Deletion(20q) as the sole abnormality in plasma cell myeloma is not associated with plasma cells as identified by cIg FISH.

Deletion of 20q is a common finding in myeloid disorders but it is also observed in plasma cell myeloma (PCM). As a del(20q) in a patient receiving treatment for myeloma may indicate therapy-related myelodysplastic syndrome (t-MDS), it is important to differentiate chromosome abnormalities associated with myeloma from those reflecting t-MDS. We performed fluorescence in situ hybridization (FISH) using a 20q12 probe (D20S108) in conjunction with cytoplasmic immunoglobulin (cIg) staining in 20 PCM cases with a del(20q) in order to confirm the cell type involved. Of the nine cases studied with a clone showing a del(20q) as the sole abnormality, 8 of 9 demonstrated loss of the D20S108 signals in non-plasma cells only and 5 of 9 had either a confirmed myeloid malignancy in addition to PCM or showed evidence of dysplastic changes in the marrow; however, of the 11 patients with a del(20q) within a complex PCM karyotype, 4 of 11 showed loss of the D20S108 signals in plasma cells only and 7 of 11 showed no significant loss in either plasma cells or non-plasma cells. Therefore, our results indicate that a del(20q) as the sole abnormality in PCM is present in non-plasma cells and, therefore, suggests the presence of an associated myeloid malignancy.

Cytogenetic analysis in acute myeloid leukaemia.

Cytogenetic analysis is an integral part of the diagnostic work-up of the patient with acute myeloid leukaemia. Conventional cytogenetic analysis relies on obtaining a good quality bone marrow specimen in a timely fashion and setting up at least two short-term cultures. A 15-24-h culture and a 48-h synchronised culture are routinely set up but as the cytogenetics result is often required urgently to determine the type of therapy to be administered, analysis is undertaken using the overnight culture in the first instance. Rapid and accurate analysis relies on obtaining high-quality G-banding. Knowledge of the conditions affecting banding is therefore essential.

Community-based perinatal depression services for African American women: the healthy start model.

A variety of factors place African American women at risk for depression. Unfortunately, a behavioral health system insensitive to these women's needs exacerbates their risk. Recent reports recommended that mental health services be accessible and acceptable to women of color and include comprehensive, culturally appropriate case management. The federal Healthy Start Initiative, a national maternal and child health program to reduce infant mortality and low birth weight, is an often-overlooked resource for responding to perinatal depression among African American women. Pittsburgh/Allegheny and Fayette County Healthy Start, Inc., offers a case example of the Healthy Start model to address depression.