Blood Res 2018; 53(1):
Published online March 31, 2018
https://doi.org/10.5045/br.2018.53.1.35
© The Korean Society of Hematology
1Hematology and Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México City, México.
2Médica Sur Foundation and Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México City, México.
3Pathology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México City, México.
Correspondence to : Víctor Manuel Anguiano-Álvarez, M.D. Hematology and Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, CP 14080, Tlalpan, México City, México. vanguianin1@hotmail.com
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Splenic myeloid metaplasia (SMM) is a kind of extramedullary hematopoiesis, whereas its clinical significance in wAIHA remains unclear. The aim of this study is evaluating the frequency and clinical characteristics of SMM, compared with splenic-congestion (SC).
We included patients with wAIHA treated in a Mexican tertiary hospital between January 1992 and December 2015. All patients received steroids as first-line treatment and splenectomy as second-line treatment.
Among the thirty-six splenectomized patients, 15 (41.6%) and 21 (58.4%) were diagnosed as SMM and SC, respectively. No differences were found in clinical characteristics between two groups. SMM patients showed lower platelet count (147×109/L vs. 240×109/L,
The wAIHA patients with SMM have different biological profiles with those without SMM. This study is the first trial evaluating the significance of histopathological spleen findings and their association with rheumatologic profile.
Keywords Warm autoimmune hemolytic anemia, Splenic myeloid metaplasia, Splenic-congestion, Extramedullary hematopoiesis
Blood Res 2018; 53(1): 35-40
Published online March 31, 2018 https://doi.org/10.5045/br.2018.53.1.35
Copyright © The Korean Society of Hematology.
Víctor Manuel Anguiano-Álvarez1*, Alonso Hernández-Company1, Nashla Hamdan-Pérez2, Daniel Montante-M3, Diego A. Zúñiga-Tamayo3, Sergio Rodríguez-Rodríguez1, Alan Pomerantz1, and Elena J. Tuna-Aguilar1
1Hematology and Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México City, México.
2Médica Sur Foundation and Clinic, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México City, México.
3Pathology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Tlalpan, México City, México.
Correspondence to:Víctor Manuel Anguiano-Álvarez, M.D. Hematology and Oncology Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Vasco de Quiroga 15, Col. Belisario Domínguez Sección XVI, CP 14080, Tlalpan, México City, México. vanguianin1@hotmail.com
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Splenic myeloid metaplasia (SMM) is a kind of extramedullary hematopoiesis, whereas its clinical significance in wAIHA remains unclear. The aim of this study is evaluating the frequency and clinical characteristics of SMM, compared with splenic-congestion (SC).
We included patients with wAIHA treated in a Mexican tertiary hospital between January 1992 and December 2015. All patients received steroids as first-line treatment and splenectomy as second-line treatment.
Among the thirty-six splenectomized patients, 15 (41.6%) and 21 (58.4%) were diagnosed as SMM and SC, respectively. No differences were found in clinical characteristics between two groups. SMM patients showed lower platelet count (147×109/L vs. 240×109/L,
The wAIHA patients with SMM have different biological profiles with those without SMM. This study is the first trial evaluating the significance of histopathological spleen findings and their association with rheumatologic profile.
Keywords: Warm autoimmune hemolytic anemia, Splenic myeloid metaplasia, Splenic-congestion, Extramedullary hematopoiesis
Consolidated Standards of Reporting Trials (CONSORT) diagram of this study.
Event-free survival after splenectomy. Event-free survival after splenectomy was 16.2 months in patients with MME versus 5.1 months in the splenic congestion group (
Table 1 . Demographic and clinical characteristics of patients with wAIHA..
a)Fisher's exact test, Chi-square test and Mann-Whitney's
Abbreviations: APLS, antiphospholipid syndrome; DAT, direct antiglobulin test; LDH, lactate dehydrogenase; SC, splenic congestion; SLE, systemic lupus erythematosus; SMM, splenic myeloid metaplasia..
Table 2 . Rheumatologic profile in patients with wAIHA..
a)Fisher's exact test, and Chi-square test were used for the comparison between groups..
Abbreviations: AAHA, anti-apolipoprotein H/anti-β2 glycoprotein 1 antibodies; ACL, anti-cardiolipin antibodies; ANA, antinuclear antibodies; Anti-dsDNA, anti-double stranded DNA antibodies; GPL, G phospholipids; LAC, lupus anticoagulant; MPL, M phospholipids; SC, splenic congestion; SMM, splenic myeloid metaplasia..
Table 3 . Treatment responses between groups..
a)Fisher's exact test was used for the comparison between groups..
Abbreviations: CR, complete response; NR, no response; PR, partial response; SC, splenic congestion; SMM, splenic myeloid metaplasia..
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Consolidated Standards of Reporting Trials (CONSORT) diagram of this study.
|@|~(^,^)~|@|Event-free survival after splenectomy. Event-free survival after splenectomy was 16.2 months in patients with MME versus 5.1 months in the splenic congestion group (