Z. Abdullah, Luma Amer Yasir, R. M. Ewadh, Shakir H. Mohammed Al. Alwany
Certain hematologic cancers, including Kaposi’s sarcoma (KS), have been associated with the pathogenicity of human herpesvirus-8 (HHV-8). HHV-8’s involvement in acute leukemia patients is yet unclear, nevertheless. The diagnosis, categorization, and course of treatment for acute myelogenous leukemia, an aggressive heterogeneous hematologic malignancy, have changed dramatically in recent years. This study aims to investigate the pathogenicity role of HHV-8 in patients with acute myeloid leukemia (AML) of a group of the Iraqi population. Case–control research has been carried out on 75 fresh blood samples recruited from the Mirjan Teaching Hospital in Al-Hilla City. The studied blood samples were obtained from patients with AML enrolled in this study, whereas control groups in the current study included 75 fresh whole blood. The specimens were collected during the period from June 2023 to February 2024. Conventional polymerase chain reaction (PCR) was used to identify HHV-8. The results show that the mean age of the patients with AML (48.5 ± 10.23 years) was more than that of the apparently healthy control (46.26 ± 11.21 years). There was a nonsignificant difference between patients with AML and the control group. In addition, the male in this study group constituted 56% (42/75), whereas 44% (33/75) were female. Furthermore, the positive of viral genome extraction was found in 41.3% (31 out of 75 of the specimens with viral genome), whereas 59.7% (44/75) specimens did not contain viral genome. The PCR results showed that in the AML patient group, the rate of HHV-8 infection was 35.4% (11 out of 31 cases). Considering the relatively small numbers included in our results, the positive results lead to the idea that HHV-8 works as a cofactor in the tumor biology of the AML subset under consideration and may have contributed to its development.
{"title":"Pathogenicity role of human herpesvirus-8 in patients with acute myeloid leukemia","authors":"Z. Abdullah, Luma Amer Yasir, R. M. Ewadh, Shakir H. Mohammed Al. Alwany","doi":"10.4103/ijh.ijh_34_24","DOIUrl":"https://doi.org/10.4103/ijh.ijh_34_24","url":null,"abstract":"\u0000 \u0000 \u0000 Certain hematologic cancers, including Kaposi’s sarcoma (KS), have been associated with the pathogenicity of human herpesvirus-8 (HHV-8). HHV-8’s involvement in acute leukemia patients is yet unclear, nevertheless. The diagnosis, categorization, and course of treatment for acute myelogenous leukemia, an aggressive heterogeneous hematologic malignancy, have changed dramatically in recent years.\u0000 \u0000 \u0000 \u0000 This study aims to investigate the pathogenicity role of HHV-8 in patients with acute myeloid leukemia (AML) of a group of the Iraqi population.\u0000 \u0000 \u0000 \u0000 Case–control research has been carried out on 75 fresh blood samples recruited from the Mirjan Teaching Hospital in Al-Hilla City. The studied blood samples were obtained from patients with AML enrolled in this study, whereas control groups in the current study included 75 fresh whole blood. The specimens were collected during the period from June 2023 to February 2024. Conventional polymerase chain reaction (PCR) was used to identify HHV-8.\u0000 \u0000 \u0000 \u0000 The results show that the mean age of the patients with AML (48.5 ± 10.23 years) was more than that of the apparently healthy control (46.26 ± 11.21 years). There was a nonsignificant difference between patients with AML and the control group. In addition, the male in this study group constituted 56% (42/75), whereas 44% (33/75) were female. Furthermore, the positive of viral genome extraction was found in 41.3% (31 out of 75 of the specimens with viral genome), whereas 59.7% (44/75) specimens did not contain viral genome. The PCR results showed that in the AML patient group, the rate of HHV-8 infection was 35.4% (11 out of 31 cases).\u0000 \u0000 \u0000 \u0000 Considering the relatively small numbers included in our results, the positive results lead to the idea that HHV-8 works as a cofactor in the tumor biology of the AML subset under consideration and may have contributed to its development.\u0000","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141660303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Philadelphia chromosome serves as the molecular marker for chronic myeloid leukemia (CML) result from fusion oncogene, leading to genetic instability including chromosomal aberrations and common altered genes that regulate cell proliferation and apoptosis. Transforming growth factor-β (TGF-β) signaling pathway is an important regulator of cellular functions, such as proliferation, differentiation, migration, and cell survival. The objective of this research was to investigate the role of TGFs-β3 as predictive biomarker on disease progression. This study includes three groups (50) individuals: newly diagnosed CML patients (male: 28 and female: 22), (50) CML chronic phase (male: 25 and female: 25), and (50) apparently healthy volunteers (male: 30 and female: 20). The National Center of Hematology at Mustansiriyah University admitted the patients. An analysis of each patient was diagnosed using a complete blood count, a bone marrow test, and a BCR-ABL gene test. ELISA technique was applied to assess the serum level of TGFs-β3. the results displayed high significant differences among patients (newly diagnosed) compared to the chronic phase, it was 59.7517 and 39.9167 pg/mL, respectively, and high significant differences among patients (newly diagnosed) compared to control, it was 59.7517 and 36.8861 pg/mL, respectively, as well as the serum level of TGF-β3, was elevated with some hematological marker. Elevated TGF-β levels can promote the development of myelofibrosis and some hematologic malignancies by influencing the immune system.
