Yi-Kong Keung

Prevention and management of central venous catheter thrombosis.

Central venous catheters play an integral part in the treatment of patients with a variety of illnesses. Complications, although not common, do occur. However, the benefits of these devices far outweigh the risks. Thrombosis, one of the most common problems, can be divided into three distinct clinical entities. The prophylaxis, diagnosis, pathogenesis, and treatment of central venus catheter-related thromboses are critical in the treatment of patients requiring long-term venous access.

Secondary syringomyelia due to intramedullary spinal cord metastasis : Case report and review of literature

Intramedullary spinal cord metastasis is relatively rare. We describe a patient having intramedullary spinal cord metastasis associated with syringomyelia, confirmed by magnetic resonance imaging, in a patient who had poorly differentiated carcinoma of the lung. The patient responded to treatment with steroids and radiotherapy, with complete resolution of neurologic symptoms and syringomyelia.

Determining factors for the outcome of peripheral blood progenitor cells harvests

This is a pilot retrospective study to investigate the factors that may affect the collection of peripheral blood progenitor cells (PBPC). Sixty‐nine PBPC harvests in 18 cancer patients (median age 39.5:8 males and 10 females) were performed during marrow recovery after chemotherapy and hematopoietic growth factors. Median number of nucleated cells (MNC) collected were 13.3 (range 2.3–44.5) × 109 per session. Median CFU‐GM was 362 colonies (range 63–1,720) per 500,000 MNC. Neither sex, body weight, diagnosis, nor the number of days into leukapheresis was significantly associated with MNC and CFU‐GM. Older patients tend to have higher CFU‐GM in the PBPC harvests (P = .0437). Higher WBC on the day of harvest is significantly associated with higher yield of MNC after leukapheresis (P < .0001). Patients without any evidence of disease have significantly higher yield of MNC than those having local/distant metastases with or without marrow involvement (P = .0302 and .0446). For patients with metastatic disease, those with bone marrow involvement tend to have higher CFU‐GM than those without bone marrow involvement although the difference is not statistically significant (P = .0559). Those patients who have received only one, or three and more chemotherapy regimens have a higher yield of MNC than those who have only two previous chemotherapy regimens (P = .036 and .0324). The mechanism of PBPC mobilization is also discussed. In view of the limited patient number in this study, the results should be confirmed by larger studies.

Translocation t(15;17) in acute myelogenous leukemia with atypical megakaryoblastic features: Diagnostic, clinical, and therapeutic implications

We describe the first reported case of acute myelogenous leukemia with characteristics of megakaryoblastic differentiation and the t(15;17) chromosomal translocation, which has been associated with promyelocytic leukemia. The diagnostic, clinical, and therapeutic implications are discussed.

Myelodysplasia-Like Syndrome and End-Stage Liver Disease

We report 2 cases of myelodysplastic syndrome associated with cirrhosis caused by primary biliary cirrhosis and α1-antitrypsin deficiency. The etiology of myelodysplasia and its implication in liver transplantation is discussed.

Translocation (X;14)(p11;q32) in a patient with refractory anemia

Abstract We describe an unusual translocation, t(X;14)(pl1;q32), in a patient with refractory anemia of myelodysplastic syndrome.

Cocaine-Contaminated Allogeneic Bone Marrow Transplantation

Should a person with history of drug addiction be categorically denied as a bone marrow donor? The answer to the question is controversial. We report a case of allogeneic bone marrow transplantation for refractory acute myeloid leukemia preceded by essential thrombocythemia. The donor used cocaine and marijuana the night before the bone marrow harvest.

Development of minimally differentiated acute myeloblastic leukemia with novel isochromosome 18p and antecedent aplastic anemia

We describe a case of acute myeloblastic leukemia with a novel isochromosome 18, i(18)(p10), preceded by aplastic anemia for six months. The patient is a cotton grower chronically exposed to pesticides. The significance of this chromosomal abnormality is unknown. The possible relationship to the preceding history of aplastic anemia and occupational pesticide exposure is speculated on. The possible mechanism of the association of acute leukemia and aplastic anemia is discussed.