Vitamin d status in children with acute lymphoblastic leukemia

Background: Skeletal morbidities are a common initial presentation and outcome in acute lymphoblastic leukemia(ALL). Vitamin D plays a vital role in the physiological regulation of calcium and phosphate transport and bone mineralization. Also high (25(OH)) level and high vitamin d intake at the time of diagnosis and initiation of anticancer treatment were associated with improved outcome. Methods: Twenty five ALL patients admitted to hematology and oncology unit, children hospital Zagazig University in one-year .vitamin D (25 (OH)) level was assessed in all patients at diagnosis. Patients were classified into deficient vitamin D (0-20)ng/ml , insufficient vitamin D (20-30)ng/ml and sufficient vitamin D (30-50)ng/ml. Statistical analysis was done to determine relation between different groups and ALL patients characteristics. Results: Vitamin D deficient in 24% of patients, vitamin D insufficient in 48% of patients, and vitamin D sufficient in 28% of patients. There was high statistical difference between different groups regarding bone pain and sex. Conclusions: A non-sufficient level in childhood all (deficiency and insufficiency) is common in childhood ALL and this is related to bone pain as initial clinical presentation. Vitamin D is related to presentation and prognosis of ALL in children

Retrospective case-series analysis of haematological malignancies in goldmining areas of South Africa

Background. South Africa (SA)'s high levels of environmental contamination of mine tailings from uranium and its decay products, coupled with remarkably short distances between mine tailings and residential areas, raise concern about whether there is an association between environmental uranium exposure and risk of cancer, including haematological malignancies. Objectives. We reviewed information on cases from the central hospital offering cancer diagnostics and treatment in a major mining area of SA to describe their basic clinical and demographic characteristics, as part of assessing whether a cancer epidemiological study in this area would be feasible.Methods. Basic clinical, demographic and residential information on patients with haematological malignancy diagnosed between 2004 and 2013 was collected retrospectively from the patient files at Chris Hani Baragwanath Academic Hospital in Soweto, Johannesburg.Results. In total, 1 880 patients aged 18 - 94 years were identified. Referral from distant provinces was not uncommon, but >80% lived within 50 km of the hospital. Non-Hodgkin's lymphoma accounted for 44% of the haematological malignancies, followed by leukaemia with 26%. HIV status was known for 93% of the patients, of whom 47% were HIV-positive.Conclusions. Caution is required when interpreting spatial distributions of patients, given inaccuracies in residential addresses and referral patterns to the hospital, and with HIV and other infections probable important confounders. Our study therefore shows that active case recruitment is required for accurate assessment of residential information. However, some findings on spatial distributions in the study warrant the continuation of efforts to develop a study protocol to investigate the possible link between uranium exposure in mining areas and haematological malignancies in residents. Disproportionately high incidence rates of haematological malignancies observed in specific districts would be relevant for further investigation

Hémopathies malignes à Brazzaville (Congo) : analyse de situation

L'épidémiologie des hémopathies malignes au Congo n'est pas connue. L'objectif de cette étude était de rapporter la distribution des hémopathies malignes à Brazzaville.Patients et méthodes : Il s'agissait d'une étude transversale descriptive réalisée dans le Service d'Hématologie Clinique du CHU de Brazzaville au Congo. La période étudiée est de 10 ans (du 1er janvier 2006 au 31 décembre 2015). Ont été inclus dans l'étude tous les dossiers de consultation et d'hospitalisation portant le diagnostic d'hémopathie maligne.Résultats : Deux cent-soixante-deux cas d'hémopathies malignes ont été diagnostiquées durant la période d'étude.Les hémopathies malignes ont été de typelymphoprolifératif chronique dans 57,3% (n = 150), leucémie aiguë dans 24, 4% (n = 64) et myéloprolifératif dans 18,3% (n = 48) des cas. Le myélome multiple et la leucémie aigüe lymphoblastique représentaient respectivement 29,8% (n = 70) et 19,1% (n = 50) des groupes nosologiques lymphoprolifératifs chroniques et leucémies aiguës. La leucémie myéloïde chronique représentait 100% du groupe myéloprolifératif. Une prédominance féminine a été observée (sex-ratio = 0,65). Les pathologies lymphoprolifératives chroniques intéressaient la tranche d'âge de 45 à 59 ans (66,7%), a leucémie myéloïde chronique celle de 15-29 ans (45,8%) et la leucémie aiguë lymphoblastique avait une distribution pédiatrique : 0-14 ans (68%).Conclusion : Les hémopathies malignes constituent par leur fréquence un problème sanitaire. Elles plaident pour des études épidémiologiques analytiques afin de mettre en place une politique préventive de celles-ci

Imatinib theraphy in chronic myeloid leukaemia : review of mechanisms of resistance and therapheutic options in imatinib failure

