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Dixith R, Sara A, Vangala N, Uppin SG, Uppin MS, Narendra AMVR, Paul TR. Clinicopathological spectrum of BCR-ABL-Negative myeloproliferative neoplasms with correlation with janus-associated kinase 2 mutation. Indian J Med Paediatr Oncol 2021. [DOI: 10.4103/ijmpo.ijmpo_192_17] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Abstract
Background: Non chronic myelogenous leukemia (non-CML)/BCR-ABL-negative myeloproliferative neoplasms (MPNs) include essential thrombocythemia (ET), polycythemia vera (PV), and primary myelofibrosis (PMF) (apart from chronic neutrophilic leukemia and chronic eosinophilic leukemia, which are rare). They are uncommon clonal disorders of adults, with an incidence ranging from 0.5 to 3/100,000 persons, BCR-ABL negative, and characterized by the activation of Janus-associated kinase 2 (JAK2). Very few studies have been reported from India. Aims and Objectives: The aims and objectives of this study were to analyze the clinicopathological spectrum and to determine the frequency of JAK2 mutation in patients of non-CML/BCR-ABL negative MPNs. Materials and Methods: Clinical and morphological features and frequency of JAK2 mutation in patients with PV, ET, and PMF were studied at a tertiary care hospital. The material was retrieved from the hematopathology records and reviewed. Results: JAK2V617F mutation was found in 10 of 14 cases (71%) of MPNs, 100% in PV, 50% in ET, and 71% of idiopathic myelofibrosis. The presence of JAK2V617F mutation was associated with a higher hemoglobin level (P < 0.05), a higher TLC (P < 0.05), and higher age (P < 0.05). Results showed that there are morphologic differences, and megakaryocytic morphology represents a useful clue for the differential diagnosis of these three BCR-ABL-negative MPN subtypes. Conclusion: The JAK2 V617F mutation was detected in 71% of patients with MPN disorders. Peripheral blood mutation screening for JAK2 V617F should be incorporated into the initial evaluation of patients suspected to have MPNs. Differences in megakaryocytic morphology provide the histomorphological hallmark of BCR-ABL-negative MPN subtypes.
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Affiliation(s)
- Roopa Dixith
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - A Sara
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Navatha Vangala
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Shantveer G Uppin
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Megha S Uppin
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - AMVR Narendra
- Department of Hematology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
| | - Tara Roshni Paul
- Department of Pathology, Nizam's Institute of Medical Sciences, Hyderabad, Telangana, India
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Tandon A, Paul TR, Singh R, Narendra AMVR. Synchronous Thyroid Involvement in Plasma Cell Leukemia Masquerading as Hashimoto's Thyroiditis: Role of Ancillary Cytology Techniques in Diagnostic Workup. Endocr Pathol 2015; 26:324-7. [PMID: 26330190 DOI: 10.1007/s12022-015-9392-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Neoplastic plasma cell involvement of thyroid is an uncommon condition, and it may involve thyroid in multiple myeloma or solitary plasmacytoma. Its clinical and pathological features are not well understood. We present a rare case of synchronous thyroid involvement in plasma cell leukemia presenting as thyroid nodule with primary hypothyroidism. Simultaneous cytology, immunocytochemistry, FISH analysis with 13q14.3 and TP53 on cytology smears and haematology workup were performed to diagnose and to understand disease pathobiology with poor outcome.
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Affiliation(s)
- Ashwani Tandon
- Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, 500082, India.
| | - T Roshni Paul
- Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, 500082, India
| | - Rekha Singh
- Department of Endocrinology and Metabolism, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India
| | - A M V R Narendra
- Department of General Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, India
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Narendra AMVR, Varun Kumar G, Krishna Prasad A, Shetty M, Uppin MS, Srinivasan VR. Hemophagocytic lymphohistiocytosis. Indian J Hematol Blood Transfus 2012; 30:204-7. [PMID: 25114410 DOI: 10.1007/s12288-012-0210-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2012] [Accepted: 10/22/2012] [Indexed: 11/30/2022] Open
Abstract
Hemophagocytic lymphohistiocytosis (HLH) is an immune disorder characterized by uncontrolled inflammation due to defective immune response. It may be familial or acquired, but both share a common feature of threatening the life of a patient and may lead to death unless treated by appropriate treatment. Here in we report a case of adult HLH.
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Affiliation(s)
- A M V R Narendra
- Haematology Division, Department of Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, 500 082 Andhra Pradesh India
| | - G Varun Kumar
- Haematology Division, Department of Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, 500 082 Andhra Pradesh India
| | - A Krishna Prasad
- Haematology Division, Department of Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, 500 082 Andhra Pradesh India
| | - M Shetty
- Haematology Division, Department of Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, 500 082 Andhra Pradesh India
| | - Megha S Uppin
- Department of Pathology, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, 500 082 Andhra Pradesh India
| | - V R Srinivasan
- Haematology Division, Department of Medicine, Nizam's Institute of Medical Sciences, Punjagutta, Hyderabad, 500 082 Andhra Pradesh India
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Kumar R, Prem S, Mahapatra M, Seth T, Chowdhary DR, Mishra P, Pillai L, Narendra AMVR, Mehra NK, Saxena R, Choudhry VP. Fludarabine, cyclophosphamide and horse antithymocyte globulin conditioning regimen for allogeneic peripheral blood stem cell transplantation performed in non-HEPA filter rooms for multiply transfused patients with severe aplastic anemia. Bone Marrow Transplant 2006; 37:745-9. [PMID: 16518427 DOI: 10.1038/sj.bmt.1705321] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Multiply transfused patients of severe aplastic anemia are at increased risk of graft rejection. Five such patients underwent peripheral blood stem cell transplantation from HLA-identical siblings with a fludarabine-based protocol. The conditioning consisted of fludarabine 30 mg/m(2)/day x 6 days, cyclophosphamide 60 mg/kg/day x 2 days and horse antithymocyte globulin (ATG) x 4 days. Two different ATG preparations were used: ATGAM (dose 30 mg/kg/day x 4 days) or Thymogam (dose 40 mg/kg/day x 4 days). Engraftment: median time to absolute neutrophil count (ANC) >0.5 x 10(9)/l was 11 days (range: 8-17) and median time to platelet count >20 x 10(9)/l was 11 days (range: 9-17). At a median follow-up of 171 days (range: 47-389), there has been no graft rejection and all patients are in complete remission. Acute GVHD (grade 1) occurred in one patient only. Chronic GVHD developed in two patients (extensive in one and limited in another). The transplants were performed in non-HEPA filter rooms. In only one patient, systemic antifungal therapy (voriconazole) was used. The use of Thymogam brand of ATG for conditioning is being reported for the first time. Our experience suggests that this fludarabine-based protocol allows rapid sustained engraftment in high-risk patients without significant immediate toxicity.
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Affiliation(s)
- R Kumar
- Department of Hematology, All India Institute of Medical Sciences, New Delhi, India.
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