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The journal publishes original articles revealing recent research results in public health and management, review articles providingup-to-date analysis or discussion on research previously published by others, case reports describing interesting and exceptional clinical cases the authors have confronted with.

 

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Starting with issue 1/2015, Acta Medica Transilvanica journal will publish the articles in English language only.

 

Published since 1996

LEUCEMIA MIELO-MONOCITARĂ CRONICĂ PREZENTARE DE CAZ

Rezumat:

Introducere: Leucemia mielo-monocitară cronică (LMMC) reprezintă un grup heterogen de boli cu caractere atât mielodisplazice cât şi mieloproliferative: boli mielodisplazice / mieloproliferative. După revizuirea clasificării Organizaţiei Mondiale de Sănătate (OMS) a neoplasmelor mieloide şi a leucemiei acute (2008), subgrupul „boli mielodisplazice/mieloproliferative” a fost renumit „neoplasme mielodisplazice/mieloproliferative”. Acest subgrup include LMMC, leucemia mieloidă cronică atipică (LMCa), leucemia mielo-monocitară juvenilă (LMMJ) şi o entitate provizorie din grupul neoplasmelor mielodisplazice/mieloproliferative neclasificabile, anemia refractară cu sideroblaşti inelari şi trombocitoză (ARSI-t). Material şi metode: Prezint cazul unui pacient în vârstă de 76 ani internat în Secţia de Hematologie a Spitalului Clinic Judeţean Sibiu pentru leucocitoză cu splenomegalie. Acestui pacient i-au fost făcute examenul clinic şi următoarele investigaţii paraclinice: hemograma cu examenul citologic,examenul morfologic şi histopatologic al măduvei osoase, studiul citogenetic şi testele de biologie moleculară. Rezultate: Pacientul s-a internat în Secţia de Hematologie în mai 2007 pentru splenomegalie. Hemograma a arătat leucocitoză (90000/µl) cu deviere a formulei leucocitare la stânga până la 2% mieloblaşti şi monocitoză (1800/µl). Aspiratul şi biopsia măduvei osoase au evidenţiat hipercelularitate cu mielodisplazie triliniară. Studiul citogenetic a indicat absenţa cromozomului Philadelphia. Testele de biologie moleculară au fost negative pentru BCR-ABL1. Pacientul prezintă criteriile LMMC I (criteriile WHO). Pacientul a urmat tratament cu Hydreea. Concluzie: Prezenţa acestei boli rare, leucemia mielo-monocitară cronică, subliniază importanţa efectuării investigaţiilor paraclinice complete pentru elucidarea acestei entităţi.

Abstract:

Background: Chronic myelomonocytic leukemia (CMML) is a heterogeneous group of disorders with features both of myelodysplasia and of myeloproliferation: myelodysplastic / myeloproliferative diseases. In the 2008 revision of the World Health Organization (WHO) classification of myeloid neoplasms and acute leukemia, the subgroup designated as „myelodysplastic / myeloproliferative diseases” has been renamed „myelodysplastic / myeloproliferative neoplasms (MDS/MPN). This subgroup comprise CMML, atypical chronic myelogenous leukemia (aCML) juvenile myelomonocytic leukemia (JMML) and a provisional entity within the MDS/MPN unclassifiable group, refractory anemia with ring sideroblasts and thrombocytosis (RARS-t). Material and methods: I present the case of a 76 years-old male admitted in Hematology Department of Sibiu County Hospital for the analysis of the leukocytosis with splenomegaly. The clinical exam and the paraclinic investigations of this patient were performed: the hemogram with cytology,morphological and hystopathological exam of bone marrow , cytogenetic study and molecular biology tests. Results: The patient presented in Hematology Department in may 2007 with splenomegaly. The hemogram showed leukocytosis (90000/µl) with deviation to the left of the leucocyte formula to 2% myeloblasts and monocytosis (1800/µl). The bone marrow aspirate and biopsy showed hipercellularity with trilineal myelodysplasia. The cytogenetic study revealed the absence of Philadelphia chromosome. The molecular biology tests were negative for BCR-ABL1. The patient presents criteria of CMML I (WHO criteria). The patient followed treatment with Hydreea. Conclusion: The presence of this rare disease, chronic myelomonocytic leukemia, underlines the importance of performing complete paraclinic investigations for elucidation of this entity.
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