ABSTRACT
INTRODUCTION: In a developing country like Algeria, such expensive therapy is not available. Alternative approaches are needed to help these adult. In Algeria 'imatib' (CIPLA-India) was introduced in 2006; but no study has been published yet in the North Africa region regarding response and outcome of this copy in CML patients. The goal of this multicenter study is to characterize newly adult CML in the western region of Algeria and to assess the effectiveness and safety of imatib (IM, copy) as frontline therapy for patients with CML. PATIENTS AND METHODS: The study was carried out in 7 hematology centers in the western Algeria. Patients, who were diagnosed to be suffering from CML between January 1st, 2007 and December 31st, 2014 were selected for data analysis. All patients received a copy preparation, consisting of the alpha crystal form of imatinib, (IM, copy) at an oral dose of 400 mg daily and monitored for tolerance and side effects while on therapy. RESULTS: Between January 2007 and December 2014, 355 patients with CML were treated with imatib (Copy). The median follow- up of the study was 46 months (range: 13-107 months). Complete hematological response (CHR) was seen in 83% of patients within 3 months. According to the Sokal score, 72% patients with low, 78% with intermediate and 69% with high risk disease achieved a CHR in 3 months (p=0.26) and according to the EUTOS score, 81% of patients with low and 70% with high risk disease achieved a CHR in 3 months (p=0.08). The major molecular response (MMR) at six months (M6), M9, M12, M18 and M24 was 21%, 38%, 35%, 51% and 67% respectively and 34% of patients achieved a complete molecular response (CMR). The projected 5-year overall survival (OS) rate was 83%. Side effects of imatib (copy) in this study were similar to those reported previously for the entire imatinib mesylate treatment study and only 8% of patients were intolerant to imatib (copy) and treated with a second generation of BCR-ABL inhibitor. CONCLUSION: This study reflects real world experience treating patients with CML in a developing country and thus sheds light on differences in this population compared to Western countries. In conclusion, imatib (copy) is effective and safe in treating patients with CML in chronic phase and proves to have a durable outcome. To our knowledge this is the first study reporting the response to imatib (copy) in an Algerian population.
ABSTRACT
BACKGROUND AND OBJECTIVES: In Algeria, the incidence of hematologic malignancies has been difficult to estimate for many years. Today, many hematological centers, including 14 university hospitals, have been developed in the entire north and have useful epidemiological data pertinent to acute myeloid leukemia (AML). We studied the incidence of AML and its subtypes, age distribution, geographic distribution and trends in the rate of diagnosis over the last 5 years in Algeria. Secondary goals were to study trends of referral of AML cases from various regions to specific centers to assess the needs for health infrastructure and change of current practices. DESIGN AND SETTING: Retrospective analysis of nationwide survey of all adult cases of AML (>16 years) diagnosed between 1 January 2006 and 31 December 2010. PATIENTS AND METHODS: A survey form was distributed to all departments of hematology at the 15 participating centers. RESULTS: The 1426 cases of AML diagnosed during the study period represented an annual incidence of 0.91/100000 persons with a male to female (M/F) ratio of 1:16 and a median age of 45 years (range, 16-82 years). Nationally, 20% of cases AML were diagnosed in the whole western region of the country, 47% in the central and 33% in the east. There was a trend of continuous increase in the rate with age and in the rate of diagnosis over the last 5 years. The most common subtype was M2, followed by M4 and M5. CONCLUSION: An overall increase in the number of AML patients diagnosed nationwide over the last five years indicates a need for additional health care resources including curative and therapy-intense strategies, such as stem cell transplant facilities to optimize outcome. The relatively younger age of patients compared to the Western countries may be due to the demographic composition of our population.
Subject(s)
Leukemia, Myeloid, Acute/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Algeria/epidemiology , Female , Humans , Incidence , Leukemia, Myeloid, Acute/diagnosis , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
Since the disinfecting activity of disinfectants is evaluated by standards, the intrinsic detergent activity is not easily quantifiable and no standard have been suggested yet. Beyond the physicochemical parameters like wettability or foaming presented by the manufacturers, it appears necessary to us to objectively measure the real effect of the detergent agent. The objective of our work is to propose a simple, fast and reproducible method to evaluate detersive activity of the disinfecting detergents. We measured three factors (total amount of extracted bacteria, extraction efficiency and slope of extracting curve) by using Rodac prints technique on two different supports (PVC, stainless steel) that have been contaminated by either E. coli or S. aureus. An increasing mark from 1 to 6 is given to each of these factors in case of statistically differences. The three factors allowed us to calculate a "Specific Index of detersion" (SI) for each germ/support couple (3 to 18). Addition of the marks given to each couple for each disinfecting detergent allowed to calculate a "Globally Index of detersion" (GI) (9 to 72). We tested 4 commercialised disinfecting detergents: Surfanios, Aniosurf, Major C100 and Ecodiol. All detergents may be classified according to their effectiveness on a bacterium/support couple (value of the SI). This enlights a specific spectrum for each disinfecting detergents. As a result, Ecodiol seems to be the most effective deterging agent on 3 of the 4 germ/support couples (S. aureus/PVC, E. coli/PVC and E. coli/stainless steel), whereas Aniosurf is most effective on the S. aureus/stainless steel couple. The GI is very useful to choose the best compromise between activities for all situations. GI rankings of the tested agents were as follows: water < Aniosurf < Surfanios < neutralizing < Major C100 < Ecodiol. This experimental model will be used to test and compare the intrinsic detergent activities of other commercialised products which are usually used for the biocleaning of the medical devices (i.e. endoscopes or reusable dialysis device).
