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  • 1
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    Online Resource
    Annals of Laboratory Medicine ; 2007
    In:  Annals of Laboratory Medicine Vol. 27, No. 2 ( 2007-04-01), p. 83-88
    In: Annals of Laboratory Medicine, Annals of Laboratory Medicine, Vol. 27, No. 2 ( 2007-04-01), p. 83-88
    Type of Medium: Online Resource
    ISSN: 2234-3806 , 2234-3814
    Language: English
    Publisher: Annals of Laboratory Medicine
    Publication Date: 2007
    detail.hit.zdb_id: 2677441-0
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  • 2
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 4867-4867
    Abstract: Background: Chromosomal abnormalities of acute erythroid leukemia (AEL) are reported to be complex and nonspecific. We compared the cytogenetic abnormalities of AEL to other subtypes of acute myeloid leukemia (AML) by G- band karyotyping and fluorescence in situ hybridization (FISH) techinique using 18 probes. Methods: 384 patients diagnosed with AML between January 2000 and December 2007 were classified morphologically by French-American-British classification. G-band karyotyping and FISH for 4 recurrent chromosomal abnormalities in AML [AML/ETO rearrangement, PML/RARa rearrangement, MLL rearrangement, inv(16)] were performed. To verify whether common cytogenetic abnormalities of myelodysplastic syndrome (MDS) were present in AEL, FISH for 5q deletion, 7q deletion, trisomy 8 and gain of 1q were performed on bone marrow nucleated cells of 25 patients with AEL. To evaluate the numerical chromosomal changes, ten additional FISH tests were done. Chromosomal enumeration probes (CEP) were primarily used and in case where there were no CEP available, probes for chromosomal rearrangement were surrogately used. Results: Incidence of recurrent genetic changes of AML [AML/ETO, PML/RARA, MLL, inv(16)] was 0% in AEL, while the incidence of AML/ETO, PML/RARA, MLL and inv(16) rearrangement in AML excluding AEL was 12.8%, 12.7%, 5.0%, 4.6%, respectively. Frequencies of numerical chromosomal changes were 11.8% in AML excluding AEL and 44% in AEL, showing significantly higher incidence of numerical changes in AEL. Frequencies of cytogenetic changes, which are common in MDS, were 20% for 5q deletion, 32% for trisomy 8, 16% for 1q gain among AEL patients. In total, 40% of the AEL patients showed similar chromosomal changes to MDS. By G-banding, 32% of the AEL patients showed numerical change of chromosome 8 and 20% for chromosome 5. However, numerical chromosomal changes by G-banding were not statistically different between AEL and other AML, while & gt;3 complex chromosomal changes were significantly higher in AEL. (P=0.001) Out of 25 AEL patients, 4 patients (16%) were transformed from MDS and 1 patient (4%) transformed to other subtype of AML during treatment. Discussions: Numerical chromosomal change was the most predominant genetic change of AEL, while recurrent genetic changes of AML were not found in AEL. Instead, AEL patients showed similar chromosomal changes to MDS. This implies that AEL subtype of AML is rather a separate disease entity from the other types of AML, more within the spectrum of MDS. We infer that AEL is a transitional stage from MDS to AML. Table 1. General aspects and the summary of the results of AML and AEL* Characteristics AML AEL Abbreviations: AML, Acute myeloid leukemia; FAB, French-American-British classification; AEL, acute erythroid leukemia * AEL diagnosed by WHO criteria ¢” FISH was done on available specimen only ¢Ô Ploidy changes were determined by 18 kinds of probes in AEL, and 4 kinds of Probes in AML subtypes excluding AEL Gender female 161 41.9% 6 22.2% male 223 58.1% 21 77.8% total 384 100.0% 27 100.0% FAB classification M0 16 4.2% M1 43 11.2% M2 124 32.3% M3 43 11.2% M4 81 21.2% M5 17 4.4% M6 27 7.0% M7 7 1.8% undetermined 26 6.8% AML excluding AEL AEL Age, years (median) 15–77 (51) 17–84 (60) & lt;60 248 69.5% 11 40.7% °Ã60 109 30.5% 16 59.3% Recurrent genetic abnormalities ¢” PML/RARA 43/338 12.7% 0/27 0.0% AML/ETO 42/327 12.8% 0/27 0.0% inv(16) 12/259 4.6% 0/27 0.0% MLL 16/319 5.0% 0/27 0.0% Abnormal karyotype 85/356 23.9% 13/27 48.1% Ploidy change by FISH ¢Ô 41/348 11.8% 14/25 56.0%
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
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    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
