Sara

C.

Sara

C. A

cree

Acr

ee, M

.D.

, M.D

.LA

Cou

nty

+ U

SC M

edic

al C

ente

rLA

Cou

nty

+ U

SC M

edic

al C

ente

rLo

s A

ngel

es, C

A 9

0033

Los

Ang

eles

, CA

900

33ac

ree@

usc.

edu

acre

e@us

c.ed

u

Cas

e Pr

esen

tatio

nC

ase

Pres

enta

tion

His

tory

His

tory

••Pt

: Pt

: 53

yea

r53

yea

r --ol

d A

sian

fem

ale

old

Asi

an fe

mal

e

••C

C:

CC

:Fa

tigue

, wea

knes

s, d

izzi

ness

, and

left

Fatig

ue, w

eakn

ess,

diz

zine

ss, a

nd le

ft kn

ee p

ain.

kn

ee p

ain.

••PM

H:

PMH

:St

age

IVB

diff

use

larg

e B

Stag

e IV

B d

iffus

e la

rge

B-- c

ell

cell

lym

phom

a (D

LBC

L), s

tatu

s po

st 5

cyc

les

of

lym

phom

a (D

LBC

L), s

tatu

s po

st 5

cyc

les

of

RR-- C

HO

P (la

st re

gim

en: 2

8 m

onth

s ag

o)C

HO

P (la

st re

gim

en: 2

8 m

onth

s ag

o)

••PE

:PE

:LL e

ft kn

ee e

ffusi

on a

nd jo

int t

ende

rnes

sef

t kne

e ef

fusi

on a

nd jo

int t

ende

rnes

s

Cho

ndro

calc

inos

isw

ith p

atel

lofe

mor

al c

ompa

rtm

ent n

arro

win

g,

oste

ophy

tes

and

effu

sion

(? r/

om

alig

nant

effu

sion

).

LLLL

Tric

ompa

rtm

ento

steo

arth

ritis

, with

ost

eoph

ytes

. Los

s of

pa

tello

fem

oral

cart

ilage

and

loos

e bo

dies

.

LLLL

Syno

vial

flui

dSy

novi

al fl

uid

Flow

Cyt

omet

ry

Flow

Cyt

omet

ry --

Syno

vial

Flu

idSy

novi

al F

luid

SSSS

CD

45C

D45

CD33 CD33C

D71

CD

71

Flow

Cyt

omet

ry

Flow

Cyt

omet

ry --

Syno

vial

Flu

idSy

novi

al F

luid

CD15 CD15

CD

11b

CD

11b

CD14 CD14C

D13

CD

13

Flow

Cyt

omet

ry

Flow

Cyt

omet

ry --

Res

ults

Res

ults

Syno

vial

Flu

idSy

novi

al F

luid

••G

ranu

locy

tic m

arke

rs:

Gra

nulo

cytic

mar

kers

:––

CD

13 d

imC

D13

dim

––C

D15

sub

popu

latio

nC

D15

sub

popu

latio

n––

CD

33 m

oder

ate/

dim

CD

33 m

oder

ate/

dim

••M

onoc

ytic

Mar

kers

:M

onoc

ytic

Mar

kers

:––

CD

11b

mod

erat

eC

D11

b m

oder

ate

––C

D14

brig

ht/m

oder

ate

CD

14 b

right

/mod

erat

e

MPO

MPO

NSE

NSE

Syno

vial

flui

dSy

novi

al fl

uid

Labs

Labs

CB

CC

BC

••H

bH

b7.

0 7.

0 g/

dLg/

dL••

Hct

Hct

21%

21%

••W

BC

WB

C5.

4 x1

05.

