The transformation chronic lymphocytic leukemia (CLL) into Richter syndrome represents aggressive clinical evolution of CLL. In most cases, this transformation corresponds to diffuse large B-cell lymphoma, but in very rare cases it can lead to Hodgkin’s Disease Variant of Richter’s Syndrome. We report a case of CLL transformed into Hodgkin’s disease type of Richter’s Syndrome in a 70-year-old male patient. Microscopic examination showed the presence of large tumor cells with the morphological and immunophenotypic features in favor of classical Hodgkin and Reed-Sternberg cells. The transformation of CLL into Hodgkin’s disease poses a problem of histogenetic diagnosis. According to the literature, the clonal relationship between CLL and Hodgkin’s disease is likely with prognostic value. Two forms of Hodgkin’s Disease Variant of Richter’s Syndrome are described with different prognoses: a form that corresponds to a true transformation of the CLL into a Hodgkin’s disease, a poor prognosis and a second form that corresponds to the co-existence of CLL and Hodgkin’s disease with better prognosis.
Our study aims to determine the reference values of the CBC in an adult and healthy moroccan population. This is a study of 996 cases including 874 men and 122 women whose samples were analyzed by the Coulter LH 750 controller then entered and analyzed by SPSS statistical software. The reference values obtained for the main parameters are: GB between 5,10×109- 11,58 x 109/L for women and 4,60 x 109- 13,81 x 109/L for men, PNN between 2,05 x 109 – 9,46 x 109/L for women and 1,60 x 109 – 9,80 x 109/L for men and the LYM between 0,42 x 109 – 4,18 x 109/L for women and 0,59 x 109 – 4,41 x 109/L for men. The HB between 10.10 to 16.97 g / dL for women and 13.8 to 20.21 g / dL for men, PLQ between 121,13 x 109 – 341,00 x 109/L for women and 108,00×109-327,25 x 109 /L for men. Comparing our results with those of literature or other studies revealed the existence of several dissimilarities. They are mainly due to ethnicity, smoking and habits of individuals. This preliminary study has achieved the baseline blood counts for a Moroccan sample and detects potential differences among populations, often involving diagnostic decisions; hence the need for the establishment of our own intervals reference through more extended studies in different regions of Morocco. This must be done under the responsibility of the health authorities and the values obtained must be validated to be applied to the disparities revealed by our study.
Introduction: The purpose of our study is presenting new national statistics of phenotypic prevalence Rhesus systems (Rh) and Kell using a new sample of blood donors.
Materials and Methods:This study was conducted in the blood transfusion department of the Avicenna military hospital of Marrakech on a sample of 1286 donors collected between 01/01/2015 and 31/12/2015. This is a military population dominated by men (99%), and composed of young people aged from 18 to 45 years. The samples have been collected in EDTA tubes. The tests were performed on gel-card or on opaline plate at the laboratory temperature. Reagents used are monoclonal antibodies from Society Bio-Rad.
Results : Our results shows a clear predominance of the Rh1 (D) positive (89.81%) compared to Rh-1 (d) negative (10.19%). CcDee was the most common phenotype (38.95%) followed by ccDee (18.91%) CCDee, ccDEe, ccdee and CcDEe. The ccDEE, CCDEe and ccdEe phenotypes are the minority phenotypes. For the Kell system, the predominance of Kell-1 subjects was clearly observed at a frequency of 93%. The Rh D allele was the most prevalent (68.08%) among RH blood type alleles while and the Kell-1 (96.44%) was the frequent among the alleles of Kell blood group system.
Discussion and Conclusion : our results compared to previous national and international studies show that Morocco is in an intermediate situation among the Caucasoid and negroids populations.
Hemophagocytic Syndrome (HS) is an aggressive and life-threatening syndrome of excessive immune activation. It is mostly associated with underlying pathology, it can reveal: immunodeficiency, infections, cancers and auto-immune diseases.
Objective of work: Identify the clinical, biological, etiological and evolutionary features of the HLH.
Methods: A retrospective study of patients with HS syndrome collected in the Hematology Laboratory of the Mohamed V Military Hospital Rabat (MVMHR) in Morocco (between 2013 and 2015).
Results: We identified 7 cases, 4 males and 3 females, middle aged 46 years. The onset of symptoms was brutal in all patients. The splenomegaly and the inflammatory syndrome were found in all cases. The pancytopenia was observed in 6 patients. The hemophagocytosis in bone marrow smear examination was found in all cases. There were infectious underlying causes in 4 cases: one case of visceral leishmaniasis, one case of Staphylococcus aureus sepsis, one case of Escherichia coli sepsis and one case of glandular tuberculosis. For the other patients, there was a case of follicular lymphoma, a case of Hodgkin lymphoma and a case of myelodysplastic syndrome. The outcome was favorable in 3 cases, 4 patients died.
Conclusion: The HS is an extreme emergency. Clinical and biological signs are not specific; the management should be quick for a better survival.
There is no data on myelodysplastic syndrome (MDS) in Morocco. Indeed, this disease has long remained unexplored. We present the epidemiological data on MDS of the department of hematology of the Mohamed V Military Hospital for a period of 9 years and 4 months. In this study, we registered the MDS cases diagnosed by bone marrow examinations between January 2006 and April 2015. We classified these cases according to the 2008 WHO classification. Patients with secondary MDS (post-chemo/radiotherapy were excluded from the analysis. We compiled 155 cases, which is equivalent to 21% of the malign hemopathies recorded on the same period. The median age of diagnosis was 62 years. The group of age under 50 years represented only 8% of the whole study population. There was a preponderance of males with a M/F ratio of 1.58. The distribution according to the WHO subtypes was as follows: refractory cytopenia with multilineage dysplasia (61%) followed by refractory anemia with excess of blasts type 1 (26%) and type 2 (9%). The number of new MDS cases increased through the analyzed period of time. It went from 45 new cases between
2006 and 2011 to 110 new cases between 2012 and the start of 2015. The global frequency of MDS increased over recent years due to the cytologists’ increasing awareness of this disease. A national registry is thus imperative in order to estimate the real incidence of MDS in our country and to improve the knowledge on these hemopathies.
The plasma cell leukemia (PCL) is an extremely uncommon malignant blood disorder with a pejorative prognosis. It is defined by the presence of at least 20% of plasma cells in the peripheral blood or an absolute number of circulating plasma cells greater than 2 G /L. It appears under two variants: secondary PCL that complicates known multiple myeloma and primitive PCL that is immediately leukemic. We report the case of a 56 years old male patient who presented 2 months before his hospitalization diffuse bone pains with asthenia. The CBC revealed an anemia and a leukocytosis. The blood smear objectified 3 G/L circulating plasma cells. The bone marrow exam noted a rich cellularity and a marrow invaded up to 60% by dystrophic plasma cells. The clinical presentation of the plasma cell leukemia, its cytological smear characteristics, immunophenotypical, pathophysiological, therapeutic approach and outcome will be reminded in this article.