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
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
Acute myeloid leukemia [AML], the most common form of acute leukemia, is treated by remission induction and post-remission therapy. Remission induction is usually achieved by administration of cytarabine along with an anthracycline such as Daunorubicin [DAU] or Idarubicin [IDA]. Our objective was see the benefits if any of IDA over DAU in AML therapy. Eighty adult AML patients were enrolled in this study, where 40 received DAU and 40 were treated with IDA. Remission status in each subject was studied and response to therapy was subsequently analyzed using SPSS. Complete remission, partial remission and no responsive status were 15, 19, and 14 respectively for patients on DAU and 14, 18, and 11 for patients on IDA protocol. No significant benefit was detected for IDA compared to DAU in response to therapy. We found no benefit in using IDA over DAU in induction therapy for AML patients treated in northwest of Iran
Subject(s)
Humans , Male , Female , Cytarabine , Daunorubicin , Idarubicin , Remission Induction , Treatment Outcome , Remission InductionABSTRACT
The aim of this study was to evaluate the efficacy of mitoxantrone versus daunorubicin on the response rates of acute myeloid leukemia [AML] patients. In this prospective randomized trial, adult patients with newly diagnosed AML received daunorubicin[45mg/m[2]/d for 3 days] or mitoxantrone [12mg/m[2]/d for 3 days], each combined with the identical dose of cytarabine[ara-c] [150mg/m/d by continuous infusion for 7 days]. Of 27 patients, 10 were randomly allocated to the mitoxantrone plus ara-c "MA" treatment arm and 17 to the daunorubicin plus ara-c "DA" treatment arm. Median age of the patients in MA was18 years and in DA was 25. Fifty percent of the MA achieved complete remission and 40% achieved a partial remission giving an overall response rate of%90. The same overall response rate was significantly lower in DA group [P=0.025]. The combination of mitoxantrone and ara-c is a possible alternative to daunorubicin and ara-c combination for the treatment of AML