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We hypothesized that serum PTH might be associated with various clinicopathological parameters in multiple myeloma (MM). So we investigated the implications of serum PTH in MM patients and the relationship with other risk factors of MM. A total of 115 patients who were newly diagnosed with MM were enrolled. Serum PTH level was 24.7 ± 34.9 (ranged 0.0–284.1) pg/mL. Serum levels of IgG, IgM, FLC-lambda, albumin, and LDH were in positive correlation with serum PTH. Compared to non-high PTH (<68.3 pg/mL) group, the hazard ratio (HR) for overall survival was higher for group with high PTH level (≥68.3 pg/mL) (HR, 1.710). Furthermore, the patient group with high PTH level showed inferior progression-free survival than non-high PTH group (P = 0.056). Interestingly, subgroup analysis showed that serum PTH level at diagnosis was associated with risk factors and clinical outcome in MM patients, especially in complete remission group, transplantation cases, ISS stage II cases, and cases without chromosome abnormality. In conclusion, this study showed that blood PTH level in MM at diagnosis was associated with risk factors and clinical outcome in MM patients.

Blastocystis is an obligate anaerobic microbial eukaryote that frequently inhabits the gastrointestinal tract. Despite this prevalence, very little is known about the extent of its genetic diversity, pathogenicity, and interaction with the rest of the microbiome and its host. Although the organism is morphologically static, it has no less than 28 genetically distinct subtypes (STs). Reports on the pathogenicity of Blastocystis are conflicting. The association between Blastocystis and intestinal bacterial communities is being increasingly explored. Nonetheless, similar investigations extending to the metabolome are non-existent.Using established NMR metabolomics protocols in 149 faecal samples from individuals from South Korea (n = 38), Thailand (n = 44) and Turkey (n = 69), we have provided a snapshot of the core metabolic compounds present in human stools with (B+) and without (B−) Blastocystis. Samples included hosts with gastrointestinal symptoms and asymptomatics. A total of nine, 62 and 98 significant metabolites were associated with Blastocystis carriage in the South Korean, Thai and Turkish sample sets respectively, with a number of metabolites increased in colonised groups. The metabolic profiles of B+ and B− samples from all countries were distinct and grouped separately in the partial least squares-discriminant analysis (PLS-DA). Typical inflammation-related metabolites negatively associated with Blastocystis positive samples. This data will assist in directing future studies underlying the involvement of Blastocystis in physiological processes of both the gut microbiome and the host. Future studies using metabolome and microbiome data along with host physiology and immune responses information will contribute significantly towards elucidating the role of Blastocystis in health and disease.

4004 Background: Mitochondrial DNA (mtDNA) is widely used in forensic identification and anthropologic studies on account of its abundance resulting in preferential amplification, sequencing and inherent variability. We developed mtDNA markers to monitor donor cell engraftment after allogeneic stem cell transplantation(SCT), then compared with nuclear short tandem repeat (STR) markers. Patients and methods: The mtDNA control regions and six mtDNA minisatellites (mtMS) (303 poly C, 16184 poly C, 514 (CA) repeat, 3566 poly C, 12385 poly C and 12418 poly A) from the total DNA samples of 215 cases (donor, recipient and after allogeneic SCT) were amplified using the designated specific primers and PCR. The results were compared with those from the six short tandem repeat (STR) markers (D12S391, D18S51, F13A1, HUM RENA-4, HUM FABP2 and Amelogenin). Results: Polymorphisms in the mtDNA control region identify an informative marker in 88% (189 cases) of all cases. Among the six mtMS markers, the informativeness of 303 poly C and 16184 poly C mtMS was 63% and 67% respectively. A combination of direct sequencing through the mtDNA control region, 303poly C and 16184 poly C mtMS could completely distinguish the donor cells from the recipient cells. The results from a typical mixing experiment to determine the sensitivity revealed a detection limit (DL) of the gene scan analysis in a mtDNA mixture to be visible at 1% heteroplasmy in 303 poly C mtMS marker. However, the DL from D12S391 in the same mixing experiment was 5–10% heteroplasmy. Conclusions: mtMS markers, especially 303 poly C and 16184 poly C markers, can provide a sensitive, accurate and quantitative determination of mixed chimerism after a SCT. Disclosures: No relevant conflicts of interest to declare.

Th e frequency of simultaneous paroxysmal nocturnal hemoglobinuria (PNH) clones in patients with myelodysplastic syndrome (MDS) ranges from 12.8 to 15.5% [1]. Th e clinical signifi cance of PNH-type cells in MDS is controversial. One study reports that the presence of an increased number of PNH-type cells was predictive of a good response to immunosuppressive therapy and a favorable prognosis among patients with marrow failure [2]. However, another study reports that patients with MDS of worse prognosis more strongly expressed the PNH clone compared to patients with refractive anemia (RA) and refractory anemia with ringed sideroblasts (RARS), who had a better prognosis [1]. Marrow failure, especially MDS, occasionally shows thrombocytosis due to an overlap of myeloproliferative neoplasms (MPNs) and association with some MDS subtypes. Classically, thrombocytosis has been associated with the MDS subtypes RARS and 5q Ϫ syndrome. Here, we report an extremely rare and interesting case of PNH-MDS associated with marked thrombocytosis and clonal chromosomal abnormality.A 51-year-old man suff ered from fever and pleural eff usion with left chest pain, which persisted for 1 month despite antimicrobial treatment. Th e patient was a heavy alcohol drinker and smoker. Physical examination revealed anemic conjunctiva, crackles in the left lung and splenomegaly. At admission, the following hematologic features were found: hemoglobin 8.3 g/dL, hematocrit 25.9%, mean corpuscular volume 103.8 fL, leukocyte count 10 300/ μ L with 2.6% basophils, 10.8% monocytes, and a platelet count of 532 000/ μ L. Serum levels of vitamin B12 and folate were in the normal ranges. Serum iron (16 μ g/dL) and total iron binding capacity (166 μ g/dL) levels were decreased, and the ferritin level (496.4 ng/dL) was elevated. Th e coagulation profi le showed a slightly prolonged prothrombin time (16.5 s, international normalized ratio 1.50, 46.9%), prolonged activated partial thromboplastin time (51.6 s), and elevated levels of D-dimer (0.74 mg/L), fi brin degradation product (10.0 μ g/mL) and fi brinogen (474.3 mg/dL). Th e C-reactive protein level (1.98 mg/dL) and lactate dehydrogenase (LDH) activity (1545 U/L) were also elevated. Laboratory parameters for evaluating hemolysis were in the normal ranges: total bilirubin 0.66 mg/dL, direct bilirubin 0.22 mg/ dL, haptoglobin 63.7 mg/dL, no abnormal urine analysis and negative for occult blood. Computed tomography scans of the chest showed empyema with pleural eff usion in the left hemithorax. Examination of pleural fl uid revealed a bloody color and leukocytes 1382/ μ L (96% lymphocytes), protein 5.0 g/dL (serum protein 6.5 mg/dL), albumin 2.9 g/dL (serum albumin 3.6 mg/dL), LDH activity 1457 U/L (serum LDH 1545 U/L), adenosine deaminase 59.8 IU/L and glucose 86 mg/dL (serum glucose 99 mg/dL). Screening for tuberculosis using the QuantiFERON assay was positive. Th erefore, tuberculosis pleurisy was suspected and the patient was treated for tuberculosis. Peripheral blood smears revealed moderate macrocytic...