{"title":"Serum level of human transforming growth factors β3 in Iraqi patient with chronic myeloid leukemia","authors":"Noor Tariq Naeem, B. Q. H. Alsaadi","doi":"10.4103/ijh.ijh_12_24","DOIUrl":"https://doi.org/10.4103/ijh.ijh_12_24","url":null,"abstract":"\u0000 \u0000 \u0000 The Philadelphia chromosome serves as the molecular marker for chronic myeloid leukemia (CML) result from fusion oncogene, leading to genetic instability including chromosomal aberrations and common altered genes that regulate cell proliferation and apoptosis. Transforming growth factor-β (TGF-β) signaling pathway is an important regulator of cellular functions, such as proliferation, differentiation, migration, and cell survival.\u0000 \u0000 \u0000 \u0000 The objective of this research was to investigate the role of TGFs-β3 as predictive biomarker on disease progression.\u0000 \u0000 \u0000 \u0000 This study includes three groups (50) individuals: newly diagnosed CML patients (male: 28 and female: 22), (50) CML chronic phase (male: 25 and female: 25), and (50) apparently healthy volunteers (male: 30 and female: 20). The National Center of Hematology at Mustansiriyah University admitted the patients. An analysis of each patient was diagnosed using a complete blood count, a bone marrow test, and a BCR-ABL gene test. ELISA technique was applied to assess the serum level of TGFs-β3.\u0000 \u0000 \u0000 \u0000 the results displayed high significant differences among patients (newly diagnosed) compared to the chronic phase, it was 59.7517 and 39.9167 pg/mL, respectively, and high significant differences among patients (newly diagnosed) compared to control, it was 59.7517 and 36.8861 pg/mL, respectively, as well as the serum level of TGF-β3, was elevated with some hematological marker.\u0000 \u0000 \u0000 \u0000 Elevated TGF-β levels can promote the development of myelofibrosis and some hematologic malignancies by influencing the immune system.\u0000","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In transfusion medicine, cross-matching and compatibility are determined using the conventional tube approach. The goal of the current study is to compare the microtyping gel approach to the conventional tube method for studying blood cross-match. The objective of the study was to assess the compatibility of donor’s blood with recipient blood by microtyping gel technique and conventional tube technique and comparison of advantages and disadvantages of the two techniques. This observational, cross-sectional study investigation was carried out in a tertiary care facility’s blood bank for 1½ years. It was decided to compare the effectiveness of the traditional tube and gel techniques. In the current investigation, we evaluated the age of the study participants and found that the majority of the study participants were male (63.17%) and most of them were between the ages of 21 and 40 years. The men-to-women ratio in this study was 1.71:1. About 2300 blood samples were subjected to compatibility testing using both the traditional test tube technology and the microtyping gel technology. The conventional method and the gel card approach are equivalent in terms of sensitivity and specificity. However, the gel card approach is simple to use, quick, reliable, and allows for the recording of data. The spin saline tube approach, in comparison, takes longer and produces unreliable results. This makes the gel card approach preferable to the conventional method. The findings were examined. Although the conventional tube technology is still regarded as the gold standard for pretransfusion analysis, it nevertheless has several drawbacks and relies on the precise hand–eye coordination of the laboratory staff. We advise using the microtyping gel approach due to its ease of use, stability of outcomes, dispensing of controls and absence of washing process, and equivalent specificity and sensitivity.
