The Pothomorphe clade of Piper contains ten species of shrubs and vines that are native to the New World tropics. One of these, Piper umbellatum, has been introduced outside its native range, and has become successfully established in most wet tropical areas around the World. The species is rather weedy in its native range, and also in parts of the Old World, where it occurs along roadsides, in cultivated fields, and other disturbed habitats. In other parts of the Old World, however, it behaves much like a native plant and can only be found on forested slopes along mountain streams. This is the exact opposite of the expected pattern, and makes one question whether P. umbellatum is indeed New World in origin. Research analyzing the Pothomorphe clade was undertaken to help understand the origin and distribution of P. umbellatum in both the Old and New World. DNA was extracted from various Piper specimens and sequenced to examine nuclear ITS and chloroplast petA–psbJ sequences. The complete analysis revealed poor resolution among species, but indicates the New World origin of P. umbellatum. Additional data are clearly needed to further study and understand the relationships among populations of Pothomorphe around the world.
A 67-year-old female presented with an abnormal complete blood count (CBC) when arriving for an angiogram. An abnormal white blood cell (WBC) differential showed 17% blasts which led her physician to have a bone marrow biopsy performed. The bone marrow aspirate smear showed an increased number of blasts and the bone marrow core biopsy revealed 90% cellularity where normal precursors were replaced by blasts. Flow cytometry and chromosome analysis results were consistent with Acute Myelomonocytic Leukemia (AMML). The patient was placed on FLAG chemotherapy until a goal of 0.9-1.0x10^9/L absolute neutrophil count is achieved, at which time a catheter will be placed to address her cardiac comorbidities. Cardiac disease and AML comorbidities are a commonly encountered issue in oncology patients. Due to this patient’s history of cardiac disease, treating her AML is more complicated in order to ensure that chemotherapy does not worsen her cardiac complications.