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RISS 인기검색어
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- 저자 : Alan Pomerantz (검색결과 2 건)
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Mixed-phenotype acute leukemia: suboptimal treatment when the 2008/2016 WHO classification is used
Alan Pomerantz,Sergio Rodriguez-Rodriguez,Roberta Demichelis-Gomez,Georgina Barrera-Lumbreras,Olga Barrales-Benitez,Xavier Lopez-Karpovitch,Alvaro Aguayo-Gonzalez 대한혈액학회 2016 Blood Research Vol.51 No.4
BackgroundDifferent criteria have been used to diagnose mixed-phenotype acute leukemia (MPAL), which has impacted the number of individuals diagnosed with this pathology. Better out-comes have been reported when using acute lymphoblastic leukemia (ALL)-type chemo-therapy in the treatment of MPAL.MethodsWe compared the outcome of 4 groups of patients with MPAL. Group 1 included patients diagnosed using the 2008/2016 World Health Organization (WHO) classification; group 2 included patients diagnosed using the European Group for the Immunological Characterization of Leukemias (EGIL) criteria; group 3 included patients diagnosed using either the EGIL or the 2008/2016 WHO criteria; and group 4 was comprised of patients diagnosed with MPAL using the EGIL classification only.ResultsWe found a significantly worse disease-free survival (groups 1‒4) and overall survival (OS) (groups 2 and 3) when comparing MPAL patients to other acute leukemia (AL) patients. A significantly better OS was obtained in patients (groups 2‒4) treated with ALL-type che-motherapy compared to acute myeloid leukemia (AML)-type regimens.ConclusionIn light of these results, and because a trend (P=0.06) was found with regard to a better OS in group 4 when compared to other AL patients, an argument can be made that the 2008/2016 WHO classification is underpowered to diagnose all MPAL cases, potentially resulting in the suboptimal treatment of some individuals with AL.
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Splenic myeloid metaplasia in warm autoimmune hemolytic anemia (wAIHA): a retrospective study
Víctor Manuel Anguiano-Álvarez,Alonso Hernández-Company,Nashla Hamdan-Pérez,Daniel Montante-M,Diego A. Zúñiga-Tamayo,Sergio Rodríguez-Rodríguez,Alan Pomerantz,Elena J. Tuna-Aguilar 대한혈액학회 2018 Blood Research Vol.53 No.1
BackgroundSplenic myeloid metaplasia (SMM) is a kind of extramedullary hematopoiesis, whereasits clinical significance in wAIHA remains unclear. The aim of this study is evaluating thefrequency and clinical characteristics of SMM, compared with splenic-congestion (SC). MethodsWe included patients with wAIHA treated in a Mexican tertiary hospital between January1992 and December 2015. All patients received steroids as first-line treatment and splenectomyas second-line treatment. ResultsAmong the thirty-six splenectomized patients, 15 (41.6%) and 21 (58.4%) were diagnosedas SMM and SC, respectively. No differences were found in clinical characteristicsbetween two groups. SMM patients showed lower platelet count (147×109/L vs. 240×109/L, P=0.02) and higher presence of anti-dsDNA antibodies (40% vs. 4.7%,P=0.01) than SC patients. Although the complete response (CR) rate with first-line treatmentwas lower in SMM patients (13.3% vs. 47.6%; P=0.04), post-splenectomy mediandisease-free-survival (DFS) was longer (16.2 mo vs. 5.1 mo; P=0.19). Univariate/multivariateanalysis showed that achieving CR during first-line treatment (OR 0.3, 95% CI:0.03‒0.94, P=0.03) and higher platelet count (OR 0.99, 95% CI: 0.98‒0.99, P=0.03)were protective factors for SMM; and anti-dsDNA titer higher than 9.6 IU/dL was a riskfactor for SMM (OR 2.76, 95% CI: 1.48‒5.14, P<0.001). ConclusionThe wAIHA patients with SMM have different biological profiles with those without SMM. This study is the first trial evaluating the significance of histopathological spleen findingsand their association with rheumatologic profile.
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