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1.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(4): 476-481, Oct.-Dec. 2021. tab, ilus
Article in English | LILACS | ID: biblio-1350816

ABSTRACT

ABSTRACT Introduction: We performed cost-effectiveness and cost-utility analyses of the modified International Consortium on Acute Promyelocytic Leukemia protocol in Mexico for the treatment of acute promyelocytic leukemia Acute Promyelocytic Leukemia. Methods: We performed a three-state Markov analysis: stable disease (first line complete response [CR]), disease event (relapse, second line response and CR) and death. The modified IC-APL protocol is composed of three phases: induction, consolidation and maintenance. Cost and outcomes were used to calculate incremental cost-effectiveness ratios (ICERs); quality-adjusted life-years were used to calculate incremental cost-utility ratios (ICURs). Results: The CR was achieved in 18 patients (90%), treated with the IC-APL protocol as the first-line option; one patient (5%) died in induction, another one never achieved CR (5%); of the 18 patients that achieved CR, 1 relapsed (5.5%). The median treatment cost of the IC-APL protocol was $21,523 USD. The average life-year in our study was 7.8 years, while the average quality-adjusted life-year (QALY) was 6.1 years. When comparing the ICER between the IC-APL and the all-trans retinoic acid (ATRA) plus arsenic trioxide (ATO) protocols, we found the different costs of $6497, $19,133 and $17,123 USD in Italy, the USA and Canada, respectively. In relation to the ICUR, we found the different costs to be $13,955 and $11,979 USD in the USA and Canada, respectively. Conclusion: Taking into account the similar response rates, lower cost and easy access to the modified IC-APL regimen, we consider it a cost-effective and cost-utility protocol, deeming it the treatment of choice for our population.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Leukemia, Promyelocytic, Acute/diagnosis , Leukemia, Promyelocytic, Acute/drug therapy , Tretinoin/therapeutic use , Clinical Protocols , Cost-Benefit Analysis
2.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(3): 309-312, July-Sept. 2021. tab
Article in English | LILACS | ID: biblio-1346267

ABSTRACT

Abstract Introduction: Little attention is given to thrombosis associated with pediatric acute promyelocytic leukemia (APL). This study describes the thrombotic and hemorrhagic manifestations of APL in pediatric patients and evaluates their hemostasis, based on coagulation tests. Methods: Inclusion criteria were age 0-18 years and APL diagnosis between April 2005 and November 2017. Patients who had received blood transfusion prior to coagulation tests were excluded. Baseline coagulation tests, hematologic counts, and hemorrhagic/thrombotic manifestations were evaluated. Results: Median age was 10.7 years (1-15 years). The initial coagulation tests revealed a median Hgb of 8.3 g/dL (4.7-12.9 g/dL), median leucocyte count of 10.9 × 109/L (1.1-95.8 × 109/L), median platelet count of 31.8 × 109/L (2.0-109.0 × 109/L), median activated partial thromboplastin time (aPTT) of 31.7 s (23.0-50.4 s), median aPTT ratio of 1.0 (0.78-1.6), median thromboplastin time (PT) of 17.5 s (13.8-27.7 s), median PT activity of 62% (25-95 %), and median fibrinogen of 157.7 mg/dL (60.0-281.0 mg/dL). Three patients (13%) had thrombosis. At diagnosis, 21 patients (91.3%) had bruising, one patient (4.3%) had splenic vein and artery thrombosis and one patient (4.3%) presented without thrombohemorrhagic manifestations. During treatment, two patients (8.6%) had thrombosis. Conclusion: Knowledge of thrombosis in pediatric APL is important to determine its risk factors and the best way to treat and prevent this complication.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Thrombosis , Leukemia, Promyelocytic, Acute/diagnosis , Hemostasis
3.
Rev. cuba. hematol. inmunol. hemoter ; 37(3): e1505, 2021. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1341404

