ABSTRACT
14q32 rearrangement has been identified as a recurrent hotspot of translocations in multiple myeloma [MM]. The Fluorescence Immunophenotyping and Interphase Cytogenetics as a tool for the Investigation of Neoplasms [known as FICTION technique] for evaluation of chromosomal changes in MM. The aim of this work is to detect 14q32 rearrangement, using FICTION technique, on archival bone marrow [BM] slides of MM patients, and to study its prognostic value. This study was conducted at Ain Shams University Hospital. The FICTION technique, which uses CD138 and dual color, and the break-apart 14q32 rearrangement probe, was performed on archived smears of BM slides for 50 MM patients at the time of diagnosis. A significantly higher percentage of cases were positive for 14q32 rearrangement by FICTION [32%] compared to fluorescence in situ hybridization [FISH] [12%] [p = 0.04]. Cases positive by FICTION for the rearrangement were designated as Group A, while negative cases were designated as Group B. Significantly lower Hb and CRP levels were found among Group B when compared to Group A patients [p = 0.001 and 0.01, respectively]. Serum albumin level and Bence Jones protein [BJP] significantly affect overall survival [OS] [p = 0.01, 0.007, respectively]. However, a statistically non-significant shorter mean survival time was found in positive cases through FICTION versus negative cases. FICTION technique provides a sensitive tool for establishing clonal plasma cells [PC] infiltration of BM aspirates, and is amenable for use on archived as well as fresh smears
ABSTRACT
Tissue factor [TF] is the main initiator of the extrinsic coagulation pathway through factor VII [FVII] activation, which is physiologically inhibited by tissue factor pathway inhibitor [TFPI]. Alteration of this pathway has been described in Type 2 diabetes mellitus [T2DM]. The aim of this study is to assess TF and TFPI plasma levels and FVII coagulant activity [FVIIa] in T2DM in relation to cardiothrombotic disease and their correlation to metabolic and clinical behavior of the patients. The study was conducted on 80 T2DM patients divided to accordingly; groupI: 40 patients without a history or clinically detected heart disease, and groupII: 40 patients with a history of myocardial infarction compared to 30 controls. The patients were recruited from Ain Shams University diabetes clinic from September 2007 to February 2009 after informed consent was obtained. Peripheral blood samples were taken for measurement of plasma TF and TFPI levels using ELISA technique and quantitative FVIIa using FVII deficient plasma. Plasma levels of TF, TFPI and FVIIa were significantly higher in T2DM patients compared to the controls [p<0.001]. TF [236.50 +/- 79.23]and TFPI [242.33 +/- 85.84]were significantly higher in group II, compared to group I [150.33 +/- 81.16], [152.8 +/- 82.46], [p<0.001]. TF and TFPI were significantly correlated to body mass index and glycemic control. Also, TF and TFPI were significantly higher in hypertensives [p=0.001] and dyslipidemics [p=0.006] but not in smokers [p=0.64], [p=0.11] respectively. There was a correlation between high TF, TFPI plasma levels, FVIIa activity and cardiothrombotic complications in T2DM especially in the presence of high risk factors such as poor glycemic control, dyslipidemia and obesity. Future target therapy against TF may be beneficial for T2DM patients