Background:Anaemia is a common extra-articular manifestation of rheumatoid arthritis (RA) where anaemia of chronic disease (ACD) and iron deficiency anaemia (IDA) are the two most frequent types. The distinction between these two types of anaemia has always been challenging requiring sophisticated techniques. Serum transferrin receptor (sTfR) a truncated soluble form of the transferrin receptor is one of the parameters that is influenced by the Iron content and supply to the erythrons and is not affected by inflammatory status and therefore the use of the sTfR/log ferritin (sTfR-F) index can be a reliable indicator of functional iron deficiency.Aim of the study:This study aims to evaluate the usefulness of sTfR and sTfR-F index in discriminating the most common types of anaemia in patients with RA.Patients and methods:The study included 50 patients with RA and 30 healthy subjects as a control group. Complete blood picture, C-reactive protein, serum Iron, unsaturated iron binding capacity, sTfR and serum ferritin were tested.Results and Conclusion:anaemia was present in 34/50 patients; 19 patients had ACD, 9 had ACD/IDA and only 6 patients had IDA. Both the sTfR and the sTfR-F index showed a significant difference between anaemia groups (P values = 0.037 and 0.001, respectively). sTfR-F index has shown to be a very useful parameter that can discriminate efficiently between IDA and ACD and between ACD and ACD/IDA in patients with RA.

Background: JAK2V617F mutation is the most prevalent molecular abnormality in myeloproliferative neoplasms (MPNs) and has become a valuable marker for diagnosis of MPNs. Almost all patients with polycythemia vera (PV) have this acquired mutation. However, it has also been found in many other hematological diseases, and some studies even detected the presence of JAK2V617F in normal blood samples. Objectives: To discuss the actual need to defer blood donors with high hematocrit. Patients and methods: This prospective case control study was started on 16th of December 2012 and completed on 8th of July 2013, and enrolled 94 male blood donors who attended the National Blood Transfusion Center (NBTC) in Baghdad, Iraq. Their age range was between 21 and 62 years, and their hematocrit was ≥ 0.48 l/l. A control group of 20 patients known to have JAK2V617F positive PV were also included. The following investigations were done for both the study and the control groups: complete blood count, serum erythropoietin, and real time PCR for JAK2V617F detection. Results: The present study found that 21.3% (20/ 94) of healthy blood donors were positive for JAK2V617F mutation. The mutant ratio was higher in the PV control than positive JAK2V617F donors (p=0.001). Out of 20 donors who have positive JAK2V617F mutation, 90% were smokers, and 22.8% (18/79) of all smokers were positive for JAK2V617F, while 13.3% (2/15) of non-smokers showed positivity for the mutation, the difference between various types of smoking and the level of JAK2V617F mutation among study groups was statistically insignificant with a p-value of 0.356. There is a frequent association of pruritis with JAK2 positivity as the percentage of pruritis in JAK2V617F positive blood donors was 40%. There was significant statistical difference between donors with positive JAK2V617F mutation and the PV control group for the hematocrit, total WBC count, absolute neutrophil count, and platelet count with p-values of (0.002), (0.001), (0.001), and (0.001) respectively. Conclusion:The frequency of JAK2V617F mutation was much higher than that anticipated for blood donors. The blood donated from individuals with upper normal hematocrit does not necessarily denote to complete safety of blood as being devoid of JAK2V617F mutation.

