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Sat, 20 Jul 2024 16:03:54 +0000The current gold standard as initial therapy is a combination of an immunomodulatory agent (IMiD), a proteasome inhibitor, and dexamethasone such as CRD. Very intensive chemotherapy was then given with two cycles of cyclophosphamide, vincristine, doxorubicin, and methotrexate alternating with two cycles of iphosphamide, etoposide, and high-dose cytosine arabinoside (CODOX-M/IVAC). Hematology and Hemostasis Customer Case Studies and White Papers. This patient has early stage (IIA) favorable classic Hodgkin lymphoma by the National Comprehensive Cancer Network (NCCN), European Organisation for the Research and Treatment of Cancer (EORTC), and German Hodgkin Study Group (GHSG) criteria given age younger than 50 years, no B symptoms, normal ESR, and only two nodal sites (right neck and mediastinum) without bulky disease or extranodal involvement. However, the high troponin T level of 85 mg/L and the fact that her systolic blood pressure was only 90 mm Hg generated resistance to this approach, and she was started on a regimen of melphalan and dexamethasone with the addition of low-dose lenalidomide (0. Which of the following statements regarding treatment outcomes in BL is FALSE? A. IgG is the most frequent type of paraprotein found in myeloma.
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He also complained of intermittent fevers, loss of appetite, and loss of weight, which proved to be 12% of his usual weight. Finding the Best Prognostic Outcome in a Patient With AML. The IGHV gene was mutated. The immunoglobulin (Ig) levels were normal, but an IgM paraprotein was just detectable on serum protein electrophoresis. Hematology Case Studies (made up) Flashcards. A 67-year-old man is evaluated for exertional dyspnea. A splenectomy was performed, with normalization of the hemoglobin, neutrophil, and platelet counts, but a rise in the lymphocyte count to 20. Her hemoglobin was 128 g/L, the WBC was 5. The lactate dehydrogenase (LDH) level was 690 IU/L (normal <214 IU/L). The abnormal lymphoid cells were CD19+, CD20+, CD79+, CD5-, and CD10-. Anemias and Myeloid Malignancies. The presence of scattered EBV+ B-cells is frequent in AITL and is thought to reflect an element of underlying immunodeficiency.
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LGL clones have been described in AML and a hallmark of this association is cytopenia, as is observed in this patient. The cyclophosphamide was stopped, and the patient has remained in clinical remission for the past 3 years. Authors: Jonathan E. Brammer; Anjali Mishra; Aharon G. Freud; Pierluigi Porcu. Microcytic Anemia Refractory to Oral Iron Supplementation.
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What diagnosis do you suspect at this point? Which other situations should arouse suspicion of Ig or light chain amyloidosis? Authors: Morie A. Gertz; Taimur Sher; Angela Dispenzieri; Francis K. Buadi. Which of the following is the most likely diagnosis? What is the treatment plan for hairy cell leukemia? Hematology case studies with answers pdf online. Trisomies are frequent in myeloma, but, strangely, they mainly involve odd numbered chromosomes (chromosomes 3, 5, 7, 9, 11, 15, 19, and 21). B. Involved-field radiotherapy of at least 45 Gy.
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The breath test at 6 weeks was negative, confirming eradication of H. pylori. The serum N-terminal B-type natriuretic peptide (NT-proBNP) and troponin-T were both raised (see below). Sickle Cell Disease – A 25-Year-Old in Transition. On examination, his temperature was 38.
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It frequently undergoes transformation to a large-cell lymphoma. Although it is not possible to make a diagnosis without histology, the pronounced B symptoms, disseminated lymphadenopathy and hepatosplenomegaly, skin rash, eosinophilia, concomitant autoimmune hemolysis, hypergammaglobulinemia, and presence of a paraprotein are characteristic of AITL. CD23 is not usually expressed, which helps differentiate this proliferation from chronic lymphocytic leukemia, another CD5+ B-cell malignancy. Hematology case studies with answers pdf to word. Putting Two and Two Together (May 2011). Clonal thrombocytosis is related to a myeloproliferative neoplasm, which usually causes splenomegaly. Treat ONLY if symptomatic "active dx", otherwise just observe. The edema reduced but did not fully resolve. Some patients with light chain amyloidosis have typical myeloma signs or symptoms such as hypercalcemia, renal failure, anemia, and bone lesions (CRAB criteria), but if these are not present when the amyloidosis is diagnosed, they do not usually develop.
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Standard doses of lenalidomide are not tolerated in light chain amyloidosis. Monoclonal Gammopathy. The hemoglobin was 102 g/L with an MCV of 106 fl. Investigations at this time revealed a hemoglobin of 110 g/L, a WBC of 8. A diagnosis of amyloidosis was confirmed, and microdissection mass spectroscopy showed that the amyloid was composed of Ig light chains. Hematology case studies with answers pdf downloads. Dabigatran is FDA approved as an anticoagulant for patients who have received a mechanical heart valve. Laboratory testing shows normal results for a complete blood cell count and for tests of liver and kidney function.
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What is the suspected diagnosis? IgG myeloma accounts for about 60% of cases with about 20% being Ig A and a similar proportion light chain only. Watchful waiting, chemo vs biologic therapy. The β2m level was 2. Sickle-shaped cells appear on the peripheral blood smear. He appeared moderately dehydrated. The patient had a CT/PET scan, and no disease was found outside of the breast. Subsequently, the neutrophil count dropped over a period of about 6 months to 0. FCR is probably the optimal therapy for a relatively young patient such as this with good-risk disease.
5 years, but the hemoglobin and platelet count are now again declining. Although there is a strong possibility that the patient has AITL, it is not possible, without histology, to say that she definitely has a lymphoma. In the past, she had an appendectomy when an adolescent and had a cholecystectomy at age 46 years. A chest x-ray examination shows a mediastinal mass ratio less than 0. A computed tomographic scan showed a 12-cm-diameter anterior mediastinal mass. In addition, he had become aware of enlarged nodes, about 2 cm is size, in both inguinal regions.
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