Acute promyelocytic leukemia: An experience from a tertiary care centre in north India.

Background: There are very limited data reported about acute promyelocytic leukemia (APL) from developing countries. We reviewed the clinical course and treatment outcome of APL patients treated at our center. Materials and Methods: Between January 1997 and December 2007, 33 patients with APL received induction therapy using ATRA + daunorubicin (n = 26), As = 26), As2O3 (n = 4) or daunorubicin + cytosar ( n = 3). Results: Median age was 30 years with a male to female ratio of 1.68. Twenty seven patients (82%) achieved CR. Complications during induction therapy were febrile neutropenia (33%), ATRA syndrome (30%), bleeding (58%), and diarrhea in (6%) patients. During induction and follow up, 8 (24.24%) patients died, 6 (18.18%) during induction, 1 (3%) during maintenance, and 1 (3%) after relapse. Median OS is 128 months while median EFS is 61 months. Four patients relapsed at a median time of 61 months. At the time of censoring, 25 patients were alive at a median follow up of 13 months (range 0.6 -127 months); 21 in CR1, 3 in CR2, 1 in CR3. Comparisons among the risk groups (CR and relapse rate and survival statistics) were not statistically significant. Conclusions: APL is a highly curable malignancy. Our results confirm the findings of the published literature from larger cooperative studies from the West. We may further improve outcome with quicker diagnosis and more efficient supportive care system.

Optimización y validación metodológica de la cuantificación de arsénico por inyección en flujo -generación de hidruros- espectrometría de absorción atómica (IF-GH-EAA) previa derivatización con L-cisteína / Optimization and validation method for arsenic quantification by flow injection-hydride generation - atomic absorption spectrometry (FI-HG-AAS) after L-cysteine derivatization

El arsénico (As) es un contaminante natural que afecta una amplia zona de Argentina. El nivel de As en agua de consumo es utilizado para evaluar la fuente de exposición y en orina para evaluar exposición a este tóxico. El presente trabajo tuvo como objetivo la optimización y validación metodológica de una técnica para la cuantificación de As [As suma = As inorgánico (AsI) + especies metiladas: ácido monometilarsónico (MMA) y ácido dimetilarsónico (DMA)], producto del metabolismo del AsI, por inyección en flujo- generación de hidruros- espectrometría de absorción atómica (IF-GH-EAA), previa derivatización con L-cisteína. La recuperación de las especies estudiadas: AsI (AsIII y AsV), MMA y DMA fue cercana al 100% en todos los casos. Los límites de detección y cuantificación encontrados fueron para agua y orina: 2 y 3 µg/L; 5 y 8 µg/L respectivamente y el rango dinámico de trabajo establecido fue desde 5 a 75 µg/L, permitiendo cuantificar As en muestras de agua cercanos a los estándares internacionales vigentes para valores máximos de As en agua de consumo y en orina en niveles comparables con los establecidos en población laboralmente no expuesta. Esta propuesta metodológica es una alternativa para evaluar la exposición al As en muestras de agua y orina, sin necesidad de utilizar prolongados pre-tratamientos de muestra, de forma más rápida y económica.

Arsenic (As) is a natural contaminant that affects a large area of Argentina. Quantification of As in drinking water has been used to evaluate the source of exposure and As in urine to assess exposure to this toxic. This study aimed to optimize and validate a methodological technique for the quantification of As [As sum = inorganic As (AsI) + methylated species: monometilarsonic acid (MMA) and dimetilarsinic acid (DMA)], product of AsI metabolism by flow injection hydridegeneration-atomic absorption spectrometry (FI-GH-AAS), after derivatization with L-cysteine. The recovery of the studied species: AsI (AsIII and AsV), MMA and DMA was close to 100% in all cases. The limits of detection and quantitation were foundfor water and urine: 2 and 3 µg/L; 5 and 8 µg/L respectively and a linear working range from 5 to 75 µg/L, allowing quantify As in water close to international standards of maximum As values for drinking water and urine samples with levels comparables with those found in people non exposed ocupacionally . This methodology is a valid alternative for assessing exposure to As in water and urine samples without the need of prolonged pre-treatment sample, more quickly and inexpensively.

