An Atypical Presentation of Brucellosis in a Patient with Isolated Thrombocytopenia Complicated with Upper Gastrointestinal Tract Bleeding

A 59-year-old female patient was admitted to the emergency service with complaints of hematemesis and melena for the last few days. In laboratory tests, the platelet count was found to be /L. Intravenous or oral corticosteroid treatment was thought to be given for ITP but disclaimed due to upper GIS bleeding. On the 5th day of treatment, Brucella melitensis was isolated from blood culture before the results of Wright tube agglutination tests were reported positive as 1 : 80. On the second day of the anti-brucellosis treatment, the thrombocyte count was raised from 6000/mm3 to 110000/mm3, and on the 3rd day to 225000/mm3

Successful treatment of gastric relapse in multiple myeloma with bortezomib after autologous hematopoietic stem cell transplantation (autoHSCT)

We report a  case of  59-year-old Turkish   man with history of MVR and COPD whom was diagnosed with stage IIIA IgG lambda multiple myeloma (MM) in 1997. He underwent autologous hematopoietic stem cell transplantation following melphalan 200mg per body area(m2)in February 2006. On 18th of February 2011; he was admitted to the emergency service of university hospital with complaints of hematemesis and melena. In gastric biopsy obtained from the lesion; pathological evaluation showed monoclonal lambda light chain infiltration originated from neoplastic plasma cells in gastric mucosa. The patient was considered as local gastric relapsed disease and was treated with 2 cycles of bortezomib. An excellent response was achieved after  2 cycles of BEP regimen, his paraprotein levels dropped below 10 g/L and there was no recurrence of the hematemesis or melena

The management of iron overload in allogeneic hematopoietic stem cell transplant (alloHSCT) recipients: Where do we stand?

Iron overload (IO), primarily related to multiple red blood cell transfusions, is a relatively common complication in hematopoietic stem cell transplant (HSCT) recipients. Elevated pretransplant ferritin levels have been reported to increase the risk of non-relapse mortality following HSCT and might influence the risk of acute and chronic graft versus host disease. IO has been shown to be an important cause of mortality and morbidity in patients who have undergone alloHSCT (Armand et al., Blood 109:4586-4588, 2007; Kim et al., Acta Haematol 120:182-189, 2008; Kataoka et al., Biol Blood Marrow Transplant 15:195-204, 2009). We know that excessive iron accumulation results in tissue damage and organ failure, mainly as a result of the generation of free radicals that cause oxidative damage and organ dysfunction (e.g., hepatotoxicity, cardiotoxicity, and endocrine dysfunction) (Altes et al., Bone Marrow Transplantation 29: 987-989, 2002; Papanikolaou et al., Toxicol Appl Pharmac 202:199-211, 2005). In the last decade, efforts have been directed toward identifying alternative treatment for IO in alloHSCT recipients to maintain improved transplant outcomes. Iron overload (IO), primarily related to multiple red blood cell transfusions, is a relatively common complication in hematopoietic stem cell transplant (HSCT) recipients. Elevated pretransplant ferritin levels have been reported to increase the risk of non-relapse mortality following HSCT and might influence the risk of acute and chronic graft versus host disease. IO has been shown to be an important cause of mortality and morbidity in patients who have undergone alloHSCT (Armand et al., Blood 109:4586-4588, 2007; Kim et al., Acta Haematol 120:182-189, 2008; Kataoka et al., Biol Blood Marrow Transplant 15:195-204, 2009). We know that excessive iron accumulation results in tissue damage and organ failure, mainly as a result of the generation of free radicals that cause oxidative damage and organ dysfunction (e.g., hepatotoxicity, cardiotoxicity, and endocrine dysfunction) (Altes et al., Bone Marrow Transplantation 29: 987-989, 2002; Papanikolaou et al., Toxicol Appl Pharmac 202:199-211, 2005). In the last decade, efforts have been directed toward identifying alternative treatment for IO in alloHSCT recipients to maintain improved transplant outcomes. &nbsp;</p

Effect of Serum Selenium Levels on Radiotherapy-related Toxicity in Patients Undergoing Radiotherapy for Head and Neck Cancer

Aim: To investigate whether there is a difference in selenium levels before and after radiotherapy (RT) and to study the effects of serum selenium levels on RT-related toxicity in patients undergoing RT for head and neck cancer. Patients and Methods: A population of 47 consecutive patients was enrolled in the study. RT was given by conventional fractionation. RT-related acute toxicity was evaluated once a week. Blood samples were obtained before and after RT to evaluate selenium levels. Results: There was no significant difference between the levels of selenium before and after RT (58.09 +/- 1.36 mu g/l and 56.34 +/- 1.11 mu g/l, p-value=0.747, respectively). Grade mucositis, dysphagia, radiodermatitis, and nausea were seen in 6 (12.7%), 32 (68.2%), 24 (51.1%), and 3 (6.4%) patients, respectively. It was found that there was no statistically significant difference in the levels of selenium before and after RT, and no observed diferrences in regard to RT-related toxicities. Conclusion: The serum selenium levels do not affect RT-related toxicities

Two cases of H1N1 influenza infection as the initial presentation of acute leukemia

Pandemic 2009 influenza A virus (H1N1) is a new influenza virus causing illness in human populations. Immunocompromised patients are at high risk for the acquisition of influenza and serious influenza-associated complications. However, there are no reports about patients with both newly diagnosed acute leukemia and H IN I influenza infection. We reported 2 cases of previously healthy patients with H1N1 influenza infection as the initial presentation of acute leukemia