Hematology RSS : Gourt

Nine years interval between first and second bone marrow transplantations and subsequent long-term survival—a case of acute myeloid leukemia with MLL-AF6 fusion gene

Nine years interval between first and second bone marrow transplantations and subsequent long-term survival—a case of acute myeloid leukemia with MLL-AF6 fusion gene Content Type Journal ArticleCategory Letter to the EditorPages 1-3DOI 10.1007/s00277-012-1417-2Authors Yasuhisa Yokoyama, Department of Hematology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, JapanKazumi Suzukawa, Department of Hematology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, JapanYasushi Okoshi, Department of Hematology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, JapanToru Nanmoku, Department of Clinical Laboratory, Tsukuba University Hospital, Tsukuba, Ibaraki, JapanNaoshi Obara, Department of Hematology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, JapanTerukazu Enami, Department of Hematology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, JapanYuichi Hasegawa, Department of Hematology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, JapanShigeru Chiba, Department of Hematology, Faculty of Medicine, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, Japan Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Kinetics of blood CD34+ cells after chemotherapy plus G-CSF in poor mobilizers: Implications for pre-emptive plerixafor use

Abstract Mobilization and collection of stem cells is difficult in a proportion of patients intended for autologous stem cell transplantation (ASCT). We have evaluated mobilization kinetics of blood CD34+ cells (B-CD34+) to form basis for algorithm to facilitate rational pre-emptive plerixafor use. Altogether 390 chemomobilized patients were included. Forty-three patients (11%) did not reach B-CD34+ count ≥10 × 106/l. Mobilization kinetics differed according to the mobilization capacity observed. Among those who were very poor or inadequate mobilizers (peak B-CD34+ count ≤5 × 106/l and 6–10 × 106/l, respectively), B-CD34+ counts rarely rose after white blood cells (WBC) >5–10 × 109/l, whereas in many standard mobilizers a later rise in CD34+ counts could be observed. Four algorithms based on WBC and CD34+ counts were constructed. According to this patient series, algorithm II (WBC >5 × 109/l and B-CD34+ ≤10 × 106/l) and algorithm IV (WBC >10 × 109/l and B-CD34+ ≤10 × 109/l) were the most applicable. For algorithm II the sensitivity was 0.97 and specificity 1.00, respectively, to identify patients for plerixafor use provided that all patients with B-CD34+ maximum ≤10 × 106/l would have needed plerixafor. This simple model needs a prospective validation. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00277-012-1411-8Authors E. Jantunen, University of Eastern Finland/Clinical Medicine, Kuopio, FinlandV. Varmavuo, Department of Medicine, Kuopio University Hospital, P.O.B. 1777, 70211 Kuopio, FinlandA. Juutilainen, University of Eastern Finland/Clinical Medicine, Kuopio, FinlandT. Kuittinen, Department of Medicine, Kuopio University Hospital, P.O.B. 1777, 70211 Kuopio, FinlandE. Mahlamäki, Laboratory of Eastern Finland, Kuopio, FinlandP. Mäntymaa, Laboratory of Eastern Finland, Kuopio, FinlandT. Nousiainen, Department of Medicine, Kuopio University Hospital, P.O.B. 1777, 70211 Kuopio, Finland Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Primary MALT lymphoma of the urinary bladder in the background of interstitial cystitis

Primary MALT lymphoma of the urinary bladder in the background of interstitial cystitis Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-012-1419-0Authors Ken Morita, Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 JapanFumihiko Nakamura, Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 JapanYasuhito Nannya, Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 JapanAkira Nomiya, Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 JapanShunya Arai, Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 JapanMotoshi Ichikawa, Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 JapanYukio Homma, Department of Urology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 JapanMineo Kurokawa, Department of Hematology and Oncology, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655 Japan Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Features of extramedullary myeloma relapse: high proliferation, minimal marrow involvement, adverse cytogenetics: a retrospective single-center study of 24 cases

Abstract Extramedullary (e) relapse in multiple myeloma (MM) has an adverse prognosis, but knowledge concerning biological features and preferred treatment is scarce. We screened the myeloma registry of our institution for eMM relapses and identified 24 cases among 357 patients (pts). Only 8% of eMM relapses occurred after initial therapy, but 54% occurred after third-line or subsequent therapy. Baseline molecular cytogenetics revealed high-risk features in 10 of 19 evaluable patients. Most frequently, eMM presented as soft tissue (67%) and organ involvement (25%) or malignant effusion (12.5%). Incidence of leptomeningeal/CNS involvement was 21%. At eMM relapse, bone marrow infiltration was absent in 46% and low in 21%. Ten eMM biopsies were available showing increased proliferation, i.e., Ki-67 of 67% (range, 30–90%) of all cancer cells. Pts received radiation therapy, dose-intense chemotherapy, novel agents, and allogeneic SCT resulting in an overall response rate of 54%. Median progression-free survival was 2 (95% CI 0.08–3.92) and median overall survival 7 months (95% CI 3.56–10.43), respectively, with only three patients being alive at 12 months from diagnosis. EMM relapse may present at any anatomical site with frequent CNS involvement. Biological features include increased proliferation and low rate of marrow involvement. Prognosis remains poor despite intensive treatment. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00277-012-1414-5Authors Leo Rasche, Department of Hematology and Oncology, University Hospital Wuerzburg, Oberdürrbacher Str. 6, 97080 Wuerzburg, GermanyCorinna Bernard, Department of Hematology and Oncology, University Hospital Wuerzburg, Oberdürrbacher Str. 6, 97080 Wuerzburg, GermanyMax S. Topp, Department of Hematology and Oncology, University Hospital Wuerzburg, Oberdürrbacher Str. 6, 97080 Wuerzburg, GermanyMarkus Kapp, Department of Hematology and Oncology, University Hospital Wuerzburg, Oberdürrbacher Str. 6, 97080 Wuerzburg, GermanyJohannes Duell, Department of Hematology and Oncology, University Hospital Wuerzburg, Oberdürrbacher Str. 6, 97080 Wuerzburg, GermanyCarmen Wesemeier, Department of Hematology and Oncology, University Hospital Wuerzburg, Oberdürrbacher Str. 6, 97080 Wuerzburg, GermanyEugenia Haralambieva, Institute of Pathology, University Wuerzburg, Josef-Schneider Str.6, 97080 Wuerzburg, GermanyUwe Maeder, Tumor Registry, Comprehensive Cancer Center Mainfranken, Oberdürrbacher Str. 6, 97080 Wuerzburg, GermanyHermann Einsele, Department of Hematology and Oncology, University Hospital Wuerzburg, Oberdürrbacher Str. 6, 97080 Wuerzburg, GermanyStefan Knop, Department of Hematology and Oncology, University Hospital Wuerzburg, Oberdürrbacher Str. 6, 97080 Wuerzburg, Germany Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Clinical features and prognostic factors of Asian patients with paroxysmal nocturnal hemoglobinuria: results from a single center in China

Abstract Although all patients with paroxysmal nocturnal hemoglobinuria (PNH) have acquired mutations in the phosphatidylinositol glycan class-A(PIG-A)gene, their clinical courses are highly variable. We reviewed 280 PNH cases referred to our hospital from January 1990 through June 2010 to assess clinical presentations, prognostic factors influencing survival, difference among subcategories, and clinical significance of PNH clone size. The overall survival at 10 years after diagnosis estimated by Kaplan–Meier was 77.6%. Both univariate and multivariate analyses identified risk factors affecting survival, including age >40 years, absolute neutrophil count<0.5 × 109 cells/L, development of thrombotic events, evolution to myelodysplastic syndrome or acute myelogenous leukemia, and recurrent infections. The cohort of patients were divided into subcategories of classic PNH, PNH/AA, and PNH-sc/AA based on the recent proposed PNH working clinical classification, hemoglobinuria as the initial symptomatic manifestation was high up to 82.0% in classic PNH subcategory, whereas only as low as 1.4% in PNH-sc/AA subcategory; the frequencies of infectious (26.0%) and bleeding symptoms (14.0%) in classic PNH subcategory were significantly less than those in PNH/AA (25.3% and 51.7%, respectively) and PNH-sc/AA (48.3% and 83.2%, respectively) subcategories. Our results revealed that large PNH clone was associated with increased risks for hemoglobinuria and thrombosis, whereas small PNH clone was associated with bone marrow failure. Thus, this study may shed insights into Chinese PNH patients to set up individually therapeutic regimens. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00277-012-1413-6Authors Meili Ge, State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin, 300020 People’s Republic of ChinaXingxin Li, State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin, 300020 People’s Republic of ChinaJun Shi, State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin, 300020 People’s Republic of ChinaYingqi Shao, State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin, 300020 People’s Republic of ChinaYizhou Zheng, State Key Laboratory of Experimental Hematology, Institute of Hematology & Blood Diseases Hospital, Chinese Academy of Medical Science & Peking Union Medical College, 288 Nanjing Road, Tianjin, 300020 People’s Republic of China Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Serum ferritin levels and endocrinopathy in medically treated patients with β thalassemia major

Abstract The association between iron overload indices and pathology of the heart and liver in transfusion-dependent patients with β thalassemia major (TM) has been extensively studied. Nonetheless, data on endocrine disease remains limited. This was a cross-sectional study of 382 TM patients treated with regular transfusions and desferrioxamine at the Thalassemia Center in Dubai, UAE. Retrieved data included demographics, splenectomy status, steady-state serum ferritin levels, and the presence of endocrinopathies (diabetes mellitus, hypothyroidism, hypoparathyroidism, and hypogonadism). Multivariate logistic regression analyses were used to determine which variables were independently associated with the occurrence of each endocrinopathy. The mean age of patients was 15.4 ± 7.6 years, with an equal sex distribution. The mean serum ferritin level was 2597.2 ± 1976.8 μg/l. The frequencies of specific endocrinopathies were diabetes mellitus (10.5%), hypothyroidism (6.3%), hypoparathyroidism (10.5%), and hypogonadism (25.9%). On multivariate logistic regression analysis, patients with a serum ferritin level >2,500 μg/l, but not >1,000–2,500 μg/l, were 3.53 times (95% CI 1.09–11.40) more likely to have diabetes mellitus, 3.25 times (95% CI 1.07–10.90) more likely to have hypothyroidism, 3.27 times (95% CI 1.27–8.39) more likely to have hypoparathyroidism, and 2.75 times (95% CI 1.38–5.49) more likely to have hypogonadism compared to patients with a serum ferritin level ≤1,000 μg/l. However, splenectomized patients with serum ferritin levels ≤2,500 μg/l had comparably high rates of all endocrinopathies as patients with serum ferritin levels >2,500 μg/l. Endocrinopathy is common in TM patients treated with desferrioxamine therapy, especially in patients with serum ferritin levels >2,500 μg/l or those splenectomized. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00277-012-1412-7Authors Khawla M. Belhoul, Thalassemia Center, Al Wasl Hospital, Dubai, United Arab EmiratesMaisam L. Bakir, Thalassemia Center, Al Wasl Hospital, Dubai, United Arab EmiratesMohamed-SalahEldin Saned, Thalassemia Center, Al Wasl Hospital, Dubai, United Arab EmiratesAhmed M. A. Kadhim, Thalassemia Center, Al Wasl Hospital, Dubai, United Arab EmiratesKhaled M. Musallam, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, LebanonAli T. Taher, Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Rituximab pharmacokinetics in ascites and serum in the treatment of follicular lymphoma with massive ascites

Rituximab pharmacokinetics in ascites and serum in the treatment of follicular lymphoma with massive ascites Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-012-1410-9Authors Yuki Hiroshima, Third Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2, Iidanishi, Yamagata-shi, Yamagata, 990-9585 JapanKatsushi Tajima, Third Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2, Iidanishi, Yamagata-shi, Yamagata, 990-9585 JapanYousuke Shiono, Third Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2, Iidanishi, Yamagata-shi, Yamagata, 990-9585 JapanIkuko Suzuki, Third Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2, Iidanishi, Yamagata-shi, Yamagata, 990-9585 JapanKei Kouno, Third Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2, Iidanishi, Yamagata-shi, Yamagata, 990-9585 JapanMasakazu Yamamoto, Third Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2, Iidanishi, Yamagata-shi, Yamagata, 990-9585 JapanYuichi Kato, Third Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2, Iidanishi, Yamagata-shi, Yamagata, 990-9585 JapanTakeo Kato, Third Department of Internal Medicine, Yamagata University School of Medicine, 2-2-2, Iidanishi, Yamagata-shi, Yamagata, 990-9585 Japan Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Analysis of hepatitis B surface antibody titers in B cell lymphoma patients after rituximab therapy

Abstract Hepatitis B virus (HBV) reactivation is a well-known complication after rituximab therapy in patients with B cell lymphoma. Traditionally, hepatitis B surface antibody (anti-HBs) is a protective antibody, but the effect of rituximab on these antibodies has not been well studied. In 29 B cell lymphoma patients who were positive for anti-HBs before rituximab therapy, anti-HBs serologies before and after rituximab therapy were compared. Anti-HBs titers after rituximab treatment were significantly lower (P < 0.001) than those before treatment. None of the ten cases with pre-treatment anti-HBs titers above 100 mIU/mL became negative for anti-HBs after rituximab therapy. In contrast, 8 of the 19 patients with pre-treatment anti-HBs titers below 100 mIU/mL lost their anti-HBs (P = 0.027). Of these, one patient developed HBsAg seroreversion and HBV reactivation after rituximab therapy. Regarding patients with loss of anti-HBs or not, there was no significant difference in pre- and post-treatment immunoglobulin G levels between both groups. The rate of anti-HBs loss increased with advanced lymphoma stage and international prognostic index (P = 0.002 and <0.001, respectively). Multiple logistic regression analysis showed that pre-treatment anti-HBs titer is the only independent factor influencing the loss of anti-HBs (per one log mIU/mL, odds ratio, 0.003; 95% confidence interval, 0.000–0.302; P = 0.014). In conclusion, we found that anti-HBs titers decreased significantly (P < 0.001) after rituximab treatment. B cell lymphoma patients with low pre-treatment anti-HBs titers (<100 mIU/mL) were more likely to lose anti-HBs antibodies and were at risk of HBV reactivation after rituximab immunochemotherapy. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00277-012-1405-6Authors Sung-Nan Pei, Division of Hema-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanMing-Chun Ma, Division of Hema-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanMing-Chung Wang, Division of Hema-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanChing-Yuan Kuo, Division of Hema-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanKun-Min Rau, Division of Hema-Oncology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanCheng-Yu Su, Department of Laboratory Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, TaiwanChien-Hung Chen, Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, Taiwan Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Falciparum malaria in a patient with sickle cell trait with hemophagocytosis and secondary pancytopenia