Background: JAK2V617F mutation is the most prevalent molecular abnormality in myeloproliferative neoplasms (MPNs) and has become a valuable marker for diagnosis of MPNs. Almost all patients with polycythemia vera (PV) have this acquired mutation. However, it has also been found in many other hematological diseases, and some studies even detected the presence of JAK2V617F in normal blood samples.Objectives: To discuss the actual need to defer blood donors with high hematocrit.Patients and methods: This prospective case control study was started on 16th of December 2012 and completed on 8th of July 2013, and enrolled 94 male blood donors who attended the National Blood Transfusion Center (NBTC) in Baghdad, Iraq. Their age range was between 21 and 62 years, and their hematocrit was ≥ 0.48 l/l. A control group of 20 patients known to have JAK2V617F positive PV were also included. The following investigations were done for both the study and the control groups: complete blood count, serum erythropoietin, and real time PCR for JAK2V617F detection.Results: The present study found that 21.3% (20/ 94) of healthy blood donors were positive for JAK2V617F mutation. The mutant ratio was higher in the PV control than positive JAK2V617F donors (p=0.001). Out of 20 donors who have positive JAK2V617F mutation, 90% were smokers, and 22.8% (18/79) of all smokers were positive for JAK2V617F, while 13.3% (2/15) of non-smokers showed positivity for the mutation, the difference between various types of smoking and the level of JAK2V617F mutation among study groups was statistically insignificant with a p-value of 0.356. There is a frequent association of pruritis with JAK2 positivity as the percentage of pruritis in JAK2V617F positive blood donors was 40%. There was significant statistical difference between donors with positive JAK2V617F mutation and the PV control group for the hematocrit, total WBC count, absolute neutrophil count, and platelet count with p-values of (0.002), (0.001), (0.001), and (0.001) respectively.Conclusion: The frequency of JAK2V617F mutation was much higher than that anticipated for blood donors. The blood donated from individuals with upper normal hematocrit does not necessarily denote to complete safety of blood as being devoid of JAK2V617F mutation.

JAK2V617F mutation is the most prevalent molecular abnormality in myeloproliferative neoplasms (MPN). This study aims to evaluate the impact of JAK2 V617F allelic burden on clinical and laboratory parameters in MPN.Fifty four patients with MPNwere enrolled in this study. JAK2 V617F allelic burden was determined using a real time PCR. JAK2 V617F was found in 91.7% of polycythaemiavera (PV) cases, in 66.7% of patients with essential thrombocythaemia (ET), and in 75% of patients with primarymyelofibrosis (PMF). The total WBC and absolute neutrophil counts and the presence of splenomegaly were all significantly higher in PV patients with allelic burden greater than 50% than in patients with allelic burden less than 50%.These findings were not observed in patients with ET or in patients with PMF. There was no significant difference for JAK2 V617F between the three MPN disease groups. In conclusion, JAK2 V617F allelic burden ≥30% has evident influence on clinical and laboratory parameters in patients with PV. Only platelet count was noticed to show continued significant difference down to a level of 10%.

Background: Acute lymphoblastic leukaemia accounts for approximately 14% of leukaemia cases in the adults with B linage subtype being more common than T linage subtype. immnophenotyping using the multicolour flow cytometry is an essential tool for diagnosis, classification as well as treatment guidance and prognosis. Objectives: This study aims to provide an overview of the immunophenotypic profile of adult ALL cases in Iraq, it’s possible link with other characters and also study the frequency of expression of aberrant myeloid antigens in them. Patients and methods: this is a descriptive study included 64 adult patients diagnosed as ALL in haematology unit at Baghdad teaching hospital for the period between May 2014 till May 2015 , immunophenotyping was carried out at the flow cytometry laboratory in the nursing home hospital using 6 coloured (BD-FACS-Canto II System from Becton Dickenson). Results: of the study population 63.7% of the cases were B-ALL and 27.5% were T-ALL, there was no significant difference in respect to age and gender between them. Of the CD markers used both CD10 and CD34 were significantly associated with B-ALL compared to T-ALL (p values 0.002 and 0.003 respectively).aberrant myeloid Ag expression was seen in 43.18% of B-ALL cases and in 52.6% of T-ALL cases with no significant difference however aberrant myeloid Ag expression was significantly associated with CD34 expression with a p value of 00.018. Conclusion: Immunophenotyping retains a crucial place in the work up for patients with acute lymphoblastic leukaemia. CD34 was significantly associated with B linage ALL and with aberrant myeloid Ag expression, larger study with clinical evaluation and cytogenetic study is recommended to evaluate the impact of those findings over prognosis.