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  • 3
    In: Blood, American Society of Hematology, Vol. 114, No. 22 ( 2009-11-20), p. 4714-4714
    Abstract: Abstract 4714 Background Morphologic examination of CSF cytospin is the standard method in the detection of CNS involvement of childhood acute lymphoblastic leukemia (ALL). However, the result widely varies depending on the status of cell degeneration caused by cytospin procedure. We performed interphase fluoroscence in situ hybridization (FISH) on CSF cytospin cells to examine its potential usefulness in detecting malignant cell population in the CSF. Materials and Methods The study used 19 CSF cytospin specimens of the childhood ALL patients under treatment. All of them had cytogenetic abnormalities in the bone marrow nuclear cells at the initial diagnosis. None of the patients showed malignant cells in morphologic examination of the cytospin. Interphase FISH was performed to detect recurrent genetic abnormalities including rearrangement of BCR/ABL, TEL/AML1, MLL and IgH rearrangement, and p16 deletion using LSI BCR/ABL dual color, dual fusion translocation probe, LSI TEL/AML1 ES dual color translocation probe, LSI MLL dual color, break apart rearrangement probe, LSI IGH dual color, break apart rearrangement probe, and LSI p16/CEP 9 dual-color probe (Abbot Molecular Diagnostics). FISH signals were interpreted using automated slide scanning system (Metafer 4 system) and manually read for confirmation. Result Two patients had the same cytogenetic abnormalities in CSF cytospin as observed in the bone marrow mononuclear cells: one patient had 4 copies of AML1 gene, suggesting tetrasomy 21 or multiple fusion partner gene other than chromosome 12, both in bone marrow and in CSF; the other had 3 copies of p16 gene including one with low signal intensity both in bone marrow and in CSF. Ten patients did not have any cytogenetic abnormalities. We could not interpret the result in the other 7 patients due to low cell count and/or low signal intensity. Conclusion Out of 19 who were diagnosed not to have malignant cell in CSF in morphologic examination, 2 patients had cells with the same clonal abnormalities in the CSF as bone marrow. Our result indicates that FISH study would be helpful in evaluating CSF involvement of hematologic malignancies including ALL. In order to improve the performance, it is required to prevent degeneration of the cells by prompt specimen delivery and slide preparation. Disclosures: No relevant conflicts of interest to declare.
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2009
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  • 4
    In: Blood, American Society of Hematology, Vol. 112, No. 11 ( 2008-11-16), p. 3640-3640
    Abstract: The gain of the 1q region, which is a recurrent chromosomal aberration in B lymphoproliferative disorder, has been reported one of the most common anomalies in Korean myelodysplastic patients. Recently, risk based application of hypomethylating agents or tailored therapy in MDS rely on the prognostic variables of International Prognostic Scoring System (IPSS). To investigate the possibility of 1q gain as a new prognostic marker, we evaluated the prognostic impact of 1q gain, along with comparison with IPSS variables. A total of 117 patients with newly diagnosed MDS between 1997 and 2007 at the Seoul National University Hospital were investigated. Fluorescence in situ hybridization (FISH) studies with 5 specific probe(EGR1 for 5q31 deletion, D7S522 for 7q31 deletion, CEP8, D20S108 for 20q12 deletion, LSI 1p36/1q25 for 1q gain) and conventional G-banding karyotyping were performed on bone marrow aspirates. Other laboratory findings, such as hemoglobin(Hb), absolute neutrophil count(ANC), platelet count, bone marrow blast percent and IPSS score, and clinical data were collected through the individual medical records. The median age was 54 years and the male-to-female ratio was 1.4. Using WHO classification, refractory anemia(RA) was 27.4% and the other subgroups as follows: RA with ringed sideroblast(RARS), 3.4%; refractory cytopenia with multilineage dysplasia(RCMD), 8.5%; RCMD with ringed sideroblasts(RCMD-RS), 0.9%; RA with excess blasts-1(RAEB-1), 26.5%; RAEB-2, 31.6%; and 5q- syndrome, 1.7%. Cytogenetic abnormalities by FISH and G-banding were detected in 58 patients (49.6%). Most frequent anomaly was trisomy 8 occuring in 28 patients(23.9% of the 117 patients, 48.3% of the 58 patients with clonal cytogenetic abnormalities). Gain of 1q was the second common anomalies seen in 18 patients (15.4%) and other anomalies were −7/del7q (13.7%), −5/del5q (13.7%), and del20q (2.6%). G-banding showed gain of 1q in 7 cases, additional 11 patients with gain of 1q were revealed by FISH only. Patients with 1q gain showed a poor survival (median survival 23 months; n=18) compared to patients without 1q gain (median survival 60 months; p=0.02). EGR1 and D7S522 deletion by FISH also had a shorter median survival (8 months vs. 60 months p=0.0001, 16 months vs. 60 months p=0.005). The initial platelet count and blast count were found to affect overall survival, whereas CEP8 FISH, D20S108 FISH, Hb and ANC did not. Our results show that gain of 1q is associated with an adverse clinical outcome and can be considered as a poor cytogenetic risk factor of IPSS. In the Western study, the prevalence of 1q gain was low because most studies report G-banding result only. But it may be increased up to 2.5 fold higher by using FISH analysis in combination with G-banding. A gain of 1q could be a candidate as an adverse prognostic marker in clinical practice, which could help for risk-adapted therapies. Figure 1. Kaplan-Meier survival curve for chromosomal anomalies and IPSS. (A) gain of 1q. (B) −1/del(7q). (C) del(20q). Figure 1. Kaplan-Meier survival curve for chromosomal anomalies and IPSS. (A) gain of 1q. (B) −1/del(7q). (C) del(20q).
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2008
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  • 5
    In: British Journal of Haematology, Wiley, Vol. 155, No. 4 ( 2011-11), p. 530-533
    Type of Medium: Online Resource
    ISSN: 0007-1048
    URL: Issue
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    Language: English
    Publisher: Wiley
    Publication Date: 2011
    detail.hit.zdb_id: 1475751-5
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  • 6
    In: Blood, American Society of Hematology, Vol. 110, No. 11 ( 2007-11-16), p. 4272-4272
    Abstract: Introduction: To investigate the clinical difference between CD56+AML and CD56−AML, we examined the incidence of CD56+AML and analyzed several clinical and biological characteristics, cytogenetic features, immunophenotypic features, and clinical prognosis of CD56+AML. Method: 213 patients (177 adults, 36 children) with de novo AML in Seoul National University Hospital were enrolled. FAB subtypes were 4 M0 (2.3%), 26 M1, (12.2%), 78 M2 (36.6%), 27 M3 (12.8%), 43 M4 (20.2%), 15 M5 (7.1%), 14 M6 (6.6%), and 5 M7 (2.4%). Immunophenotyping was performed by immunohistochemical stain or multiparameter flow cytometry. The association between CD 56 expression and variables (age, sex, WBC count, blast, cytogenetic features, extramedullary involvement, disease free survival, and overall survival) was analyzed by the fisher’s exact test, chi-square test and T test, and Kaplan-Meier method. All statistical calculation were performed using SPSS system. Results: CD56 was detected in 6 of 177 adults (3.4%) and in 9 (25.0%) of children, showing significantly higher in children group (p = 0.000). The CD56 expression was significantly frequent in M7 subtype (p=0.003). The other clinical characteristics, such as sex, WBC count, % blasts in peripheral blood was not significantly associated with CD56 positivity. Frequency of extramedullary involvement did not differ between CD56+AML and CD56−AML. However, the frequency of CNS involvement at initial diagnosis or relapse were significantly higher in CD56+AML (p=0.018). (Table 1) Among cytogenetic changes, AML1/ETO rearrangement was significantly associated with CD56 expression (p=0.024). Aberrant expression of one or more lymphoid markers was observed in 42.9% (6/15 CD56+AML) and 45.2% (80/198 CD56+AML), showing no difference between CD56+AML and CD56−AML. Median disease free survival was 7 months in CD56+AML and 19 months in CD56−AML, showing no significant difference in two groups (p=0.2466). Median overall survival was not reached in CD56+AML and 25 months in CD56−AML (p=0.1591). Conclusion: The incidence of CD56 positive AML was higher in childhood AML and association of CD56+AML with AML1/ETO rearrangement, CNS involvement and M7 subtype was observed, suggesting the different biologic behavior of CD56+AML. Furthermore, we suggest that 3rd lineage of leukemic cells, would be taken into consideration for the biphenotypic leukemia. Extramedullary involvement of CD56+ vs. CD56− CD56+ CD56- p * chi-square test or fisher’s exact test (level of significance: p 〈 0.05) n=15 (7.0%) n=198 (93.0%) Extramedullary involvement 3 (20.0%) 27 (13.6%) 0.450 Adult 0 19 Child 3 8 CNS involvement 3 (20.0%) 7 (3.5%) 0.025 Adult 0 4 Child 3 3