ABSTRACT

Introducción: Con el protocolo LPM-TOA para el tratamiento de la leucemia promielocítica se obtienen excelentes resultados, se prolonga la sobrevida global y es posible la curación de los enfermos. En la de inducción a la remisión se utilizan dos drogas, una antraciclina y trióxido de arsénico, y en la consolidación los enfermos reciben de nuevo una dosis elevada de arsénico. Objetivo: Evaluar la toxicidad hepática tardía en pacientes con leucemia promielocítica tratados según el protocolo LPM-TOA. Métodos: Se realizó estudio longitudinal prospectivo que incluyó20 pacientes tratados con dicho protocolo, todos con más de dos años de haberlo suspendido. Se revisaron las historias clínicas para evaluar mediante los valores iniciales y evolutivos de las enzimas hepáticas, la función hepática inicial y evolutiva. Se determinó el índice de Ritis para predecir evolución a la cronicidad de existir daño hepático. Resultados: Hombres y mujeres se presentaron con la misma frecuencia y la media para la edad del sexo masculino fue 36,39 y para el femenino 39, con desviación estándar de ±14,02 y ±9,43, respectivamente. La variedad morfológica más frecuente fue la hipergranular, el promedio del índice de Ritis fue de solo 1,006 con desviación estándar de 0,745. Conclusiones: No hubo evidencias clínica ni enzimática de toxicidad hepática tardía en los pacientes estudiados(AU)


Introduction: With the LPM-TOA protocol for the treatment of acute promyelocytic leukemia, excellent results are obtained, overall survival is prolonged and the patients are cured, in the induction to remission two drugs are used, an anthracycline and arsenic trioxide, and in consolidation the patients again receive a high dose of arsenic. Objective: To assess late liver toxicity in patients with promyelocytic leukemia treated according to the PML-TOA protocol. Methods: A prospective longitudinal study was carried out that included 20 patients treated with this protocol, all with more than two years of having suspended treatment. The clinical histories were reviewed and by means of the initial and evolutionary values of liver enzymes, the initial and evolutionary liver function was evaluated and the Ritis index was determined to predict evolution to chronicity if there is liver damage. Results: Men and women presented with the same frequency and the mean age for males was 36.39 and for females it was 39, with a standard deviation of ± 14.02 and ± 9.43 respectively. The most frequent morphological variety was hypergranular, the average Ritis index was only 1.006 with a standard deviation of 0.745. Conclusions: There was no clinical or enzymatic evidence of late liver toxicity in the patients studied(AU)


Subject(s)
Humans , Leukemia, Promyelocytic, Acute/drug therapy , Chemical and Drug Induced Liver Injury/prevention & control , Arsenic Trioxide/toxicity , Survival Analysis , Prospective Studies , Longitudinal Studies
4.
Article in Spanish | LILACS, CUMED | ID: biblio-1341403

ABSTRACT

Introducción: La leucemia promielocítica presenta particularidades biológicas y clínicas con respecto al resto de las leucemias mieloides agudas. El descubrimiento de los detalles moleculares de su patogénesis, posibilitó que su tratamiento, constituya una de las mejores representaciones de la investigación traslacional y esto hace que establezca un modelo para el desarrollo de terapias dirigidas a dianas moleculares con enfoque curativo en pacientes con cáncer. Objetivo: Abordar los principales avances en la terapia de la LPM desde el descubrimiento de los agentes diferenciadores hasta su estado actual. Métodos: Se realizó una búsqueda exhaustiva en bases de datos como Scielo, Pubmed, ScienceDirect, Redalyc y se utilizaron como referencias los artículos actualizados publicados principalmente en los últimos cinco años. Análisis y síntesis de la información: Se abordaron los principales avances en la terapia de este tipo de leucemia, desde el descubrimiento de los agentes diferenciadores hasta su estado actual, haciendo énfasis en su mecanismo de acción y nuevas opciones terapéuticas. Conclusiones: Los aportes realizados en el estudio etiopatogénico y molecular de la leucemia promielocítica y su impacto objetivo en la investigación clínica, constituyen uno de los mejores ejemplos de tratamiento dirigido a alteraciones moleculares específicas y representa un modelo de integración biológica, clínica y terapéutica en beneficio de los pacientes afectados con esta enfermedad(AU)


Introduction: Acute promyelocytic leukemia is a biologically and clinically different type from other acute myeloid leukemias. The discovery of molecular details in its pathogenesis enabled its treatment to constitute one of the best examples of translational research and makes a model for the development of targeted therapies with a curative approach in cancer patients. Objective: To analize the main advances in PML therapy from the discovery of differentiating agents to their current state. Methods: An exhaustive search was carried out in the databases as Scielo, Pubmed, ScienceDirect, Redalyc, and updated articles published mainly in the last five years were used as references. Analysis and synthesis of the information: The article addressed the main advances in the therapy of this type of leukemia, from the discovery of differentiating agents to its current state, emphasizing its mechanism of action and new therapeutic options. Conclusions: The contributions made in the etiopathogenic and molecular study of promyelocytic leukemia and its objective impact on clinical research constitute one of the best examples of treatment aimed at specific molecular alterations and represents a model of biological, clinical and therapeutic integration in benefit of patients affected with this disease(AU)