4 x1

03 3 μμ LL

••Pl

tsPl

ts10

7 x1

010

7 x1

03 3 μμ LL

Perip

hera

l blo

odPe

riphe

ral b

lood

BM

Asp

irate

BM

Asp

irate

NSE

NSE

MPO

MPO

BM

Asp

irate

BM

Asp

irate

Flow

Cyt

omet

ry

Flow

Cyt

omet

ry --

Mar

row

Mar

row

SSSS

CD

45C

D45CD15 CD15

CD

11b

CD

11b

Flow

Cyt

omet

ry

Flow

Cyt

omet

ry --

Mar

row

Mar

row

CD14 CD14

CD

13C

D13

CD4 CD4

CD

3C

D3

Flow

Cyt

omet

ry

Flow

Cyt

omet

ry --

Res

ults

Res

ults

Syno

vial

Flu

idSy

novi

al F

luid

••C

D15

C

D15

sub

pop

subp

op••

CD

33 m

od/d

imC

D33

mod

/dim

••C

D13

dim

CD

13 d

im••

CD

11b

mod

erat

eC

D11

b m

oder

ate

••C

D14

brig

ht/m

odC

D14

brig

ht/m

od

Bon

e M

arro

wB

one

Mar

row

••C

D15

C

D15

sub

pop

subp

op••

CD

33C

D33

••C

D4

dim

CD

4 di

m••

CD

11b

dim

CD

11b

dim

••C

D14

C

D14

sub

pop

subp

op••

CD

34

CD

34 s

ubpo

psu

bpop

••C

D11

7 C

D11

7 su

bpop

subp

op••

HLA

HLA

-- DR

DR

INTE

RPR

ETA

TIO

N:

INTE

RPR

ETA

TIO

N:

Mye

lom

onoc

ytic

Mye

lom

onoc

ytic

phen

otyp

eph

enot

ype

Cyt

ogen

etic

sC

ytog

enet

ics

••46

,XX,

del

(1)(p

13q2

2),t(

8;11

)(p11

.2;p

15),

46,X

X, d

el(1

)(p13

q22)

,t(8;

11)(p

11.2

;p15

), de

l(12)

(p11

.2)

del(1

2)(p

11.2

)

––D

elet

ion

12p:

Del

etio

n 12

p:••

Obs

erve

d in

MD

SO

bser

ved

in M

DS

••In

term

edia

te p

rogn

ostic

mar

ker

Inte

rmed

iate

pro

gnos

tic m

arke

r

––A

dditi

onal

abn

orm

aliti

es s

ugge

st e

volu

tion

Add

ition

al a

bnor

mal

ities

sug

gest

evo

lutio

n of

dis

ease

.of

dis

ease

.

Dia

gnos

isD

iagn

osis

••A

cute

Mye

lom

onoc

ytic

Leu

kem

ia,

Acu

te M

yelo

mon

ocyt

ic L

euke

mia

, Th

erap

y R

elat

ed

Ther

apy

Rel

ated

––

Ass

ocia

ted

with

dox

orub

icin

ther

apy

Ass

ocia

ted

with

dox

orub

icin

ther

apy

(aka

, (a

ka, HH

ydro

xyda

unor

ubic

inyd

roxy

daun

orub

icin

= R

= R

-- CCHH

OP)

OP)

••Le

ukem

ic S

ynov

itis

Leuk

emic

Syn

oviti

s

Leuk

emic

Syn

oviti

s (L

S)Le

ukem

ic S

ynov

itis

(LS)

••W

ell

Wel

l -- rec

ogni

zed

but r

are

com

plic

atio

n of

acu

te

reco

gniz

ed b

ut ra

re c

ompl

icat

ion

of a

cute

an

d ch

roni

c an

d ch

roni

c le

ukem

ias

leuk

emia

s

––14

% o

f 14

% o

f ped

iatr

icpe

diat

ricle

ukem

ias

leuk

emia

s••

Acu

te ly

mph

obla

stic

A

cute

lym

phob

last

ic le

ukem

iale

ukem

ia––

4% o

f adu

lt 4%

of a

dult

leuk

emia

sle

ukem

ias

••A

cute

& c

hron

ic ly

mph

ocyt

ic &

mye

loid

A

cute

& c

hron

ic ly

mph

ocyt

ic &

mye

loid

leuk

emia

leuk

emia

••C

an b

e th

e in

itial

man

ifest

atio

n of

C

an b

e th

e in

itial

man

ifest

atio

n of

leuk

emia

leuk

emia

or

or

of re

laps

e (e

ven

if no

t pre

sent

initi

ally

).of

rela

pse

(eve

n if

not p

rese

nt in

itial

ly).

