Primary myelofibrosis (PMF) is a neoplastic hematologic disease, characterized by clonal hemapoietic stem cell and collagenaccumulation in bone marrow. PMF is not related with underlying myeloproliferative disorders or other diseases. The features of PMFshow marrow fibrosis, megakaryocytes and granulocytes proliferation, and extramedullary hemapoiesis. PMF is classified as BCR-ABLnegativemyeloproliferative disorders. Diagnosis of PMF is based on clinical symptoms of splenomegaly and myelopthisis; bone marrowbiopsy shows granulocytes/megakaryocytes hyperplasia, megakaryocytes dysmorphic and fibrosis; cytogenic testing for mutation ofJAK2V617F+, MPLW5I5L/K+ and BCR-ABL. The diagnostic criterion according to the 2008 WHO classification considers major andminor crieria. The primary purpose for treatment is to improve the quality of life by paliative tratment. The five year survival of PMFpatients is low.
ABSTRAK.Bawang putih (Allium sativum) telah terbukti memiliki banyak efek positif untuk kesehatan, antara lain antibakteri, antivirus, antijamur dan juga antioksidan. Selain itu, bawang putih juga memiliki beragam efek positif untuk sistem kardiovaskular, antara lain menyebabkan penurunan tekanan darah, mencegah terjadinya aterosklerosis, dan juga bersifat antitrombotik. Salah satu obat antitrombotik yang umum digunakan oleh masyarakat adalah aspirin. Aspirin bekerja dengan cara menghambat pembentukan tromboksan A2. Komponen antitrombotik yang dimiliki bawang putih adalah allisin, yang bekerja dengan berbagai cara, salah satunya dengan cara menghambat jalur pembentukan tromboksan A2 dan ADP. Penelitian ini bertujuan untuk mengetahui efektivitas bawang putih mentah, rebus, dan goreng bila dibandingkan dengan aspirin. Desain dari peneltian ini adalah eksperimental laboratoris dengan 8 (delapan) kelompok yang terdiri dari kelompok kontrol negative (CMC 1%), kontrol positif (Aspirin), kelompok bawang putih mentah dosis tinggi, bawang putih mentah dosis rendah, bawang putih rebus dosis tinggi, bawang putih rebus dosis rendah, bawang putih goring dosis tinggi, dan bawang putih goreng dosis rendah. Setiap kelompok terdiri dari 5 (lima) mencit yang akan menerima perlakuan dalam 1 (satu) bulan. Pada hari ke 30, waktu perdarahan dari setiap mencit akan diukur dengan cara memotong ekor mencit. Hasil dari penelitian ini menunjukkan bahwa kelompok kontrol positif (aspirin) memiliki waktu perdarahan terpanjang, disusul dengan kelompok bawang putih mentah dosis tinggi. Di peringkat ketiga ada kelompok kontrol negative (CMC 1%) dan kelompok bawang putih mentah dosis rendah yang memiliki waktu perdarahan yang sama. Sementara itu, kelompok bawang putih rebus dan goreng, baik pada dosis tinggi maupun rendah, menunjukkan waktu perdarahan yang lebih panjang dibandingkan dengan kelompok kontrol negative (CMC 1%).Pemanjangan waktu perdarahan ini kemungkinan disebabkan karena allisin pada bawang putih yang bersifat termolabil dan terdegradasi dengan peningkatan suhu.