Subject(s)
Humans , Leukemia, Promyelocytic, Acute/therapy , SUMO-1 Protein
6.
Article in Spanish | LILACS, CUMED | ID: biblio-1341400

ABSTRACT

Introducción: En los últimos años se ha comprobado que el riesgo de trombosis en pacientes con enfermedades oncohematológicas es elevado. Presentación del caso: Paciente masculino de 51 años de edad, con diagnóstico de leucemia promielocítica, recibió tratamiento de inducción con trióxido de arsénico y ya alcanzada la remisión morfológica de la leucemia, y sin antecedentes personales ni familiares de eventos trombóticos, presentó una trombosis venosa profunda del miembro inferior izquierdo, se trató con heparina de bajo peso molecular y warfarina. Conclusiones: El paciente evolutivamente tuvo una evolución favorable del evento trombótico y se alcanzó la remisión completa hematológica, citogenética y molecular con una adecuada calidad de vida que permitió su reinserción a su vida personal, familiar y social(AU)


Introduction: In recent years it has been proven that the risk of thrombosis in patients with oncohematological diseases has increased. Case presentation: A 51-year-old male patient, diagnosed with Promyelocytic Leukemia, received induction treatment with arsenic trioxide and the morphological remission of the leukemia had already been achieved and with no personal or family history of thrombotic events, presented a deep vein thrombosis of the left lower limb. He was treated with low molecular weight heparin and warfarin. Conclusions: The patient progressively had a favorable evolution of the thrombotic event and complete hematological, cytogenetic and molecular remission was achieved with an adequate quality of life that allowed his reinsertion into his personal, family and social life(AU)


Subject(s)
Humans , Male , Middle Aged , Leukemia, Promyelocytic, Acute/complications , Thrombophilia/prevention & control , Venous Thrombosis/complications
7.
Article in Spanish | LILACS, CUMED | ID: biblio-1341396

ABSTRACT

Introducción: La leucemia promielocítica es un subtipo de leucemia mieloide aguda que se presenta frecuentemente con una coagulopatía potencialmente mortal, por lo que representa una emergencia médica. En la gran mayoría de los pacientes ocurre la t(15;17)(q24;q21) que genera el gen aberrante PML-RARA. Mediante diferentes técnicas de citogenética y de la biología molecular que detectan dichas aberraciones es posible diagnosticar la entidad de manera inequívoca y estudiar la enfermedad mínima residual. Objetivo: Describir, comparar y analizar las técnicas de citogenética y de la biología molecular que son útiles para el diagnóstico y el seguimiento del paciente con leucemia promielocítica. Así como señalar sus ventajas y limitaciones. Métodos: Se realizó revisión de la bibliografía científica de los últimos cinco años relacionada con el tema a través de PUBMED. Se realizó análisis y resumen de la información. Análisis y síntesis de la información: Se describen dos técnicas de citogenética y tres moleculares basadas en la aplicación de la reacción en cadena de la polimerasa. Se comparan y analizan sus ventajas y limitaciones. Conclusiones: Algunas de estas técnicas son útiles únicamente para el diagnóstico, mientras que otras, por su alta sensibilidad, se recomiendan para el seguimiento del paciente con leucemia promielocítica(AU)


Introduction: Promyelocytic leukemia (PML) is a subtype of acute myeloid leukemia that frequently presents with a potentially fatal coagulopathy, therefore it represents a medical emergency. In the vast majority of patients, the t (15; 17) (q24; q21) occurs, which generates the aberrant gene PML-RARA. Using different cytogenetic and molecular biology techniques that detect these aberrations, it is possible to unequivocally diagnose the entity and study minimal residual disease. Objective: To describe, compare and analyze cytogenetics and molecular biology techniques that are useful for diagnosis and follow-up of the patient with Promyelocytic leukemia. As well as pointing out its advantages and limitations. Methods: A review of the scientific bibliography of the last five years related to the subject was carried out through PUBMED. An analysis and summary of the information was made. Analysis and synthesis of the information: Two cytogenetic and three molecular techniques are described based on the application of the polymerase chain reaction. Its advantages and limitations are compared and analyzed. Conclusions: Some of these techniques are only useful for diagnosis, while others, due to their high sensitivity, are recommended for monitoring the patient with Promyelocytic leukemia(AU)