••Th

e av

erag

e rh

eum

atic

Th

e av

erag

e rh

eum

atic

pro

drom

epr

odro

me

is 3

mon

ths

is 3

mon

ths

Leuk

emic

Syn

oviti

s (L

S)Le

ukem

ic S

ynov

itis

(LS)

••C

linic

al P

rese

ntat

ion:

Clin

ical

Pre

sent

atio

n:––

Join

ts w

arm

, sw

olle

n, te

nder

Jo

ints

war

m, s

wol

len,

tend

er

––D

ista

l and

sym

met

ric, o

r asy

mm

etric

, D

ista

l and

sym

met

ric, o

r asy

mm

etric

, in

volv

ing

larg

e jo

ints

invo

lvin

g la

rge

join

ts––

Effu

sion

s us

ually

sm

all

Effu

sion

s us

ually

sm

all

––Se

vere

pai

n is

com

mon

Seve

re p

ain

is c

omm

on––

Ost

eope

nia,

lytic

lesi

ons

on X

Ost

eope

nia,

lytic

lesi

ons

on X

-- ray

sra

ys––

Sero

nega

tive

Sero

nega

tive

reac

tive

arth

ritis

reac

tive

arth

ritis

-- likelike

Leuk

emic

Syn

oviti

s Le

ukem

ic S

ynov

itis

-- Dia

gnos

isD

iagn

osis

••Im

agin

g st

udie

s of

ten

non

Imag

ing

stud

ies

ofte

n no

n --sp

ecifi

csp

ecifi

c

••Sy

novi

al fl

uid

exam

with

Sy

novi

al fl

uid

exam

with

cyt

ospi

ncy

tosp

inm

orph

olog

ym

orph

olog

y––

Flow

Fl

ow c

ytom

etry

cyto

met

ry––

Enzy

me

Enzy

me

cyto

chem

istr

ycy

toch

emis

try

••Sy

novi

al b

iops

y (?

Sy

novi

al b

iops

y (?

““G

old

Stan

dard

Gol

d St

anda

rd”” ))

––Im

mun

ohis

toch

emis

try

Imm

unoh

isto

chem

istr

y––

Not

e: m

ay fa

il to

sam

ple

Not

e: m

ay fa

il to

sam

ple

neop

last

icne

opla

stic

infil

trat

ein

filtr

ate

Trea

tmen

t of L

euke

mic

Tr

eatm

ent o

f Leu

kem

ic S

ynov

itis

Syno

vitis

••Le

ukem

ic

Leuk

emic

syn

oviti

ssy

novi

tisis

a s

ign

of s

yste

mic

is

a s

ign

of s

yste

mic

in

volv

emen

t and

sho

uld

prom

pt im

med

iate

in

volv

emen

t and

sho

uld

prom

pt im

med

iate

an

d ag

gres

sive

ther

apy

even

in th

e ab

senc

e an

d ag

gres

sive

ther

apy

even

in th

e ab

senc

e of

sig

ns o

f bon

e m

arro

w in

volv

emen

t.of

sig

ns o

f bon

e m

arro

w in

volv

emen

t.

••Th

erap

y fo

r the

und

erly

ing

leuk

emia

is th

e Th

erap

y fo

r the

und

erly

ing

leuk

emia

is th

e tr

eatm

ent o

f cho

ice.

trea

tmen

t of c

hoic

e.

••D

ecre

asin

g jo

int p

ain

ofte

n is

the

first

sig

n D

ecre

asin

g jo

int p

ain

ofte

n is

the

first

sig

n of

a c

linic

al re

spon

se to

che

mot

hera

py.

of a

clin

ical

resp

onse

to c

hem

othe

rapy

.

