Presenting phases of chronic myeloid leukaemia

To determine the frequency of three phases of chronic myeloid leukaemia at first presentation. Department of Oncology, Combined Military Hospital [CMH], Rawalpindi, from June 2006 to December 2007. Forty-five patients of either gender with Chronic Myeloid Leukaemia [CML] at their first presentation in outpatient department were included in the study by consecutive sampling technique. All patients were diagnosed on blood complete picture and bone marrow examination including aspiration, trephine and cytogenetics at Armed Forces Institute of Pathology [AFIP]. Each phase was defined on the basis of World Health Organization [WHO] criteria. Out of 45, there were 31 [68.9%] male and 14 [31.1%] female patients. The mean age of presentation was 37.9 years. The pattern of presentation revealed 35 [77.8%] in Chronic Phase [CP], 7 [15.5%] in Accelerated Phase [AP] and 3 [6.7%] in Blast Crisis [BC]. Philadelphia chromosome was detected in 39 [86.7%] cases on culture method. Splenomegaly was observed in 37 [82.2%] patients. The mean total leukocyte count, platelet count, haemoglobin and marrow blast were 214.3x10[9]/L, 551.4x10[9]/L, 9.94 g/dl and 9.3% respectively. CML presented at a younger age in the chronic phase

Toxicity profile and objective response of paclitaxel in metastatic breast cancer

To evaluate the efficacy and toxicity of 1-hour weekly Paclitaxel in metastatic breast cancer along with evaluation of overall survival. A phase II interventional trial. Oncology Department, Combined Military Hospital, Rawalpindi, between August 2001 to July 2003. Thirtysix patients were enrolled in the study. All patients with histologically confirmed and bidimensionally measurable metastatic breast cancer who had received previously either chemotherapy or hormone therapy were included in the study. Paclitaxel was administered in 1-hour weekly infusion in a dose of 100 mg/m2 for 12 doses. All patients had received previous chemotherapy with either CAF or CMF. Twenty five patients had also received hormone therapy, 61% had two or more metastatic sites involved, and lung was the common site of involvement. Complete response was observed in 4 [11.1%] patients, partial response in 14 [38.8%] patients, with an overall response rate of 50.0%. Clinical benefit was 94.4% and median overall survival was 11 months. Treatment was well-tolerated with no grade 3 or 4 toxicity. Common side effects were arthralgias, myalgias and neutropenia. Treatment with 1-hour weekly infusion of Paclitaxel is a well-tolerated chemotherapy with a substantial degree of efficacy in patients with metastatic breast cancer

Salmonella paratyphi a induced pancytopenia-a new association

A case of salmonella paratyphi A fever with reversible pancytopenia in a 15 year old boy who presented with history of high grade continuous fever, epistaxis and haemoptysis, relative bradycardia and splenomegaly is described here. A brief review of the literature on possible causes of reversible pancytopenia in this case is also discussed