    Type of Medium: Online Resource
    ISSN: 0006-4971 , 1528-0020
    RVK:
    RVK:
    Language: English
    Publisher: American Society of Hematology
    Publication Date: 2007
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  • 7
    In: Acta Haematologica, S. Karger AG, Vol. 117, No. 1 ( 2007), p. 34-39
    Abstract: Although the presence of decreased plasma fibrinogen has been regarded as an indicator of ongoing disseminated intravascular coagulation (DIC), fibrinogen, which is one of the acute phase reactants, is often increased in the patients with DIC. We investigated the diagnostic and prognostic utility of a new parameter [the fibrinogen/C-reactive protein (CRP) ratio] for predicting DIC in 1,056 patients with suspected DIC and who also had underlying disorders associated with DIC. Among the 535 patients with overt DIC, 46 patients (8.6%) showed low plasma fibrinogen ( 〈 100 mg/dl), suggesting that the plasma fibrinogen level is not a sensitive marker for DIC. There was a strong correlation between the increased DIC scores and increased number of patients with low ( 〈 104) fibrinogen/CRP ratios. Among the three groups with different serum fibrinogen/fibrin degradation product levels, the fibrinogen/CRP ratio showed a higher difference than did the fibrinogen level. The DIC score was highly correlated with the 28-day mortality and the number of patients with low fibrinogen/CRP ratios. The odds ratio (the relative risk of 28-day mortality) of the low fibrinogen/CRP ratio was 6.15, while the odds ratio of the low fibrinogen level was 2.13. The area under the receiver-operating characteristic curve of the fibrinogen/CRP ratio, when this was used for predicting mortality, showed significantly better discriminative power than did that of the fibrinogen level. This study demonstrates that the fibrinogen/CRP ratio may provide more discriminating power for identifying the patients with active coagulation consumption, and the fibrinogen/CRP ratio has a good predictive value concerning the 28-day mortality in the patients suspected of having DIC. The results of our study suggest that replacement of fibrinogen by the fibrinogen/CRP ratio for calculating the DIC score may lead to enhance diagnostic and prognostic power for DIC.
    Type of Medium: Online Resource
    ISSN: 0001-5792 , 1421-9662
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2007
    detail.hit.zdb_id: 1481888-7
    detail.hit.zdb_id: 80008-9
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  • 8
    In: American Journal of Clinical Pathology, Oxford University Press (OUP), Vol. 131, No. 2 ( 2009-02-01), p. 189-194
    Abstract: We compared the TEST 1 (Alifax, Padova, Italy) and Westergren methods of measuring the erythrocyte sedimentation rate (ESR) to assess inflammation. The ESR was measured by both methods in 154 blood samples from patients with malignancy (n = 69), autoimmune disease (n = 44), or infection (n = 41). Total protein, albumin, and C-reactive protein (CRP) levels were measured in each plasma sample, and albumin and α1-, α2-, β1-, β2-, and γ-globulin fractions were measured by capillary electrophoresis. TEST 1 ESR values were significantly lower than the Westergren values, by 10.9 mm/h. We found that the correlations of TEST 1 ESR values with inflammatory protein levels (total protein, globulin, CRP, and α1-, α2-, β2-, and γ-globulin) were better than those obtained using the Westergren method. These findings indicate that ESR measurements by TEST 1 reflect inflammation better than do those by the Westergren method in patients with malignancy, autoimmune disease, or infection.
    Type of Medium: Online Resource
    ISSN: 1943-7722 , 0002-9173
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    Language: English
    Publisher: Oxford University Press (OUP)
    Publication Date: 2009
    detail.hit.zdb_id: 2039921-2
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