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Objectives: Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by the presence of autoantibodies against nuclear antigens and immune complex deposition. The pathogenesis of SLE is not fully understood; however, there are alterations in neutrophils and lymphocytes. Recent parameters assessing both neutrophil activations (Neut‐RI, Neut‐GI, IG) and activated lymphocytes (Re‐Lymp, As‐Lymp) can be used to assess the activation of immune cells. The aim of this study was to explore the potential role of this parameter in detecting active SLE. Methods: Cross‐sectional study using secondary data from Hasan Sadikin Lupus Registry. Parameters were examined using Sysmex XN‐1500. Lupus activity was determined according to SLEDAI‐2K. Results: This study included 30 active (SLEDAI 2K ≥ 4) and 30 inactive SLE patients. Compared to inactive SLE, active SLE showed significantly higher Neut‐RI (51.5 vs. 49.6 FL, p = 0.004), and lower Re‐Lymph (0.09 vs. 0.14 × 103/mm3, p = 0.024). There was no significant difference in Neut‐GI (150 vs. 151.6 SI, p = 0.359), As‐Lymp (0.02 vs. 0.01 × 103/mm3, p = 0.621), and IG (0.11 vs. 0.06 × 103/mm3, p = 0.384) between active and inactive SLE. Neut‐RI/Re‐Lymp ratio cutoff > 0.47 could distinguish between active and inactive SLE with AUC 0.689, 66.7% sensitivity, and 70.0% specificity. Conclusion: In active SLE, there is an elevation in Neut‐RI and a reduction in Re‐Lymp. Neut‐RI/Re‐Lymp ratio exceeding 0.47 could be used to detect active SLE. [ABSTRACT FROM AUTHOR]

Background: No specific data have been systematically collected regarding lymphoma patient characteristics, while non-Hodgkin lymphoma (NHL) is identified as the 7th most common cancer and Hodgkin lymphoma (HL) is the 28th. Inflammation plays an important role in the pathogenesis and progression of lymphoma. Malnutrition is an adverse prognostic factor in lymphoma. Systemic Inflammatory Index (SII), Prognostic Nutritional Index (PNI), and Advanced Lung Cancer Inflammation Index (ALI) were biomarkers depicting inflammation and nutritional status. This study aims to describe the clinical and biomarker characteristics of both HL and NHL patients. Methods: This descriptive study used a cross-sectional design, and data were collected from Hasan Sadikin Hospital lymphoma registry from January 2020 to November 2023. Demographic, staging, and histopathological data were extracted. Three biomarkers were evaluated. Survival curves were drawn using Kaplan–Meier curve analysis, and the log rank test was used for comparison of survival between early and advanced stage. Results: A total of 271 patients were recruited as participants, and the majority (80.5%) had NHL, with diffuse large B-cell lymphoma (DLBCL) being the most common histopathological type (50.5%). Early disease was observed in two-thirds of patients, and low-risk International Prognostic Index (IPI) score was the most common prognostic score found (95%). SII was slightly higher in early compared to advanced stages. Treatment response was evaluated from 101 patients, and complete response was observed in 44.5%. Two-year overall survival (OS) was 93.1%, with median survival 22.7 (95% CI 21.9– 23.5) months. In early stage, the median survival was slightly longer than in advanced stage [23.0 (95% CI 22.2– 23.8) vs 21.6 (95% CI 19.3– 23.8) months, P= 0.09]. Conclusion: Hodgkin lymphoma and DLBCL had similar clinical and biomarker characteristics. There were slight differences between the three biomarkers SII, ALI, and PNI based on the disease stage. Almost all patients still survived at 2-year follow-up. [ABSTRACT FROM AUTHOR]