Falciparum malaria in a patient with sickle cell trait with hemophagocytosis and secondary pancytopenia Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-012-1408-3Authors Jalil Ur Rehman, Department of Oncology, King Faisal Specialist Hospital and Research Centre, Po Box 40047, Jeddah, 21499 Kingdom of Saudi ArabiaNezar Bhabri, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Kingdom of Saudi ArabiaAhmed Waleed, Department of Medicine, King Faisal Specialist Hospital and Research Centre, Jeddah, Kingdom of Saudi ArabiaA. Maulawi, Department of Pathology, King Faisal Specialist Hospital and Research Centre, Jeddah, Kingdom of Saudi ArabiaM. Aslam, Department of Oncology, King Faisal Specialist Hospital and Research Centre, Po Box 40047, Jeddah, 21499 Kingdom of Saudi Arabia Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Unstable hemoglobin Rush [beta 101(G3) Glu>Gln, HBB:c.304G>C] in a Brazilian family with moderate hemolytic anemia

Abstract Hemoglobin Rush is an unstable variant generated by a mutation of the β-globin gene which causes amino acid replacement Glu>Gln in the central cavity of hemoglobin (G3). Many members of a Brazilian family of Italian descent have hemoglobin Rush. This is the second report in world literature. Clinical and laboratory features were retrieved and gene mutation was characterized. Hemoglobin electrophoresis, gene sequencing, and restriction fragment length polymorphism with Hpy188I were used to characterize it. In 13 affected members, hemoglobin ranged from 9.3 to 13.0 g/dL and reticulocyte count up to 12.8%. The intensity of hemolysis appeared to be linked to increased stress. The mutation was proved to be HBB:c.304G>C, beta 101(G3) Glu>Gln. Heterozygous hemoglobin Rush should be suspected when alkaline electrophoresis shows three bands, whereas isoelectric focusing and acid electrophoresis show only two. Adequate genetic counseling to avoid intermarriage should be provided because homozygous hemoglobin Rush is predicted to be clinically severe. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00277-011-1403-0Authors Marcilene Rezende Silva, Faculdade de Medicina (UFMG), Universidade Federal de Minas Gerais, Minas Gerais, BrazilShimene Mascarenhas Sendin, Instituto de Ciências Biológicas (UFMG), Universidade Federal de Minas Gerais, Minas Gerais, BrazilCibele Velloso-Rodrigues, Fundação Hemominas, Minas Gerais, BrazilAndré Rolim Belisário, Fundação Hemominas, Minas Gerais, BrazilTerezinha Santos D’Ávila, Fundação Hemominas, Minas Gerais, BrazilLiege Ribeiro Lyra, Fundação Hemominas, Minas Gerais, BrazilMarcos Borato Viana, Faculdade de Medicina (UFMG), Universidade Federal de Minas Gerais, Minas Gerais, Brazil Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Inhibition of p38 MAPK activity promotes ex vivo expansion of human cord blood hematopoietic stem cells

Abstract Ex vivo expansion of hematopoietic stem cells (HSCs) depends on HSC self-renewing proliferation and functional maintenance, which can be negatively affected by HSC differentiation, apoptosis, and senescence. Therefore, inhibition of HSC senescence may promote HSC expansion. To test this hypothesis, we examined the effect of inhibition of p38 mitogen-activated protein kinase (p38) on the expansion of human umbilical cord blood (hUCB) CD133+ cells because activation of p38 has been implicated in the induction of HSC senescence under various physiological and pathological conditions. Our results showed that ex vivo expansion of hUCB CD133+ cells activated p38, which was abrogated by the p38 specific inhibitor SB203580 (SB). Inhibition of p38 activity with SB promoted the expansion of CD133+ cells and CD133+CD38− cells. In addition, hUCB CD133+ cells expanded in the presence of SB for 7 days showed about threefold increase in the clonogenic function of HSCs and engraftment in non-obese diabetic/severe combined immunodeficient mice after transplantation compared to the input cells. In contrast, the cells expanded without SB exhibited a significant reduction in these HSC functions. The enhancement of ex vivo expansion of hUCB HSCs is primarily attributable to SB-mediated inhibition of HSC senescence. In addition, inhibition of HSC apoptosis and upregulation of CXCR4 may also contribute to the enhancement. However, p38 inhibition had no significant effect on HSC differentiation and proliferation. These findings suggest that inhibition of p38 activation may represent a novel strategy to promote ex vivo expansion of hUCB HSCs. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00277-011-1397-7Authors Jing Zou, Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 ChinaPing Zou, Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 ChinaJie Wang, Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 ChinaLei Li, Institute of Pediatrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, ChinaYong Wang, Department of Pathology, Medical University of South Carolina, Charleston, SC 29425, USADaohong Zhou, Division of Radiation Health, Department of Pharmaceutical Sciences and Winthrop P. Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205, USALingbo Liu, Institute of Hematology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022 China Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Prothrombin complex concentrate (Octaplex®) for postsurgical bleeding control in a Stauffer’s syndrome

Prothrombin complex concentrate (Octaplex®) for postsurgical bleeding control in a Stauffer’s syndrome Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-011-1396-8Authors Ana B. Fernández, Anaesthesiology and Intensive Care Department, Nuestra Sra de Candelaria University Hospital, Tenerife, Canary Islands, SpainAzahara Sancho de Ávila, Anaesthesiology and Intensive Care Department, Nuestra Sra de Candelaria University Hospital, Tenerife, Canary Islands, Spain Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Adult onset of primary hemophagocytic syndrome in subjects carrying PRF1 mutations

Adult onset of primary hemophagocytic syndrome in subjects carrying PRF1 mutations Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-012-1409-2Authors Yini Wang, Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaZhao Wang, Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaHua Chen, Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, ChinaXiaolin Wang, Department of Hematology, Beijing Friendship Hospital, Capital Medical University, Beijing, China Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Toxoplasmosis after allogeneic stem cell transplantation—a single centre experience

Abstract Toxoplasmosis is a rare but possibly underestimated complication following allogeneic stem cell transplantation with a high mortality rate. One reason might be the limitation of the diagnostic instruments relying mainly on imaging and molecular-based techniques. In this report, we present three cases of toxoplasmosis identified among 155 allograft recipients treated at Greifswald University Hospital. Widely disseminated toxoplasmosis was detected post-mortem in two patients allografted for high-risk multiple myeloma. Clinical signs suspicious for toxoplasmosis occurred after days +32 and +75, respectively. In one case, serology and conventional Toxoplasma gondii PCR, targeting the B1 gene, revealed negative results, while in the other patient, toxoplasmosis was not investigated. Both patients received pentamidine for Pneumocystis jirovecii pneumonia (PcP) prophylaxis. The third patient, a 68-year-old woman allografted for AML, developed cerebral toxoplasmosis from day +395 after allogeneic SCT with typical signs in magnetic resonance tomography. Toxoplasma DNA was amplified from one of two samples of cerebrospinal fluid. The patient died of disseminated toxoplasmosis despite immediate initiation of therapy. Retrospective comparative testing of clinical specimens by the conventional T. gondii PCR and by a real-time PCR targeting a 529-bp genomic fragment suggests a higher sensitivity of the latter method in our patients. In conclusion, we suggest a rigorous real-time PCR monitoring for high-risk patients or patients with signs of infections suspicious for toxoplasmosis, even though low-copy results are presently difficult to interpret. Our reported cases might also encourage the use of trimethoprim–sufmethoxazole instead of pentamidine for PcP prophylaxis in those patients. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00277-012-1406-5Authors Christoph Busemann, Department of Internal Medicine C (Haematology and Oncology, Marrow Transplantation), Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanySilvia Ribback, Institute for Pathology, Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanyKathrin Zimmermann, Friedrich-Loeffler Institute for Medical Microbiology, Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanyVerena Sailer, Institute for Pathology, Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanyThomas Kiefer, Department of Internal Medicine C (Haematology and Oncology, Marrow Transplantation), Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanyChristian A. Schmidt, Department of Internal Medicine C (Haematology and Oncology, Marrow Transplantation), Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanyKatrin Schulz, Friedrich-Loeffler Institute for Medical Microbiology, Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanyIvo Steinmetz, Friedrich-Loeffler Institute for Medical Microbiology, Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanyFrank Dombrowski, Institute for Pathology, Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanyGottfried Dölken, Department of Internal Medicine C (Haematology and Oncology, Marrow Transplantation), Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, GermanyWilliam H. Krüger, Department of Internal Medicine C (Haematology and Oncology, Marrow Transplantation), Ernst-Moritz-Arndt-University Greifswald, Ferdinand-Sauerbruch-Str, 17475 Greifswald, Germany Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Association of CD20 levels with clinicopathological parameters and its prognostic significance for patients with DLBCL

Abstract Diffuse large B-cell lymphomas (DLBCL) express CD20. CD20 expression is described as negative, weak, or normal as determined by flow cytometry (FCM) and is an important target for the treatment of DLBCL. However, the impact of CD20 levels at onset of the disease on patient prognosis has not been fully elucidated. We analyzed 174 DLBCL cases newly diagnosed between January 1998 and April 2010. The relationship of the association between CD20 levels and patients’ backgrounds and prognoses was analyzed using the Kaplan–Meier method and Cox proportional hazard regression. Of the 174 patients, three cases (1.7%) were defined as CD20 negative based on immunohistochemistry (IHC). Although the other 171 cases were positive by IHC, eight cases (4.7%) were defined as negative and 33 cases (19.3%) were defined as weak when analyzed by FCM. Of the 105 patients who received rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisolone therapy, those who were CD20 negative (FCM) showed significantly inferior overall (hazard ratios (HR): 6.79, 95% CI: 1.32–34.96, p = 0.04) and progression-free survival (HR: 7.3, 95% CI: 1.49–35.8, p = 0.04) compared to patients who were CD20 normal. Our findings indicate that the CD20 level (FCM) at onset is an independent predictor of the prognosis of patients with DLBCL. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00277-012-1407-4Authors Yuhko Suzuki, Department of Hematology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0374 JapanTsutomu Yoshida, Department of Pathology, Kitasato University School of Medicine, Sagamihara, JapanGuoqin Wang, Kitasato Clinical Research Center, Kitasato University School of Medicine, Sagamihara, JapanTomiteru Togano, Department of Hematology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0374 JapanShunsuke Miyamoto, Department of Otolaryngology, Kitasato University School of Medicine, Sagamihara, JapanKoji Miyazaki, Department of Hematology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0374 JapanKeiichi Iwabuchi, Department of Pathology, Kitasato University School of Medicine, Sagamihara, JapanMeijin Nakayama, Department of Otolaryngology, Kitasato University School of Medicine, Sagamihara, JapanRyouichi Horie, Department of Hematology, Kitasato University School of Medicine, 1-15-1 Kitasato, Minami-ku, Sagamihara, 252-0374 JapanNozomi Niitsu, Department of Hematology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Hidaka, JapanYuichi Sato, Department of Molecular Diagnostics, Kitasato University School of Allied Health Science, Sagamihara, JapanNaoya Nakamura, Department of Pathology, Tokai University,School of Medicine, Isehara, Japan Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Ferroportin (SLC40A1) Q248H mutation is associated with lower circulating serum hepcidin levels in Rwandese HIV-positive women

Abstract The Q248H mutation in the gene SLC40A1 which encodes for the cellular iron exporter ferroportin is relatively common in Africa. This mutation has been associated with resistance to hepcidin and therefore we hypothesized that iron-related parameters and the prevalence of opportunistic infections in HIV might be influenced by the Q248H mutation. We conducted a cross-sectional study among 200 HIV-positive women in the Butare University Teaching Hospital in Rwanda. Polymerase chain reaction (PCR) and restriction enzyme digestion were used to identify the Q248H mutation. Physical examination was carried out and WHO HIV disease stage classification, complete blood count, CD4 count, indirect measures of iron status, serum hepcidin, and C-reactive protein concentrations were determined. The prevalence of ferroportin Q248H mutation was 6%. Subjects with ferroportin Q248H mutation had significantly higher values for serum ferritin (P = 0.001) and significantly lower values for serum hepcidin (P = 0.001) and transferrin (P = 0.01). Among the 12 HIV + Q248H heterozygotes, 8 suffered from at least one opportunistic infection. There was significantly higher prevalence of pulmonary TB (P = 0.01) and Pneumocystis jiroveci pneumonia (P = 0.02) in subjects with ferroportin Q248H mutation. Low hepcidin levels were found in ferroportin Q248H heterozygotes with HIV infection, notwithstanding the absence of anemia and the higher prevalence of some opportunistic infections. Hepcidin seems to be regulated in a different way in Q248H heterozygotes than is known thus far. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00277-011-1400-3Authors Florence Masaisa, Department of Clinical Chemistry, Microbiology and Immunology, Faculty of Medicine and Health sciences, Ghent University, Ghent, BelgiumCandace Breman, Department of Clinical Chemistry, Microbiology and Immunology, Faculty of Medicine and Health sciences, Ghent University, Ghent, BelgiumJean Bosco Gahutu, Department of Medical Biology, Faculty of Medicine and Butare University Teaching Hospital, National University of Rwanda, Huye, RwandaJoshua Mukiibi, Department of Internal Medicine, Faculty of Medicine and Butare University Teaching Hospital, National University of Rwanda, Huye, RwandaJoris Delanghe, Department of Clinical Chemistry, Microbiology and Immunology, Faculty of Medicine and Health sciences, Ghent University, Ghent, BelgiumJan Philippé, Department of Clinical Chemistry, Microbiology and Immunology, Faculty of Medicine and Health sciences, Ghent University, Ghent, Belgium Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Allogeneic hematopoietic stem cell transplantation in patients with diffuse large B cell lymphoma relapsed after autologous stem cell transplantation: A GITMO study

