RESUMEN
The development of Burkitt cell leukemia (FABL3) [1] in a patient 7 years after successful treatment of Hodgkin's disease (HD) by combined modality (chemotherapy and radiotherapy) therapy is described. The B-cell nature of the leukemic blasts is shown by immunologic surface marker studies. While L3 leukemia is very rarely seen following therapy for HD, diffuse lymphoma of small noncleaved cells (LSNC)--resembling the Burkitt tumor--is more common in this setting.
Asunto(s)
Enfermedad de Hodgkin/complicaciones , Leucemia Linfoide/complicaciones , Adulto , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapéutico , Linfocitos B , Enfermedad de Hodgkin/tratamiento farmacológico , Enfermedad de Hodgkin/radioterapia , Humanos , Leucemia Linfoide/etiología , Ganglios Linfáticos/patología , Masculino , Mecloretamina/administración & dosificación , Células Madre Neoplásicas , Prednisona/administración & dosificación , Procarbazina/administración & dosificación , Formación de Roseta , Vincristina/administración & dosificaciónRESUMEN
A multiply transfused Rh-positive patient with congenital dyserythropoietic anemia type II or hereditary erythroblastic multinuclearity with a positive acidified serum test is described in whom a transient anti-D was accompanied by a positive direct antiglobulin test. A brief review of the literature and possible mechanisms for this observation are presented.
Asunto(s)
Anemia Diseritropoyética Congénita/sangre , Anemia Hemolítica Congénita/sangre , Autoanticuerpos/biosíntesis , Inmunoglobulinas/biosíntesis , Sistema del Grupo Sanguíneo Rh-Hr/inmunología , Adulto , Anemia Diseritropoyética Congénita/diagnóstico , Anemia Diseritropoyética Congénita/genética , Autoanticuerpos/genética , Prueba de Coombs , Femenino , Humanos , Inmunoglobulinas/genética , Sistema del Grupo Sanguíneo Rh-Hr/genética , Globulina Inmune rho(D)RESUMEN
BACKGROUND: A hemoglobin (Hb) standard of 115 g per L on the copper sulfate test has been in use by the Canadian Red Cross Society Blood Services for female blood donor predonation screening since 1989. STUDY DESIGN AND METHODS: To determine if this lowered Hb standard results in increased iron deficiency in repeat blood donors, a study was conducted to evaluate the performance of the copper sulfate test and predonation capillary and venous Hb assays in a population of female blood donors most at risk of developing iron deficiency. RESULTS: Of the 174 donors who were of childbearing age, who were not taking iron supplements, and who had made at least three blood donations per year, 45 (25.9%) were iron deficient, and 64 (36.8%) had reduced iron stores; only 65 (37.3%) had normal iron stores. This study showed that capillary blood is more likely to have a higher Hb concentration (3.2 +/- 7.8 g/L) than venous blood samples, which could affect the performance of predonation screening assays that are based on capillary blood samples at a given discriminating value. With an Hb standard of 115 g per L, both the copper sulfate and capillary Hb assays were not sensitive enough to screen for iron deficiency (sensitivity, 27% and 33%; specificity, 96% and 93%, respectively) and were comparable only to the performance of a venous Hb assay with a cutoff value of 110 g per L (sensitivity, 27%; specificity, 99%). In contrast, an Hb standard of 125 g per L in the copper sulfate test could achieve a more optimal sensitivity of 79 percent and specificity of 78 percent. CONCLUSION: This study supports the use of a higher Hb cutoff value of 125 g per L for female blood donors in the predonation fingerstick copper sulfate test.