Subject(s)
Humans , Leukemia, Promyelocytic, Acute/diagnosis , Polymerase Chain Reaction/methods , Aftercare , Cytogenetics/methods , Molecular Biology
8.
Hematol., Transfus. Cell Ther. (Impr.) ; 43(1): 21-27, Jan.-Mar. 2021. tab, graf
Article in English | LILACS | ID: biblio-1154299

ABSTRACT

ABSTRACT Acute promyelocytic leukemia is a subtype of acute myeloid leukemia, characterized by the presence of neoplastic promyelocytes, due to the reciprocal balanced translocation between chromosomes 15 and 17. Currently, with the use of agents that act directly on this molecular change, such as all-trans retinoic acid and arsenic trioxide, APL has shifted from a highly mortal to a curable disease. However, some cases are still at high risk of death, especially early death, and acquiring a better understanding of the clinical and biological factors involving APL is needed to correctly identify and treat such cases. The early suspected diagnosis and prompt initiation of the target therapy are important for better response rates. The follow-up and outcomes, using real-life data from 44 consecutive APL patients, were studied between 2001 and 2013. The overall survival rate was 82.7% and early death was 16%. Almost all patient deaths were due to severe bleeding, which was confirmed by multivariate analysis, as the most important prognostic factor leading to death. A better understanding the pathogenesis of the hemorrhagic complications in APL is needed, as well as the risk factors associated with early death in APL patients, as this has become synonymous with overall mortality.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Leukemia, Promyelocytic, Acute/diagnosis , Leukemia, Promyelocytic, Acute/therapy , SUMO-1 Protein
9.
Iatreia ; 34(1): 42-53, ene.-mar. 2021. tab
Article in Spanish | LILACS | ID: biblio-1154357

ABSTRACT

RESUMEN La leucemia promielocítica aguda (LPA) es un subtipo de leucemia mieloide aguda (LMA) que se origina por una traslocación balanceada entre los cromosomas 15 y 17, involucra al gen que codifica para el receptor alfa del ácido retinoico (RARA) en el cromosoma 17 y el de la leucemia promielocítica (PML) en el cromosoma 15, lo que da origen a la traslocación t(15;17) PML/RARA. Dicho reordenamiento origina la proteína de fusión PML/RAR alfa, que bloquea la diferenciación de las células madre mieloides en el estadio de promielocito. La LPA afecta con mayor frecuencia a adultos jóvenes y conlleva un alto riesgo de mortalidad temprana, en especial por el desarrollo de una coagulopatía grave, que sin tratamiento es definitivamente fatal. El diagnóstico temprano, el tratamiento de soporte y la introducción de fármacos que promueven la diferenciación terminal de los promielocitos patológicos como la tretinoina, también conocida como ácido todo transretinoico (ATRA) o trióxido de arsénico (ATO), ha hecho que en la actua-lidad esta sea una enfermedad curable con altas tasas de remisión completa.


SUMMARY Acute promyelocytic leukemia (APL) is a subtype of acute myeloid leukemia (AML) that results from a balanced translocation between chromosomes 15 and 17, which involves the gene encoding the retinoic acid receptor alpha (RARA) on chromosome 17 and the gene for promyelocytic leukemia (PML) on chromosome 15, causing the translocation t (15; 17) PML / RARA. This rearrangement originates the PML / RAR alpha fusion protein, which blocks the differentiation of myeloid stem cells at the promyelocyte stage. APL affects young adults more frequently and carries a high risk of early mortality, especially due to development of severe coagulopathy that, without treatment, is invariably fatal. Early diagnosis, supportive treatment, and the introduction of drugs that promote the terminal differentiation of pathological promyelocytes such as alltrans retinoic acid (ATRA) and arsenic trioxide (ATO), have currently made this a curable disease with high rates of complete remission.


