Comparison of haemoglobin H inclusion bodies with embryonic ζ globin in screening for α thalassaemia

Aims - To compare the haemoglobin (Hb) H inclusion test with immunocytochemical detection of embryonic ζ chains in screening for a thalassaemia. Methods - Blood samples from 115 patients with relevant clinical history and hypochromic microcytic indexes were screened using the HbH inclusion test and the Variant Hemoglobin Testing System (BioRad, Hercules, CA, USA). Results - The HbH inclusion test was positive in 61 of 115 cases, three of whom had HbH disease confirmed by electrophoresis. The remaining 58 had α thalassaemia 1. All three HbH cases and 56 of 58 cases of a thalassaemia 1 expressed embryonic ζ chains, giving a specificity of 96.7%. Fifty four of 115 cases had a negative HbH inclusion test, of whom 50 had β thalassaemia trait and three had iron deficiency. No diagnosis was reached for the remaining patient. Conclusion - The immunocytochemical test is as sensitive as the HbH inclusion test in screening for a thalassaemia. The presence of ζ chains is highly specific for a thalassaemia I incorporating the (--/SEA) deletion. The specificity and simplicity of the immunocytochemical test make it the test of choice in screening for α thalassaemia.published_or_final_versio

Establishment of a bortezomib-resistant Chinese human multiple myeloma cell line: MMLAL

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Diagnostic challenges in a case of B cell lymphoma unclassifiable with features intermediate between diffuse large B-cell lymphoma and Burkitt lymphoma

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Histiocytic sarcoma simulating immune thrombocytopenic purpura

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Transfusion-refractory anaemia in liver cirrhosis

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Novel point mutation of the α2-globin gene (HBA2) and a rare 2.4 kb deletion of the α1-globin gene (HBA1), identified in two chinese patients with Hb H disease

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Occult alpha globin gene mutations are the commonest causes of red cell microcytosis unexplained by phenotypic testing

HAA: Haematology Society of Australia and New Zealand, The Australian & New Zealand Society of Blood Transfusion and The Australasian Society of Thrombosis and HaemostasisAIM: Hypochromic microcytic anaemia is the hallmark phenotype of thalassaemia. Current phenotypic tests do not provide a diagnosis in a small proportion of patients with red cell microcytosis. We investigated the genetic basis of microcytosis in a cohort of such subjects. METHOD: We identified from a large cohort of 1684 unselected requests for thalassaemia testing 25 Chinese subjects who had unexplained microcytosis after phenotypic haemoglobin studies. Extensive genotypic analysis of the α and β globin gene cluster was performed in 20 of these subjects who had adequate DNA. Techniques employed included gap-polymerase chain reaction, amplification-refractory mutation system, Sanger sequencing and multiplex ligation-dependent …postprin

Dysregulation of the intrinsic apoptotic pathway mediates megakaryocytic hyperplasia in myeloproliferative neoplasms

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Central Diabetes Insipidus: An Unusual Complication in a Child With Juvenile Myelomonocytic Leukemia and Monosomy 7

Central diabetes insipidus (DI) is well-documented as a presenting feature of myelodysplastic syndrome and acute myeloid leukemia in adults. However, DI is unusual in pediatric patients with myeloid malignancies. We report here this rare complication in a child with neurofibromatosis type 1 who developed juvenile myelomonocytic leukemia and monosomy 7. Our case and previously reported cases of DI arising as a complication in myeloid malignancies demonstrate a close association with deletion of chromosome 7. The clinical characteristics and outcomes of these uncommon cases in children are reviewed and discussed.postprin

Next-generation sequencing with a myeloid gene panel in core-binding factor AML showed KIT activation loop and TET2 mutations predictive of outcome

Clinical outcome and mutations of 96 core-binding factor acute myeloid leukemia (AML) patients 18-60 years old were examined. Complete remission (CR) after induction was 94.6%. There was no significant difference in CR, leukemia-free-survival (LFS) and overall survival (OS) between t(8;21) (N=67) and inv(16) patients (N=29). Univariate analysis showed hematopoietic stem cell transplantation at CR1 as the only clinical parameter associated with superior LFS. Next-generation sequencing based on a myeloid gene panel was performed in 72 patients. Mutations in genes involved in cell signaling were associated with inferior LFS and OS, whereas those in genes involved in DNA methylation were associated with inferior LFS. KIT activation loop (AL) mutations occurred in 25 patients, and were associated with inferior LFS (P=0.003) and OS (P=0.001). TET2 mutations occurred in 8 patients, and were associated with significantly shorter LFS (P=0.015) but not OS. Patients negative for KIT-AL and TET2 mutations (N=41) had significantly better LFS (P<0.001) and OS (P=0.012) than those positive for both or either mutation. Multivariate analysis showed that KIT-AL and TET2 mutations were associated with inferior LFS, whereas age ⩾40 years and marrow blast ⩾70% were associated with inferior OS. These observations provide new insights that may guide better treatment for this AML subtype.published_or_final_versio