Identification and clinical evaluation of the receptor for hyaluronic acid-mediated motility [RHAMM/CD 168] in AML patients

RHAMM/CD 168 is a cell surface receptor for hyaluronan, a glycosaminoglycan that plays a fundamental role in cell growth, differentiation and motility. It is one of the leukemia-associated antigens [LAA] identified in patients with acute myeloid leukemia. In the present study, RHAMM expression was tested in the peripheral blood samples of 40 de novo AML patients as well as 15 healthy volunteers as a control group by RT-PCR. The mRNA of RHAMM was detected in 24/40 [60%] of the patients while it was not detected in the control group. There were no statistically significant difference between RHAMM positive and negative patients as regard their clinical and laboratory data, although the highest remission rate was achieved in RHAMM positive patients while RHAMM negative patients had a higher rate of adverse treatment outcome [relapse or death during induction chemotherapy. In conclusion, our findings are highly suggestive that the expression of RHAMM in newly diagnosed AML patients is a good prognostic marker as its expression is associated with facourable response to induction chemotherapy. Also being a tumour associated antigen, RHAMM represents a promising target for future immunotherapy

Brain metastases of pediatric solid tumors

The aim of the current study is to evaluate the incidence, pattern of metastases [whether isolated, multiple or associated with local recurrence of primary tumor or metastases to other sites], treatment outcome and prognosis of brain metastases in pediatric patients with extracranial solid tumors excluding lymphomas. Eighteen patients with extracranial pediatric solid tumors [excluding lymphomas] and brain metastases, were retrospectively studied during the period from September 1997 till January 2003. The relevant data of each patient were obtained from the medical records of The Pediatric Unit of Kasr El-Aini Center of Radiation Oncology and Nuclear Medicine [NEMROCK]. At diagnosis all patients were assessed by careful history taking, complete physical examination, laboratory as well as radiological assessment. Follow-up was done by radiological imaging of the primary tumor as well as the metastatic sites [including the brain] immediately after finishing active treatment and then every 3 months for 1 year. Brain metastases occurred after initial treatment of the primary tumor with a median period of 6 months [range 1-11 months]. Eight patients had solitary metastases and in 10 patients metastases were multiple. The median time for disease progression was 19 months and median survival was 5.8 months [3 days - 12 months]. The median survival of solitary and multiple metastases was 5.5 and 4.1 months respectively, and the median survival of metachronous and synchronous brain metastases was 5 months and 2.9 months respectively. The possibility of development of brain metastases is highly increased with the presence of poor prognostic features. Patients presented with disseminated disease, especially in the presence of poor performance status are better to receive no active treatment, only supportive measures as the treatment outcome is very poor