Subject(s)
Humans , Leukemia, Promyelocytic, Acute
10.
Rev. cuba. hematol. inmunol. hemoter ; 37(1): e1249, ene.-mar. 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1251713

ABSTRACT

Introducción: Con el protocolo LPM-TOA para tratamiento de la leucemia promielocítica, se han obtenido excelentes resultados, ya que se logra sobrevida global prolongada y posible curación de los enfermos. En la inducción se utilizan dos drogas cardiotóxicas: las antraciclinas y el trióxido de arsénico y en la consolidación los enfermos reciben una dosis elevada de arsénico. Objetivo: Evaluar la toxicidad cardíaca tardía en pacientes con leucemia promielocítica tratados según el protocolo LPM-TOA. Métodos: Se realizó un estudio observacional descriptivo, prospectivo y longitudinal que incluyó 20 pacientes tratados con protocolo LPM-TOA, seguidos en consulta entre enero y julio 2019. Los pacientes tenían más de dos años de haber recibido las drogas cardiotóxicas. Se revisaron las historias clínicas y se determinó la fracción de eyección ventricular izquierda y la deformidad longitudinal global, mediante ecocardiograma. Resultados: Se presentaron hombres y mujeres con igual frecuencia, edad promedio 41,5 ± 11,0 años. Durante la inducción, en menos de la mitad de los enfermos se suspendió el arsénico por elevación del segmento QT corregido; en la mayoría solo se suspendió por uno o dos días. La mayor parte de los pacientes tuvo la fracción de eyección ventricular izquierda con valores entre 61 y 70 por ciento y la deformidad longitudinal global fue - 24 - 22 por ciento Conclusiones: En los pacientes estudiados, el tiempo de haber recibido el trióxido de arsénico y la dosis recibida, no influyó en la función cardíaca(AU)


Introduction: The PML-ATO protocol for the treatment of promyelocytic leukemia has obtained excellent results, achieving high overall survival rates and the possible healing of patients. Two cardiotoxic drugs are used in the induction process: anthracyclines and arsenic trioxide, whereas during consolidation patients receive a high dose of arsenic. Objective: Evaluate the late cardiotoxicity in patients with promyelocytic leukemia treated by the PML-ATO protocol. Methods: An observational prospective longitudinal descriptive study was conducted of 20 patients treated with the PML-ATO protocol and followed-up in outpatient consultation from January to July 2019. More than two years had elapsed since the patients received the cardiotoxic drugs. A review was carried out of the patients' medical records and echocardiographic determination was made of left ventricular ejection fraction and overall longitudinal deformity. Results: Men and women presented the same frequency; mean age was 41.5 ± 11.0 years. During induction, arsenic was suspended in less than half the patients due to corrected QT elevation. In most it was only suspended for one or two days. Most patients had left ventricular ejection fraction values between 61 percent and 70 percent, whereas overall longitudinal deformity was - 24 percent - 22 percent. Conclusions: In the patients studied, cardiac function was not affected by the time elapsed since arsenic trioxide administration or the dose received(AU)


Subject(s)
Humans , Leukemia, Promyelocytic, Acute/mortality , Leukemia, Promyelocytic, Acute/therapy , Anthracyclines , Arsenic Trioxide/therapeutic use , Medical Records , Survival Rate , Cardiotoxicity/drug therapy
11.
Journal of Experimental Hematology ; (6): 1462-1470, 2021.
Article in Chinese | WPRIM | ID: wpr-922280

ABSTRACT

OBJECTIVE@#To screen the serum differentially expressed proteins of APL in children.@*METHODS@#Serum protein expression profiles from 20 cases of normal healthy controls, and 20 cases of APL patients were detected by iTRAQ (isobaric tag for relative and absolute quantification)labeling coupled with two-dimensional liquid chromatography-tandem mass spectrometry(2DLC-MS/MS), and analyzed by bioinformatics software. S100A8, LRG1 and SPARC were validated by ELISA. ROC was built by SPSS 20.0 software.@*RESULTS@#Analysis identified 83 differentially expressed proteins in APL serum compared with control according to our defined criteria, of which 33 proteins were up-regulated and 50 proteins were down-regulated (P<0.05).IPA analysis revealed that these differentially expressed proteins were related to the function of Cellular Movement, Immune Cell Trafficking, Hematological System Development and Function, Cell-To-Cell Signaling and Interaction, Tissue Development, and involved in a variety of signalling Pathways, the most representative pathways including LXR/RXR Activation and Acute Phase Response Signaling. S100A8 and LRG1 were found to be elevated and SPARC was markedly down-regulated in serum of childhood APL when compared to the normal controls as examined by ELISA (P<0.05), which was consistent with the iTRAQ result. The overall predictive accuracy of each protein was reflected by the area under the ROC curve(AUC), S100A8,LRG1 and SPARC with ROC areas of 0.841,1.000 and 0.944 respectively.@*CONCLUSION@#S100A8,LRG1 and SPARC may be serve as serum candidate biomarkers for pediatric APL.