Sum

mar

y of

Leu

kem

ic

Sum

mar

y of

Leu

kem

ic S

ynov

itis

Syno

vitis

Cas

es a

t LA

C+U

SCC

ases

at L

AC

+USC

L kn

ee

L kn

ee

effu

sion

effu

sion

R k

nee

effu

sion

R k

nee

effu

sion

L kn

ee e

ffusi

onL

knee

effu

sion

Si/S

x

Syno

vial

Flu

idSy

novi

al F

luid

Syno

vial

Bio

psy

Syno

vial

Bio

psy

Syno

vial

Flu

idSy

novi

al F

luid

Exam

CM

ML

CM

ML

(rel

apse

)(r

elap

se)

AM

ML

AM

ML

AM

ML

AM

ML

Dia

gnos

is

Late

Late

Early

Early

Early

Early

Tim

e co

urse

of

LS

CM

ML

CM

ML

? O

A

? O

A v

svsR

AR

AO

steo

arth

ritis

Ost

eoar

thrit

isD

LBC

LD

LBC

LO

steo

arth

ritis

Ost

eoar

thrit

isPM

H

63yo

Asi

an

63yo

Asi

an

Mal

eM

ale

53yo

Asi

an

53yo

Asi

an

Fem

ale

Fem

ale

53yo

His

pani

c 53

yo H

ispa

nic

Fem

ale

Fem

ale

Age

/Gen

der

Cas

e 3

Cas

e 2

Cas

e 1

Type

s of

Mye

loid

Leu

kem

ia in

Ty

pes

of M

yelo

id L

euke

mia

in

Adu

lt Le

ukem

ic

Adu

lt Le

ukem

ic S

ynov

itis

Syno

vitis

••5

Cas

es:

5 C

ases

:A

ll FA

B ty

pes

of A

ML

(i.e.

A

ll FA

B ty

pes

of A

ML

(i.e.

AM

ML

AM

ML ,

, AM

oLA

MoL

))11••

58

58 y

oyoM

: M

: A

MM

LA

MM

L22••

24

24 y

oyoF:

F:

A

cute

bip

heno

typi

c le

ukem

iaA

cute

bip

heno

typi

c le

ukem

ia33

••60

60

yoyo

M:

M:

AM

ML

AM

ML44

••68

68

yoyo

M:

M:

CM

ML

CM

ML55

••75

75

yoyo

F:

F:

MD

S M

DS →→

AM

ML

AM

ML66

••76

76

yoyo

M:

M:

AM

oLA

MoL

77

••27

27

yoyo

F:

F:

CM

L C

ML →→

AM

ML

AM

ML

blas

t pha

sebl

ast p

hase

88

1 Act

a H

aem

atol

199

9:10

1;1

2 Sem

Art

hrit

Rhe

um. 1

994;

24(1

):48

3 Clin

Rhe

umat

ol20

06:2

5;38

0 4 L

ab M

ed 2

003:

34;7

175 J

Rhe

umat

ol20

06:3

3;17

09

6 Rhe

umat

ol 2

006:

45;1

143

7 Br J

Hae

mat

ol 2

004:

124;

258

8 Sau

di M

ed J

. 200

1;22

(9):8

08-1

1.

Type

s of

Mye

loid

Leu

kem

ia in

Ty

pes

of M

yelo

id L

euke

mia

in

Adu

lt Le

ukem

ic

Adu

lt Le

ukem

ic S

ynov

itis

Syno

vitis

••5

Cas

es:

5 C

ases

:A

ll FA

B ty

pes

of A

ML

All

FAB

type

s of

AM

L(i.

e.

(i.e.