Abstract Patients who relapse after an autologous hematopoietic stem cell transplantation (SCT) have a very poor prognosis. We have retrospectively analyzed diffuse large B cell lymphoma patients who underwent an allo-SCT after an auto-SCT relapse reported in the Gruppo Italiano Trapianto di Midollo Osseo (GITMO) database. From 1995 to 2008, 3449 autologous transplants were reported in the GITMO database. Eight hundred eighty-four patients relapsed or progressed after transplant; 165 patients, 19% of the relapsed patients, were treated with allo-transplant. The stem cell donor was related to the patient in 108 cases. A reduced intensity conditioning regimen was used in 116. After allo-SCT, 72 patients (43%) obtained a complete response and 9 obtained a partial response with an overall response rate of 49%; 84 patients (51%) experienced rapid progression of disease. Ninety-one patients died, 45 due to disease and 46 due to treatment-related mortality. Acute graft-versus-host disease was recorded in 57 patients and a chronic GvHD in 38 patients. With a median follow-up of 24 months (2–144) after allo, overall survival (OS) was 39%, and after a median of 21 months (2–138) after allo, progression-free survival (PFS) was 32%. Multivariate analysis indicated that the only factors affecting OS were status at allo-SCT, and those affecting PFS were status at allo-SCT and stem cell donor. This retrospective analysis shows that about one-fifth of patients with diffuse large B cell lymphoma who experience relapse after autologous transplantation may be treated with allogeneic transplantation. Moreover, the only parameter affecting either OS or PFS was the response status at the time of allo-SCT. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00277-011-1395-9Authors Luigi Rigacci, Division of Hematology and Bone Marrow Transplantation, Azienda Ospedaliera Universitaria Careggi, Via delle Oblate, 1-50141 Florence, ItalyBendetta Puccini, Division of Hematology and Bone Marrow Transplantation, Azienda Ospedaliera Universitaria Careggi, Via delle Oblate, 1-50141 Florence, ItalyAnna Dodero, Division of Hematology and Bone Marrow Transplantation, Istituto Nazionale dei Tumori, Milan, ItalyPasquale Iacopino, Centro Trapianti Midollo Osseo, Azienda Ospedaliera Bianchi-Melacrino-Morelli, Reggio Calabria, ItalyLuca Castagna, Department of Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Milan, ItalyStefania Bramanti, Department of Oncology and Hematology, Istituto Clinico Humanitas, Rozzano, Milan, ItalyFabio Ciceri, Hematology and BMT Unit, San Raffaele Scientific Institute, Milan, ItalyRenato Fanin, Division of Hematology and Bone Marrow Transplantation, University of Udine, Udine, ItalyAlessandro Rambaldi, Divisione di Ematologia, Ospedali Riuniti, Bergamo, ItalyMichele Falda, Division of Hematology, San Giovanni Battista Hospital, Turin, ItalyGiuseppe Milone, Division of Hematology and BM Transplantation, Ospedale Ferrarotto, Catania, ItalyStefano Guidi, Division of Hematology and Bone Marrow Transplantation, Azienda Ospedaliera Universitaria Careggi, Via delle Oblate, 1-50141 Florence, ItalyMassimo Fabrizio Martelli, Institute of Hematology, University of Perugia, Perugia, ItalyPatrizio Mazza, Struttura Complessa di Ematologia, Azienda Ospedaliera SS.Annunziata, Taranto, ItalyRosi Oneto, Italian National BMT Registry-GITMO, Ospedale San Martino, Genova, ItalyAlberto Bosi, Division of Hematology and Bone Marrow Transplantation, Azienda Ospedaliera Universitaria Careggi, Via delle Oblate, 1-50141 Florence, ItalyGruppo Italiano Trapianto di Midollo Osseo (GITMO) Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Cyclophosphamide-containing regimen (TCD) is superior to melphalan-containing regimen (MPT) in elderly multiple myeloma patients with renal impairment

Abstract Renal impairment (RI) is a frequent complication with higher incidence of infections and an important prognostic factor for survival. Melphalan clearance is renal function dependent whereas cyclophosphamide is renal function independent. We investigated which combination regimen should be selected between melphalan-combining regimen (MPT) or cyclophosphamide-combining regimen (TCD) in elderly multiple myeloma (MM) patients with RI. Between 2005 and 2009, 157 newly diagnosed MM patients with RI were included comparing MPT with TCD therapy as initial treatment. Seventy-four patients were given MPT regimen, and 83 patients were given TCD regimen. Baseline characteristics were similar between the MPT and TCD groups. Analysis of different cutoff levels between 25% and 75% quartiles using log-rank test determined that glomerular filtration rate (GFR), 40 ml/min/1.73 m2 as the cutoff point, yielded the highest difference in event-free survival (EFS) and overall survival (OS). The MPT subgroup with low GFR (GFR <40 ml/min/1.73 m2) had poorer response rates than others. The incidence of neutropenia and infection with febrile neutropenia were higher in the MPT subgroup with low GFR than the others (p = 0.016, p < 0.001). Furthermore, mortality due to the infection was higher in the MPT subgroup with low GFR than the others (p < 0.001). EFS was lower in the MPT subgroup with low GFR than the others (p < 0.001). OS was lower in the MPT subgroup with low GFR than the others (p < 0.001). In newly diagnosed elderly MM patients with RI, TCD regimen would be an effective and tolerable treatment option due to the combination of cyclophosphamide independent to renal function and dexamethasone effective for RI Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00277-011-1401-2Authors Moo-Kon Song, Department of Hematology-Oncology, School of Medicine, Pusan National University Hospital Medical Research Institute, 1-10 Ami-dong, Seo-gu, Busan, 602-739 Republic of KoreaJoo-Seop Chung, Department of Hematology-Oncology, School of Medicine, Pusan National University Hospital Medical Research Institute, 1-10 Ami-dong, Seo-gu, Busan, 602-739 Republic of KoreaHo-Jin Shin, Department of Hematology-Oncology, School of Medicine, Pusan National University Hospital Medical Research Institute, 1-10 Ami-dong, Seo-gu, Busan, 602-739 Republic of KoreaJoon-Ho Moon, Department of hematology, Kyungpook National University Hospital, Daegu, South KoreaJe-Jung Lee, Department of hematology, Chonnam National University Hwasun Hospital, Hwasun, South KoreaSung-Soo Yoon, Department of hematology, Seoul National University Hospital, Seoul, South KoreaJin-Seok Kim, Department of hematology, Yonsei University Severance Hospital, Seoul, South KoreaJeong-Ok Lee, Department of hematology, Seoul National University Bundang Hospital, Bundang, South KoreaYoung-Rok Do, Department of hematology, Keimyung University Dongsan Medical Center, Daegu, South KoreaHo-Sup Lee, Department of hematology, Kosin University Gospel Hospital, Busan, South KoreaEun-Kyung Park, Department of hematology, Chung-ang University Hospital, Seoul, South KoreaKorean Multiple Myeloma Working Party Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Posterior reversible encephalopathy syndrome (PRES) during induction chemotherapy for acute myeloblastic leukemia (AML)

Posterior reversible encephalopathy syndrome (PRES) during induction chemotherapy for acute myeloblastic leukemia (AML) Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-011-1398-6Authors Giorgia Battipaglia, Department of Biochemistry and Medical Biotechnology, Federico II University, via Pansini 5, 80131 Naples, ItalySimona Avilia, Department of Biochemistry and Medical Biotechnology, Federico II University, via Pansini 5, 80131 Naples, ItalyEmanuela Morelli, Department of Biochemistry and Medical Biotechnology, Federico II University, via Pansini 5, 80131 Naples, ItalyFerdinando Caranci, Diagnostic Imaging and Radiotherapy, Federico II University, Naples, ItalyFabiana Perna, Department of Biochemistry and Medical Biotechnology, Federico II University, via Pansini 5, 80131 Naples, ItalyAndrea Camera, Department of Biochemistry and Medical Biotechnology, Federico II University, via Pansini 5, 80131 Naples, Italy Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Langerhans/dendritic cell sarcoma arising from hairy cell leukemia: a rare phenomenon

Langerhans/dendritic cell sarcoma arising from hairy cell leukemia: a rare phenomenon Content Type Journal ArticleCategory Letter to the EditorPages 1-3DOI 10.1007/s00277-011-1399-5Authors Alaa Muslimani, Department of Hematology and Oncology, Oakland University William Beaumont School of Medicine, William Beaumont Hospital, 3577 W 13 Mile Rd, Suite 202, Royal Oak, MI 48073, USAMohammad Muhsin Chisti, Department of Hematology and Oncology, Oakland University William Beaumont School of Medicine, William Beaumont Hospital, 3577 W 13 Mile Rd, Suite 202, Royal Oak, MI 48073, USAAnn Marie Blenc, Department of Pathology, Oakland University William Beaumont School of Medicine, William Beaumont Hospital, 3601 W 13 Mile Rd, Royal Oak, MI 48073, USAIqbal Boxwala, Department of Hematology and Oncology, Oakland University William Beaumont School of Medicine, William Beaumont Hospital, 3577 W 13 Mile Rd, Suite 202, Royal Oak, MI 48073, USAMark A. Micale, Department of Pathology, Oakland University William Beaumont School of Medicine, William Beaumont Hospital, 3601 W 13 Mile Rd, Royal Oak, MI 48073, USAIshmael Jaiyesimi, Department of Hematology and Oncology, Oakland University William Beaumont School of Medicine, William Beaumont Hospital, 3577 W 13 Mile Rd, Suite 202, Royal Oak, MI 48073, USA Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Non-atopic IgE and eosinophil cationic protein after allogeneic hematopoietic stem cell transplantation in children

Abstract Allogeneic hematopoietic stem cell transplantation (HSCT) in childhood is associated with severe pulmonary complications, but the pathophysiologic mechanisms remain unclear. Our aim was to evaluate the association of total and specific IgE, eosinophil cationic protein (ECP) and eosinophilia in HSCT recipients with pulmonary complications. We prospectively measured total and specific serum IgE, eosinophils, and ECP before and 28, 100, and 180 days after HSCT. We included 30 children (age 2–17 years) undergoing HSCT. Nine patients had a history of previous atopy without being associated with pulmonary complications after HSCT until day +360. Specific IgE levels showed a decline after HSCT, associated with the absence of allergy symptoms, suggesting a reduction of atopy. Elevated total serum IgE levels occurred in seven patients on day +28 after HSCT. This elevation did not coincide with allergy symptoms. ECP showed no correlation with total allergy symptoms, eosinophilia, IgE levels, or pulmonary complications. There was a significant correlation (p = 0.0367) between ECP levels on day +28 and concurrent acute graft-versus-host disease (GvHD). Non-atopic serum ECP and IgE levels are elevated on day +28 after HSCT in children, with ECP showing a potential relation to acute GvHD. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00277-011-1402-1Authors T. Fazekas, St. Anna Children’s Hospital, Kinderspitalgasse 6, 1090 Vienna, AustriaN. Pruckner, St. Anna Children’s Hospital, Kinderspitalgasse 6, 1090 Vienna, AustriaA. Lawitschka, St. Anna Children’s Hospital, Kinderspitalgasse 6, 1090 Vienna, AustriaM. G. Seidel, St. Anna Children’s Hospital, Kinderspitalgasse 6, 1090 Vienna, AustriaP. Eickhoff, St. Anna Children’s Hospital, Kinderspitalgasse 6, 1090 Vienna, AustriaU. Pötschger, St. Anna Children’s Hospital, Children’s Cancer Research Institute, Vienna, AustriaZ. Szépfalusi, Department of Pediatrics; Division of Pediatric Pulmonology, Allergology and Endocrinology, Medical University Vienna, Vienna, AustriaH. Gadner, St. Anna Children’s Hospital, Kinderspitalgasse 6, 1090 Vienna, AustriaC. Peters, St. Anna Children’s Hospital, Kinderspitalgasse 6, 1090 Vienna, Austria Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Imatinib trough plasma levels do not correlate with the response to therapy in patients with chronic myeloid leukemia in routine clinical setting

Abstract Association of trough imatinib plasma levels (IPL) with cytogenetic or molecular response to treatment in patients with chronic myeloid leukemia (CML) was repeatedly reported. We analyzed their value in the routine clinical setting in 131 patients with chronic phase CML in whom imatinib was applied as first- or second-line treatment. A total of 1,118 measurements were obtained by ultra-performance liquid chromatography–tandem mass spectrometry assay in patients treated with daily dose of imatinib ranging from 100 to 800 mg. Samples were obtained from 1 to 96 h after drug ingestion. High inter (36%) and intraindividual variability (9–33%) of IPL was observed. For analysis of correlation of IPL with treatment response, two sets of samples were selected according to the European LeukemiaNet (ELN) criteria. The first set consisted of 241 samples taken 24 ± 2 h after dosing in 54 patients, and the second one consisted of 329 samples taken 24 ± 4 h after imatinib ingestion in 84 patients. In both sets, only patients treated with 400 mg imatinib once daily for at least 18 months were included. From multiple measurements in individual patients, mean IPL were used. In both sets, we were not able to demonstrate a statistically significant correlation between IPL and response to treatment according to the ELN. We believe that this was due to the differences in patients’ compliance, leukemia biology, and other variables that are difficult to eliminate in the routine clinical practice. The use of IPL for prognostic estimation in CML treatment outside the clinical trials is probably limited. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00277-011-1394-xAuthors Edgar Faber, Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, IP Pavlova 6, CZ 775 20 Olomouc, Czech RepublicDavid Friedecký, Department of Biochemistry and Immunogenetics, Laboratory of Inherited Metabolic Disorders, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, IP Pavlova 6, CZ 775 20 Olomouc, Czech RepublicKateřina Mičová, Department of Biochemistry and Immunogenetics, Laboratory of Inherited Metabolic Disorders, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, IP Pavlova 6, CZ 775 20 Olomouc, Czech RepublicŠárka Rožmanová, Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, IP Pavlova 6, CZ 775 20 Olomouc, Czech RepublicMartina Divoká, Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, IP Pavlova 6, CZ 775 20 Olomouc, Czech RepublicMarie Jarošová, Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, IP Pavlova 6, CZ 775 20 Olomouc, Czech RepublicKarel Indrák, Department of Hemato-Oncology, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, IP Pavlova 6, CZ 775 20 Olomouc, Czech RepublicTomáš Adam, Department of Biochemistry and Immunogenetics, Laboratory of Inherited Metabolic Disorders, Faculty of Medicine and Dentistry, Palacký University Olomouc, University Hospital Olomouc, IP Pavlova 6, CZ 775 20 Olomouc, Czech Republic Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