Subject(s)
Blood Proteins , Child , Chromatography, Liquid , Humans , Leukemia, Promyelocytic, Acute , Proteomics , Tandem Mass Spectrometry
12.
Article in Chinese | WPRIM | ID: wpr-880034

ABSTRACT

OBJECTIVE@#To observe the effects of tripterine on adhesion molecules and cell biological characteristics in mice with acute promyelocytic leukemia (APL) tumor.@*METHODS@#Eighteen SCID beige mice were caudal vein injected with NB4 cell lines (5×10@*RESULTS@#The neutrophil decrased and promyelocytes, NB4 cells, B lymphocytes and white blood cells increased in tumor-bearing group as compared with control group (P<0.05), and the expressions of serum P-selectin (P-selectin), soluble vascular adhesion molecule-1 (soluble vascular adhesion molecule-1, sVCAM-1) and soluble intercellular adhesion molecule-1 (soluble intercellular adhesion molecule-1, sICAM-1) all increased (P<0.05). The cell cycle showed that the proportion of G@*CONCLUSION@#Tripterine may not only inhibit the expression of sVCAM-1 and sICAM-1 proteins in APL tumor-bearing mice and reduce the adhesion of tumor cells, but also block tumor cells at G


Subject(s)
Animals , Cell Cycle , Cell Division , Humans , Intercellular Adhesion Molecule-1 , Leukemia, Promyelocytic, Acute/drug therapy , Mice , Mice, SCID , Triterpenes , Vascular Cell Adhesion Molecule-1
13.
Journal of Experimental Hematology ; (6): 1065-1070, 2021.
Article in Chinese | WPRIM | ID: wpr-888519

ABSTRACT

OBJECTIVE@#To investigate the expression of peptidylarginine deiminase 4 (PADI4) during the process of differentiation into granulocyte of NB4 cells induced by all-trans-retinoic acid (ATRA) and whether PADI4 is involved in the inflammatory cytokines expression.@*METHODS@#Granulocyte differentiation model of NB4 cells induced by ATRA was established. The cell morphology changes were observed by Wright-Giemsa staining. The expression of cell differentiation marker CD11b was analyzed by flow cytometry. The mRNA and protein expression of PADI4 was detected by RT-PCR and Western blot, respectively. The expression of tumor necrosis factor (TNF) α and interleukin (IL) 1β was analyzed by ELISA, and also examined with the knockdown of PADI4 expression by siRNA.@*RESULTS@#After NB4 cells induced by ATRA, the cytoplasm increased and the ratio of nuclear to cytoplasmic was reduced. Nuclear dented, and rod-shaped nucleus, lobulated phenomenon increased (P<0.05). Flow cytometry analysis results showed that the cell surface molecule CD11b expression increased (P<0.01). RT-PCR and Western blot showed the expression of PADI4 increased at both transcriptional and translational levels during the process of the differentiation. ELISA showed TNF-α and IL-1β secretion increased in differentiated macrophages, while they could be inhibited by PADI4-specific siRNA.@*CONCLUSION@#During the differentiation into granulocyte of NB4 cells induced by ATRA, PADI4 expression increased. Furthermore, PADI4 appeared to play a critical role in inflammatory cytokines secretion.


