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New Delhi, India

Puri K.,AIIMS | Singh P.,AIIMS | Das R.R.,AIIMS | Seth R.,AIIMS | And 2 more authors.
Indian Journal of Pediatrics | Year: 2011

Juvenile myelomonocytic leukemia (JMML) is a rare mixed myeloproliferative and myelodysplastic disorder of early childhood, characterized by excessive proliferation of monocytic and granulocytic cells, along with myelodysplastic features. There are reports of viral infections mimicking JMML, with all clinical and hematological parameters normalizing on resolution of infection. The authors describe a 1- year- old boy with concomitant JMML and CMV infection. The diagnostic dilemma, the significance of distinguishing it from a mimicking viral infection, as well as potential synergistic effect of concomitant infections on the presentation or actual disease severity of underlying JMML will be discussed. © 2010 Dr. K C Chaudhuri Foundation.

Chopra A.,Ansari Nagar | Kumar R.,Laboratory Oncology | Kishore K.,Ansari Nagar | Tandon N.,All India Institute of Medical Sciences | And 4 more authors.
Blood Coagulation and Fibrinolysis | Year: 2012

von Willebrand factor (vWF) gene promoter polymorphism at nucleotide positions -2659 and -2525 influences corticosteroid-mediated increase in vWF level and possibly hypercoagulability of the blood. This study was undertaken to correlate plasma vWF levels with plasma cortisol and single nucleotide polymorphisms (SNPs) at positions -2659 and -2525 in Cushing syndrome patients in India. Samples from 22 endogenous and 28 exogenous Cushing syndrome patients and 50 normal volunteers were analyzed to determine vWF level and SNPs. vWF level was raised in 40.91% of endogenous and 14.29% of exogenous Cushing syndrome patients. A positive correlation was seen between plasma cortisol and vWF level (P? =?0.01) with 1?μg/ml rise of plasma cortisol causing a 2.52IU/dl increase in vWF level. Allele frequency of SNPs -2659A, -2659G, -2525A and -2525G was 0.78, 0.22, 0.84 and 0.16, respectively, making cosegregation of -2659A and -2525A the most frequent in our population. Haplotype 1 (-2659A, -2525G) was most frequently associated with higher level of vWF. Patients with haplotype 2 (-2659G, -2525A) had normal vWF. vWF promoter polymorphisms influence corticosteroid-mediated increase in vWF especially in patients with haplotype 1. © 2012 Wolters Kluwer Health.

Bhaskar A.,Laboratory Oncology | Gupta R.,Laboratory Oncology | Kumar L.,All India Institute of Medical Sciences | Sharma A.,All India Institute of Medical Sciences | And 3 more authors.
Leukemia and Lymphoma | Year: 2012

Recent studies suggest that endothelial progenitor cells (EPCs) are mobilized from bone marrow to the peripheral circulation and aid in tumor neovascularization. In this study, circulating EPC (cEPC) numbers were assessed and correlation with clinical and laboratory parameters was determined in 75 patients with multiple myeloma (MM). Higher numbers of cEPCs (defined as CD45-/dim CD34+CD133+CD31+cells) were observed in MM as compared to healthy controls (n = 10; p < 0.001), which increased progressively from stage I to stage III (p < 0.001). A significant decline in cEPC numbers after therapy was observed in patients who attained at least a partial response (n = 47; p < 0.001). cEPCs correlated with response duration, at a baseline cut-off value of 19.6 cEPCs/μL (p = 0.006) and 6.5 cEPCs/μL after therapy (p < 0.001). This study suggests that cEPC numbers and changes in their levels may serve as a potential biomarker of disease severity, response to therapy and treatment outcome in MM. © 2012 Informa UK, Ltd.

Misra A.,Laboratory Oncology | Mishra J.,Laboratory Oncology | Chandramohan J.,Laboratory Oncology | Sharma A.,Medical Oncology | And 4 more authors.
Indian Journal of Hematology and Blood Transfusion | Year: 2016

Introduction: High resolution electrophoresis (HRE) and immunofixation (IFX) of serum and urine are integral to the diagnostic work-up of multiple myeloma. Unusual electrophoresis patterns are common and may be misinterpreted. Though primarily the responsibility of the hematopathologist, clinicians who are responsible for managing myelomas may benefit from knowledge of these. In this review article we intend to discuss the patterns and importance of electrophoresis in present day scenario. Methods: Patterns of HRE and IFX seen in our laboratory over the past 15 years were studied. Results: Monoclonal proteins are seen on HRE as sharply defined bands, sometimes two, lying from γ- to α-globulin regions on a background of normal, increased or decreased polyclonal γ-globulins, showing HRE to be a rapid and dependable method of detecting M-protein in serum or urine. Immunofixation complements HRE and due to its greater sensitivity, is able to pick up small or light chain bands, not apparent on electrophoresis, including biclonal disease even when electrophoresis shows only one M-band. Special features liable to misinterpretation are discussed. Familiarity with the interpretation of the varied patterns seen in health and disease is essential for providing dependable laboratory support in the management of multiple myeloma. © 2015, Indian Society of Haematology & Transfusion Medicine.

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