The proteasome inhibitor bortezomib targets cell cycle and apoptosis and acts synergistically in a sequence-dependent way with chemotherapeutic agents in mantle cell lymphoma

Abstract Single-agent bortezomib, a potent, selective, and reversible inhibitor of the 26S proteasome, has demonstrated clinical efficacy in relapsed and refractory mantle cell lymphoma (MCL). Objective response is achieved in up to 45% of the MCL patients; however, complete remission rates are low and duration of response proved to be relatively short. These limitations may be overcome by combining proteasome inhibition with conventional chemotherapy. Rational combination treatment and schedules require profound knowledge of underlying molecular mechanisms. Here we show that single-agent bortezomib treatment of MCL cell lines leads to G2/M arrest and induction of apoptosis accompanied by downregulation of EIF4E and CCND1 mRNA but upregulation of p15(INK4B) and p21 mRNA. We further present synergistic efficacy of bortezomib combined with cytarabine in MCL cell lines. Interestingly this sequence-dependent synergistic effect was seen almost exclusively in combination with AraC, indicating that pretreatment with cytarabine, followed by proteasome inhibition, may be the preferred approach. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00277-011-1377-yAuthors Grit Hutter, Helmholtz Centre Munich, Marchioninistr. 25, 81377 Muenchen, GermanyMalte Rieken, Urologische Klinik, Universitätsspital Basel, Basel, SwitzerlandAlessandro Pastore, Department of Medicine III, University Hospital Grosshadern, Munich, GermanyOliver Weigert, Department of Medicine III, University Hospital Grosshadern, Munich, GermanyYvonne Zimmermann, Helmholtz Centre Munich, Marchioninistr. 25, 81377 Muenchen, GermanyMarc Weinkauf, Helmholtz Centre Munich, Marchioninistr. 25, 81377 Muenchen, GermanyWolfgang Hiddemann, Department of Medicine III, University Hospital Grosshadern, Munich, GermanyMartin Dreyling, Department of Medicine III, University Hospital Grosshadern, Munich, Germany Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Concurrent search for unrelated cord and volunteer donor in high-risk acute lymphoblastic leukemia

Abstract To assess the effectiveness of the search for an unrelated donor on the outcome of patients with high-risk acute lymphoblastic leukemia, we analyzed prospectively 136 patients who underwent a search for cord blood (CB) and an unrelated volunteer donor (UD) at the same time. The probability of finding a donor was 58.2%, 70.3%, and 75.7% at 3, 6, and 12 months, respectively. The median time to find a donor was 1.8 months for CB and 3.5 months for UD. Of the 99 patients with a donor, 38.4% failed to undergo the transplant because of a relapse observed at a median of 4 months from the start of the search. In univariate analysis, absence of relapse during the search (p < 0.0001) and transplant (p = 0.004) showed a positive impact on long-term survival. In multivariate analysis, relapse during the search remained the key factor affecting survival (p < 0.0001). Since an extension of the search beyond 3 months enables only a slight increase in the probability of finding a donor compared to the increased risk of relapse, the time of the search should not exceed the 3-month time point. The simultaneous search for CB and UD increases the likelihood of performing a timely transplant. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00277-011-1392-zAuthors Anna Paola Iori, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyVeronica Valle, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyAlfonso Piciocchi, GIMEMA Data Center, Rome, ItalyGiovanna Meloni, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyGiovanni Fernando Torelli, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyAntonella Vitale, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyAnna Maria Testi, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyWalter Barberi, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyRoberto Ricci, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyFilippo Milano, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyBarbarella Lucarelli, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyMaria Screnci, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyMaria Paola Perrone, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyLuca Laurenti, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyFiammetta Natalino, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalySalvatore Perrone, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, ItalyNicoletta Sacchi, IBMDR E. O. Ospedali Galliera, Genoa, ItalyWilliam Arcese, Hemato-Oncology Transplant Unit, University Tor Vergata, Rome, ItalyRoberto Foà, Department of Hematology, Azienda Policlinico Umberto I, Sapienza University, Via Benevento 6, 00161 Rome, Italy Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Chronic lymphocytic leukemia and prolymphocytic leukemia with MYC translocations: a subgroup with an aggressive disease course

Abstract Translocations involving MYC are rare in chronic lymphocytic leukemia (CLL), and up to now, their prognostic significance remains unclear. We report the characteristics of 21 patients with CLL and nine patients with prolymphocytic leukemia (PLL), diagnosed in multiple centers (n = 13), which showed an MYC translocation demonstrated by fluorescence in situ hybridization. The prevalence was estimated to be <1%. Advanced age and male predominance were observed. Morphological analysis frequently revealed the presence of prolymphocytes. A typical “CLL-immunophenotype” was found in four of nine cases with PLL. Moreover, CD5 and CD23 were frequently expressed in PLL. The latter findings are atypical for PLL and may suggest transformation or progression of an underlying CLL. MYC translocations were frequently observed with concomitant adverse cytogenetic markers, such as del(11q) (n = 8/30) and/or del(17p)/monosomy 17 (n = 7/30). In addition, the presence of unbalanced translocations (n = 24 in 13/30 cases) and complex karyotype (n = 16/30) were frequent in cases with MYC translocations. Altogether, del(17p)/monosomy 17, del(11q), and/or complex karyotype were observed in 22 of 30 patients. Survival outcome was poor: the median time to treatment was only 5 months, and overall survival (OS) from clinical diagnosis and from genetic detection was 71 and 19 months, respectively. In conclusion, CLL/PLL with MYC translocations is a rare entity, which seems to be associated with adverse prognostic features and unfavorable outcome. Content Type Journal ArticleCategory Original ArticlePages 1-11DOI 10.1007/s00277-011-1393-yAuthors Natalie Put, Center for Human Genetics, Catholic University of Leuven, Herestraat 49, 3000 Leuven, BelgiumKatrien Van Roosbroeck, Center for Human Genetics, Catholic University of Leuven, Herestraat 49, 3000 Leuven, BelgiumPeter Konings, Department of Electrical Engineering/IBBT-K.U. Leuven Future Health Department, Catholic University of Leuven, Leuven, BelgiumPeter Meeus, Center for Human Genetics, Catholic University of Leuven, Herestraat 49, 3000 Leuven, BelgiumCaroline Brusselmans, Department of Clinical Biology, University Hospital Leuven, Leuven, BelgiumKatrina Rack, Center for Human Genetics, Institut de Pathologie et de Génétique, Gosselies, BelgiumCarine Gervais, Laboratoire de Cytogénétique, CHU de Hautepierre, Strasbourg, FranceFlorence Nguyen-Khac, Service d’Hématologie Biologique, Hôpital Pitié-Salpêtrière, Paris, FranceElise Chapiro, Service d’Hématologie Biologique, Hôpital Pitié-Salpêtrière, Paris, FranceIsabelle Radford-Weiss, Laboratoire de Cytogénétique, Hôpital Necker-Enfants Malades, Paris, FranceStéphanie Struski, Génétique des Hémopathies, CHU Toulouse, Toulouse, FranceNicole Dastugue, Génétique des Hémopathies, CHU Toulouse, Toulouse, FranceNathalie Gachard, Laboratoire de Cytogénétique, CHU Limoges, Limoges, FranceChristine Lefebvre, Laboratoire de Cytogénétique, CHU Grenoble, Grenoble, FranceCarole Barin, Laboratoire de Cytogénétique, CHU Tours, Tours, FranceVirginie Eclache, Hématologie biologique, Hôpital Avicenne, Bobigny, FranceSandra Fert-Ferrer, Laboratoire de Cytogénétique, Hôpital de Chambéry, Chambéry, FranceSophy Laibe, Département de Biopathologie, Institut Paoli-Calmettes, Marseille, FranceMarie-Joëlle Mozziconacci, Département de Biopathologie, Institut Paoli-Calmettes, Marseille, FranceBenoît Quilichini, Laboratoire Biomnis, Lyon, FranceHélène A. Poirel, Center for Human Genetics, Université catholique de Louvain, Brussels, BelgiumIwona Wlodarska, Center for Human Genetics, Catholic University of Leuven, Herestraat 49, 3000 Leuven, BelgiumAnne Hagemeijer, Center for Human Genetics, Catholic University of Leuven, Herestraat 49, 3000 Leuven, BelgiumYves Moreau, Department of Electrical Engineering/IBBT-K.U. Leuven Future Health Department, Catholic University of Leuven, Leuven, BelgiumPeter Vandenberghe, Center for Human Genetics, Catholic University of Leuven, Herestraat 49, 3000 Leuven, BelgiumLucienne Michaux, Center for Human Genetics, Catholic University of Leuven, Herestraat 49, 3000 Leuven, Belgiumon behalf of the BCGHo and the GFCH Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

The role of human leukocyte antigens as predisposing and/or protective factors in patients with idiopathic thrombotic thrombocytopenic purpura

Abstract Fifty-four adult German patients suffering from idiopathic thrombotic thrombocytopenic purpura (TTP) have been examined for HLA class II. All patients presented autoantibodies against ADAMTS13 and ADAMTS13 activity levels <5%. Blood samples have been analyzed for HLA-DRB1 and DQB1 alleles using sequence-specific primer PCR and sequence-specific oligonucleotide PCR. Reference data of German bone marrow and blood donors were obtained from www.allelefrequencies.net. The results were evaluated employing two-sided binomial tests, and p values were corrected using the Benjamini–Hochberg procedure. A significant accumulation for DQB1*02:02 (p < 0.001) and DRB1*11 (p = 0.003) was found within the patient group. Twenty percent (DQB1*02:02) or 48.1% (DRB1*11) of TTP patients were tested positive for the particular HLA antigen compared to 1.2% (DQB1*02:02) or 23.5% (DRB1*11) in the control group. A tendency for a reduced occurrence of HLA-DRB1*04 was revealed (7.4% in patients compared to 24.6% in controls). An association between the HLA antigens DQB1*02:02 and DRB1*11 and disease susceptibility for idiopathic TTP has been found. A higher risk for disease outbreak within persons carrying the mentioned alleles can be assumed. The reduced occurrence of HLA-DRB1*04 in TTP patients indicates a possible protective effect of this HLA allele in disease development. Content Type Journal ArticleCategory Original ArticlePages 1-4DOI 10.1007/s00277-011-1384-zAuthors Marie-Luise John, Department of Hematology, University Medical Center, Mainz, GermanyWalter Hitzler, Center for Transfusion Medicine, University Medical Center, Mainz, GermanyInge Scharrer, Department of Hematology, University Medical Center, Mainz, Germany Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Treatment of B cell lymphoma with chemotherapy plus rituximab: a survival benefit can be demonstrated in the routine data of a regional cancer registry

Abstract Combination of standard chemotherapy with rituximab led to improved disease control in patients with B cell lymphoma in clinical trials. We wanted to know if a similar benefit could be demonstrated in the routine data of a regional population-based cancer registry. We searched the registry of the Regensburg Tumor Center for B cell non-Hodgkin lymphomas diagnosed between 1998 and 2006 and compared overall survival of patients receiving any first-line chemotherapy with or without rituximab. Comparing registry data to death certificates, an 86% coverage within the registry was estimated. In the aggressive lymphoma group, 133 patients received rituximab-containing chemotherapy resulting in a 5-year survival of 69.6%, whereas 205 patients received chemotherapy alone with a significantly inferior 5-year survival of 56.8%. First-line chemotherapy with rituximab in 81 patients with indolent lymphoma also led to improved 5-year survival compared to 134 patients without rituximab (69.7% vs. 51.8%), primarily observed among patients with follicular lymphoma (84.7% vs. 52.0%). These data confirm the standard use of rituximab as first-line therapy in diffuse large B cell lymphomas as well as in indolent lymphoma. Furthermore, they support the collection of treatment data including detailed information on systemic therapy in cancer registries to be used for outcomes research. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00277-011-1361-6Authors Stefan W. Krause, Department of Hematology and Medical Oncology, University Hospital Erlangen, Erlangen, GermanyMichael Gerken, Tumorzentrum Regensburg, Regensburg, GermanyReinhard Andreesen, Tumorzentrum Regensburg, Regensburg, GermanyFerdinand Hofstädter, Tumorzentrum Regensburg, Regensburg, GermanyMonika Klinkhammer-Schalke, Tumorzentrum Regensburg, Regensburg, Germany Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

First report of incidence of adult myelodysplastic syndrome in China

First report of incidence of adult myelodysplastic syndrome in China Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-011-1389-7Authors Wei Wang, Hematology Department, Huashan Hospital of Fudan University, Wulumuqi Central Road No 12, Shanghai, 200040 ChinaHong Wang, Hematology Department, Huashan Hospital of Fudan University, Wulumuqi Central Road No 12, Shanghai, 200040 ChinaXiao-Qin Wang, Hematology Department, Huashan Hospital of Fudan University, Wulumuqi Central Road No 12, Shanghai, 200040 ChinaGuo-Wei Lin, Hematology Department, Huashan Hospital of Fudan University, Wulumuqi Central Road No 12, Shanghai, 200040 China Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Extreme eosinophilia in a setting of metastatic leiomyosarcoma: An unusual case report

Extreme eosinophilia in a setting of metastatic leiomyosarcoma: An unusual case report Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-011-1391-0Authors Arwa Z. Al-Riyami, Division of Hematological Pathology, Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, BC, CanadaPeter W. K. Tsang, Division of Hematology, University of British Columbia, Vancouver, BC, CanadaMonika Hudoba, Department of Pathology and Laboratory Medicine, Vancouver General Hospital and University of British Columbia, Vancouver, BC, Canada Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Plasmacytic differentiation in MALT lymphomas following treatment with rituximab