Subject(s)
Cell Differentiation , Cell Line, Tumor , Cytokines/metabolism , Granulocytes , Humans , Leukemia, Promyelocytic, Acute , Protein-Arginine Deiminase Type 4/metabolism , Tretinoin/pharmacology
14.
Autops. Case Rep ; 11: e2021339, 2021. tab, graf
Article in English | LILACS | ID: biblio-1345358

ABSTRACT

Myeloid sarcoma (MS) is a rare extramedullary neoplasm of myeloid cells, which can arise before, concurrently with, or following hematolymphoid malignancies. We report 04 such cases of MS, diagnosed in this institute over a period of 6 years, during various phases of their respective myeloid neoplasms/leukemias. These cases include MS occurring as a relapse of AML (Case 1), MS occurring as an initial presentation of CML (Case 2), MS occurring during ongoing chemotherapy in APML (Case 3), and MS presenting as a progression of MDS to AML (Case 4). In the absence of relevant clinical history and unemployment of appropriate immunohistochemical (IHC) studies, these cases have a high risk of being frequently misdiagnosed either as Non-Hodgkin's Lymphoma (NHL) or small round cell tumors or undifferentiated carcinomas, which may further delay their management, making an already bad prognosis worse. This case series has been designed to throw light on the varied presentation of MS and the lineage differentiation of its neoplastic cells through the application of relevant IHC markers along with their clinical correlation.


Subject(s)
Humans , Male , Female , Child, Preschool , Adolescent , Middle Aged , Aged , Sarcoma, Myeloid/pathology , Myelodysplastic Syndromes/pathology , Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology , Leukemia, Myeloid, Acute/pathology , Leukemia, Promyelocytic, Acute/pathology , Diagnostic Errors/prevention & control
15.
Article in English | WPRIM | ID: wpr-827417

ABSTRACT

In the clinical settings, disseminated intravascular coagulation (DIC) and complications such as hemorrhage are commonly seen in acute promyelocytic leukemia patients, whereas thrombosis is rarely reported. We reported a case here that the patient presented with cerebral infarction as the first manifestation. During the admission, the patient encountered differentiation syndrome, pulmonary embolism, pulmonary hemorrhage, and myocardial ischemia, as well as bleeding and thrombosis complications. Hence the patient was diagnosed as DIC. After the treatment of blood transfusion instead of anticoagulation, his condition was stable and the remission was completely achieved. The treatment experience provides guides for other patients with similar complications of simultaneous bleeding and thrombosis.


Subject(s)
Blood Coagulation , Cerebral Infarction , Disseminated Intravascular Coagulation , Humans , Leukemia, Promyelocytic, Acute , Thrombosis
17.
Article in Chinese | WPRIM | ID: wpr-829038

ABSTRACT

OBJECTIVE@#To explore the molecular mechanism by which miR-218 targeting Bmi-1 inhibits the proliferation of acute promyelocytic leukemia (APL) cells.@*METHODS@#APL cell line HL-60 was transfected by miR-218 and RNA-negative control sequences, respectively. The expression of miR-218 in cells was detected by real-time fluorescence quantitative PCR. The effect of transfected miR-218 on the proliferation of APL cells was detected by MTT assay. Cell apoptosis was detected by flow cytometry. The regulation effect of miR-218 on Bmi-1 expression was determined by Western blot. The correlation of miR-218 expressions with Bmi-1 was analyzed by Spearman test. The targeted relationship between miR-218 and Bmi-1 was verified by luciferase assay.@*RESULTS@#MTT assay showed that the proliferation of HL-60 cells in vitro was inhibited by high expression miR-218 significantly. Flow cytometry showed that the G1 and G2 phase cells increased while the S phase cells decreased after transfected by miR-218. Western blot showed that the level of Bmi-1 protein in HL-60 cells decreased significantly after transfection of miR-218 (P<0.05). Spearman correlation analysis showed that the mRNA level of miR-218 negatively correlated with the protein content of Bmi-1 (r=-0.326, P<0.01). Luciferase assay indicated that Bmi-1 could targeted on miR-218 directly.@*CONCLUSION@#miR-218 can inhibit the proliferation, metastasis and invasion of APL cells, which can be related with the down-regulated of Bmi-1.