AM

ML

AM

ML ,

, AM

oLA

MoL

))••

58

58 y

oyoM

:M

:A

MM

LA

MM

L••

24

24 y

oyoF:

F:

A

cute

bip

heno

typi

c le

ukem

iaA

cute

bip

heno

typi

c le

ukem

ia••

60

60 y

oyoM

: M

: A

MM

LA

MM

L••

68

68 y

oyoM

: M

: C

MM

LC

MM

L••

75

75 y

oyoF:

F:

M

DS

MD

S →→

AM

ML

AM

ML

••76

76

yoyo

M:

M:

AM

oLA

MoL

••27

27

yoyo

F:

F:

CM

L C

ML →→

AM

ML

AM

ML

blas

t pha

sebl

ast p

hase

••53

53

yoyo

F:

F:

MD

S M

DS →→

AM

ML

AM

ML

••53

53

yoyo

F:

F:

AM

ML

AM

ML

••63

63

yoyo

M:

M:

CM

ML

CM

ML

Leuk

emic

Syn

oviti

s:Le

ukem

ic S

ynov

itis:

Etio

logy

in M

yelo

id L

euke

mia

Etio

logy

in M

yelo

id L

euke

mia

••W

hat i

s th

e as

soci

atio

n w

ith

Wha

t is

the

asso

ciat

ion

with

mon

ocyt

esm

onoc

ytes

??

••W

hat r

ole

does

ost

eoar

thrit

is p

lay?

Wha

t rol

e do

es o

steo

arth

ritis

pla

y?

UN

AN

SWER

ED Q

UES

TIO

NS

UN

AN

SWER

ED Q

UES

TIO

NS

••TN

FTN

F ααis

incr

ease

d by

fibr

obla

sts,

is

incr

ease

d by

fibr

obla

sts,

syn

ovio

cyte

ssy

novi

ocyt

esan

d da

mag

ed

and

dam

aged

cho

ndro

cyte

sch

ondr

ocyt

es

••TN

FTN

F ααin

crea

ses

syno

vial

fibr

obla

st p

rodu

ctio

n of

:in

crea

ses

syno

vial

fibr

obla

st p

rodu

ctio

n of

:––

Mon

ocyt

e ch

emoa

ttrac

tant

pro

tein

Mon

ocyt

e ch

emoa

ttrac

tant

pro

tein

-- 1 (M

CP

1 (M

CP

-- 1)1)

––ILIL

-- 8 (C

XCL8

)8

(CXC

L8)

––H

epat

ocyt

eH

epat

ocyt

eG

row

th F

acto

r (H

GF)

Gro

wth

Fac

tor (

HG

F)

Leuk

emic

Syn

oviti

s:Le

ukem

ic S

ynov

itis:

Etio

logy

in M

yelo

id

Etio

logy

in M

yelo

id L

euke

mia

Leuk

emia

OST

EOA

RTH

RIT

ISO

STEO

AR

THR

ITIS

••A

lso

know

n as

CC

L2A

lso

know

n as

CC

L2

••Pa

rt o

f CC

Pa

rt o

f CC

che

mok

ine

chem

okin

efa

mily

fam

ily

••Fo

und

at th

e si

te o

f bon

e Fo

und

at th

e si

te o

f bon

e de

grad

atio

nde

grad

atio

n

••Ex

pres

sed

by

Expr

esse

d by

ost

eocl

asts

oste

ocla

sts

and

and

oste

obla

sts

oste

obla

sts

••R

ecru

its

Rec

ruits

mon

ocyt

esm

onoc

ytes

to s

ites

to s

ites

of in

jury

, inf

ectio

nof

inju

ry, i

nfec

tion

••Ef

fect

is p

oten

tiate

d by

oth

er

Effe

ct is

pot

entia

ted

by o

ther

cy

toki

nes

(cy

toki

nes

( ieie, H

GF)

, HG

F)

MO

NO

CYT

E C

HEM

OTA

CTI

C P

RO

TEIN

MO

NO

CYT

E C

HEM

OTA

CTI

C P

RO

TEIN

-- 11

MC

PM

CP

-- 1 (C

CL2

)1

(CC

L2)

••A

lso

know

n as

Gra

nulo

cyte

A

lso

know

n as

Gra

nulo

cyte

C

hem

otac

ticC

hem

otac

ticFa

ctor

Fact

or

••A

mem

ber o

f the

CXC

A

mem

ber o

f the

CXC

ch

emok

ine

chem

okin

efa

mily

fam

ily

••C

hem

oattr

acta

ntC

hem

oattr

acta

ntan

d po

tent

an

d po

tent

an

giog

enic

angi

ogen

icfa

ctor

fact

or

••Ta

rget

cel

ls:

