Reactive Plasmacytosis: A Diagnostic Conundrum In Acute Myeloid Leukaemia.

Bone-marrow being a home to various kinds of normal hematopoietic cells, sometime becomes overcrowded by abnormal cell population in malignancies like in acute myeloid leukaemia. One such dilemma in diagnosis betides when two abnormal cell populations in bone-marrow occur at the same time. A prime example is when reactive plasmacytosis in bone-marrow eventuate in relation with acute myeloid leukaemia (AML). Due to scarce amount of such cases reported, it is imperative to understand the difference between reactive plasmacytosis which arises after induction of chemotherapy and the one which is diagnosed along with AML, during initial diagnosis due to other causes, like infections and IL-6 production by the leukemic blast population. To substantiate these erstwhile arguments, the brief case history of a 45 years old female patient diagnosed with acute myeloid leukaemia with coincident reactive plasmacytosis having no previous history of chemotherapy is presented along with review of past published literature.

Correlation Of Serum Ferritin With Haemoglobin A2 Level In Beta Thalassemia Traits.

BACKGROUND: Haemoglobin-A2 is considered as a paramount diagnostic parameter for the detection of beta-thalassemia trait which may vary with the fluctuation of body iron stores. The current study aims to evaluate the correlation of serum ferritin as a parameter of body iron stores with haemoglobin-A2 level in beta-thalassemia traits. METHODS: This cross-sectional study was conducted on total 134 known beta-thalassemia traits in Rehman Medical Institute-Peshawar, Pakistan from October 2018 to June 2019. Blood samples from the contributors were drawn in EDTA and plain tubes for complete blood counts, haemoglobin-A2 and serum ferritin estimation. Participants were categorized into 3 groups on the basis of iron status; beta-thalassemia traits with low ferritin (Group A), normal ferritin (Group B) and high ferritin levels (Group C). Pearson correlation was applied to analyse the correlation between the variables. RESULTS: Out of total 134 known beta-thalassemia traits, 73 (54.5 %) were males and 61 (45.5%) were females. Participants of group A with low ferritin were 22 (16.4%), group B with normal ferritin were 96 (71.6%) and group C with high ferritin were 16 (11.9%). Group A shows lowest mean haemoglobin-A2 level comparatively to Group B and Group C, with some effect of serum ferritin on haemoglobin-A2 level. CONCLUSIONS: Haemoglobin-A2 value decreases when there is a decrease in serum ferritin and show slightly increase with high ferritin level as compared to normal ferritin level or body iron stores in beta-thalassemia traits. However, this correlation is not significant enough to mask the actual diagnosis of the disease.