Prussian blue staining examination is the current gold standard for evaluation of bone marrow iron storage. This procedure requires bone marrow aspiration examination, which is physically uncomfortable, expensive, and burdensome for patients. Reticulocyte hemoglobin equivalent (RET-He) determination is a method used to detect hemoglobin in reticulocytes, an indicator of potential iron deficiency and erythropoietic disorders. The purpose of this study is to assess RET-He as a method of measuring bone marrow iron storage. From August-December 2017, secondary data were collected from 50 patients (24 females and 26 males) without history of blood transfusion four days prior to RET-He. Data was analyzed using chi-squared and unpaired t-test. Between positive and negative bone marrow iron storage groups, there were significant differences in mean age (44 vs. 53 y, respectively, p= 0.024) and RET-He (29.7 vs. 26.9, respectively, p= 0.041). Based on ROC analyses, the AUC score was 0.672 (p= 0.030), which indicates that RET-He > 28.8 represents positive bone marrow iron storage with 72.0% sensitivity and 68.0% specificity. RET-He can be used as a method of measuring bone marrow iron storage. [ABSTRACT FROM AUTHOR]

POEMS syndrome is defined by the presence of a peripheral neuropathy (P), a monoclonal plasma cell disorder (M), and other paraneoplastic features, the most common of which include organomegaly (O), endocrinopathy (E), skin changes (S). Not all features of the disease are required to make the diagnosis. We report a case of POEMS syndrome in a 50-year-old female who presented with weakness, abdominal swelling and history of red cell transfusions. Because of the hepatosplenomegaly (Schuffner VII) we diagnosed her as chronic myelocytic leukemia (CML) or myelofibrosis. Her peripheral blood smear did not show granulopoiesis maturation from myeloblast nor leukoerytroblastic feature which was characteristic of CML and myelofibrosis. We found also anemia, peripheral motoric neuropathy and hyperpigmentation at her legs. The protein electrophoresis showed monoclonal gammopathy on b2 globulin. Bone marrow examination showed normal plasma cells. There was no lytic or sclerotic lesion on Schedel and tibia x-ray. The echocardiography showed pulmonary hypertension, pulmonary regurgitation, right and left ventricle hypertrophy with normal ejection fraction (50%). She was treated with melphalan 10 mg/m2 (day 1-4) and prednisone 60 mg/m2 (day 1-4) every 6 weeks with packed red cells transfusion. After 3 cycles the monoclonal protein was reduced from 35.5% to 26.1% (normal 2-5%) without changes in her spleen size. Until then she continued on melphalan and prednisone treatment. Although POEMS syndrome is a rare disease, it should be considered in patient with hepatosplenomegaly, especially if accompanied by peripheral neuropathy.

Thrombotic complications in acute leukemia are often underestimated because bleeding complications generally dominate the clinical picture. While there are many thrombogenic factors shared by both solid tumors and leukemia, many additional prothrombotic features are present in leukemia. The prothrombotic factors include hyperleukocytosis, increased expression of tissue factor and its activation in leukemic cells, and the prothrombotic adverse effects of therapeutic agents and vascular access cathethers. A 18-year old woman came with swelling on her right leg 10 days before hospital admission. Since 2 months before she had had weakness, pallor and fever without bleeding manifestation. Hematologic examinations showed anemia, leukocytosis with monoblast and thrombocytopenia. Deep vein thrombosis in right femoral and right popliteal vein was confirmed using compression ultrasonography. The treatment of such complications is challenging because of the high risk of hemorrhage in this group of patients, especially due to their severe thrombocytopenia.

Aim: To investigate the hematologic manifestation and the relationship of the abnormalities with mortality., Methods: We examined hematologic data from 10 Avian influenza patients in Hasan Sadikin Hospital Bandung between November 2005 and March 2007., Results: The mortality rate was 70%. Anemia was found in 30% (3 of 10 patients). Leukopenia was found in 60% (6 of 10 patients. Lymphopenia and neutropenia were found in 50% (4 of 8 patients) and 62.5% (5 of 8 patients). Sixty percent (6 of 10 patients) had thrombocytopenia. Anemia was not correlated with mortality (OR=0.08). Leukopenia, neutropenia and lymphopenia were correlated with mortality (OR=5, OR=8 and OR=12, respectively). Thrombocytopenia was also correlated with mortality (OR=5)., Conclusion: Leukopenia, neutropenia, lymphopenia and thrombocytopenia were common findings among avian influenza patients in Hasan Sadikin Hospital. Decreased white blood cells and platelets were correlated with mortality.

