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Nicoleta Berbec, Anca Roxana Lupu, Silvana Angelescu, Diana Mandescu and Maria Bari

Open access

Silvana Angelescu, Cristina Mambet, Delia I. Mut Popescu, Nicoleta M. Berbec, Andra Costache, Mihai Isaroiu and Anca R. Lupu

Abstract

Eosinophils are leukocytes with multiple functions in physiologic and pathologic circumstances. Eosinophilia is typically associated with reactive conditions (helmintic infections, allergic or drug reactions and atopic disorders) and sometimes with hematologic and non- hematologic malignancies. Evaluation of a patient with eosinophilia requires numerous imaging investigations and laboratory tests for establishing the right treatment. We measured the degree of eosinophilic activation using serologic biomarkers such as serum eosinophil cationic protein (ECP) , interleukin-5 (IL-5) and eosinophilic cationic protein/eosinophil count (ECP/Eo) ratio in order to differentiate earlier among distinct eosinophilic conditions: clonal, non-clonal with malignancy and reactive eosinophilia with inflammation. The median ECP value in eosinophilic patients was significantly higher when compared to that of the control group (19.55 vs. 4.93 ng/mL, p<0.05). Within patients with eosinophilia, the clonal eosinophilia group showed a significantly higher median ECP value compared to the median ECP values of the non-clonal eosinophilia groups - (30.15 vs. 19.5 ng/mL, p<0.05 and respectively 30.15 vs. 13.3 ng/mL, p<0.05). Also patients having non-clonal eosinophilia with malignancy had a significantly higher median ECP value compared to those of reactive eosinophilia and inflammation (19.5 vs. 13.3 ng/mL, p<0.05). While ECP serum levels seemed to be a discriminatory tool for different groups of eosinophilic patients IL-5 and ECP/Eo were less useful for this purpose. However our results must be confirmed in larger studies

Open access

Nicoleta P. Berbec, Sorina M.F. Papuc, Andreea C.D.F. Tutulan-Cunita, Silvana M. Angelescu, Anca I. Lupu and Aurora A. Arghir

Abstract

De novo acute myeloid leukemias (AML) represent a heterogeneous group of clonal hematopoietic disorders in which chromosomal abnormalities are detected in a majority of patients. At present, cytogenetic changes are recognized as important diagnostic markers and prognosis determinants. Complex karyotype changes are associated with resistance to treatment and unfavorable evolution. We report on an AML case with complex karyotype changes characterized by molecular genetic techniques (fluorescence in situ hybridization - FISH and array-based comparative genomic hybridization - array-CGH) and an extremely poor outcome. A 72 year-old female patient was admitted for genetic investigations with a clinical diagnosis of AML. Classical and molecular cytogenetic tests as well as array-CGH were performed. Complex chromosomal abnormalities were identified at diagnosis, consisting of genomic imbalances involving chromosomes 6, 7, 9, and 17. AML with complex karyotype changes is a heterogeneous disease, as a variety of genomic abnormalities are detected, involving virtually all chromosomes. The pathogenesis of AML with complex karyotype is poorly understood. The complexity of karyotypic changes in our case highlights the importance of using complementary genetic investigation in order to obtain a comprehensive view of AML genome.