Effect of Homoharringtonine as a Combined Regimen for Acute Myeloid Leukemia

Homoharringtonine (HHT), a cephalotaxus alkaloid has shown promising results in the treatment of several hematological disorders such as chronic myeloid leukemia, acute myeloid leukemia (AML), and myelodysplastic syndrome. It is known for its unique mechanism of action by which it prevents the initial elongation step of protein biosynthesis. Hence, it is used in hematological malignancies where it synergistically potentiates the action of other drugs and induces apoptosis. The relevant studies published were searched using an electronic database from 2002 to 2019. The articles published in English were only considered. Search engines such as PubMed, MEDLINE, Google Scholar, and Semantic scholar were used. In this review, we have discussed the effect of HHT in combination with other chemotherapeutic agents for AML with or without genetic mutation specification and the future perspective of these regimens. Although standard treatment options exist for most of these diseases, still cure rates are low with reported morbidity and the drug resistance emergence is pervasive. Thus, novel treatment approaches are crucial for better outcome. Alternative regimens together with HHT have not been a standard practice, although they have shown a very good potential in AML patients. Many of the combinations were also proved to be safe and effective with very low toxic potential. All these data outcomes of various combinations under different scenarios exhibit that HHT has promising results in the treatment of AML which may lead to its approval in the upcoming years.

Immunohistochemical expression of polo-like kinase 1 in oral squamous cell carcinoma and oral submucous fibrosis

Polo-like kinase 1 (PLK1) is a critical molecule in the proliferation of several human cancers. Overexpression of PLK1 has been correlated with cancer cell proliferation and lower overall survival rates. Although PLK1 has been studied in various tumors, information regarding its expression in oral cancer and precancer is limited. Aims: This study is aimed at evaluating the expression of PLK1 in a potentially malignant and malignant disorder of the oral cavity, namely, oral submucous fibrosis (OSMF) and oral squamous cell carcinoma (OSCC), respectively, using the immunohistochemistry technique. It also intended to evaluate the association of the various histological grades of OSCC with the intensity of PLK1 expression. Subjects and Methods: Thirty OSMF, thirty OSCC tissues, and thirty control tissues were obtained, and the expression of PLK1 was detected by immunohistochemistry using rabbit antihuman PLK1 polyclonal antibodies (Abcam Ab47867). The association between staining intensity and histological grade of OSCC was evaluated. Statistical Analysis Used: Using SPSS 20 version, a test for proportions, nonparametric Chi-square/correlation analysis was used to compare differences in proportions of categorical variables of interest between groups. Results: PLK1 was positively expressed in 27 (90%) OSCC tissues. OSMF showed no detectable staining in 27 (90%) tissues and positive staining in 3 (10%) tissues. PLK1 showed no staining (0%) in normal tissues. Statistically significant associations were not found between staining intensity and histological grade of OSCC. Conclusions: PLK1 could be a promising progression marker for OSCC. Therapeutically, targeting PLK1 may be a new approach to fight oral cancer.

Degos’ Like Nonclear Cell Acanthoma: Could this be a New Entity.

Degos’ acanthoma is a tumor that is clinically and histologically distinct. Typically, the lesions are solitary, sharply delineated red nodules or plaques 1-2 cm in diameter, usually covered by a thin wafer like crust. On microscopy, the striking presence of pale and slightly enlarged epidermal cells is essential to clinch the diagnosis. Here we present a case where the clinical picture was that of Degos’ acanthoma with the absence of glycogen rich clear cells on histology.

Immunolocalization of heme oxygenase-1 in periodontal diseases.

Context: Chronic periodontitis is an inflammatory condition of supporting tissues initiated by organisms in dental plaque. The reactive oxygen species and free radicals mediate connective tissue destruction in periodontitis. In order to counteract the free radical mediated tissue damage, numerous antioxidant mechanisms exist within the host. One such system is heme oxygenase enzymes. Heme oxygenase is the key enzyme involved in catabolism of heme. It cleaves the heme molecule to yield equimolar amounts of biliverdin, carbon monoxide, and iron. These end products act as important scavengers of reactive oxygen metabolites. Increased heme oxygenase expression has been identified in inflammatory condition, such as pancreatitis, diabetes, nephritis, and atherosclerosis. Since chronic periodontitis is one such inflammatory condition, we assessed the expression of heme oxygenase-1, in smokers and periodontitis group using immunohistochemistry technique. Aims: The aim of this study is to compare the expression of heme oxygenase-1 in patients with healthy periodontium, periodontitis and smokers. Materials and Methods: Gingival tissue samples were taken from 30 patients, who were divided into three groups healthy controls (n = 10), chronic periodontitis (n = 10), and smokers with chronic periodontitis (n = 10). All the samples were subjected to immunohistochemical staining using the antiheme oxygenase-1 antibody and were tested for efficiency by staining a positive control (prostate cancer tissue sections) and a negative control. The results were tabulated and analyzed. Results: Our results showed increased expression of heme oxygenase-1 in the gingival tissue samples taken from smokers compared with periodontitis and healthy tissue. Conclusion: The results of our study is an increasing evidence of involvement of antioxidant enzymes like heme oxygenase-1 in periodontal inflammation and their implication for treatment of chronic periodontitis.

Leukemia Cutis with PML-RAR-a Translocation.

Leukemia cutis is the infiltration by neoplastic leukocytes or their precursors into the epidermis, dermis or the subcutis resulting in clinically identifiable cutaneous lesions. The diagnosis is of great value in cases where leukemia cutis aids in the diagnosis of leukemia. This has a poor prognosis and strongly correlates with additional signs of extramedullary involvement. A 27-year-old male patient, known case of AML-M3, presented with cutaneous nodules on both lower limb, which on biopsy proved to be leukemic deposits. Immunohistochemistry confirmed the diagnosis and the patient was discharged with advice to continue chemotherapy.

Cytomegalovirus infection with lissencephaly.

Lissencephaly is a malformation of the brain in which the brain surface is smooth, rather than convoluted. Among the various causes of lissencephaly, infection by a virus during pregnancy plays an important role. Cytomegalovirus (CMV) is an important pathogen causing this anomaly. We present this case of a young female with 24-week-gestation diagnosed on ultrasound as carrying an anomalous fetus with lissencephalic features. At autopsy, there were multiple intra-nuclear CMV inclusions in the brain and the kidneys. This case is presented for its rarity and for the documentation of the tissue localization of CMV inclusions at autopsy.