EXCESSIVE NAKED MEGAKARYOCYTE NUCLEI IN MYELODYSPLASTIC SYNDROME MIMICKING IDIOPATHIC THROMBOCYTOPENIC PURPURA: A Complicated Pre- and Post-transplantation Course

Olcay L., TUNCER A. M., OKUR H., ERDEMLİ E., Uysal Z., ÇETİN M., ...More

PEDIATRIC HEMATOLOGY AND ONCOLOGY, vol.26, no.6, pp.387-397, 2009 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 6
  • Publication Date: 2009
  • Doi Number: 10.1080/08880010902891891
  • Journal Name: PEDIATRIC HEMATOLOGY AND ONCOLOGY
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.387-397
  • Hacettepe University Affiliated: Yes

Abstract

A boy 3 years 7 months old with thrombocytopenia and history of intracranial hemorrhage who underwent bone marrow transplantation is presented. He was refractory to steroids, immunoglobulin G, vincristine, azathioprine, cyclosporine A, interleukin-11, chemotherapy, and splenectomy. Idiopathic thrombocytopenic purpura was excluded by light /electron microscopic and flow cytometric findings; the diagnosis of refractory cytopenia, a subgroup of pediatric myelodysplastic syndrome, was made. Naked megakaryocyte nuclei were 55.38 +/- 28.2% vs. 31.67 +/- 23.22% of all megakaryocytes in the patient and the control group of 9 patients with idiopathic thrombocytopenic purpura, respectively (p = .016). The posttransplatation course was complicated by delayed platelet engraftment, bronchiolitis obliterans associated with pneumocystis carinii pneumonia, which resolved completely.