Targ

et c

ells

: neu

trop

hils

neut

roph

ils, ,

mac

roph

ages

, mas

t cel

ls,

mac

roph

ages

, mas

t cel

ls,

kera

tinoc

ytes

kera

tinoc

ytes

, and

, a

nd

endo

thel

ial c

ells

endo

thel

ial c

ells

INTE

RLE

UK

ININ

TER

LEU

KIN

-- 8 (C

XCL8

)8

(CXC

L8)

ILIL-- 8

(CXC

L8)

8 (C

XCL8

)

••Pa

racr

ine

Para

crin

ecy

toki

ne s

ecre

ted

by

cyto

kine

sec

rete

d by

m

esen

chym

alm

esen

chym

alce

llsce

lls

••A

cts

on e

pith

elia

l, en

doth

elia

l, A

cts

on e

pith

elia

l, en

doth

elia

l, an

d he

mat

opoi

etic

cel

lsan

d he

mat

opoi

etic

cel

ls

••Tr

aditi

onal

ly th

ough

t to

play

a

Trad

ition

ally

thou

ght t

o pl

ay a

ro

le in

car

tilag

e re

pair

in O

Aro

le in

car

tilag

e re

pair

in O

A

••R

ecen

tly s

how

n to

faci

litat

e R

ecen

tly s

how

n to

faci

litat

e os

teop

hyte

oste

ophy

tede

velo

pmen

t de

velo

pmen

t

••In

duce

s se

cret

ion

of M

CP

Indu

ces

secr

etio

n of

MC

P-- 1

by

1 by

fib

robl

ast

fibro

blas

t --lik

e sy

novi

al c

ells

lik

e sy

novi

al c

ells

(F

LS) a

nd

(FLS

) and

cho

ndro

cyte

sch

ondr

ocyt

es

HEP

ATO

CYT

E G

RO

WTH

FA

CTO

R (H

GF)

HEP

ATO

CYT

E G

RO

WTH

FA

CTO

R (H

GF)

J of

Ort

ho R

es 2

007;

25:5

69-5

77

Hep

atoc

yte

Hep

atoc

yte

Gro

wth

Fac

tor

Gro

wth

Fac

tor

TNF

TNF αα

↑↑M

CP

MC

P-- 1

/CC

L21/

CC

L2↑↑

ILIL-- 8

/CXC

L88/

CXC

L8↑↑

HG

FH

GF

Posi

tive

Posi

tive

Feed

back

Feed

back

++

Fibr

obla

sts

Fibr

obla

sts

Syno

vioc

ytes

Syno

vioc

ytes

Cho

ndro

cyte

sC

hond

rocy

tes

Cau

se

Cau

se m

onoc

yte

mon

ocyt

ean

d gr

anul

ocyt

e an

d gr

anul

ocyt

e m

igra

tion

to th

e af

fect

ed jo

int

mig

ratio

n to

the

affe

cted

join

t

Leuk

emic

Syn

oviti

s:Le

ukem

ic S

ynov

itis:

Etio

logy

in M

yelo

id L

euke

mia

Etio

logy

in M

yelo

id L

euke

mia

••W

hy is

leuk

emic

W

hy is

leuk

emic

syn

oviti

ssy

novi

tisra

re w

hen

rare

whe

n os

teoa

rthr

itis

is c

omm

on?

oste

oart

hriti

s is

com

mon

?

––M

utat

ed re

cept

ors

on le

ukem

ic c

ells

Mut

ated

rece

ptor

s on

leuk

emic

cel

ls

––O

ther

adh

esio

n pr

otei

nsO

ther

adh

esio

n pr

otei

ns

UN

AN

SWER

ED Q

UES

TIO

NS

UN

AN

SWER

ED Q

UES

TIO

NS

Sum

mar

ySu

mm

ary

••Le

ukem

ic s

ynov

itis

is a

rare

com

plic

atio

n of

Le

ukem

ic s

ynov

itis

is a

rare

com

plic

atio

n of

le

ukem

ia, p

rese

ntin

g ea

rly o

r lat

e.

leuk

emia

, pre

sent

ing

early

or l

ate.

