Simultaneous occurrence of factor VIIIC inhibitor and lupus anticoagulant

✍ Scribed by Renu Saxena; Paramjit S. Dhot; Anil K. Saraya; Harminder Singh; Om P. Malhotra

• Publisher: John Wiley and Sons
• Year: 1993
• Tongue: English
• Weight: 216 KB
• Volume: 42
• Category: Article
• ISSN: 0361-8609
• DOI: 10.1002/ajh.2830420221

✦ Synopsis

Letters and Correspondence

TABLE I. Cytogenetlc and Molecular Follow-Up Study of the Patient Date of sample Karyotype (no. of mitoses) Molecular analysis Diagnosis 3/84 46 XY t(9:22)(q34;ql1)(19) ND BMT 4/86 4/87 46,XY (63) ND 3/88 46.XY (16) ND 4/89 46,XY (46)46.XY 1(9;22)(q34;qI l)t(8:14)(p22;qlI)(l) ND 10189 46,XY (10) M-bcr rearrangement 5/90 46.XY (65) M-bcr rcarrangement 1/91 46,XY 1(9:22)(q34;qI 1).1(8;14)(p22;qI 1)(20) Failure excluded with the same degree of certitude, for lack of sufficient serum and erythrocyte samples. More traditional clues to this hypothesis were, however, lacking. Three years after BMT. bone marrow karyotype revealed one cell 46,XY t(9;22)t(8; 14). Cytogenetical and molecular follow-up is summarized in Table I. Following karyotype controls were normal, but molecular analysis revealed M-bcr rearrangement by PCR method. In January, 1991, the patient showed evidence of hematological relapse and bone marrow karyotype revealed 20 cells 46.XY t(9;22). t(8;14)(p22 ;qlI). He received rIFNa,, treatment, with achievement of an hematological response at time of this report. We concluded that paternity is possible few years after BMT in patients who received TBI. Therefore, assumption of probable sterility in male allogeneic bone mamw recipients should be made cautiously. Although this is only an anecdotal report, we confirmed, as have others 121, that the late reappearance of even a unique leukemic cell and/or M-bcr rearrangement may preclude CML relapse. The relationship between paternity and relapse is very speculative. Nevertheless, these two events may represent different aspects of an insufficient conditioning regimen.