ABSTRACTS OF THE 5TH INTERNATIONAL CONFERENCE ON ADVANCES IN HEMATOLOGY AND ONCOLOGY (ICAHO2017)

Background: Acute chest syndrome (ACS), a well-known medical emergency in sickle cell disease (SCD) presents as chest pain and dyspnea. SCD patients with pulmonary embolism (PE) present similarly, but PE is not the first diagnosis that physicians consider in this patient population. PE occurs in approximately 17% of SCD patients, while there is an increased risk in patients with sickle cell trait. Standard tools in approaching patients with PE, such as the Wells score, are of limited use in SCD patients due to absence of other venous thromboembolism (VTE) risk factors. This results in a low calculated pre-test probability. D-Dimer assay, commonly used to exclude PE, is also inherently elevated in SCD. Methods: A 23-year-old female patient with history of sickle cell disease presented with lumbar pain, dyspnea, and palpitations. Physical exam revealed tachycardia and tachypnea. Diagnostic work-up revealed white blood cell (WBC) count 9.7×10 3 cells/μl, hemoglobin (Hgb) 8.9 g/dl, and reticulocytes of 4.8%. Chest X-ray was normal. The patient was treated with intravenous (IV) fluids and pain management. On hospital day 2, the patient became febrile at 39.4˚C, had persistent tachycardia, and was hypoxic to 91% on room air. Repeat infectious work-up and chest X-ray were unremarkable. The patient was empirically treated with IV ceftriaxone. Wells criteria showed low probability of PE at 1.5%. Arterial blood gas (ABG) analysis revealed an elevated P(A-a)O 2 Gradient and chest computed tomography (CT) revealed pulmonary embolism. Finally, Eliquis was administered and patient improved with anticoagulation. Results: Limited data or guidelines are available in regards to PE diagnosis in patients with SCD Background: Pathogenesis of cholangiocarcinoma (CCA), a malignancy of bile duct epithelial cells, is multifactorial. CCA in the Northeast Thailand is associated with chronic inflammation due to liver fluke ( Opisthorchis viverrini , OV) infection. Since for OV-associated CCA we revisited the efficacy of antimalarial drugs, artesunate (ART) and chloroquine (CQ), against CCA. ART and CQ are the most explored among anti-parasitic drugs for their anti-cancer effects and have shown potential of inhibiting cell growth and inducing cell death in various cancer cells. ART and CQ, both induce cell death of malaria by a similar mechanism depending upon formation of reactive oxygen species (ROS). it is great interest to study whether the cell death mechanisms of bile duct cancer cells after treatment with ART and CQ are similar or different. Methods: The effects of ART and CQ were studied on bile duct cancer cell lines M214L0 and M214L5. Cell proliferation after treatment with ART and CQ was studied by WST assay. The phenotypic cell death pattern was studied using time-lapse analysis. Results: Both ART and CQ inhibited proliferation of bile duct cancer cell lines M214L0 and M214L5 in a dose- and time-dependent manner. Regarding the phenotypic pattern of cell death, ART induced necrosis, whereas CQ induced apoptosis, against both bile duct cancer cell lines. Conclusion: ART and CQ induce cell death in bile duct cancer cell lines via different mechanisms. cell Rapid clinical decompensation and a short mean survival rate necessitate early diagnosis. Early initiation of chemotherapy and therapy with Background: Metastases to the prostatic fossa (PF) from primary duodenal adenocarcinoma (DA) is a rare entity. As per our knowledge, there has been no previously reported case. We describe a patient with DA metastatic to the PF involving the urinary bladder. Methods: In April, 2014, a 76-year-old African-American male with a history of prostate cancer, status post-surgery and radiotherapy presented with nausea, vomiting, abdominal pain and was diagnosed with small bowel obstruction. Computed tomography (CT) abdomen showed 5x1 cm obstructing lower duodenal mass with mesenteric lymphadenopathy. Carcinoembryonic antigen (CEA) and cancer antigen (CA) 19-9 were 7.7 ng/ml and 431.6 U/ml, respectively. Exploratory laparotomy showed an obstructing mass adherent to the jejunum and left colon, thus en bloc duodeno-jejunal resection and left hemicolectomy with primary anastomoses were performed. Histopathology of the specimen showed well-differentiated adenocarcinoma. Adjuvant chemotherapy FOLFOX (folinic acid, fluorouracil, and oxaliplatin) was administered based on the Stage III-B the disease. Positive emission tomography (PET)-CT and tumor markers were negative in May 2014. Patient CA 19-9 CEA CA 19-9 while PET-CT showed mildly increased metabolism in the PF without bladder 2016 metabolism with involvement of the urinary bladder neck, while PSA was normal. The patient underwent cystoscopy with tumor biopsy of the bladder neck. Background: are primary brain (GTR) newer imaging managing higher grades of these the rare nature of newly diagnosed high grade meningioma which accounts for 300 cases in the United States, no prospective clinical trial has been conducted so far to determine whether adjuvant radio or chemotherapy could be beneficial (1, 2). Most data in favor of adjuvant RT are based on retrospective trials. We present a case of a patient that was initially treated with GTR though later recurred with a higher grade of the disease. Case Report: A 72-year-old female with past medical history of hypertension, hyperlipidemia, myotonic dystrophy, recurrent meningiomas, presented to the emergency department after a sudden worsening of right-sided weakness. Patient was recently discharged from acute rehabilitation following excision of a meningioma. The patient had a history of recurrent left frontoparietal meningiomas and had undergone two craniotomies with excisions. The first craniotomy with excision of WHO grade II meningioma was one year and five months ago. The patient had a second surgery done about two months ago revealing an anaplastic grade III meningioma. On examination, the patient had right sided hemiparesis, while the rest of the examination was unremarkable. The patient then underwent a CT head scan showing intracranial hemorrhage and left parietal mass. MRI demonstrated a large heterogeneous left parietal mass adjacent to recent craniotomy measuring 5×4×5.9 cm with surrounding hemorrhage and edema. There was also 2×1.2×1.2 cm mass anterior to left frontal lobe. This was followed by a Background: The myelodysplastic syndrome (MDS) is a bone marrow disorder of peripheral blood cytopenias, dysplastic cells and occasionally thrombocythemia that can result in venous thrombosis. Qualitative changes in platelet function have also been proposed. Heparin resistance requiring >35,000 U/24 h to achieve therapeutic activated thromboplastin time (aPTT) is best described in inherited or acquired anti-thrombin (AT) deficiency, though it is an uncommon finding in MDS. We present a case of venous thromboembolism (VTE) from MDS complicated by heparin resistance. Case Report: A 51-year-old male presented with syncope, pleuritic chest pain, and dyspnea for 2 weeks. Physical exam revealed pallor and a flow murmur. Initial studies revealed hemoglobin of 8.2 g/dl and thrombocythemia of 575 K/μl. Computed tomography (CT) chest revealed pulmonary embolism and lower extremity biliary metastasis peritoneal carcinoma. Biliary stents and the carboplatin and paclitaxel the peritoneal carcinoma responded to after prompt initiation of intravenous and allopurinol. Conclusion: Early suspicion and diagnosis of the in solid organ tumors is key to prevention and management.