Chronic myeloid leukaemia is triphasic, clonal malignancy, arising from the haemopoeitic stem cell. It is characterized by the presence of philadelphia chromosome, which result from reciprocal translocation between chromosome 9 and 22. The resulting oncogen- brc-abl has proliferative activity and survival advantage against normal cell and this account for the clinical and laboratory manifestation of this myeloproliferative disorder. Imatinib, a tyrosine kinase inhibitor (TKIs) is currently the first line of treatment, however, one third of patient develope resistance to it, thus necessitating alternative TKIs. Many factors are associated with the development of resistance to imatinib, such as mutation in the brc-abl gene, increase production of the mutant protein and activation of alternatve pathways amongst other causes. The aim of this reveiw is to explore these factors, and also to avaluate current TKIs that are use as alternative in Imatinib resistant cases

Algorithmic processing to aid in leukemia detection

Background: I present our medical context with some basic concepts in order to understand the results of our work, and then I begin the explanation of mathematical morphology. I will conclude by the description of algorithmic processing propose in this paper. Cancers, including leukemia and lymphoma, can cause uncontrolled growth of an abnormal type of blood cell in the bone marrow, resulting in a greatly increased risk for infection and or serious bleeding.Methods: We present detailed steps of our proposed systems, to obtain a final result that shows the detection of abnormal cells. It typically starts with a median filter pre-processing step and then applies different morphologic operator, which allows us to segment the original image and detect cancerous cells. The basic idea behind all the operators in the mathematical morphology is to compare the set of objects to analyze another object of known form, which is called a structuring element. The structuring element is a geometric figure, simple to form, known or arbitrary, and can be a circle, segment, square, or triangle.Results: We show the different results obtained after testing carried out in algorithmic processing using MATLAB: To ameliorate the visualization of the abnormal blood cells, we have applied the elements basis morphological operations in a different way. We have performed an opening by reconstruction and a closing by reconstruction. The obtained result show that we have obtained an efficient detection of the targeted objects (abnormal blood cells or leukemia).Conclusion: In this paper, we have utilized the operators of the mathematical morphology with the aim to detect abnormal cells for diagnostic aid and transmission of accurate and precise clinical information, which helps specialists in medicine (hematologists) to distinguish abnormal cells or cancerous and to follow the evolution of leukemia. The algorithmic processing presented in this article has been able to perform the task of detection of cancerous cells with success; it has produced remarkable and satisfactory results. We think of the future concept as a system of aid for diagnosis from microelectronics integration to the base of reconfigurable technologies applied to cells for the goal of quantification of the cancer region

Antioxidant Levels of Acute Leukaemia Patients in Nigeria

The incorporation of nutritional screening and comprehensive assessments of oxidative stress is increasingly recognised as imperative in the development of standards for quality care in oncology. This study evaluated the levels of nitric oxide (NO); some essential trace metals (Zn; Cu; Fe; and Se); superoxide dismutase (SOD) activity and malondialdehyde (MDA) in twenty five (25) patients with acute leukaemia and 25 apparently healthy controls. The mean levels of plasma Zinc (Zn); Iron (Fe) and Selenium (Se) were not significantly elevated (p 0.05) in leukaemia patients compared with controls. Also; slightly lower level of plasma Cu was observed in leukaemia patients compared with the controls. However; nitric oxide was significantly increased (p 0.05) in leukaemia patients compared with controls. The implication of the present finding is that intervention to increase antioxidant status in patients with Acute Lymphoblastic Leukaemia (ALL) should be considered

Plasma Interferon-gamma and IL-4; Immunoglobulin Classes and Nitric Oxide in Nigerians with Acute Leukaemia

Acute leukaemia are usually rapidly progressive with death often occurring in a few weeks to a few months in untreated patients as a result of abnormal hematopoietic function as well as impaired immune response. The risk of relapse which remains in 20 of patients in remission calls for more research on acute leukaemia. This study therefore; evaluated the plasma levels of nitric oxide (NO); interleukin-4 (IL-4); interferon-gamma (IFN-?) and immunoglobulin classes (IgA; IgG; IgM; IgE) in twenty-five (25) patients with acute leukaemia (AL) and twenty-five (25) apparently healthy controls. The mean levels of plasma IgA; IgG and IgM were not significantly elevated in leukaemia patients compared with control. However; the mean plasma levels of IgE; NO; IL-4 and IFN-? were significantly elevated in leukaemia patients compared with controls. It could therefore be concluded from this study that humoural immunity is not depressed in acute leukaemia patients

Chronic Lymphocytic Leukaemia: A-Twenty-Years Experience and Problems in Ile-Ife; South-Western Nigeria

