Prevalence of hepatitis C among multi-transfused thalassaemic patients in Oman single centre experience

Regular blood transfusions are essential for patients with thalassaemia major. However, infections with hepatotropic viruses remain a major concern. The objective of this study was to evaluate the prevalence and characteristics of hepatitis C viral [HCV] infection among patients with homozygous beta thalassaemia in a single centre in Oman. A retrospective chart review of 200 patients treated at the Thalassemia Unit of Sultan Qaboos University Hospital [SQUH] in Muscat, Oman, between August 1991 and December 2011 was performed. Relevant demographic and clinical characteristics were collected, including age, gender, HCV status and the presence of endocrinopathies. A total of 81 patients [41%] were found to be anti-HCV-antibody [anti-HCV]-positive. HCV ribonucleic acid tests were performed on 65 anti-HCV-positive patients and were positive among 33 [51%]; the remaining 16 patients died before these tests were available. Anti-HCV-positive patients were significantly older than anti-HCV-negative patients [P <0.001] and were more likely to be diabetic than anti-HCV-negative patients [27% versus 8%; P <0.001]. A total of 100 patients had been transfused before they were transferred to SQUH in 1991; of these, 70 [70%] were anti-HCV-positive. Only 11 [11.5%] of the 96 patients who were seronegative in 1991, or who were transfused later, became seropositive. It is likely that the high prevalence of HCV among multi-transfused thalassaemic patients in Oman is due to blood transfusions dating from before the implementation of HCV screening in 1991 as the risk of HCV-associated transfusions has significantly reduced since then. Additionally, results showed that anti-HCV-positive patients were more likely to be diabetic than anti-HCV-negative patients

Genital ulcer development in patients with acute promyelocytic leukaemia treated with all-trans retinoic acid: a case series

We report here four cases of genital ulcers that developed after the administration of all-trans retinoic acid [ATRA] for the treatment of acute promyelocytic leukemia [APL]. Between October 2007 and March 2010, three males and one female [age range 19-35 years] were identified to have genital ulcers after being prescribed all-trans retinoic acid [ATRA] as a part of chemotherapy for APL. This is the first series of cases describing genital ulcers, as a unique and rare complication of ATRA used for treatment of APL in these patients, with no other cause identified. Following temporary cessation of ATRA for a few days in these three cases, improvement of the ulcers was noted

Tumour lysis syndrome in haematological malignancies

Objectives: this study was conducted to determine the frequency of tumor lysis syndrome [TLS] in hematological malignancies

Materials and methods: this descriptive study was conducted at Liquate National Postgraduate Medical Centre from October 2005 to April 2006 over a period of six months. Total 50 patients with diagnosed hematological malignancies were included in the study and data were collected by non-probability convenient sampling. Patients pretreated for their malignancy were excluded from the study. Venous samples for serum uric acid, LDH, phosphorus, calcium, potassium and creatinine were collected on admission, before starting chemotherapy and then for four days after starting the chemotherapy. All patients received adequate hydration, allopurinol and induction chemotherapy. Data were analyzed by statistical package for social sciences [SPSS] version16.0

Results: out of 50 patients 10 fulfilled the criteria for TLS. Six patients developed laboratory tumor lysis syndrome [LTLS], whereas 4 developed clinical tumourlysis syndrome. Acute renal failure was observed in 4 out of 10 patients. Overall 3 patients died because of TLS. Hyperuricemia and lactate dehydrogenase above 2000 IU were the most prominent findings in patients with TLS

Conclusion: it is concluded that 20% of the patients developed TLS [including both laboratory and clinical TLS and despite all measures of prevention it can occur and result in devastating clinical effects