Another 6.6% of patients developed autoimmunity, usually autoimmune cytopenia
, inflammatory bowel disease, or vasculitis, said Nufar Marcus, MD, of the University of Toronto and her associates.
Patients can be assigned to 2 tracks if needed, such as the lymphoma track and cytopenia
track when the degree of involvement by lymphoma does not explain the patient's cytopenias
, or if dyspoietic morphology is identified.
Side effects such as increased liver or muscle enzymes, cytopenia
, and neuromyopathy may, in rare cases, require a reduction or even cessation of colchicine in patients with amyloidosis (10).
Infections are generally reported to occur after the second course of treatment, since azacitidine can exacerbate cytopenia
. (15) In a controlled trial consisting of 191 subjects who were randomized to treatment with azacitidine or to observation, febrile neutropenia was one of the most frequent severe adverse events.16 Adverse events following treatment with azacitidine have been reported to attenuate with every course of treatment and they are not cumulative.
of platelets, neutrophils, or both (74%) and elevated liver enzyme levels (63%) were frequently present.
However, determination of mutational burden/variant allele frequency (VAF) (usually >25% for MDS) is critical for the diagnostic assessment to distinguish MDS from clonal hematopoiesis of indeterminate potential (CHIP) or clonal cytopenia
of undetermined significance (CCUS).
Eleven patients experienced cytopenia
that was not resolved by day 28 or recurring after day 28: 3 patients Grades 1-3 and 8 patients Grade 4.
The patient met diagnostic criteria for HLH, including fever, splenomegaly, cytopenia
, hypertriglyceridemia, hypofibrinogenemia, hemophagocytosis in bone marrow, and elevated ferritin.
It is marked by association with malignant diseases and characteristically shows the absence of cytopenia
, splenomegaly and autoimmune disease (6).
Mohamad Younes, MD, and colleagues followed 43 patients with unexplained macrocytosis, and found that 11.6% developed a primary bone marrow disorder, and 16% developed worsening cytopenia
, over 4 years.
Follow-up consultations with hematology, rheumatology and other specialists failed to turn up any alternative diagnoses such as connective tissue diseases which could explain the cytopenia
. The cytopenias
spontaneously recovered as assessed in subsequent follow-ups (Graphic 1).
Its adverse effects include drowsiness, depression, headache, vomiting, liver disorder, cytopenia
, acute pancreatitis, toxic epidermal necrolysis, dementia-like symptoms, Parkinson's disease-like symptoms, and syndrome of inappropriate antidiuretic hormone secretion.