Aim: To investigate the usefulness of some clinical and laboratory parameters in assessing the prognosis and survival of CLL in a resource-limited setting. Methods : Between September 1986 and March 2007; 79 consecutive patients were retrospectively studied. Diagnosis was based on clinical and haematological findings. Results : A total of 79 patients; aged 30 to 81 (median = 60) years were managed. There were 34 males and 45 females (ratio = 0.8:1). About 86.1were aged above 50 years. Massive splenomegaly and hepatomegaly were recorded in 70.9and 29.1of patients; respectively. More than 63presented in stage C. Anaemia was recorded in 74.7. Haematocrit correlated negatively with WBC but positively with platelet count. The spleen correlated positively with liver. The overall survival at 2 years was 70.2. Logistic regression showed that younger age; male sex; higher haematocrit; and lower platelet count improved survival; while lower WBC; moderate hepatomegaly and splenomegaly conferred survival advantage. Conclusion : It could be concluded that massive splenomegaly is a common finding in the majority of our patients. Non availability of immunophenotyping facility is a major constraint

The Antibiotic Susceptibility of Bacteria Isolated from Blood Cultures during Episodes of Neutropenic Fever in Patients with Acute Myeloid Leukaemia

Neutropenic fever (NF) is a common and life-threatening complication of high-dose chemotherapy in patients with acute myeloid leukaemia (AML). Induction chemotherapy may result in complete remission in approximately 50-70of AML patients but is associated with an increased risk of infection due to immune suppression by the disease itself or as a result of treatment. Chemotherapy causes neutropenia as well as defective chemotaxis and phagocytosis. Chemotherapy-induced mucositis often occurs throughout the gastrointestinal tract; facilitating spread of endogenous flora to the blood circulation; leading to NF. The aim of this study was to determine the spectrum of bacteraemic microorganisms isolated during episodes of NF (NFEs) in AML patients in the Haematology Unit of the Universitas Academic Complex (UAC); as well as antibiotic susceptibility profiles of these organisms. Duration of NF; the time-span between chemotherapy and onset of NF; and the efficacy of antibiotics administered to patients; were also investigated

The Antibiotic Susceptibility of Bacteria Isolated from Blood Cultures during Episodes of Neutropenic Fever in Patients with Acute Myeloid Leukaemia

Abstract: Neutropenic fever (NF) is a common and life-threatening complication of high-dose chemotherapy in patients with acute myeloid leukaemia (AML). Induction chemotherapy may result in complete remission in approximately 50-70 of AML patients but is associated with an increased risk of infection due to immune suppression by the disease itself or as a result of treatment. Chemotherapy causes neutropenia as well as defective chemotaxis and phagocytosis. Chemotherapy-induced mucositis often occurs throughout the gastrointestinal tract; facilitating spread of endogenous flora to the blood circulation; leading to NF.The aim of this study was to determine the spectrum of bacteraemic microorganisms isolated during episodes of NF (NFEs) in AML patients in the Haematology Unit of the Universitas Academic Complex (UAC); as well as antibiotic susceptibility profiles of these organisms. Duration of NF; the time-span between chemotherapy and onset of NF; and the efficacy of antibiotics administered to patients; were also investigated

Severe Depression Following a-interferon Usage in a Patient with Chronic Myeloid Leukemia

Background: Chronic myeloid leukaemia (CML); with a median age of 40 years; is one of the commonest haematological malignancies in Nigeria. Cytoreductive agents; which were hitherto the mainstay of treatment; neither induce cytogenetic nor haematologic remission. Alpha-interferon (a-IFN); an endogenous glycoprotein with cytotoxic and natural killer cell enhancer effects has been found to induce haematologic and cytogenetic remission in patients with CML; but neuro- psychiatric complications of a -interferon (a-IFN) usage were not reported in Nigeria. Objective: To report a case of deliberate self-harm in University Lecturer as a side effect of a-IFN in the treatment of CML. Method: Clinical and laboratory follow up of a patient receiving a-IFN in the management of CML from the time of diagnosis of CML to the point of loss of contact. Result: Severe depression is a complication that may adversely influence the clinical outcome of a-IFN usage Conclusions/Recommendations: Although interferon related depression is uncommon; it is suggested that pre-therapy interferon assays and neuro-psychiatric assessment are carried out in prospective users of a-IFN

Les hemopathies malignes de l'enfant : aspects epidemiologiques dans le service d'hematologie oncologie medicale de l'hopital du point G; Bamako; Mali (1996-2003)

