Screening Aids for Oral Squamous Cell Carcinoma.

Oral cancer is the sixth most common cancer seen worldwide out of which squamous cell carcinoma accounts for 94% of oral cancer. Squamous cell carcinoma is found to be a more prevalent in south Asia because of habits like betel quid, tobacco chewing, and areca nut. Th ese along with alcohol are considered as the major risk factors. Th e mutagenic eff ects produced by these are dose and duration dependent. Some cases of squamous cell carcinoma were found in persons without habits. Early detection of oral cancer is the key factor which helps in the faster treatment and improves the survival rate of patients. A brush biopsy is the simple and inexpensive cytological technique in which an OralCDx Brush is used to collect the cells by scrubbing the mucosal site followed by spreading the sample into the glass slide which is then stained. Veloscope is a device which measures the alteration of autofl uorescence of the oral mucosa. Th e patients, in many cases, may be unaware initially as many of these lesions are asymptomatic during the initial stages and might be fi rst detected by a dentist. Th us, proper knowledge on the clinical features and eff ective use of the screening aids are essential to produce the best possible long-term outcome.

Emergence of an unrelated highly aberrant clone in an AML patient at relapse four months after peripheral blood stem cell transplantation.

We report a case of AML-M1 with 5q aberration at diagnosis. The patient was treated with high-dose chemotherapy (HDCT). After remission induction, he received allogenic peripheral blood stem cell transplantation (PBSCT) from an HLA-match donor brother. The successive follow-up conventional cytogenetics investigations in remission after HDCT and PBSCT revealed cytogenetic remission. The most interesting observation in this case is that relapsed marrow revealed the emergence of an entirely new, highly aberrant, unrelated clone with unusual translocations t(6;17)(p23;p11.2),+8,der(8)dup inv(8)(q23qter), t(10;19)(q26;q13.3) 4½ months after PBSCT. Our findings suggest the possibility of a mutagenic effect of HDCT and myeloablative intense chemotherapy before PBSCT that could have induced a genetic lesion in the recipient's genetically unstable stem cells in an environment of immunosuppression. The highly complex nature of the clone and the rapid clonal evolution indicates the possibility of selective pressure with proliferative advantage.