Abstract Mucosa-associated lymphoid tissue (MALT) lymphomas are B cell neoplasms which commonly affect the gastrointestinal (GI) tract. Gastrointestinal MALT lymphomas rarely show plasmacytic differentiation (PCD), and limited data on the potential influence of the anti-CD20 antibody rituximab (R) on PCD exist in the current literature. We have retrospectively analyzed patients with GI MALT lymphomas treated with R-containing regimens because restaging is routinely performed by repeated biopsies with pathohistological response assessment. Twenty-one patients with GI MALT lymphoma were identified to have undergone R-containing therapy. In 19 patients, the lymphoma originated in the stomach, while the colon was the primarily affected organ in two cases. Four patients received R monotherapy and 17 combinations of R with various chemotherapeutic agents. Only two patients with gastric MALT lymphoma had PCD before initiation of therapy. In 7 of 19 patients (37%) without PCD at diagnosis, restaging revealed PCD after or while on treatment with R-containing regimens. Out of these seven patients, only one patient had a complete response as opposed to 10/12 without PCD. These data suggest that R or R-containing treatment regimens may not optimally eradicate the plasma cell component and thus lead to PCD in patients with GI MALT lymphoma. In view of this, rebiopsy and histological re-assessment appear mandatory in patients failing/relapsing after R-containing regimens. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00277-011-1387-9Authors Marlene Troch, Division of Oncology, Department of Internal Medicine I, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Waehringer Guertel 18-20, 1090 Vienna, AustriaBarbara Kiesewetter, Division of Oncology, Department of Internal Medicine I, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Waehringer Guertel 18-20, 1090 Vienna, AustriaWerner Dolak, Division of Gastroenterology, Department of Internal Medicine III, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Vienna, AustriaUlrich Jaeger, Division of Haematology and Hemostaseology, Department of Internal Medicine I, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Vienna, AustriaAndreas Püspök, Division of Gastroenterology, Department of Internal Medicine III, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Vienna, AustriaLeonhard Müllauer, Division of Pathology, Department of Internal Medicine III, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Vienna, AustriaAndreas Chott, Division of Pathology, Department of Internal Medicine III, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Vienna, AustriaMarkus Raderer, Division of Oncology, Department of Internal Medicine I, Comprehensive Cancer Center of the Medical University Vienna—General Hospital, Waehringer Guertel 18-20, 1090 Vienna, Austria Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

High prevalence of hepatitis B virus infection in HIV-negative Castleman's disease

Abstract Castleman's disease (CD) is a rare non-neoplastic lymphoproliferative disorder with ambiguous etiology. This study aimed to evaluate the potential association between hepatitis B virus (HBV) and CD and to characterize the HBV-positive CD patients in China, an endemic area for HBV infection. We compared the prevalence of HBV infection in 35 consecutive CD patients initially diagnosed in our hospitals over a 10-year period with an age- and sex-matched healthy control, a national population-based control, and a non-Hodgkin's lymphoma (NHL) control. We found that the prevalence of HBV infection in CD was 17.1% (6/35), which was as high as the NHL control (19.9%, P = 0.693), but significantly higher than the age- and sex-matched healthy control (6.9%, P = 0.033) and the national population-based control (7.2%, P = 0.037). Next, we compared the clinicopathological characteristics between HBV-positive and HBV-negative CD patients. We found that HBV-positive CD patients had a significantly higher NHL malignant transformation rate (33.3% vs. 0%, P = 0.025), higher splenomegaly rate (83.3% vs. 27.6%, P = 0.019), and much poorer prognosis (estimated mean overall survival time (50.83 vs. 64.34 months, P = 0.016). In conclusion, our findings suggest an association between HBV infection and development of CD. CD patients with HBV infection have their own distinguished features. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00277-011-1388-8Authors Xiang-Gui Yuan, The Second Affiliated Hospital (Binjiang Branch), School of Medicine, Zhejiang University; Department of Internal Medicine, Hangzhou Binjiang Hospital, Hangzhou, China 310009Fei-Fei Chen, Department of Hematology, the First Affiliated Hospital, School of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, China 310003Yi-Miao Zhu, The Second Affiliated Hospital (Binjiang Branch), School of Medicine, Zhejiang University; Department of Internal Medicine, Hangzhou Binjiang Hospital, Hangzhou, China 310009Wen Hu, The Second Affiliated Hospital (Binjiang Branch), School of Medicine, Zhejiang University; Department of Internal Medicine, Hangzhou Binjiang Hospital, Hangzhou, China 310009Xiao-Ying Zhao, Department of Hematology, the Second Affiliated Hospital, School of Medicine, Zhejiang University, #88 Jiefang Road, Hangzhou, China 310009Jie Jin, Department of Hematology, the First Affiliated Hospital, School of Medicine, Zhejiang University, #79 Qingchun Road, Hangzhou, China 310003 Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

A novel ELISA for diagnosis of Glanzmann’s thrombasthenia and the heterozygote carriers

Abstract A sensitive and specific sandwich ELISA was developed for the diagnosis of Glanzmann’s thrombasthenia (GT) and the heterozygote carriers of the disease using whole blood platelets. The assay used anti-CD36 antibody to capture platelets from platelet-rich plasma which was subsequently treated with a bioengineered disintegrin/alkaline phosphatase hybrid protein specific for GP IIb/IIIa. The test allows large number of samples to be typed and can also be used on stored samples. The assay correctly diagnosed 40 normal healthy individuals, 10 GT cases, 10 heterozygotes, 3 Bernard–Soulier syndrome cases and 2 type 3 GT cases. ELISA plates were stable at room temperature up to 3 weeks without any loss of activity. This novel and simple test can be widely used for heterozygote detection besides diagnosing GT cases without using a sophisticated flow cytometer or a platelet aggregometer and has wide applicability in countries like India where many of these cases remain undiagnosed due to the lack of diagnostic facilities. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00277-011-1390-1Authors Vivian Lobo, National Institute of Immunohematology (I.C.M.R.), 13th floor, KEM. Hospital Campus, Parel, Mumbai, 400012 IndiaShrimati Shetty, National Institute of Immunohematology (I.C.M.R.), 13th floor, KEM. Hospital Campus, Parel, Mumbai, 400012 IndiaBipin Kulkarni, National Institute of Immunohematology (I.C.M.R.), 13th floor, KEM. Hospital Campus, Parel, Mumbai, 400012 IndiaKanjaksha Ghosh, National Institute of Immunohematology (I.C.M.R.), 13th floor, KEM. Hospital Campus, Parel, Mumbai, 400012 India Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Serum soluble interleukin-2 receptor (sIL-2R) level is associated with the outcome of patients with diffuse large B cell lymphoma treated with R-CHOP regimens

Abstract Serum concentration of soluble interleukin-2 receptor (sIL-2R) predicts the clinical outcome of patients with aggressive non-Hodgkin's lymphoma treated with the cyclophosphamide, doxorubicin, vincristine, and prednisolone (CHOP) regimen without rituximab. In the present study, we aim to re-assess the prognostic significance of serum sIL-2R for diffuse large B cell lymphoma (DLBCL) patients treated with CHOP plus rituximab and to assess sIL-2R with subtype of DLBCL, such as GCB type and non-GCB type. Two hundred and thirty-three patients with DLBCL were enrolled between December 2002 and March 2008. To evaluate serum levels of sIL-2R, venous blood samples were drawn from patients immediately before initiation of treatment. Serum sIL-2R was determined by sandwich enzyme-linked immunosorbent assay. The 5-year overall survival (OS) rates for patients with sIL-2R levels of ≥2,000 (110 cases) and <2,000 U/mL (123 cases) were 54.2% and 89.0% (P < 0.0001), respectively. Multivariate analysis using the proportional-hazards model revealed that serum sIL-2R (P = 0.0099) and extranodal involvement sites (P = 0.0392) were independent prognostic factors for OS and that clinical stage (P = 0.0168), performance status (P = 0.0181), sIL-2R (P = 0.0232), and LDH (P = 0.0316) were independent prognostic factors for progression-free survival in sIL-2R and every factor of the International Prognostic Index. Serum sIL-2R might be a useful prognostic factor for DLBCL patients in the rituximab era. Content Type Journal ArticleCategory Original ArticlePages 1-10DOI 10.1007/s00277-011-1363-4Authors Naoe Goto, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194 JapanHisashi Tsurumi, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194 JapanHideko Goto, Second Department of Internal Medicine, Gifu Municipal Hospital, Gifu, JapanYoriko Ino Shimomura, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194 JapanSenji Kasahara, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194 JapanTakeshi Hara, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194 JapanIchiro Yasuda, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194 JapanMasahito Shimizu, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194 JapanNobuo Murakami, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194 JapanTakeshi Yoshikawa, Department of Internal Medicine, Kisogawa Hospital, Aichi, JapanKenji Fukuno, Second Department of Internal Medicine, Gifu Municipal Hospital, Gifu, JapanTakeshi Takahashi, Second Department of Internal Medicine, Gifu Municipal Hospital, Gifu, JapanYusuke Kito, Department of Immunopathology, Gifu University Graduate School of Medicine, Gifu, JapanTsuyoshi Takami, Department of Immunopathology, Gifu University Graduate School of Medicine, Gifu, JapanHisataka Moriwaki, First Department of Internal Medicine, Gifu University Graduate School of Medicine, 1-1 Yanagido, Gifu, 501-1194 Japan Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Extracorporeal light chain elimination: high cut-off (HCO) hemodialysis parallel to chemotherapy allows for a high proportion of renal recovery in multiple myeloma patients with dialysis-dependent acute kidney injury

Abstract Acute kidney injury (AKI) is frequent in multiple myeloma (MM) patients and strongly affects prognosis, with particularly poor outcomes in patients requiring hemodialysis. Introduction of the novel therapeutic agents to MM therapy has improved myeloma response and renal outcome. This case series reviews the efficacy of combined systemic and extracorporeal therapy to further optimize time to light chain (serum-free light chain (sFLC)) reduction and renal recovery in MM patients with dialysis-dependent AKI (n = 19). High cut-off (HCO) hemodialysis for extracorporeal sFLC removal was initiated in parallel to chemotherapy. Combined therapy resulted in early sFLC response after a median of 13 (range 4–48) days and 6 (3–22) HCO hemodialysis sessions. Time to sFLC response was shorter in patients recovering renal function. Median time to dialysis independence was 15 (4–64) days. By intent-to-treat analysis, sustained renal recovery was achieved in 73.7% (77.8% adjusted for death) of patients. In multivariate analysis, duration of AKI prior to initiation of therapy was an independent predictor of renal functional outcome. Combining HCO hemodialysis for extracorporeal sFLC elimination and effective chemotherapy is a novel treatment strategy allowing for early and sustained sFLC reduction and a high proportion of renal recovery in these patients. Timely diagnosis and onset of therapy is essential for improving renal outcome. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00277-011-1383-0Authors Nils Heyne, Department of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Tübingen, GermanyBarbara Denecke, Department of Hematology, Oncology and Immunology, University of Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, GermanyMartina Guthoff, Department of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Tübingen, GermanyKatharina Oehrlein, Department of Hematology, Oncology and Immunology, University of Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, GermanyLothar Kanz, Department of Hematology, Oncology and Immunology, University of Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, GermanyHans-Ulrich Häring, Department of Endocrinology and Diabetology, Angiology, Nephrology and Clinical Chemistry, University of Tübingen, Tübingen, GermanyKatja C. Weisel, Department of Hematology, Oncology and Immunology, University of Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, Germany Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

A useful relationship between the presence of extramedullary erythropoeisis and the level of the soluble form of the transferrin receptor in a large cohort of adult patients with thalassemia intermedia: a prospective study

Abstract In thalassemia intermedia (TI), the increase in bone marrow hemopoietic activity frequently leads to extramedullary erythropoeisis (EMH), but its relationship with the soluble form of transferrin receptor (sTfR) which fully reflects the marrow erythropoietic activity, has not yet been explored. From January 2007 to December 2010, all TI patients attending at our center were prospectively enrolled to undergo sTfR assay and MRI or CT (if claustrophobic) scan evaluation for the presence of paraspinal EMH. A total of 59 patients with TI were studied; EMH involved 23 (39%) patients; overall, the concentration of sTfR varied from 2.6 to 20.6 (mean = 8.7) mg/L, but in splenectomized group and in unsplenectomized group, it varied from 4.2 to 17.8 (mean ± SD = 9.86 ± 3.33) mg/L and from 2.6 to 20.6 (mean ± SD = 7.25 ± 3.9) mg/L, respectively with a statistically significant intergroup difference (p < 0.01). The cutoff point at 8.6 mg/L using the ROC curve showed a sensitivity of 78.3% and a specificity of 72.2%, in predicting EMH but, in unsplenectomized subgroup, they raised to 100% and 90.9%, respectively. These data showed that in TI the level of sTfR could represent a predictive factor of EMH particularly in patients with spleen. Content Type Journal ArticleCategory Original ArticlePages 1-5DOI 10.1007/s00277-011-1385-yAuthors Paolo Ricchi, UOSD Centro delle Microcitemie “A. Mastrobuoni”, AORN A. Cardarelli, Naples, ItalyMassimiliano Ammirabile, UOSD Centro delle Microcitemie “A. Mastrobuoni”, AORN A. Cardarelli, Naples, ItalySilvia Costantini, UOSD Centro delle Microcitemie “A. Mastrobuoni”, AORN A. Cardarelli, Naples, ItalyTiziana Di Matola, UOC Clinical Pathology, AORN Monaldi-Cotugno-CTO, Naples, ItalyRoberto Verna, Clinical Research Center, Sapienza University, Rome, ItalyAlvaro Diano, UOC Neuroradiology AORN Cardarelli, Naples, ItalyMaria Carmela Foglia, UOS Immunopathology AORN Cardarelli, Naples, ItalyAnna Spasiano, UOSD Centro delle Microcitemie “A. Mastrobuoni”, AORN A. Cardarelli, Naples, ItalyPatrizia Cinque, UOSD Centro delle Microcitemie “A. Mastrobuoni”, AORN A. Cardarelli, Naples, ItalyLuciano Prossomariti, UOSD Centro delle Microcitemie “A. Mastrobuoni”, AORN A. Cardarelli, Naples, Italy Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

