The prognostic value of glucocorticoid receptors for adult acute lymphoblastic leukemia

BACKGROUND: Therapeutic protocols used in adult acute lymphoblastic leukemia (ALL) are widely variable, and glucocorticoids (GCs) are essential components in ALL treatment. Therefore, this study aimed to evaluate the distribution of prominent glucocorticoid receptor (GR) gene polymorphic variants among adult ALL patients. We also investigated the association between GR messenger ribonucleic acid (mRNA) isoform expressions and the response to chemotherapy. METHODS: Fifty-two newly diagnosed Philadelphia-negative adult ALL patients and 30 healthy control subjects were enrolled in this study. Genotyping was carried out using a polymerase chain reaction (PCR)-restriction fragment length polymorphism analysis. GR mRNA isoform expressions were assayed by quantitative real-time PCR. RESULTS: ALL patients in this study had a median age of 34 years (range, 18-75). GRalpha expression was associated with complete remission (P=0.03), while GRgamma mRNA expression was significantly higher in GC resistant patients (P=0.032) and in non-responders (P=0.019). However, there were no significant associations with GC resistance. The BclI polymorphic variant of the GR gene was the most frequent in adult ALL patients and was not associated with the GC response. Both higher GRalpha expression and lower GRgamma expression were associated with achievement of complete remission, while higher GRgamma expression was associated with GC-resistance. CONCLUSION: Our data suggest that the level of GR isoform expression may be useful in predicting GC response, achievement of complete remission, and better event-free survival in ALL patients. However, further evaluation with a larger cohort of patients is warranted.

Evaluation of nucleic acid amplification testing technique [NAT] in blood banks

National Cancer Institute ,Cairo University1;Clinical Pathology Department, Ain Shams University2 Hepatitis C is a major health problem for Egypt.Nucleic acid amplification testing [NAT] of blood donations was implemented to detect 'window period' infection.The aim of this study is to evaluate the efficiency of the NAT technique and compare it with the current used methods of detection of hepatitis C, to estimate the true up to date incidences of hepatitis B, hepatitis C and coinfection by both in Egypt. The study was conducted on 62543; 46868 of them were honouary blood donors from Nasser Institute and 15675 were healthy volunteers of the blood compaigns from National Cancer Institute in the period between May 2001 to May 2004.Blood samples were obtained from the donors and were screened for antibodies against HCV, HIV, Treponema pallidum and HBsAg.NAT technique was done for 60045 donors which showed a negative HCVantibody by ELISA. We found that HCV antibodies in 3.99% of the donors, HBsAg in 1.59% 0f them. The incidence of coinfection with both hepatitis B and C viruses did not exceed 0.095%.No HIV positive cases were detected and a total of 0.035% had serologic markers suggestive of active syphilis infection. The dilution used for the pooling for the RT-PCR was 1/40.We found '5' NAT positive cases out of 60045.We concluded from this that using NAT technique in conjunction with ELISA screening for anti-HCV antibodies should be further investigated especially in developing countries, putting in mind that using this technique increases the cost of screening by around 10 L.E for one blood bag. Therefore the use of NAT should be weighed against the potential benefit of reducing the incidence of HCV infection