••In

adu

lts, i

t is

asso

ciat

ed w

ith m

yelo

id

In a

dults

, it i

s as

soci

ated

with

mye

loid

le

ukem

ia e

xhib

iting

a m

onoc

ytic

com

pone

nt

leuk

emia

exh

ibiti

ng a

mon

ocyt

ic c

ompo

nent

••M

ay b

e as

soci

ated

with

ost

eoar

thrit

isM

ay b

e as

soci

ated

with

ost

eoar

thrit

is––

Che

mok

ine

Che

mok

ine --

indu

ced

adhe

sion

and

in

duce

d ad

hesi

on a

nd

mig

ratio

nm

igra

tion

Ref

eren

ces

Ref

eren

ces

•G

ura

H, K

oren

aV,

Ehr

enfe

lda

M, B

en-B

assa

tcI,

Sidi

aY.

Rhe

umat

ic m

anife

stat

ions

pre

cedi

ng

adul

t acu

te le

ukem

ia: c

hara

cter

istic

s an

d im

plic

atio

n in

cou

rse

and

prog

nosi

s. A

cta

Hae

mat

olog

ica

1999

;101

:1-6

.

•Ev

ans

TI, N

erce

ssia

nB

M, S

ande

rs K

M. L

euke

mic

Art

hriti

s. S

emin

ars

in a

rthr

itis

and

rheu

mat

ism

. 199

4;24

(1):4

8-56

.

•K

im H

R, H

ong

JH, Y

oon

CH

, Lee

SH

, Par

k SH

, Kim

HY.

Art

hriti

s pr

eced

ing

acut

e bi

phen

otyp

icle

ukem

ia. C

linic

al R

heum

atol

ogy.

200

6;25

:380

-381

.

•So

lank

iSK

, Lat

ifS,

Vei

llon

DM

, Nor

dber

g M

L, S

acca

roSJ

, Cot

elin

gam

JD, B

erne

ySM

. A

swol

len

pain

ful k

nee

in a

n el

derly

man

with

rece

ntly

dia

gnos

ed a

cute

mye

loge

nous

leuk

emia

. La

bora

tory

Med

icin

e. 2

003;

10(3

4):7

17-7

23.

•C

ros

CA

, Gut

ierr

ez I,

Góm

ezJP

. Leu

kem

ic in

filtr

atio

n of

the

knee

. Jou

rnal

of R

heum

atol

. 20

06;3

3(8)

:170

9.

•Zi

akas

PD, G

iann

ouli

S, T

ziou

fas

AG

, Vou

lgar

elis

M. L

euke

mic

syn

oviti

s. R

heum

atol

ogy

(Oxf

ord)

. 200

6 Se

p;45

(9):1

143.

•R

amad

an K

, Cah

ill M

. Suc

cess

ful i

ntra

-art

icul

arch

emot

hera

py fo

r rel

apse

d ac

ute

mye

loid

le

ukae

mia

infil

trat

ing

the

knee

join

t. B

ritis

h Jo

urna

l of H

aem

atol

ogy.

200

4;12

4(3)

:258

.

•A

l-Ray

esH

M, A

l-Sha

ikh

AA

, Hal

imM

A, A

l-Qur

ashi

FS, A

l-Jur

fMM

. Leu

kem

ic s

ynov

itis

as a

pr

esen

tatio

n of

mye

lom

onoc

ytic

blas

t cris

is o

f chr

onic

mye

loid

leuk

emia

. Sau

di M

ed .

2001

;22(

9):8

08-8

11.

Ref

eren

ces

Ref

eren

ces

•Ta

kPT

. Che

mok

ine

inhi

bitio

n in

infla

mm

ator

y ar

thrit

is. B

est P

ract

ice

& R

esea

rch

Clin

ical

R

heum

atol

ogy.