No association between Agent Orange exposure and monoclonal gammopathies

No association between Agent Orange exposure and monoclonal gammopathies Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-011-1382-1Authors Jignesh G. Parikh, Department of Pathology, University of Tennessee Health Science Center, Memphis, TN, USAEugene Pearlman, Department of Pathology, University of Tennessee Health Science Center, Memphis, TN, USA Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Rituximab in combination with CHOP chemotherapy for the treatment of diffuse large B cell lymphoma in China: a 10-year retrospective follow-up analysis of 437 cases from Shanghai Lymphoma Research Group

Abstract The purpose of the study is to evaluate the 10 years follow-up of the efficacy in Chinese patients receiving cyclophosphamide, doxorubicin/epirubicin, vincristine, and prednisone (CHOP) or rituximab plus CHOP (R-CHOP) regimen as the initial treatment for diffuse large B cell lymphoma (DLBCL). We have retrospectively analyzed 437 patients with DLBCL who were newly diagnosed and received CHOP or R-CHOP regimen in six university hospitals and closely followed up after the completion of treatment. For all patients, there were significant differences between R-CHOP and CHOP for overall survival (OS) (median follow-up 86 months, 84.1% vs 70.2%, p = 0.018) and progression-free survival (PFS) (81.5% vs 66.7%, p = 0.015), while elder patients (>60 years old) received higher OS (median follow-up 66 months, 80.7% vs 53.0%, p = 0.011). But for younger patients (≤60 years old), the treatments with rituximab did not demonstrate a significant effect on OS (85.5% vs 79.4%, p = 0.428). In the R-CHOP group, International Prognostic Index (IPI) distinguished three risk groups instead of four risk groups. But in the CHOP group, IPI still distinguished four risk groups. Furthermore, for 212 of 437 patients diagnosed with extranodal involvement DLBCL, R-CHOP regimen provided a longer OS than CHOP regimen did (OS, 89.9% vs 71.7%, p = 0.014). Moreover, patients with extranodal lymphoma had a significant longer survival in rituximab era (OS, 89.9% vs 79.2% for extranodal and nodal, respectively; p = 0.048). The results of this large-scale study suggested that R-CHOP provided a greater survival benefit in the initial treatment of DLBCL. As for the patients with extranodal lymphoma, R-CHOP was also a good choice as first-line treatment. Extranodal disease seems to be an independent good prognostic factor in rituximab era. Content Type Journal ArticleCategory Original ArticlePages 1-9DOI 10.1007/s00277-011-1375-0Authors Xiaoyang Li, Department of Hematology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin No. 2 Road, Shanghai, 200025 People’s Republic of ChinaZhao Liu, Department of Hematology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin No. 2 Road, Shanghai, 200025 People’s Republic of ChinaJunning Cao, Department of Medical Oncology, Fudan University Shanghai Cancer center, Shanghai, ChinaXiaonan Hong, Department of Medical Oncology, Fudan University Shanghai Cancer center, Shanghai, ChinaJianmin Wang, Changhai Hospital, Shanghai, ChinaFangyuan Chen, Renji Hospital, Shanghai, ChinaChun Wang, Shanghai No. 1 People’s Hospital, Shanghai, ChinaShanhua Zou, Zhongshan Hospital, Shanghai, ChinaJunmin Li, Department of Hematology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin No. 2 Road, Shanghai, 200025 People’s Republic of ChinaZhixiang Shen, Department of Hematology, Ruijin Hospital Affiliated to Shanghai Jiaotong University School of Medicine, 197 Ruijin No. 2 Road, Shanghai, 200025 People’s Republic of China Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Clinical features of adult patients with secondary hemophagocytic lymphohistiocytosis from causes other than lymphoma: an analysis of treatment outcome and prognostic factors

Abstract Although hemophagocytic syndrome (HS) featuring secondary hemophagocytic lymphohistiocytosis (HLH) has a grave prognosis, little is known about the natural course of the disease. Patients who showed the clinical features of HLH as well as tissue-proven hemophagocytosis when seen at Asan Medical Center between 1999 and 2010 were included in this analysis. Patients with proven lymphoma were excluded. The median age of our 23 study patients was 49 years. Epstein–Barr virus was suspected to have caused HS in 16 (70%) patients and hepatitis A virus in one patient. Twenty-two patients were treated, 13 according to the HLH protocol and nine using immunosuppressive agents such as corticosteroid and/or cyclosporine. Five patients undertook allogeneic hematopoietic cell transplantation (HCT) during their treatment-dependent relapse (n = 4) or responsive status (n = 1). After the median follow-up of 180 days, 17 (74%) died and six (26%) were alive. The median time from initial presentation until death was 41 days among those patients who died. The serum fibrinogen level ≥166 mg/dL determined at the initial visit was significantly associated with the survival time according to univariate analysis. The low histiocyte proportion in bone marrow and early initiation of treatment tended to correlate with a favorable outcome. On multivariate analysis, serum fibrinogen ≥166 mg/dL (hazard ratio, 0.175, P = 0.018) was an independent clinical factor for determining the patient survival time. Despite appropriate patient management, the outcome of HS featuring HLH was grave. The serum fibrinogen level at the initial presentation was significant, and selected patients obtained some benefit from allogeneic HCT. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00277-011-1380-3Authors Han-Seung Park, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaDae-Young Kim, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaJe-Hwan Lee, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaJung-Hee Lee, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaSung-Doo Kim, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaYoung-Hun Park, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaJae Seok Lee, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaBo Youn Kim, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaMijin Jeon, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaYoung-Ah Kang, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaYoung-Shin Lee, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaMiee Seol, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaYeon-Joo Lee, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaYoung-Suk Lim, Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaSeongsoo Jang, Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaChan-Jeoung Park, Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaHyun-Sook Chi, Department of Laboratory Medicine, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of KoreaKyoo-Hyung Lee, Department of Hematology, Asan Medical Center, University of Ulsan College of Medicine, Asanbyeongwon-gil 86, Songpa-gu, Seoul, 138-736 Republic of Korea Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Prognostic value of red blood cell parameters and ferritin in predicting deferral due to low hemoglobin in whole blood donors

Abstract Risk factors for deferral from red blood cell (RBC) donation due to low hemoglobin are not well defined. We analyzed in a large cohort of returning donors the prognostic value of RBC parameters and serum ferritin regarding low hemoglobin levels at the subsequent visit. Between 2004 and 2009, RBC indices and serum ferritin were recorded in 45,533 visits by 7,994 donors. In 689 instances, donation was deferred at the subsequent visit due to low hemoglobin levels (<123 g/l for female donors, <133 g/l for male donors). Pre-donation hemoglobin at the current visit correlated best with hemoglobin at the subsequent visit (R 2 = 0.63), whereas other RBC indices and serum ferritin correlated only poorly (R 2 ≤ 0.15). Similar results were obtained in ROC curve analysis and in multivariable binary logistic regression. A pre-donation hemoglobin within 5 g/l from the deferral threshold (<128 g/l for female, <138 g/l for male donors) predicted below-threshold hemoglobin levels at the subsequent visit with a sensitivity of 52% and a specificity of 94%. In conclusion, pre-donation hemoglobin is a useful marker identifying donors at risk of developing low hemoglobin levels. Diagnostic and therapeutic interventions should be aimed at donors presenting with hemoglobin levels near the threshold of donor deferral. Content Type Journal ArticleCategory Original ArticlePages 1-6DOI 10.1007/s00277-011-1371-4Authors Martin Stern, Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, SwitzerlandAlix O’Meara, Division of Hematology, Department of Internal Medicine, University Hospital Basel, Basel, SwitzerlandLaura Infanti, Blood Transfusion Center, Swiss Red Cross, Basel, Hebelstrasse 10, 4031 Basel, SwitzerlandJoerg-Peter Sigle, Blood Transfusion Center, Swiss Red Cross, Basel, Hebelstrasse 10, 4031 Basel, SwitzerlandAndreas Buser, Blood Transfusion Center, Swiss Red Cross, Basel, Hebelstrasse 10, 4031 Basel, Switzerland Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Lymphoma with specific affinity to endocrine organs

Lymphoma with specific affinity to endocrine organs Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-011-1372-3Authors Ken Morita, Department of Hematology & Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanFumihiko Nakamura, Department of Hematology & Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanYasuhito Nannya, Department of Hematology & Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanYasuhiko Kamikubo, Department of Hematology & Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanMotoshi Ichikawa, Department of Hematology & Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, JapanMineo Kurokawa, Department of Hematology & Oncology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Anti-thrombin-III reduction and posterior reversible encephalopathy syndrome (PRES) in acute lymphoblastic leukaemia (ALL). New insight into PRES pathophysiology

Anti-thrombin-III reduction and posterior reversible encephalopathy syndrome (PRES) in acute lymphoblastic leukaemia (ALL). New insight into PRES pathophysiology Content Type Journal ArticleCategory Letter to the EditorPages 1-3DOI 10.1007/s00277-011-1376-zAuthors Andrea Piccin, Department of Haematology and Bone Marrow Transplant Unit, San Maurizio Regional Hospital, Bolzano, South Tyrol, ItalyRoberto Currò Dossi, Stroke Unit, Department of Internal Medicine, San Maurizio Regional Hospital, Bolzano, South Tyrol, ItalyVincenzo Cassibba, Department of Haematology and Bone Marrow Transplant Unit, San Maurizio Regional Hospital, Bolzano, South Tyrol, ItalySigmund Stupnner, Department of Radiology, San Maurizio Regional Hospital, Bolzano, South Tyrol, ItalyGiampietro Bonatti, Department of Radiology, San Maurizio Regional Hospital, Bolzano, South Tyrol, ItalySergio Cortelazzo, Department of Haematology and Bone Marrow Transplant Unit, San Maurizio Regional Hospital, Bolzano, South Tyrol, Italy Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Aberrant expression of myeloid and B cell markers in an aggressive multiple-site myeloid sarcoma

Aberrant expression of myeloid and B cell markers in an aggressive multiple-site myeloid sarcoma Content Type Journal ArticleCategory Letter to the EditorPages 1-3DOI 10.1007/s00277-011-1378-xAuthors Georgia D. Kaiafa, Department of Haematology, First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA General Hospital, 1 S. Kiriakidi St, 546 36 Thessaloniki, GreeceVasilios Perifanis, Department of Haematology, First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA General Hospital, 1 S. Kiriakidi St, 546 36 Thessaloniki, GreeceMichael D. Diamantidis, Department of Haematology, First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA General Hospital, 1 S. Kiriakidi St, 546 36 Thessaloniki, GreeceOlga Giouleme, Department of Gastroenterology, First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA General Hospital, Thessaloniki, GreeceVirginia Voulgaridou, Department of Haematology, First Propedeutic Department of Internal Medicine, Aristotle University of Thessaloniki, AHEPA General Hospital, 1 S. Kiriakidi St, 546 36 Thessaloniki, GreeceEleni Beretouli, Department of Pathology, Aristotle University of Thessaloniki, Thessaloniki, GreeceAnna Kalogera-Fountzila, Department of Radiology, AHEPA General Hospital, Aristotle University of Thessaloniki, Thessaloniki, GreeceVassiliki Kaloutsi, Department of Pathology, Aristotle University of Thessaloniki, Thessaloniki, Greece Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Neurolymphomatosis: role of positron emission tomography in diagnosis

Neurolymphomatosis: role of positron emission tomography in diagnosis Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-011-1379-9Authors Carol Cheung, Department of Medicine, Queen Mary Hospital, Professorial Block, Pokfulam Road, Hong Kong, ChinaDavid Lopes, Department of Haematology, Hospital Conde S. Januario, Macau, ChinaKwan-Ngai Hung, Department of Surgery, Queen Mary Hospital, Hong Kong, ChinaTao Chan, Department of Diagnostic Radiology, Queen Mary Hospital, Hong Kong, ChinaKwok-Wah Chan, Department of Pathology, Queen Mary Hospital, Hong Kong, ChinaYok-Lam Kwong, Department of Medicine, Queen Mary Hospital, Professorial Block, Pokfulam Road, Hong Kong, China Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

A prospective survey of febrile events in hematological malignancies

Abstract The Hema e-Chart prospectively collected data on febrile events (FEs) in hematological malignancy patients (HMs). The aim of the study was to assess the number, causes and outcome of HM-related FEs. Data were collected in a computerized registry that systematically approached the study and the evolution of FEs developing in a cohort of adult HMs who were admitted to 19 hematology departments in Italy from March 2007 to December 2008. A total of 869 FEs in 3,197 patients with newly diagnosed HMs were recorded. Fever of unidentified origin (FUO) was observed in 386 cases (44.4%). The other causes of FE were identified as noninfectious in 48 cases (5.5%) and infectious in 435 cases (50.1%). Bacteria were the most common cause of infectious FEs (301 cases), followed by fungi (95 cases), and viruses (7 cases). Mixed agents were isolated in 32 episodes. The attributable mortality rate was 6.7% (58 FEs). No deaths were observed in viral infection or in the noninfectious groups, while 25 deaths were due to FUO, 16 to bacterial infections, 14 to fungal infections, and three to mixed infections. The Hema e-Chart provided a complete system for the epidemiological study of infectious complications in HMs. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00277-011-1373-2Authors L. Pagano, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, I-00168 Roma, ItalyM. Caira, Istituto di Ematologia, Università Cattolica del Sacro Cuore, Largo Francesco Vito, 1, I-00168 Roma, ItalyG. Rossi, U.O. Ematologia, Spedali Civili, Brescia, ItalyM. Tumbarello, Istituto di Malattie Infettive, Università Cattolica S. Cuore, Roma, ItalyR. Fanci, Azienda Osp. Univ. Careggi, Ematologia, Firenze, ItalyM. G. Garzia, Divisione di Ematologia Az. Osp. S. Camillo Forlanini, Roma, ItalyN. Vianelli, Istituto Seragnoli, Università di Bologna, Bologna, ItalyN. Filardi, Ematologia, Azienda Osp. Osp. S. Carlo, Potenza, ItalyP. De Fabritiis, Ematologia, Ospedale S. Eugenio, Roma, ItalyA. Beltrame, U.O. Ematologia Pol. Univ. Tor Vergata, Roma, ItalyM. Musso, Dipartimento di Ematoncologia ed Unità Trap. Mid. Osseo, La Maddalena, Palermo, ItalyA. Piccin, Divione di Ematologia, Ospedale Generale di Bolzano, Bologna, ItalyA. Cuneo, Istituto di Ematologia, Az. Osp. Univ. Arcispedale S. Anna, Ferrara, ItalyC. Cattaneo, U.O. Ematologia, Spedali Civili, Brescia, ItalyT. Aloisi, Istituto di Ematologia, Università di Perugia, Perugia, ItalyM. Riva, Divisione di Ematologia e Centro Trapianti Midollo, Ospedale Niguarda Ca’ Granda, Milano, ItalyG. Rossi, Unità di Ematologia, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, ItalyU. Salvadori, Divisione di Ematologia, Ospedale Civile “Ca Foncello”, Treviso, ItalyM. Brugiatelli, Ematologia, Ospedale Papardo, Messina, ItalyS. Sannicolò, Divisione di Ematologia, Umberto I, Mestre, ItalyM. Morselli, Divisione di Ematologia, Policlinico Universitario di Modena e Reggio, Modena, ItalyA. Bonini, Divisione di Ematologia, Arciospedale S. Maria Nuova, Reggio Emilia, ItalyP. Viale, Clinica di Malattie Infettive, Università di Bologna, Bologna, ItalyA. Nosari, Divisione di Ematologia e Centro Trapianti Midollo, Ospedale Niguarda Ca’ Granda, Milano, ItalyF. Aversa, Istituto di Ematologia, Università di Perugia, Perugia, Italyfor the Hema e-Chart Group, Italy Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Spondylodiscitis from infection of central venous line inserted for haemophilia prophylaxis

