Anil Handoo

Utility of family studies in diagnosing abnormal hemoglobins/thalassemic states

ObjectiveTo resolve all indeterminate cases on HPLC screening with the help of family studies and to further confirm the results by genetic analysis.MethodsIn our 11 years experience with HPLC at Sir Ganga Ram Hospital, we solved many cases with the help of family studies on parental blood samples in which patient could have possibly been homozygous vs compound heterozygous. Genetic analysis was done on index case as well as on parental samples with ARMS-PCR technique to confirm the results.ResultsIn 100% of cases, we noted that the diagnosis obtained by family studies was commensurate with that obtained by DNA analysis.ConclusionIn centers, which do not have the facility for genetic analysis, family studies by HPLC can be equally useful.

Stem Cell Transplant for Juvenile Myelomonocytic Leukemia and Chronic Myelomonocytic Leukemia

Juvenile myelomonocytic leukemia (JMML) and chronic myelomonocytic leukemia (CMML) are myelodysplastic/myeloproliferative neoplasms associated with poor prognosis. There is no definitive treatment for such patients other than stem cell transplantation, and chemotherapy is not much effective. Timely diagnosis and early referral to the transplant centre is important for the management of these diseases. We report here a case of JMML and another case of CMML who were treated successfully with peripheral blood stem cell transplantation.

Flow Cytometry: A Rapid and Robust Adjuvant Technique for Pathological Diagnosis

.Immunophenotyping was performed using CD45, CD19, CD3, CD5, CD7, CD4, CD8, CD38, CD56, kappa, and lambda light chains. gating was performed using for-ward-side scatter and CD45-side scatter.A single large cluster observed in the lymphocyte region of the SSC/CD45 side scatter showed a high level of CD45 expression and was composed predominantly of T-cells (CD3+) with moderately high CD38 positivity (T-cell activation marker). nothing abnormal with respect to T-cell markers (CD3/CD5/CD7) was noted. reversal of the CD4:CD8 ratio (0.1) was also noted. CD19, kappa, lambda, and CD56 expression was not observed. Immu-nophenotyping results suggested non-neoplastic prolifera-tion of lymphocytes—primarily involving a T-cell compo-nent with an inverted CD4:CD8 ratio, which could also be a manifestation of immunosuppressive states and viral infections, e.g. EBv, Cmv, and HIv [1]. EBv Igm was positive (17.58 U ml

Ascitic fluid cytology and flow cytometry in the primary diagnosis of lymphoma - A case report

Primary diagnosis of lymphomas from ascitic fluid is rare. We report a case in which a patient being worked up as a case of carcinoma head of pancreas turned out to be a lymphoma on routine ascitic fluid examination and was further sub-classified as a CD 10+ B-cell lymphoma on flow cytometric analysis.