Mastocytosis KIT D816V AML Microdissection A B S T R A C TThe KIT mutation D816V is associated with autonomous growth of mast cells (MC) and is detectable in most patients with systemic mastocytosis (SM), including cases with associated hematologic non-MC-lineage disease (AHNMD). Recently, KIT D816V was reported to be expressed in patients with acute myeloid leukemia (AML). However, it was not clarified whether these patients have co-existing occult SM. We investigated neoplastic cells in 101 patients with AML for expression of KIT D816V. In 7/101 patients (6.9%), KIT D816V was detectable. After a thorough histologic, molecular, and biochemical analysis, all 7 cases were found to have an associated SM, leading to the final diagnosis SM-AML. Microdissected tryptaseþ MC displayed KIT D816V in all patients tested, whereas CD34þ blasts exhibited KIT D816V in only 2/4 patients. In one AML patient, SM without KIT D816V was detected.In all other patients, no associated SM was found, and leukemic blasts were negative for KIT D816V. In summary, our data show that KIT D816V in AML is highly associated with co-existing SM (SM-AML). Moreover, our data show that AML blasts may lack this transforming target-mutant, which may be important when considering the use of KIT D816V-targeting drugs for treatment of patients with KIT D816V-positive AML.ª 2010 Federation of European Biochemical Societies.Published by Elsevier B.V. All rights reserved. IntroductionAcute myeloid leukemia (AML) is a life-threatening hematopoi- E-mail address: peter.valent@meduniwien.ac.at (P. Valent). Abbreviations: AML, acute myeloid leukemia; ASM, aggressive systemic mastocytosis; BM, bone marrow; CMML, chronic myelomonocytic leukemia; FAB, FrencheAmericaneBritish; FCS, fetal calf serum; MC, mast cell(s); MCL, mast cell leukemia; PB, peripheral blood; PBS, phosphate-buffered saline; RFLP, restriction fragment length polymorphism; RT, room temperature; SCF, stem cell factor; SM, systemic mastocytosis; TK, tyrosine kinase.

SummaryEffective pain therapy after shoulder surgery is the main prerequisite for safe management in an ambulatory setting. We evaluated adverse events and hospital re-admission using a database of 509 interscalene catheters inserted during ambulatory shoulder surgery. Adverse events were recorded for 34 (6.7%) patients (9 (1.8%) catheter dislocations diagnosed in the recovery room, 9 (1.8%) catheter dislocations at home with pain, 2 (0.4%) pain without catheter dislocation, 1 (0.2%) 'secondary' pneumothorax without intervention and 13 (2.6%) other). Twelve (2.4%) patients were re-admitted to hospital (8 (1.6%) for pain, 2 (0.4%) for dyspnoea and 2 (0.4%) for nausea and vomiting), 9 of whom had rotator cuff repair. A well-organised infrastructure, optimally trained medical professionals and appropriate patient selection are the main prerequisites for the safe, effective implementation of ambulatory interscalene catheters in routine clinical practice.

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