Spondylodiscitis from infection of central venous line inserted for haemophilia prophylaxis Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-011-1374-1Authors Jecko Thachil, Department of Haematology, Roald Dahl Haemostasis and Thrombosis Centre, Royal Liverpool University Hospital, Liverpool, L7 8XP UKArvind Pillai, Department of Haematology, Roald Dahl Haemostasis and Thrombosis Centre, Royal Liverpool University Hospital, Liverpool, L7 8XP UKVanessa Martlew, Department of Haematology, Roald Dahl Haemostasis and Thrombosis Centre, Royal Liverpool University Hospital, Liverpool, L7 8XP UK Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Lessons from an incidental diagnosis of paroxysmal nocturnal haemoglobinuria

Lessons from an incidental diagnosis of paroxysmal nocturnal haemoglobinuria Content Type Journal ArticleCategory Letter to the EditorPages 1-2DOI 10.1007/s00277-011-1362-5Authors Jecko Thachil, Department of Haematology, Roald Dahl Haemostasis and Thrombosis Centre, Royal Liverpool University Hospital, L7 8XP, Liverpool, UKTim Webster, Department of Stroke Medicine, Royal Liverpool University Hospital, L7 8XP, Liverpool, UKRichard Kelly, Department of Haematology, Leeds Teaching Hospitals, Leeds, UKPeter Hillmen, Department of Haematology, Leeds Teaching Hospitals, Leeds, UKVanessa Martlew, Department of Haematology, Roald Dahl Haemostasis and Thrombosis Centre, Royal Liverpool University Hospital, L7 8XP, Liverpool, UKAnita Hill, Department of Haematology, Leeds Teaching Hospitals, Leeds, UK Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Detection of SET-NUP214 rearrangement using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) in acute leukemias: a case report and literature review on a Korean case series

Detection of SET-NUP214 rearrangement using multiplex reverse transcriptase-polymerase chain reaction (RT-PCR) in acute leukemias: a case report and literature review on a Korean case series Content Type Journal ArticleCategory Letter to the EditorPages 1-4DOI 10.1007/s00277-011-1366-1Authors Eun Young Lee, Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of KoreaTae Sung Park, Department of Laboratory Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of KoreaMin Jin Kim, Department of Laboratory Medicine, School of Medicine, Kyung Hee University, Seoul, Republic of KoreaMyung Hee Chang, Department of Internal Medicine, National Health Insurance Corporation Ilsan Hospital, Goyang, Republic of KoreaEun Hae Cho, Greencross Reference Laboratory, Yongin, Republic of KoreaSeo-Jin Park, Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of KoreaJong Rak Choi, Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of KoreaJong-Ha Yoo, Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Genomic analysis of a four-way t(4;11;22;10) associated with MLL-AF4 in an adult acute lymphoblastic leukemia

Genomic analysis of a four-way t(4;11;22;10) associated with MLL-AF4 in an adult acute lymphoblastic leukemia Content Type Journal ArticleCategory Letter to the EditorPages 1-3DOI 10.1007/s00277-011-1364-3Authors Sun Young Cho, Department of Laboratory Medicine, Kyung Hee University School of Medicine, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702 South KoreaTae Sung Park, Department of Laboratory Medicine, Kyung Hee University School of Medicine, 1 Hoegi-dong, Dongdaemun-gu, Seoul, 130-702 South KoreaSeung Hwan Oh, Department of Laboratory Medicine, College of Medicine, Inje University, GaeGeum-dong, Busanjin-gu, Busan, 614-735 South KoreaEun Hae Cho, Greencross Reference Laboratory, 314 Bojeong-dong, Kiheung-gu, Yongin-city, Gyeonggi-do, South KoreaDoyeun Oh, Division of Hematology-Oncology, Department of Internal Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, South KoreaJi Young Huh, Department of Laboratory Medicine, CHA Bundang Medical Center, CHA University, Seongnam, Gyeonggi-do, South KoreaRolf Marschalek, Institute of Pharmaceutical Biology, ZAFES, Diagnostic Center of Acute Leukemia, Goethe-University of Frankfurt, Biocenter, Max-von-Laue-Str. 9, 60438 Frankfurt/Main, GermanyClaus Meyer, Institute of Pharmaceutical Biology, ZAFES, Diagnostic Center of Acute Leukemia, Goethe-University of Frankfurt, Biocenter, Max-von-Laue-Str. 9, 60438 Frankfurt/Main, Germany Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Identification of patients with indolent B cell lymphoma sensitive to rituximab monotherapy

Abstract The potential predictive value of tumor bulk, genetic, and immunological variants in patients with low-grade non-Hodgkin's lymphoma to respond to treatment with rituximab (RTX) monotherapy was evaluated. Thus, the value of assessing the effect of 18-fluoro-desoxy-d-glucose (FDG) uptake on PET scan, polymorphisms in Fc gamma receptor (FcγR) IIIa-158, FcγRIIa-131, and C1qA-276 genes in predicting the response to treatment were evaluated in 50 low-grade non-Hodgkin's lymphoma patients. The influence of RTX pharmacokinetics, plasma levels of the B cell-activating factor (BAFF), and human antichimeric antibodies was also investigated. The therapeutic response was evaluated 10 weeks after treatment using revised Cheson's criteria. Lower maximal standardized uptake values (SUVmax) at baseline were predictive of complete response. FcγRIIIa-158 polymorphism was also associated with complete response to RTX confirming previous findings, whereas polymorphisms in the FcγRIIa-131 and C1qA-276 genes were not. Lower blood levels of RTX were observed in males, but the effectiveness of RTX in males and females was the same. BAFF was not detectable in plasma before or after treatment, and no patients developed human antichimeric antibodies. Low-grade non-Hodgkin's lymphoma patients with a low SUVmax at baseline and an FcγRIIIa-158 V/V genotype generally had a complete response to RTX. Content Type Journal ArticleCategory Original ArticlePages 1-7DOI 10.1007/s00277-011-1369-yAuthors Divi Cornec, EA2216 “Immunology and Pathology” and IFR146 “ScInBios”, Université Européenne de Bretagne, Brest, FranceAdrian Tempescul, Department of Clinical Oncology, Brest University Medical School Hospital, Brest, FranceSolène Querellou, Unit of Nuclear Medicine, Brest University Medical School Hospital, Brest, FrancePascal Hutin, EA2216 “Immunology and Pathology” and IFR146 “ScInBios”, Université Européenne de Bretagne, Brest, FranceJacques-Olivier Pers, EA2216 “Immunology and Pathology” and IFR146 “ScInBios”, Université Européenne de Bretagne, Brest, FranceChristophe Jamin, EA2216 “Immunology and Pathology” and IFR146 “ScInBios”, Université Européenne de Bretagne, Brest, FranceBoutahar Bendaoud, EA2216 “Immunology and Pathology” and IFR146 “ScInBios”, Université Européenne de Bretagne, Brest, FranceChristian Berthou, EA2216 “Immunology and Pathology” and IFR146 “ScInBios”, Université Européenne de Bretagne, Brest, FranceYves Renaudineau, EA2216 “Immunology and Pathology” and IFR146 “ScInBios”, Université Européenne de Bretagne, Brest, FrancePierre Youinou, EA2216 “Immunology and Pathology” and IFR146 “ScInBios”, Université Européenne de Bretagne, Brest, France Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Course of serum 25-hydroxyvitamin D3 status and its influencing factors in adults undergoing allogeneic hematopoietic cell transplantation

Abstract Hypovitaminosis D (<30 ng/ml) is highly prevalent in allogeneic hematopoietic cell transplantation (alloHCT), but the relevance of influencing factors for serum 25-hydroxyvitamin D3 [25(OH)D3] status in adult patients remains unknown. We are the first to have prospectively assessed 25(OH)D3 status and its influencing factors in 102 patients before and at days +30 and +100 after alloHCT. Among others, we evaluated age, gender, weight, fat mass, season, sun exposure habits, and dietary and supplemental vitamin D intake as factors potentially influencing baseline vitamin D status in uni- and multivariate linear regression analysis. Furthermore, we investigated the impact of changes in fat mass, duration of parenteral nutrition, and acute graft-versus-host disease (aGVHD) on the course of serum 25(OH)D3. Baseline 25(OH)D3 concentrations were 16.4 ± 8.9 ng/ml, revealing that the majority (89%) had concentrations beneath the normal range. In multivariate linear regression model, only higher body fat mass remained an independent risk factor for reduced baseline 25(OH)D3 concentrations (P = 0.007). In the early post-transplant period, 25(OH)D3 status remained low, revealing a tendency to further deterioration, especially in patients with corticosteroid-treated aGVHD (≥II). Reduced vitamin D status was very common in these patients before and after alloHCT, whereby the most important influencing factors, namely season and dietary factors seem to have little impact. Our findings suggest that monitoring and if necessary, correcting vitamin D status may be indicated at regular intervals before alloHCT and during long-term follow-up. Further investigations of these patients' vitamin D requirements are needed, especially if they are on long-term corticosteroids. Content Type Journal ArticleCategory Original ArticlePages 1-8DOI 10.1007/s00277-011-1365-2Authors Paul Urbain, Department of Hematology/Oncology, Section of Nutrition, Albert Ludwigs-University Medical Center Freiburg, Hugstetter Str 55, 79106 Freiburg, GermanyGabriele Ihorst, Clinical Trials Unit, Albert Ludwigs-University Medical Center Freiburg, Freiburg, GermanyHans-Konrad Biesalski, Department of Biological Chemistry and Nutrition, University of Hohenheim, Stuttgart, GermanyHartmut Bertz, Department of Hematology/Oncology, Section of Allogeneic Stem Cell Transplantation, Albert Ludwigs-University Medical Center Freiburg, Freiburg, Germany Journal Annals of HematologyOnline ISSN 1432-0584Print ISSN 0939-5555

Hematology-Oncology jobs

All Hematology-Oncology jobs for Tue Feb 7 2012

Hematology-Oncology jobs in "Hospital Based Practice Opportunity for an Oncologist in the Southeast" - GA

Job 941229 Hospital Based Practice Opportunity for an Oncologist in the Southeast Join 4 Oncologists in an expanding practice Practicing physicians and fellows will all be considered Clinical trials

Hematology-Oncology jobs in "Hospital Employed Hematology Oncology Opportunity in Southern Virginia" - VA

Job 921917 Hospital is recruiting 2 Oncologist to make their program a 3 person group. The hospital will offer a full patient base upon arrival and great security. Compensation will be based on MGMA

Hematology-Oncology jobs in "Marvelous Oncology Opportunity - Cancer Center in Southern California" - CA

Job 94545 Terrific cancer center in the Los Angeles area seeks to add an Oncologist to their growing practice. The center has everything needed to treat cancer patients including radiation oncology, radiology

Hematology-Oncology jobs in "Seeking a Medical Oncologist to work with a growing community clinic" - AZ

Job 941230 Seeking a Medical Oncologist with interest in working in Community Clinic Practicing physicians and fellows will all be considered Opportunity to participate in clinical trials and research

Hematology-Oncology jobs in "Hematology/Medical Oncologist wanted for practice in Washington" - WA

Job 941279 Hematology/Medical Oncologist wanted for practice in Washington Hospital based practice Need is due to growth Guaranteed Salary RVU incentive bonus Wonderful support staff--Certified Oncology

Hematology-Oncology jobs in "Hematology Oncology position in Beautiful Coastal Carolina." - NC

Job 941199 Lucertive opportunity with clinical based practice. Competitive starting salary WRVU production bonus worth up to $100,000 per year Full Benefit package Beautiful location with easy access

Hematology-Oncology jobs in "Live in Seattle, WA proper and practic Hematology Oncology" - WA

Job 941105 Enjoy livening in Downtown Seattle, WA and practice Oncology where patient care is the main priority. The Office and Hospital are close to each other and only a short drive from downtown Seattle.

Hematology-Oncology jobs in "Live in Seattle, WA proper and practic Hematology Oncology" - WA

Job 941044 Enjoy livening in Downtown Seattle, WA and practice Oncology where patient care is the main priority. The Office and Hospital are close to each other and only a short drive from downtown Seattle.