Neutropenic enterocolitis or typhlitis (from the Greek typhlon, meaning caecum) is defined as a necrotizing colitis with inflammation of the cecum and surrounding tissues. Although this condition occurs primarily in severely myelosuppressed and immunosuppressed patients with leukemia, it may also occur in those with other advanced malignancies receiving myelosuppressive chemotherapy. It has been described most recently in patients with solid tumors who receive taxane-based therapy. A 60-year old woman with medullary breast cancer stage IIIB underwent neoadjuvant chemotherapy with TAC (doxetaxele 100 mg/m2, doxorubicin 50 mg/m2 and cyclophosphamide 600 mg/m2). Sixth day after TAC chemotherapy, she had abdominal pain and vomiting. Abdomen CT scan showed diffuse circumferential thickening of ileum wall typical for ileitis, narrowing of the lumen, disturbance of peristaltic. This abdomen CT scan was thought as abnormality pictures of neutropenic enterocolitis. Neutropenic enterocolitis should be considered in patients with abdominal symptoms especially during the granulocyte nadir following chemotherapy. Increased awareness of this rapidly progressive and potentially fatal disease leads to accurate diagnosis and the prompt treatment that can decrease morbidity and mortality.

Aim: autophagy is a pivotal physiological process for survival during starvation, differentiation and normal growth control. It is defined as the process of sequestrating cytoplasmic proteins or even entire organelles into the lytic compartment (lysosome/vacuole). This study investigates the expression of autophagy in Hodgkin lymphoma cells treated with various anti-cancer drugs., Methods: Hodgkin's lymphoma cells (HD-My-Z cells) were cultured with various anti-cancer drugs, such as bleomycin, adriamycin, gemcitabine and paclitaxel. Autophagy was detected by fluorescent pattern of light chain 3(LC3) proteins and the apoptotic cell death was determined by annexin V binding., Results: autophagy was detected in HD-My-Z cells treated with gemcitabine, but not with bleomycin, adriamycin and paclitaxel. Adriamycin exhibited the strongest cytotoxic action, and the cytotoxic action of bleomycin and gemcitabine was less marked compared with adriamycin. Paclitaxel did not cause significant cell death in the cells., Conclusion: autophagy was differentially expressed in Hodgkin lymphoma cells treated with anti-cancer drugs and the expression did not correspond to the apoptotic cell death.

Aim: Gene rearrangement has an important role in the management of lymphoma. We investigated the rearrangements of B-cell leukaemia/lymphoma 2 (BCL2), BCL6 and Paired homeobox 5 (PAX5) genes in Indonesian follicular lymphoma (FL) patients., Methods: We examined gene rearrangements using various kinds of polymerase chain reactions (PCRs) on 24 patients' peripheral blood DNA., Results: BCL2 rearrangement was found in 58% (14 of 24 patients), 8 at mbr (major breakpoint region), 2 at mcr (minor cluster region) and 4 at icr (intermediate cluster region), respectively. No rearrangement in BCL6 and PAX5 was detected. There was a significant difference in the incidence of spleen involvement between patients with BCL-2 rearrangement and without it (50% vs. 11%, p=0.04). BCL-2 rearrangement was correlated with spleen involvement (OR=9) and anemia (OR=2.3)., Conclusion: BCL2 rearrangement in Indonesian FL was higher than previous reports from other Asia countries (58% vs. 48%, respectively). Our method using peripheral blood DNA might be useful for the molecular diagnosis of FL.