200

6;20

(5):9

29-9

39

•B

uckl

ey C

D. W

hy d

o le

ucoc

ytes

acc

umul

ate

with

in c

hron

ical

ly in

flam

ed jo

ints

?.

Rhe

umat

olog

y. 2

003;

42:1

433-

1444

.

•Fe

rnan

des

JC, M

arte

l-Pel

letie

r J, P

elle

tier J

P. T

he ro

le o

f cyt

okin

es in

ost

eoar

thrit

is

path

ophy

siol

ogy.

Bio

rheo

logy

. 200

2;39

(1-2

):237

-246

.

•O

gura

N, T

obe

M, S

akam

akiH

, Nag

ura

H, A

biko

Y, K

ondo

hT.

Tum

or n

ecro

sis

fact

or-a

lpha

in

crea

ses

chem

okin

ege

ne e

xpre

ssio

n an

d pr

oduc

tion

in s

ynov

ial f

ibro

blas

ts fr

om h

uman

te

mpo

rom

andi

bula

rjoi

nt. J

ourn

al o

f Ora

l Pat

holo

gy &

Med

icin

e. 2

005;

34:3

57-3

63.

•G

rego

ry J

L, M

oran

dEF

, McK

eow

nSJ

, Ral

ph J

A, H

all P

, Yan

g YH

, McC

oll S

R, H

icke

y M

J.

Mac

roph

age

mig

ratio

n in

hibi

tory

fact

or in

duce

s m

acro

phag

e re

crui

tmen

t via

CC

che

mok

ine

ligan

d2.

The

Jou

rnal

of I

mm

unol

ogy.

200

6;17

7:80

72-8

079.

•B

enito

MJ,

Vea

le D

J, F

itzge

rald

O, v

an d

en B

erg

WB

, Bre

snih

anB

. Syn

ovia

l tis

sue

infla

mm

atio

n in

ear

ly a

nd la

te o

steo

arth

ritis

. Ann

als

of th

e R

heum

atic

Dis

ease

. 200

5;64

:126

3-12

67.

•D

ankb

arB

, Neu

geba

uerK

, Wun

rau

C, T

ibes

kuC

O, S

kwar

aA

, Pap

T, F

uchs

-Win

kelm

ann

S.

Hep

atoc

yte

grow

th fa

ctor

indu

ctio

n of

mac

roph

age

chem

oattr

acta

ntpr

otei

n-1

and

oste

ophy

te-

indu

cing

fact

ors

in o

steo

arth

ritis

. Jou

rnal

of O

rtho

paed

icR

esea

rch.

200

7;25

:569

-577

.

Ack

now

ledg

emen

tsA

ckno

wle

dgem

ents

Rus

sell

K.

Rus

sell

K. B

ryne

sB

ryne

s , M

D, M

DC

oC

o --di

rect

or, L

AC

+USC

Med

ical

Cen

ter C

ore

Labo

rato

rydi

rect

or, L

AC

+USC

Med

ical

Cen

ter C

ore

Labo

rato

ryD

irect

or, L

AC

+USC

D

irect

or, L

AC

+USC

Hem

atop

atho

logy

Hem

atop

atho

logy

Fello

wsh

ip P

rogr

amFe

llow

ship

Pro

gram

Rau

l G.

Rau

l G. S

imen

tal

Sim

enta

l -- Piz

zaro

Pizz

aro ,

MD

, MD

LAC

+USC

Sta

ff Pa

thol

ogis

t, A

nato

mic

Pat

holo

gyLA

C+U

SC S

taff

Path

olog

ist,

Ana

tom

ic P

atho

logy

Surg

ical

Pat

holo

gy,

Surg

ical

Pat

holo

gy, C

ytop

atho

logy

Cyt

opat

holo

gy, , H

emat

opat

holo

gyH

emat

opat

holo

gy

Geo

rge

Yang

, MD

Geo

rge

Yang

, MD

LAC

+USC

LA

C+U

SC H

emat

opat

holo

gyH

emat

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holo

gyFe

llow

Fello

w

Than

k Yo

u