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2010| July-September | Volume 31 | Issue 3
Online since
December 6, 2010
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CASE REPORTS
Thyroiditis mimicking relapse of acute lymphoblastic leukemia: Gallium-67 scan suggested the diagnosis
Saleh Othman
July-September 2010, 31(3):94-95
DOI
:10.4103/0971-5851.73601
PMID
:21206717
Acute lymphoblastic leukemia (ALL) is the most common form of leukemia in childhood and accounts for 85% of cases. ALL frequently presents as an infectious process with an abrupt onset of high fever. Thyroid disease has been reported to have a strong association with acute leukemia. Gallium (Ga-67) citrate has been used in the investigation of patients labeled as having pyrexia of unknown origin. We report a case of a 13-year-old female patient who presented with fever and suspected disease relapse after a period of disease remission; however, gallium-67 citrate whole body scan suggested the diagnosis of thyroiditis.
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Primary plasma cell leukemia with light chain secretion and multiple chromosomal abnormalities: How successfully treated? - A case report with review of literature
Manu Goyal, Noorjahan Mohammad, Satya Dattatreya Palanki, Salil N Vaniawala
July-September 2010, 31(3):96-100
DOI
:10.4103/0971-5851.73603
PMID
:21206718
Primary plasma cell leukemia is a rare form of plasma cell dyscrasia. We present a case which had leukocytosis with numerous circulating plasma cells in the peripheral blood. Flow cytometry revealed an unusual CD117 expression. Free light chain analysis in the serum showed a markedly elevated level of free lambda light chains. Radiography did not reveal any lytic lesions. Fluorescent in-situ hybridization analysis revealed deletion of 13q14.3 and t(4;14)/t(11;14), while the cytogenetic analysis was normal. The patient was given chemotherapy and was subjected to autologous stem cell transplant, after which she is in complete remission till date.
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Disease recurrence in a transplant kidney in a patient with extramedullary plasmacytoma
Pooja Binnani, MM Bahadur, Nikhil Kedia, Prakash Sharbidre
July-September 2010, 31(3):91-93
DOI
:10.4103/0971-5851.73600
PMID
:21206716
Renal transplantation in patients with malignancy is controversial. Renal transplantation is generally not considered for patients with multiple myeloma (MM) because of their extremely poor prognosis. There are few reports of MM recurrence among kidney transplant recipients. We present a case of disease relapse of plasmacytoma in a transplanted kidney. We present a patient with extramedullary plasmacytoma, who responded well to chemotherapy and underwent allogenic renal transplantation. He relapsed after 4 years with progression to extramedullary plasmacytoma. Despite minimal clinical symptoms, the patient had developed myeloma cast nephropathy and acute renal failure. His renal failure settled after excision of tumor. Extramedullary plasmacytoma as a mode of relapse is highly unusual. Experience of renal transplantation in MM is limited. In the literature, the recurrence of MM is mentioned as a severe complication with a poor graft prognosis. Extramedullary plasmacytoma as a mode of relapse is highly unusual. It should not be considered as a contraindication for transplantation. Renal transplantation for patients with end stage renal disease (ESRD) due to MM is possible. But large prospective studies are needed to develop a strategy for preventing multiple myeloma recurrence.
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ORIGINAL ARTICLE
Granulocyte colony-stimulating factor (filgrastim) in chemotherapy-induced febrile neutropenia
SH Advani, Suvarna Achreckar, Dennis Thomas, Binny Krishnankutty
July-September 2010, 31(3):79-82
DOI
:10.4103/0971-5851.73590
PMID
:21206712
Background:
The use of granulocyte colony-stimulating factors to treat patients with chemotherapy-induced neutropenia is well accepted. To assess whether administration of filgrastim along with standard empiric antibiotic therapy is beneficial for patients with chemotherapy-induced febrile neutropenia (FN), we conducted an open, non-randomized clinical trial.
Materials and Methods:
This was a prospective, open, Phase IV clinical trial in patients receiving chemotherapy for histologically confirmed cancer, with an oral temperature of >38.2°C and absolute neutrophil count (ANC) of <500/mm
3
. Filgrastim was administered subcutaneously in a dose of 5 mcg/kg/day, 24 hours after administration of cytotoxic therapy, for up to two weeks or until the ANC reached 10,000 cells/mm
3
. The parameters of assessment included duration of neutropenia, fever, hospitalization and antibiotic usage.
Results:
All 24 evaluable patients recovered from neutropenia, fever and FN in a median duration of two days. This result is similar to that reported in earlier studies with filgrastim. Despite the acceleration in recovery from neutropenia and fever, it also reduced the duration of hospital stay and usage of intravenous (IV) antibiotic. Only two adverse events were reported, which were of mild nature.
Conclusion:
Filgrastim, when used in patients with chemotherapy-induced neutropenia, exhibited efficacy in accelerating the recovery from neutropenia and fever comparable to that reported with filgrastim in literature. The data from this study suggest that filgrastim is effective in the treatment of chemotherapy-induced neutropenia and is well tolerated by Indian patients.
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CASE REPORTS
Giant intrathoracic mycotic aneurysm of left subclavian artery
RP Bansal, Prerna Gupta, Lalit M Sharma
July-September 2010, 31(3):83-85
DOI
:10.4103/0971-5851.73592
PMID
:21206713
Fungal infections are serious and important cause of morbidity and mortality in immunocompromised patients. Angioinvasive aspergillosis causing mycotic aneurysm of major blood vessels is very rare and only a few cases are reported in literature. We hereby report one case of acute lymphoblastic leukaemia presenting with this fatal complication.
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Hyperleukocytosis in a neonate: A diagnostic dilemma
Sushanth , K Shreedhara Avabratha, Kiran Joseph Tauro, GK Shwethadri
July-September 2010, 31(3):86-88
DOI
:10.4103/0971-5851.73596
PMID
:21206714
A preterm baby presented with lethargy and tachypnea. Blood counts revealed hyperleukocytosis. Peripheral smear and bone marrow examination were not suggestive of leukemia. The baby was treated for sepsis. The baby recovered and WBC counts gradually reduced. Hyperleukocytosis was presumed to be a part of leukemoid reaction secondary to sepsis. The diagnostic possibilities with a review of literature are also presented.
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Kimura's disease: An uncommon cause of lymphadenopathy
Veerendra Kumar, Salini , Savida Haridas
July-September 2010, 31(3):89-90
DOI
:10.4103/0971-5851.73598
PMID
:21206715
Lymph node enlargement of neck and axilla is one of the common presenting complaints in pediatrics. We are presenting here a very rare cause of axillary lymphadenopathy detected in a toddler.
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COMMENTARY
Cisplatin as neoadjuvant chemotherapy in triple negative breast cancer: Exciting early results
Arun Kumar Goel, Malay Nandy, Gopal Sharma
July-September 2010, 31(3):76-78
DOI
:10.4103/0971-5851.73588
PMID
:21206711
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EDITORIAL
Of teachers and students…
Sudeep Gupta
July-September 2010, 31(3):75-75
DOI
:10.4103/0971-5851.73587
PMID
:21206710
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HISTORY OF ONCOLOGY
First Pediatric Oncology Unit in India at the Cancer Institute (WIA), Chennai
V Shanta
July-September 2010, 31(3):101-102
PMID
:21206719
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