ABSTRACT
Objective: Detection of chromosomal translocations has an important role in diagnosis and treatment of hematological disorders. We aimed to evaluate the 46 new cases of de novo acute myeloid leukemia [AML] patients for common translocations and to assess the effect of geographic and ethnic differences on their frequencies
Materials and Methods: In this descriptive study, reverse transcriptase-polymerase chain reaction [RT-PCR] was used on 46 fresh bone marrow or peripheral blood samples to detect translocations t [8; 21], t [15; 17], t [9; 11] and inv [16]. Patients were classified using the French-American-British [FAB] criteria in to eight sub-groups [M0-M7]. Immunophenotyping and biochemical test results of patients were compared with RT-PCR results
Results: Our patients were relatively young with a mean age of 44 years. AML was relatively predominant in female patients [54.3%] and most of patients belonged to AML-M2. Translocation t [8; 21] had the highest frequency [13%] and t [15; 17] with 2.7% incidence was the second most frequent. CD19 as an immunophenotypic marker was at a relatively high frequency [50%] in cases with t [8; 21] and patients with this translocation had a specific immunophenotypic pattern of complete expression of CD45, CD38, CD34, CD33 and HLA-DR
Conclusion: Similarities and differences of results in Iran with different parts of the world can be explained with ethnic and geographic factors in characterizations of AML. Recognition of these factors especially in other comprehensive studies may aid better diagnosis and management of this disease
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Translocation, Genetic , Geography , Ethnicity , Reverse Transcriptase Polymerase Chain ReactionABSTRACT
Chronic myeloid leukemia [CML] is a myeloproliferative disease. The cytogenetic hallmark of CML is Philadelphia [Ph] chromosome. This study aimed to diagnose suspected CML patients, to monitor CML patients under therapy using cytogenetic and fluorescence in situ hybridization [FISH] techniques to analyze their bone marrow [BM] and peripheral blood [PB] samples, and finally to compare their obtained results for both specimens. This study was conducted during one-year period [2012-2013]. The participants were recruited from the Hematology and Oncology Clinic of Shahid Gazi [Emam Reza] Hospital of Tabriz University of Medical Sciences, Tabriz, East Azerbaijan Province, Iran. We analyzed 90 samples from 60 suspected CML patients [30 BM and 60 PB samples]. All samples were analyzed using G-banding, 5 samples using dual fusion FISH [DF-FISH] probes, as well as 30 samples using both FISH and G-banding. Among the 90 analyzed samples of 60 patients, 25 [41.66%] were Ph+ using karyotyping, whereas five cases were not analyzable, so FISH was applied and the results confirmed that only two individuals were BCR-ABL+. In the comparison between 25 BM and 25 PB samples using karyotyping, 15 [60%] and 10 [40%] were ph+, respectively. The comparison of FISH and karyotyping on 30 samples showed that 9 [30%] and 8 [26.66%] were Ph+, respectively, and only 18.18% of Ph+ patients showed atypical patterns. In the comparison between BM-cytogenetic and PB-interphase-FISH [I-FISH], BM-cytogenetic was more reliable than PB-I-FISH in detecting Ph. Our data demonstrate that FISH analysis is a rapid, reliable and sensitive technique. The comparison between BM and PB showed that PB can not be replaced by BM, even in detecting by FISH
ABSTRACT
Chemotherapeutic agents used in patients with cancer cause to generate the enormous amounts of free radicals associated with cell injury. In this study we assess the effects of chemotherapy regimen on oxidant/antioxidant status in patients with acute myeloid leukemia [AML]. 38 newly diagnosed patients with acute myeloid leukemia were recruited in this study. All patients received cytarabine and daunorubicin as chemotherapy regimen. Plasma levels of malondialdehyde [MDA], total antioxidant status [TAS], and the levels of erythrocyte activity of superoxide dismutase [SOD] and glutathione peroxidase [GPx] were determined before chemotherapy and 14 days after chemotherapy with cytarabine and daunorubicin. Plasma MDA concentrations increased significantly [from 2.68 +/- 0.89 nmol/L to 3.14 +/- 1.29 nmol/L] during the 14days post-chemotherapy period [P=0.04]. Plasma TAS concentrations changed with chemotherapy from 1.09 +/- 0.15 mmol/L to 1.02 +/- 0.14 mmol/L with P=0.005. Erythrocyte SOD and GPX activity decreased overtime from 1157.24 +/- 543.61 U/g Hb to 984.01 +/- 419.09 U/g Hb [P=0.04] and 46.96 +/- 13.70 U/g Hb to 41.40 +/- 6.44 U/g Hb [P=0.02] respectively. We report here that there is an increase in malondialdehyde levels and a decrease in the levels of antioxidant enzymes and total antioxidant status. This suggests that chemotherapy causes these changes as a result of enormous production of reactive oxygen species in the patients with AML. Antioxidant supplementation must be approached with caution because of the probability of reduction the therapeutic efficacy of these cytotoxic drugs.
ABSTRACT
Multiple myeloma [MM] characterized by proliferation of plasma cells in bone marrow and production of monoclonal immunoglobulin's. Recently, arsenic trioxide [ATO], has been considered for treatment refractory MM. We assessed the safety and efficacy of ATO for patients with refractory MM. A phase 2, study of arsenic trioxide was conducted in 12 MM patients, whose refractory to two standard therapy. Patients received arsenic trioxide, 0.25 mg/kg/d for 5 d/week during the first 2 consecutive weeks of each 4-week cycle with 2 week rest. Patients who completed one 4-week cycle were evaluated for response to treatment. Twelve patients with refractory multiple myeloma received ATO. Disease assessment was based the amount of serum proteins electrophoresis. Of the10 patients; stable disease was observed in four patients[33%], progression disease in five patients [41.6%], complete response in one patient [3.8%] and the remaining two patients could not be assessed for a response [because of increased liver enzymes after the first week]. Some adverse events: increase liver enzymes and serum creatinine, neutropenia, pruritus, nausea, vomiting, lower extremities edema, noninfectious diarrhea was observed. These results indicate that ATO is active and well tolerated as a single-agent salvage therapy, even in patients with late-stage, refractory MM