Selon les statistiques des pays industrialises; les hemopathies malignes sont les cancers les plus frequents chez l'enfant. L'absence de registres specifiquement consacres a ces pathologies et le deficit d'etudes cliniques expliquent que les aspects epidemiologiques et pronostiques des hemopathies malignes de l'enfant sont mal connus dans les pays en developpement notamment ceux d'Afrique subsaharienne. Pourtant; la maitrise progressive des affections pediatriques autrefois preoccupantes; pourrait engager desormais les pays du Sud dans l'elaboration de programmes specifiques de lutte contre les hemopathies malignes de l'enfant; d'ou la necessite de donnees epidemiologiques locales. Cette etude decrit les particularites epidemiologiques des hemopathies malignes de l'enfant dans un service hospitalier de dernier niveau de reference au Mali. Cin- quante neuf cas d'hemopathies malignes de l'enfant ont ete recrutes de janvier 1996 a decembre 2003 chez 19 filles et 40 garcons. L'analyse des donnees enregistrees retrospectivement sur logiciel Access a ete faite par SPSS 11.0. L'age des enfants variait entre 4 et 15 ans avec une classe modale correspondant a 6-10 ans. Le taux de recrutement annuel etait stable sur les 8 annees considerees avec une moyenne de 7;37 nouveaux cas par an. Les hemopathies malignes predominantes etaient les lymphomes malins (70) notamment le lymphome de Burkitt. La maladie de Hodgkin n'etait pas observee avant 5 ans; mais elle representait 24des hemopathies apres cet age avec une predominance masculine. Cette etude souligne la necessite de la mise en place de strategies permettant une meilleure comprehension des aspects epidemiologiques des hemopathies malignes de l'enfant au Mali et de politiques de prise en charge et de prevention des cas

Aspects epidemiologiques des leucemies aigues en Cote d'Ivoire

Les auteurs rapportent un etude epidemiologique des leucemies aigues allant d'octobre 1991 a fevrier 1999. La prevalence hospitaliere est de 23;86pour 1000 malades hospitalises. Il y avait 59;09de leucemies aigues lymphoblastique (LAL) et 40;91de leucemies aigues myeloide (LAM). L'age global etait de 29;13 ans et 60;60des patients etaient ages de 2 a 30 ans. Il a ete note une legere predominance masculine. Les hydrocarbures aromatiques (benzene et ses derives) sont fortement incrimines

Acute leukaemias in adults Ethiopians in a Teaching Hospital

Eighty-two consective cases of acute leukaemias in adult Ethiopians were admitted to Tikur Anbessa (Black Lion) Hospital; a teaching and referral hospital in Addis Ababa; Ethiopia; from January 1982 to December 1992. These cases were studied to describe the clinical and haematological findings; response to therapy and prognosis. The age range was 13-78 (mean 29.6) years. The male to female ratio was 1.6:1. Acute myeloblastic (AML) and acute lymphoblastic (ALL) leukaemias occurred in 53.7 percent and 46.3 percent; respectively. The commonest symptoms were anaemia; fever and bleeding tendencies. The commonest signs were pallor; fever; sternal tenderness and purpura. Splenomegaly was more commonly seen in ALL patients. The haematological findings were anaemia (mean Hgb 6.35 percent); leucocytosis (mean WBC count 88;507/mm3) and thrombocytopenia (mean platelet count 31;700/mm3). Of the patients eligible for evaluation treated with chemotherapeutic agents; only 38.4 percent of ALL and 6.2 percent of AML achieved complete remission. Twenty-seven patients with ALL died from one day to 84 (median 1.0) months after diagnosis. Ten are lost to follow-up from two weeks to 36 (median 2.5) months; one is still alive 40 months after diagnosis. Thirty-nine of the AML patients died from one day to nine (median 0.3) months after diagnosis. Five are lost to follow-up from two weeks to two and a half (median 2.0) months. The causes of death were sepsis and bleeding; separately or in combination. Increasing numbers of acute leukaemia patients are being referred to this centre. Therefore; attempts should be made to equip it for the treatment of such cases

Panorama des hemopathies diagnostiquees au Laboratoire central du CHU de Treichville: bilan de 10 annees d'activites

Ce texte rapporte le bilan des hemopathies diagnostiquees dans le laboratoire central du CHU de Treichville. Ce travail a permis d'en souligner les caracteristiques generales. Il a ete collige au cours de cette periode 432 cas repartis de la facon suivante: leucemies (142;2 cas/an) aussi bien chez l'enfant que chez l'adulte; lymphomes 264 cas soit 26;4 cas par an avec 26 cas de maladies de Hodgkin; 238 cas de lymphomes non Hodgkiens parmi lesquels la maladie de Burkitt occupe une place importante avec 195 cas; et les autres lymphomes (43 cas). Concernant les dysglobulinemies; il a ete denombre 26 cas de myelomes. L'affection frappe les classes sociales les plus demunies; avec une predominance du sexe masculin

Ocular granulocytic sarcoma with acute myeloid leukaemia in Dar es Salaam

It appears that granulocytic sarcoma in children has not been reported before in Tanzania. This report describes three cases of granulocytic sarcoma which were associated with otherwise typical acute myeloid leukaemia