Differentiation of human nasopharyngeal carcinoma xenografts and repression of telomerase activity induced by arsenic trioxide.

BACKGROUND: Arsenic trioxide (As2O3) induced apoptosis and differentiation of acute promyelocytic leukaemia. A few in vivo experimental investigations of its efficacy in solid tumours have been done. This study was designed to explore the differentiation-inducing effect, and the possible mechanisms involved, of As2O3 on human nasopharyngeal carcinoma CSNE-1 xenografts. METHODS: Nasopharyngeal carcinoma cell CSNE-1 was established as a xenograft in nude mice. The tumour-bearing mice were treated with As2O3 at a dose of 5 mg/kg/day. To assess tumour differentiation, tumour growth was observed and histological changes were analysed under light and electron microscopy. Expression of latent membrane protein 1 (LMP1) and cytokeratin 4 (CK4) was determined by immunohistochemistry. A PCR-based telomeric repeat amplification protocol assay (TRAP-ELISA) was used to measure telomerase activity. RESULTS: The xenografts underwent differentiation. LMP 1 of the cells decreased significantly and there was a pronounced decline in telomerase activity. CONCLUSION: As2O3 can inhibit xenograft growth and induce morphological and functional differentiation of CSNE-1 cells. The As2O3-induced differentiation was associated with downregulation of telomerase activity.

A study on arsenical dermatosis in rural community of West Bengal.

The spatial distribution of chronic arsenicosis due to consumption of arsenic contaminated tube well water in different districts of West Bengal was gradually unfolding since 1983. Arsenical dermatosis was found to be the commonest and earliest manifestation of chronic arsenic toxicity. This study was conduct in Baruipur block of South 24 Parganas district of West Bengal. Total 313 people selected from three randomly selected villages with reported arsenic contamination in tube well water and 342 people living three randomly selected villages without such evidence of contamination were examined as control population. 5.97% of exposed population and 2.05% of unexposed population showed melanosis (p < 0.01). Moreover, 5.11% of exposed population and 0.88% of unexposed population showed keratosis (p < 0.01). The prevalence of dermatosis among exposed population was also seen to have increased with increasing age, from 7.19% in 0-19 year age group to 37.50% in above 40 year group (p < 0.001). Prevalence was also found to be more with increase in level of contamination. The prevalence rate of dermatosis among unexposedgroup was 2.92%. But age adjusted prevalence rate among exposed group was 19.08% at arsenic contamination level of 0.487 ppm. Mean arsenic concentration in nail and hair samples of exposed group was also found higher than the prescribed limit.

Intoxicación aguda por arsina: aspecto médico laboral / Sharp intoxication due to arsine: medico legal aspect

La intoxicación aguda por arsina está descripta como una entidad rara de origen accidental en la industria. La acción de los ácidos sobre metales que tienen impureza de arsénico forman el gas arsina. Se describe una triada compuesta por ictericia, hemoglobinuria y dolor abdominal como consecuencia de anemia hemolítica (el gas arsénico es un potente agente hemolítico), insuficiencia renal aguda y hepatopatía tóxica. Como tratamiento se encuentra indicado la diuresis alcalina forzada, transfusión de sangre, la diálisis peritoneal o hemodiálisis e incluso la exanguinotransfusion

Poroqueratosis de Mibelli diseminada y carcinoma espinocelular con metástasis / Disseminated Mibelli's porokeratosis and metastatic squamous cell carcinoma

En la literatura se reportaron hasta el presente dos casos de pacientes con poroqueratosis de Mibelli diseminada, que desarrollaron carcinoma espinocelular con matástasis y evolución fatal. Se presenta el tercer caso de poroqueratosis de Mibelli, con carcinoma espinocelular y adenopatía metastásica y se comparan las características clínico-evolutivas de los tres casos. Asimismo se destaca la importancia del control de pacientes con lesiones ulcerosas persistentes, que deben ser estudiadas histopatológicamente, más aún cuando están asociadas a enfermedades con potencial neoplásico como la poroqueratosis de Mibelli y la queratosis arsenical