This paper deals with clinical manifestations and
hematological findings in 71 cases of bone marrow
metastatic cancer. In all patients, the diagnosis of
malignant diseases was not made until bone marrow
aspiration was examined. In contrary to what was
reported in the literature, in our cases metastatic
cancer cells were not found more easily in bone mar
row biopsy than in aspirates. We consider combina
tion of biopsy with aspirates at multiple sites a better
way for obtaining positive findings. The morpho-
logical characteristics of metastatic cancer cells and
nonspecific myeloproliferative reaction to metastasis
are described, and differential diagnosis between
cancer cells and atypical marrow cells discussed. 相似文献
Background American College of Cardiology/American Heart Association/European Society of Cardiology (ACC/AHA/ESC) guidelines gave fondaparinux a class I recommendation for use in patients with non-ST elevation acute coronary syndromes (NSTE-ACS) undergoing invasive or conservative strategy. Nadroparin is one of the common anticoagulants used in NSTE-ACS in China. Accordingly, this study compared the safety and efficacy between fondaparinux and nadroparin in patients with NSTE-ACS.
Methods In this prospective, randomized, open-label, and single center study, a total of 300 patients with NSTE-ACS were randomized to receive either fondaparinux (group F, n=150, 2.5 mg/d) or nadroparin (group N, n=150, 0.1 ml/10 kg q12 h) for a mean of 4 days. The primary safety endpoint was the incidence of major or minor bleeding at 9 days that was not related to coronary artery bypass grafting (CABG). The primary efficacy endpoints included death, myocardial infarction, or recurrent ischemia at 9 days. All patients underwent a 180-day follow-up.
Results Baseline characteristics were well matched between the two groups. There was a non-significant 28% relative risk reduction in the primary safety endpoint in group F compared with group N (4.7% vs. 6.7%, HR 0.72, 95% CI 0.42–1.65, P=0.38). The primary efficacy endpoint was 8.0% in group F and 10.0% in group N (HR, 0.82, 95% CI 0.54–1.71, P=0.49). The composite of the safety and efficacy endpoints at 9 days (10.0% vs. 16.0%, HR 0.61, 95% CI 0.31–1.10, P=0.10), 30 days (14.0% vs. 17.9%, HR 0.72, 95% CI 0.47–1.16, P=0.21), or 180 days (18.7% vs. 27.3%, HR 0.65, 95% CI 0.38–1.11, P=0.11) showed a non-significant trend toward a lower value in group F.
Conclusion Fondaparinux resulted in a nonsignificant risk reduction in patients with NSTE-ACS in both bleeding and ischaemic events during short- and long-term follow-up compared with nadroparin.