Evaluation of growth factor independence 1 expression in patients with de novo acute myeloid leukemia

Objective: Growth factor independence 1 (GFI1), a transcriptional repressor, is required for hematopoietic stem cell maintenance and self-renewal in addition to controlling differentiation and proliferation of myeloid cells. As murine studies have demonstrated that this transcription factor has a notable role in the initiation and progression of acute myeloid leukemia (AML) disease, the aim of the current study was to investigate and review the influence of GFI1 in human AML cells. Methods: GFI1 expression levels were measured by means of real-time polymerase chain reaction in 96 primary AML samples which were then compared to gene expression levels observed in 18 healthy subjects. Moreover, GFI1 expression patterns were analyzed based on specific AML subtypes including acute promyelocytic leukemia (APL). Finally, leukemic cells were stained to measure levels of myeloperoxidase (MPO) activity. Results: This study reports that AML patients have significantly higher GFI1 mRNA levels in comparison to healthy subjects and that, when considering AML subtypes, patients with APL have higher GFI1 expression than non-APL patients. Conclusion: It is also concluded that GFI1 overexpression in patients with high MPO levels, such as those of the APL subtype, is correlated with favorable disease prognosis as supported by other studies which demonstrate that increased peroxide activity and GFI1 are independently correlated with a favorable prognosis

Changes of AML 1 and P53 tumor suppressor gene expression in patients de novo acute myeloid leukemia

P53 and AML1are two important tumor suppressor genes in regulation of hematopoiesis with a critical role in keeping balance between proliferation and differentiation. Alternations in the expression of these genes can be resulted in malignancy. The present study investigated the expression levels of P53 and AML1 genes in 82 de novo AML patient specimens against 12 normal control group using Real-Time-PCR. The results presented in this study revealed that AML1 gene expression was significantly higher and P53 gene expression levels was significantly lower in patients with AML in comparison with the normal control group [P = 0.016 and P = 0.002]. Furthermore, the correlation between P53 and AML1 was significant and positive [P= 0.037 and r= 0.231]. The lower levels of P53 expression were expected and in line with the normal role of this gene as a tumor suppressor gene, however AML1 over expression was in contrast with of its well known role in myeloid maturation. However, this findings suggest that despite the current established role this genes in myeloid cell differentiation, oncogenic form of AML1 [AML1a] has possibly increased and high expression of this isoform may act as an inhibitor for other normal AML1 isoforms and P53 as well

Ocular abnormalities in multi‑transfused beta‑thalassemia patients.

Aims: The aim of this study was to assess ocular changes in thalassemia patients who have received multiple transfusions and chelate binding therapy in order to avoid iron accumulation. Settings and Design: A cross‑sectional study. Subjects and Methods: A total of 54 thalassemia major patients were selected as case group, and 54 age‑ and sex‑matched healthy subjects were regarded as a control group. Ocular examination included visual acuity, refraction testing, slit lamp examination, funduscopy, tonometry, perimetry, tear break‑up time test, and color vision testing were performed for all the participants. We computed the frequency and duration of blood transfusion, the mean serum ferritin level, pretransfusion hemoglobin concentration, and type, duration, and daily dose of chelation therapy for thalassemia patients based on their records. Statistical Analysis Used: All data analysis was performed using SPSS, version 19. Results: All the thalassemic patients were asymptomatic, but abnormal ocular findings (dry eye (33.3%), cataract (10.2%), retinal pigment epithelium degeneration (16.7%), color vision deficiency (3.7%), and visual field defects (33.7%)) were seen in 68.5% of thalassemic group. The prevalence of ocular abnormalities in normal group was 19.4%, which was significantly lower than that in thalassemia patients (P = 0.000). No significant correlation was found between ocular abnormalities and mean serum ferritin level (P = 0.627) and mean hemoglobin concentration (P = 0.143). Correlation of number of blood transfusion with the presence of ocular abnormalities was found to be statistically significant (P = 0.005). Conclusions: As life expectancy for beta‑thalassemia patients extends, regular ophthalmological evaluation to detect early changes in their ocular system is recommended.

Neuroendocrine tumor of the gallbladder

Neuroendocrine tumors [NET] arise from neuroendocrine cells and are an exceedingly rare malignancy in the gallbladder. In this case report, a 52-year-old woman with complaints of episodic abdominal pain for two months prior was admitted to our hospital. She had no other signs and symptoms and her laboratory tests were within normal limits. Ultrasonography showed a broad-necked mass [26 x 12 mm] in the gallbladder for which she underwent laparoscopic cholecystectomy. The final pathological diagnosis was a high grade neuroendocrine carcinoma of the gallbladder with involvement of the lymph nodes and omentum. The patient received the chemotherapy regimens of gemcitabine plus cisplatin, followed by docetaxel plus sunitinib for her metastatic liver lesions. She also underwent radiofrequency ablation. Serial CT-scans revealed metastatic liver lesions that had decreased in size, with no significant improvement. The patient refused additional treatment and at 46 months, she was doing well with no complaints of any pain, disease recurrence, or metastatic progression

Clinical, high resolution computed tomography and pulmonary function in sulphur mustard victims

We aimed to evaluate clinical, high resolution computed tomography [HRCT] and pulmonary function test [PFT] findings after 18-23 years of exposure in veterans of sulphur mustard [SM] exposure. We performed a cross-sectional study of 106 patients. Inclusion criteria were 1: documented exposure to SM as confirmed by toxicological analysis of their urine and vesicular fluid after exposure 2: single exposure to SM that cause skin blisters and subsequent transient or permanent sequel. Cigarette smoking and pre-exposure lung diseases were of exclusion criteria. After taking history and thorough respiratory examination, patients underwent high resolution computed tomography and spirometry. Clinical diagnoses were made considering the findings. More than 85% of the patients were complaining of dyspnea and cough. Obstructive pattern [56.6%] was main finding in spirometry followed by restrictive and normal patterns. HRCT revealed air trapping [65.09%] and mosaic parenchymal attenuation patterns [58.49%] as most common results. Established diagnoses mainly were chronic obstructive pulmonary disease [COPD] [54.71%], bronchiolitis obliterans [27.35%] and asthmatic bronchitis [8.49%]. There were not any significant association between the clinical findings and results of PFT and HRCT imaging and also between PFT and HRCT findings [P-values were more than 0.05]. Considering debilitating and progressive nature of the respiratory complications of SM exposure, attempts are needed for appropriate diagnosis and treatment.

Six-year follow up of imatinib therapy for newly diagnosed chronic myeloid leukemia in Iranian patients

The present study reported a six-year follow up of patients with chronic myeloid leukemia who were on imatinib therapy. We performed a retrospective study on a total of 417 patients diagnosed with chronic-phase, Philadelphia-positive [Ph+] chronic myeloid leukemia within six months before study entry. Patients were eligible for the study if they were between 18 and 70 years of age. Enrolled patients were treated at an initial dose of 400 mg of imatinib. The mean age of 417 patients was 40.9 +/- 14.5 years; 220 [52%] were men and 197 [47.2%] were women. Complete hematologic response at three months occurred in 99% of patients, 221 [53%] before four weeks and 196 [47%] after four weeks. Adverse events occurred in 17 [4.1%] of patients, relapse in 46 [11%] and death in 31 [7.4%] of our studied population. At 72 months, the estimated rate of overall survival rate was 89%.Our findings showed the efficacy and safety of imatinib mesylate among Iranian patients with chronic myeloid leukemia by hematological and molecular response