6 males and 14 females, mean age 41 (31–54). We also searched for a relation between homocysteine level and MTHFR gene mutation as well as vitamin B12 and folic acid concentration. Median homocysteine serum level was higher in ET patients than in control group. Elevated homocysteine level primarily stems from folic acid deficiency rather than from the presence of MTHFR gene mutation. Median folic acid level was lower in ET patients presenting thrombotic and bleeding complications than in ET patient without vascular episodes. We concluded that folic acid substitution may not only prevent hyperhomocysteinemia but also the development of vascular complications in ET patients

Level of depression and occurrence of cognitive changes in patients with multiple myeloma - a preliminary report

The aim of the article is to study the changes in the level of cognitive and affective functioning in patients with multiple myeloma undergoing chemotherapy. Montreal Cognitive Assessment scale (MoCA) – screening method – was used to determine the general cognitive state of patients. The general level of depression and its characteristic symptoms were determined with the use of Depression Measurement Questionnaire. Gathering first initial results of author’s own research – increasing the research sample could indicate an improved cognitive functioning in patients with multiple myeloma during chemotherapeutic treatment. Moreover, the research demonstrates a decrease in depression symptoms, i.e., self-blame and anxiety states, during chemotherapy. The study requires further research owing to a small group of research participants (n = 21), the presence of research data at the level of statistical tendency, and a need for a comparison with a group of healthy people (without a cancer diagnosis).Celem artykułu jest zbadanie zmian w poziomie funkcjonowania poznawczego i afektywnego u pacjentów chorych na szpiczaka mnogiego przechodzących chemoterapię. Do określenia ogólnego stanu poznawczego pacjentów użyto Montrealskiej Skali Oceny Funkcji Poznawczych – metody przesiewowej. Ogólny poziom depresji oraz charakterystyczne objawy tego zaburzenia zostały określone na podstawie narzędzia – Kwestionariusza do Pomiaru Depresji. Uzyskano pierwsze wstępne wyniki badań własnych, które przy zwiększeniu próby badawczej mogłyby świadczyć lepszym funkcjonowaniu poznawczym pacjentów chorych na szpiczaka mnogiego w trakcie leczenia chemioterapeutycznego. Ponadto odnotowano spadek objawów depresji, tj. poczucia winy i napięcia lękowego podczas terapii onkologicznej. Badania wymagają kontynuacji, ze względu na nieliczną grupę osób badanych (n = 21), wyniki na poziomie tendencji statystycznej oraz chęć porównania rezultatów badanych z grupą osób zdrowych (bez diagnozy nowotworu)

Chemotherapy-Related Differences in Cognitive Functioning and Their Biological Predictors in Patients with Multiple Myeloma

The paper presents a study on the changes in cognitive functioning in patients undergoing chemotherapy with diagnosed multiple myeloma (MM). The aim of the study was to answer the following two main research questions: Does the treatment stage differentiate the functioning of cognitive processes in patients with diagnosed MM and to what extent? Is it possible to treat biological factors (TNF-α, IL-6, IL-10, and BDNF) as predictors of patients’ cognitive functioning? The patients were examined twice, before the treatment and after 4–6 cycles of chemotherapy. Selected neuropsychological research methods as well as experimental and clinical trials were employed to diagnose the patients’ general cognitive state, attention, memory, and executive functions. The level of biological factors was assessed with the ELISA test. The results show that the patients’ cognitive functioning was worse before the treatment than during the cytostatic therapy. It was also possible to predict the cognitive state of patients suffering from multiple myeloma based on a selected biological parameter (neurotrophin BDNF)