Hematology-Oncology jobs in "Part time Oncology opportunity in Central California" - CA

Job 94936 Part time opportunity to join two other Oncologists in a growing community practice. Part time Oncology opportunity Radiation Oncology on site Very busy practice - Referrals are increasing

Hematology-Oncology jobs in "Oncology Specialists For Brand New Cancer Center" - OK

Clinician, Educator, Scientist Clinical prestige, ahead-of-the-curve technology and an unrivaled team environment await you at The University of Oklahoma Medical Center. This summer, The Peggy

Hematology-Oncology jobs in "Hematology Oncology Opportunity in No. Colorado" - CO

Job 94913 Employment model with guaranteed salary (mid 300's) plus RVU productivity incentives. Compensation package includes fully-paid malpractice, paid CME plus allowance, strong benefit/retirement

Hematology-Oncology jobs in "Metro Hematology Oncology Position in Missouri" - MO

Job 941073 Work independently out of a free standing center, but share call with 4 other doctors. Great earning potential and exceptional benefits offered. Group is seeking a physician with experience

Hematology-Oncology jobs in "Medical Oncology Opportunity in West Virginia" - WV

Job 941341 Wonderful opportunity to join a solid, successful, growing practice Very established multi-specialty group Walk into an existing patient base Solid support staff including NPs, clinical pharmacist

Hematology-Oncology jobs in "Western North Carolina Hematology/Oncology" - NC

Hospital in western North Carolina is seeking a Hematologist/Oncologist to join their staff. The hospital is in the midst of adding a brand new state of the art Cancer Center. They currently have 2

Hematology-Oncology jobs in "Coastal North Carolina Hematology/Oncology" - NC

Multi Specialty Group in coastal North Carolina is seeking a BC/BE Hematologist Oncologist to join their team. They currently have 1 other Hem/Onc on staff. Call will be consultative as patients will

Hematology-Oncology jobs in "New Oncology Job in Metropolitan Washington" - WA

Job 941343 Successful private practice near Tacoma, Seattle area Successful private practice Great location in Washington State Partnership Track Competetive Salary Full Medical Benefits Partnership

Hematology-Oncology jobs in "Hematology Oncology Position in Connecticut" - CT

Job 94605 Opportunity to join a private practice in Connecticut. Competitive salary and bonuses along with a partnership track will be offered. Practice will provide full benefits to the physician.

Hematology-Oncology jobs in "Southwest Missouri Hematology/Oncologist" - MD

We are currently assisting a client that is looking for BC/BE Medical Oncologist for their hospital based Cancer Center. There are currently 5 Med/Oncs in the practice. Call is 1:5 and with physicians

Hematology-Oncology jobs in "Great Falls, Montana Hematology/Oncology" - MT

Multi Specialty Group in Montana is seeking an experienced/board certified Medical Oncologist. There is currently one other Medical Oncologist in the group. The practice is supported by a full spectrum

Hematology-Oncology jobs in "Hematology/Oncology Medical Directorship" - PA

Lead The Charge! Our premier cancer care center is looking for an experienced and passionate provider to continue our tradition of providing exceptional care. Bring your unique experience to

Hematology-Oncology jobs in "Northwest Florida Hematology/Oncologist" - FL

Large hospital system in northwest FL is seeking a Hem/Onc for a hospital employed Oncology group. There are currently 3 Hem/Onc, 1 Gyn/Onc, 1 Rad/Onc and 2 Urologists in the center now. The group

Hematology-Oncology jobs in "Near Columbia, MO Hematology/Oncologist" - MO

Hospital in Missouri is searching for a BE/BC Hematologist/Oncologist for their stat of the art Cancer Center which is complete with medical oncology, radiation oncology, and outpatient imaging. The

Hematology-Oncology jobs in "Spokane, Washington Surg/Onc Director" - WA

Washington based Delivery System is looking to develop a regional, multidisciplinary cancer center. Clinic seeks a BC/BE Oncologist Specialist (Medical, Surgical, or Radiation) - Physician leader

Hematology-Oncology jobs in "South Bend, IN Hematology/Oncologist" - IN

Well established well respected Multi Specialty Group in Indiana is seeking an additional Hem/Onc for their practice. They currently have three Hem/Onc's on staff. They have recently completed a 100,000

Hematology-Oncology jobs in "Tulsa" - OK

Large MSG in Oklahoma is seeking a BC/BE Hem/Onc for their group. The group currently has one other Oncologist. They have 20 physicians on staff and 8 different specialties. This will be an employed

Hematology-Oncology jobs in "Northwest Florida Hem/Onc Director" - FL

Large hospital system in northwest FL is seeking a Medical Director for their Cancer Center. There are currently 3 Hem/Onc, 1 Gyn/Onc, 1 Rad/Onc and 2 Urologists employed with the center now. This will

Hematology-Oncology jobs in "Northern Maine Hem/Onc Opportunity" - ME

Hospital in Northern Maine is seeking a Medical Oncologist. This new physician will be the only Med/Onc on staff. Any call would be consultative. They have an active Hospitalist program to handle admitting.

Hematology-Oncology jobs in "Hematologist/Oncologist - Kentucky" - KY

101028-1405 Hematologist/Oncologist - Kentucky KY BC/BE hematologist/oncologist for established 2 member private group of 15 years Medical school training in the United States required Partner

Hematology-Oncology jobs in "College Town USA Oncology Practice" - IN

State-of-the-Art Facility - Indianapolis Our oncology group is part of the largest and fastest-growing multispecialty group in the region. Based in a 65,000-square-foot medical

Hematology-Oncology jobs in "Augusta, GA Hematology/Oncologist" - GA

Join an established Medical/Hematology Oncology group in Georgia. There are currently 3 well respected/established physicians in the practice. This will be a hospital employed opportunity. Call will

Hematology-Oncology jobs in "Hematology/Oncology - Minnesota" - MN

110120-1523 Hematology/Oncology - Minnesota MN Seeking BC/BE hematology/oncology physician for multi-specialty group Work at new state-of-the-art outpatient cancer center Call schedule is night

Hematology-Oncology jobs in "Lake" - MI

Single specialty practice, one Oncology provider. Clinic hours are 8am to 5pm. Clinic and infusion center located in the hospital. Physician will see 20-25 patients per day. Clinic specialized in

Hematology-Oncology jobs in "Western Pennsylvania - Hem/Onc" - PA

We are currently assisting a client in Western PA with the recruitment of a Hematologist/Medical Oncologist. The new physician will be joining an established Multi Specialty Group with over 115 physicians

Hematology-Oncology jobs in "Boston" - MA

Hospital in Massachusetts is seeking a board certified Hematology Oncology physician for their cancer center. There is currently one other Hem/Onc and one Nurse Practitioner on staff. Will work out

Hematology-Oncology jobs in "Medical Director of Oncology" - NC

Job 94695 New Medical Director of Oncology opportunity. This will be a non-clinical, research based position in a major metropolitan are of North Carolina. Medical Director Great opportunity for Physicians

Hematology-Oncology jobs in "Northwest KRC.0911.0801.48" - KS

KRC.0911.0801.48 Hematologist/Oncologist needed to join an existing group of 2 Hematology/Oncology physicians providing comprehensive care for patients residing the region. Call will be shared

Hematology-Oncology jobs in "West Central Illinois" - IL

NORTHWEST IL - NEAR QUAD CITIES IOWA and PEORIA, IL 3 HOURS FROM CHICAGO: Multispecialty group of 4 (two physicians and two mid-level providers). The physicians are Hematology/Oncology and

Hematology-Oncology jobs in "Inquire for details" - BM

Reason for coverage Recruiting Population 65,000 - 100,000 Provider Qualifications Specialist/Consultant Benefits CME Paid Vacation Relocation Package

Hematology-Oncology jobs in "Inquire for details" - NS

Population 10,000 - 30,000 Provider Qualifications Specialist/Consultant Location Highlights Near Coast Hiking/Tramping Fishing

Hematology-Oncology jobs in "Southeast Region" - MO

A regional medical center is searching for a Hem/Onc to join their team of physicians at a growing Cancer Treatment Center. The opportunity exists to gain a large portion of market share within the

Hematology-Oncology jobs in "Columbia suburb" - SC

Hem/Onc physician, preferably BC in both, is needed for this lovely community 30 minutes from Columbia and just an hour from Charleston. This is an employed opportunity with a very competitive

Hematology-Oncology jobs in Michigan

All Hematology-Oncology jobs in Michigan for Tue Feb 7 2012

Hematology-Oncology jobs in "Riyadh, Al Ahsa" - SA

Head Medical: Haematology and Oncology Consultants required for the Gulf Region Ref Number: ANS0037 Excellent tax free remuneration packages including;

Hematology-Oncology jobs in "Charlotte Area" - NC

Reference: 20107 Specialty: Hematology Oncology Location: North Carolina (Just outside the Charlotte area) Population: Less than 50,000 Service Area: over 350,000 J1 or H1B visa: No The communitys

Hematology-Oncology jobs in "Metro/Central" - TN

We have a great opportunity for to come join a new practice located in the Metro/Central area of TN as a Hematologist/Oncologist. Board Certified is preferred but Board Eligible will be accepted.

Hematology-Oncology jobs in "Staten Island" - NY

Leadership position with Staten Island University Hospital VISTA Physician Search and Consulting is working with Staten Island University Hospital (SIUH) to find a Director

Hematology-Oncology jobs in "State College" - PA

Hematology/Oncology-Pennsylvania-Physician needed- Short partner track- 16801 Join 3 Hematology/oncologist in practice at large Medical group located in central Pennsylvania. They have

Hematology-Oncology jobs in "Poplar Bluff" - MO

Employed position Join well-established partner Call 1:3 New 250-300 bed facility slated to open in 2014 Extremely competitive base income with WRVU productivity Full benefit package that includes

Hematology-Oncology jobs in "Philadelphia" - PA

HEMATOLOGIST/ONCOLOGIST Philadelphia Suburbs, Pennsylvania Hospital is searching for a third to join their program that is affiliated with the University of Pennsylvania. This candidate must be experienced

Hematology-Oncology jobs in "College Town" - PA

Hematology/Oncology- Central Pennsylvania- Short partner track

Hematology-Oncology jobs in "Newburyport" - MA

Hematology/Oncology-Massachusetts Beautiful Coastal Massachusetts location-North of Boston Hematology/Oncology-Massachusetts-Physician needed- Private Cancer group

Hematology-Oncology jobs in "Springfield" - MA

Hematology/Oncology-Massachusetts-Physician -Springfield area- Well-established Medical Center is need of hematology/oncologist. Join a 1 oncologist and 1 NP for employed position. Call

Hematology-Oncology jobs in "Manchester" - NH

Hematology/Oncology- New Hampshire-Physician Needed- Busy program is in need of new Hematology/Oncologist- They offer a competitive salary based on MGMA median with a two year guarantee: salary based

Hematology-Oncology jobs in "Portsmouth" - NH

Hematology/Oncology-New Hampshire-Physician needed - Join a large group of Oncologists in Southern NH. Hospital has 200+ beds, up to date equipment and great support staff. Competitive Salary and

Hematology-Oncology jobs in "Portsmouth" - NH

Oncologist New Hampshire-- opportunity to work in beautiful Seacoast New Hampshire. Oncologists needed to join community due to growth. Immediate patient base. Call schedule

Hematology-Oncology jobs in "California" - CA

NORTHERN CALIFORNIA HEMATOLOGY-ONCOLOGY PHYSICIAN NO HMOS/ NO CAPITATION BUSY ESTABLISHED PRACTICE 1-2 YEAR PARTNERSHIP TRACK If you have dreamed of joining a group where patient care comes

Hematology-Oncology jobs in "Fort Kent" - ME

Fort Kent : 49-bed acute care hospital in northern Maine that needs to expand their services in oncology. We are looking for a skilled physician trained in Internal Medicine and Oncology

Hematology-Oncology jobs in "Rochester" - NH

Dartmouth-Hitchcock Clinic Oncologist/Hematologist -New Hampshire Frisbie Memorial Hospital and Dartmouth-Hitchcock Clinic are seeking a seasoned Oncologist with a strong

Hematology-Oncology jobs in "Johnstown" - PA

Hematology/Oncology-Pennsylvania-Physician-10 days+ 4k for CME! Hematologist/Oncologist sought to join team at 700+ bed hospital. They offer an excellent salary with great benefits including Sign-on bonus,

Hematology-Oncology jobs in "Portland" - OR

Portland, Oregon Providence St. Vincent Medical Center and Providence Medical Group are searching for an exceptional Hematology Oncologist to join our care team in beautiful west Portland. Join five

Hematology-Oncology jobs in "Gadsden" - SC

Hematology/Oncology Position near the S.C. coast Carolinas Hospital System (420 Beds) is actively seeking to assist a local practice in recruiting another associate. The hospital is a modern, state-of-the-art

Hematology-Oncology jobs in "Gillette" - WY

Practice in Wyoming Hematolgoy & Oncology Practice opportunity, good case mix, great colleagues and large referral base, Attractive salary Sign-on and incentivizes CME and several other benefits

Hematology-Oncology jobs in "Sandusky" - OH

Firelands Regional Medical Center and University Hospitals Ireland Cancer Center are seeking a BE/BC oncologist to successfully operate an oncology practice in Sandusky, Ohio. The oncologist will be

Hematology-Oncology jobs in "Midstate" - MO

Cancer Center Director Opportunity The Director will be responsible for developing and implementing a vision for the Cancer Center that expands its clinical activities, scientific discoveries and education

Hematology-Oncology jobs in "Brockton" - MA

Hematology/Oncology- Massachusetts-02301 Physician needed-30 minutes to Boston- Well established practice with 2 physicians seeks Hematologist/Oncologist. Practice boats of very competitive

Hematology-Oncology jobs in "Augusta" - ME

Hematology/Oncology-Maine-Physician needed Central suburban region Excellent opportunity to join 6 Physicians and 2 PA’s. We offer competitive salary. Full Benefits include loan repayment

Hematology-Oncology jobs in "Midwest" - MO

Excellent opportunity to join a very successful bone marrow transplant team. Must be Board Certified in Hematology/Oncology with proven experience or Fellowship training in Adult BMT. An excellent

Hematology-Oncology jobs in "Hanover" - NH

Hematology/Oncology-Physcian needed- Prestigious Medical center is need of a Hematology/oncologist. They offer competitive salary based on experience. Excellent benefits package includes 20+ days

Hematology-Oncology jobs in "Lebanon" - NH

Hematology/Oncology-Physcian needed-03756 Prestigious Medical center is need of a Hematology/oncologist. They offer competitive salary based on experience. Excellent benefits package includes