Introduction : Chronic myelogeneous leukemia (CML) is a myeloproliferative neoplasm that can progress into various conditions. Transformation of CML into acute lymphoblastic leukemia (ALL) is a rare case. Case : A 22-year-old male with history of CML since 2014 and positive BCR-ABL p210 in 2017 came with complaint of weakness. Physical examination showed hepatosplenomegaly. CBC results Hb 7.1 g/dL, WBC 290,620/μL, platelet 434,000/μL. Blood smear evaluation (BSE) suggested CML blastic crisis dd AML-M5. Patient’s condition got worse. CBC result showed WBC 96,770/μL and platelet 7,000/μL in 2 weeks later. BSE was dominated by mononuclear cells with scanty blue cytoplasm, no granules, no auer rods, loose chromatine and indistinct nucleoli, suggesting lymphoblasts with a proportion of 60%. Bone marrow aspiration (BMA) and immunophenotyping was done to confirm BSE. The BMA result was dominated by lymphoblast, consistent with ALL. The immunophenotyping result was CD10+, CD34+(0,99%), CD79a+, HLA-DR+, and CD20+. Molecular examination showed positive RUNX1 and NRAS while negative FLT3, NPM1 and del(5q). Discussion : BCR-ABL gene can be found both in CML and ALL. CML transformation into ALL had been reported to be related with deletion of a transcription gene. Diagnosis of ALL can be established by BMA and immunophenotyping. CD34+ expression of lymphoblast in ALL can be varied, but in this case was minimal. Conclusion : Patient with history of CML showed an ALL picture based on BSE, BMA and immunophenotyping suggesting CML transformation into ALL although CD34+ expression was minimal.
Several changes occur during whole blood (WB) storage in the blood banks. The structure of erythrocytes and thrombocytes changes, and their viability decreases. Leukocyte degradation causes the release of cytokines and enzymes that can trigger a transfusion reaction. In addition, a decrease in pH will damage the WB components. The coagulation factors will be degraded during the storage process. All of these changes will impact the WB quality and the recipient. Therefore, this study aims to analyze the effect of storage time on WB quality. This research employed an analytical study with a time series design conducted at the Clinical Pathology Installation and Blood Bank at Dr. Soetomo General Hospital, Surabaya, on February-June 2020. The researchers utilized a sample of sixteen WB bags. The sample will be tested with several examinations, including a complete blood count examination (to determine the number of erythrocytes, leukocytes, thrombocytes, and hemoglobin), the coagulation examination (to determine PPT and APTT), and a BGA examination (to determine pH, pO2, and pCO2). All parameters were checked on day 0, day 5, day 10, day 20, and day 30.
Pasien keganasan hematologi sering menunjukkan gejala anemia dengan hasil laboratorium leukositosis. Tolok ukur penentu anemiasalah satunya hemoglobin, namun pemeriksaannya terganggu oleh jumlah leukosit tinggi yang menyebabkan hemoglobin tinggi palsu.Penelitian ini bertujuan mencari berapa jumlah leukosit minimal penyebab hemoglobin tinggi palsu pada keganasan hematologi. Sampeldarah EDTA pasien keganasan hematologi yang memeriksakan darah rutin di Laboratorium Patologi Klinik RSUD Dr. Soetomo bulanApril–Mei 2016. Penelitian analisis observasional dengan membandingkan hemoglobin tanpa pemusingan dengan hemoglobin setelahpemusingan serta dibuang buffy coat-nya. Terdapat 93 sampel dengan leukemia 43%, limfoma 16,12% dan terduga leukemia 38%.Rerata selisih hemoglobin yaitu 0,06±0,089; 0,025±0,05; 0,1±0,081; 0,15±0,07; 0,81±0,63; 0,94±1,13; 1,13±0,718; 1,6±0,818 g/dL pada peningkatan kelompok jumlah leukosit secara berurutan >11.000-20.000 sel/μL, >20.000-30.000 sel/μL, >30.000-40.000sel/μL, >40.000-50.000 sel/μL, >50.000-100.000 sel/μL, >100.000-200.000 sel/μL, >200.000-300.000 sel/μL, >400.000 sel/μL.Kenasaban rerata selisih hemoglobin dengan kelompok jumlah leukosit menunjukkan makin tinggi leukosit maka makin besar rerataselisih hemoglobin dengan kenasaban positif sedang. Semakin tinggi jumlah leukosit makin tinggi persentase hemoglobin tinggi palsudan rerata selisih hemoglobin makin besar. Leukosit minimal penyebab hemoglobin tinggi palsu pada keganasan hematologi yaitu 56.745sel/μL yang memiliki kepekaan 89,4% dan kekhasan 100%, dengan koefisien 0,592.
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