Subject(s)
Apoptosis , Cell Proliferation , Gene Expression Regulation, Neoplastic , HL-60 Cells , Humans , Leukemia, Promyelocytic, Acute , Genetics , MicroRNAs , Genetics , Polycomb Repressive Complex 1 , Genetics
18.
Journal of Experimental Hematology ; (6): 1848-1852, 2020.
Article in Chinese | WPRIM | ID: wpr-879982

ABSTRACT

OBJECTIVE@#To analyze the characteristics of volatile organic compounds (VOCs) in expiratory air components of patients with acute promyelocytic leukemia (APL), and assess the feasibility of VOCs for the diagnosis and prognostic evaluation of APL.@*METHODS@#The VOCs exhaled from the patients with APL and healthy volunteers should be analyzed with SPME-GC/MS, and compared between newly-diagnosed group, relapse group, remission group, and healthy group with Wilcoxon/Kruskal-Wallis one-way analysis of variance and Dunn-Bonferroni test.@*RESULTS@#Dimethyl sulfide, toluene, and dodecane obtained of newly-diagnosed APL patients were significantly higher, while ethanol, n-hexanal, and benzaldehyde were significantly lower than those of healthy people (P<0.05). Compared with the newly-diagnosed group, dimethylsulfide, toluene, and dodecane of the remission group significantly decreased, while ethanol, n-hexanal, and benzaldehyde significantly increased (P<0.05), which was just opposite from the relapse group.@*CONCLUSION@#Dimethyl sulfide, toluene, dodecane, ethanol, n-hexanal, and benzaldehyde can be used as biomarkers for the diagnosis and prognosis assessment of APL patients.


Subject(s)
Exhalation , Gas Chromatography-Mass Spectrometry , Granulocyte Precursor Cells , Humans , Leukemia, Promyelocytic, Acute/diagnosis , Volatile Organic Compounds/analysis
19.
Rev. Hosp. El Cruce ; (27): 35-42, 2020.
Article in Spanish | LILACS | ID: biblio-1282916

ABSTRACT

Acute promyelocytic leukemiais a subtype of acute my eloid leukemia characterized by the presence of the PML:RAR aonco proteindueto a specific geneticalteration, translocation (15;17), which avoids my eloid differentiation, generating the accumulation of leukemic promyelocytes with posterior alteration of hemostasis. It presents with symptoms related to pancytopenia and thrombohemorrhagic coagulopathy, and there are few report sof cases with vasculitis secondary to promyelocytic leukemia. The clinical case aimed to describe a particular form of presentation of acute promyelocytic leukemia with vasculitis.


La leucemia promielocítica aguda es un subtipo de leucemia mieloide aguda caracterizada por la presencia de la oncoproteína PML-RARa debido a una alteracióngenéticaespecífica, la translocación (15;17), que impide la diferenciación mieloide generando la acumulación de promielocitos leucémicos y una alteración compleja de la hemostasia. Se presenta con síntomas relacionados a pancitopenia y coagulopatía trombo-hemorrágica existiendo escasos reportes de casos de vasculitis asociada a leucemia. El caso clínico descrito representa una forma particular de presentación de una leucemia promielocítica aguda con vasculitis.


Subject(s)
Leukemia, Promyelocytic, Acute , Tretinoin , Vasculitis
20.
Rev. Eugenio Espejo ; 13(2): 62-70, 20191202.
Article in Spanish | LILACS | ID: biblio-1048531

ABSTRACT

La leucemia es una neoplásica hemática que contiene múltiples subtipos, entre ellos la leucemia promielocítica aguda, caracterizada por la multiplicación clonal del linaje mieloide y eritroide. El presente caso pertenece a un paciente masculino de 20 años, sin antecedentes de importancia y con un cuadro evolutivo de 20 días con sangrado del dedo anular de la mano derecha, y con ausencia de proceso cicatricial. A partir de los exámenes de laboratorio se identifica bicitopénia eritroide y plaquetaria, con evidencia de un 93% de promielocitos. El tratamiento con ATO, ATRA y Antraciclinas logró una leve mejoría. Durante su estadía hospitalaria desarrolló síndrome de diferenciación, lo que ocasionó su fallecimiento.


Leukemia is a hematic neoplastic that contains multiple subtypes, including acute promyelocytic leukemia, characterized by the clonal multiplication of the myeloid and erythroid lineage. The present case belongs to a 20-year-old male patient without health history of importance and with a 20-day evolutionary picture with bleeding from the ring finger of his right hand, and without scarring process. Erythroid and platelet bicytopenia is identified from laboratory tests with evidence of 93% promyelocytes. The treatment including ATO, ATRA and Anthracyclines achieved a slight improvement. He developed differentiation syndrome during hospitalization, which caused his death.


Subject(s)
Humans , Male , Adult , Leukemia, Promyelocytic, Acute , Granulocyte Precursor Cells , Hematology , Bone Marrow , Leukemia , Infiltration-Percolation
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