{"title":"A comparative study to assess diagnostic efficacy of micro typing gel technique versus conventional tube technique in blood cross-match in blood bank at a tertiary care hospital","authors":"Rutuja Gawande, Ramawatar Ramprasadji Soni, Vikram Vinod Rode","doi":"10.4103/ijh.ijh_31_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_31_23","url":null,"abstract":"\u0000 \u0000 \u0000 In transfusion medicine, cross-matching and compatibility are determined using the conventional tube approach. The goal of the current study is to compare the microtyping gel approach to the conventional tube method for studying blood cross-match.\u0000 \u0000 \u0000 \u0000 The objective of the study was to assess the compatibility of donor’s blood with recipient blood by microtyping gel technique and conventional tube technique and comparison of advantages and disadvantages of the two techniques.\u0000 \u0000 \u0000 \u0000 This observational, cross-sectional study investigation was carried out in a tertiary care facility’s blood bank for 1½ years. It was decided to compare the effectiveness of the traditional tube and gel techniques.\u0000 \u0000 \u0000 \u0000 In the current investigation, we evaluated the age of the study participants and found that the majority of the study participants were male (63.17%) and most of them were between the ages of 21 and 40 years. The men-to-women ratio in this study was 1.71:1. About 2300 blood samples were subjected to compatibility testing using both the traditional test tube technology and the microtyping gel technology. The conventional method and the gel card approach are equivalent in terms of sensitivity and specificity. However, the gel card approach is simple to use, quick, reliable, and allows for the recording of data. The spin saline tube approach, in comparison, takes longer and produces unreliable results. This makes the gel card approach preferable to the conventional method. The findings were examined.\u0000 \u0000 \u0000 \u0000 Although the conventional tube technology is still regarded as the gold standard for pretransfusion analysis, it nevertheless has several drawbacks and relies on the precise hand–eye coordination of the laboratory staff. We advise using the microtyping gel approach due to its ease of use, stability of outcomes, dispensing of controls and absence of washing process, and equivalent specificity and sensitivity.\u0000","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141099034","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zahraa S. Shakir, Sarah Muayad Saeb, Fawaz Salim Yousif, Sinaa Mahdi Shakir, Zina Ali Al-Bakri, Safa A Faraji, Raghad Majid Al-Saeed, Kanar Tahseen Taha
Infectious complications occur in most of the patients undergoing hemopietic stem cell transplantation (HSCT), these carry high risk of mortality mainly due to Gram-negative bacteria unless effective antibiotic treatment is provided. The aims of the study were to review bacterial isolates from different samples in febrile neutropenic patients underwent HSCT in terms of incidence, types, and antimicrobial resistance, and to assess the efficacy of infection control measures used in transplantation ward. This is retrospective study .The medical records of a total of 82 patients who underwent HSCT in the Specialized BMT Center, Baghdad Medical City, in 2021 and 2022 were reviewed; for any patient with neutropenic fever (NF), the clinical assessment was made, and samples were taken for culture any sensitivity before starting empirical antibiotics. The study was reviewed by the ethical committee of the hematology transplant center in the Medical City Complex, and since the study is retrospective, no consent is needed from the patient. There were 57 patients who developed NF, two at the time of collection, while 55 patients during transplant. In 16 patients, there was a clinical focus for NF, most commonly respiratory. From 175 samples sent for culture and sensitivity, bacterial growth was detected in 103 samples, and the incidence of bloodstream infection was 53%. Polymicrbial bacterial growth was detected in 6 patients with NF. Gram-positive bacteria were slightly more common than Gram negative. Staphylococcus epidermidis and Burkholderia cepacia were the most common Gram positive and Gram negative, respectively. An increasing number of patients admitted to transplant centers were associated with more infections. Ten out of 13 bacteria were multidrug resistant (MDR). Only two patients died from infection posttransplant. The predominance of Gram-positive cocci and Burkholderia cepacia complex supported the need to review the adherence to infection control policy. The empirical antibiotic protocol should be guided by local antibiogram, and since the high rate of blood stream infection (BSI) with MDR pathogens, a de-escalating strategy utilizing carbapenems – as advised by the ECIL-4 guidelines – would be more appropriate while awaiting culture result. The ability to quickly identify infections and their susceptibility profile is still crucial for choosing antibiotic therapy.
{"title":"Pattern of bacterial infections in neutropenic febrile patients (experience of the Specialized BMT center - Medical city complex - Baghdad, Iraq)","authors":"Zahraa S. Shakir, Sarah Muayad Saeb, Fawaz Salim Yousif, Sinaa Mahdi Shakir, Zina Ali Al-Bakri, Safa A Faraji, Raghad Majid Al-Saeed, Kanar Tahseen Taha","doi":"10.4103/ijh.ijh_13_24","DOIUrl":"https://doi.org/10.4103/ijh.ijh_13_24","url":null,"abstract":"\u0000 \u0000 \u0000 Infectious complications occur in most of the patients undergoing hemopietic stem cell transplantation (HSCT), these carry high risk of mortality mainly due to Gram-negative bacteria unless effective antibiotic treatment is provided.\u0000 \u0000 \u0000 \u0000 The aims of the study were to review bacterial isolates from different samples in febrile neutropenic patients underwent HSCT in terms of incidence, types, and antimicrobial resistance, and to assess the efficacy of infection control measures used in transplantation ward.\u0000 \u0000 \u0000 \u0000 This is retrospective study .The medical records of a total of 82 patients who underwent HSCT in the Specialized BMT Center, Baghdad Medical City, in 2021 and 2022 were reviewed; for any patient with neutropenic fever (NF), the clinical assessment was made, and samples were taken for culture any sensitivity before starting empirical antibiotics. The study was reviewed by the ethical committee of the hematology transplant center in the Medical City Complex, and since the study is retrospective, no consent is needed from the patient.\u0000 \u0000 \u0000 \u0000 There were 57 patients who developed NF, two at the time of collection, while 55 patients during transplant. In 16 patients, there was a clinical focus for NF, most commonly respiratory. From 175 samples sent for culture and sensitivity, bacterial growth was detected in 103 samples, and the incidence of bloodstream infection was 53%. Polymicrbial bacterial growth was detected in 6 patients with NF. Gram-positive bacteria were slightly more common than Gram negative. Staphylococcus\u0000 epidermidis and Burkholderia\u0000 cepacia were the most common Gram positive and Gram negative, respectively. An increasing number of patients admitted to transplant centers were associated with more infections. Ten out of 13 bacteria were multidrug resistant (MDR). Only two patients died from infection posttransplant.\u0000 \u0000 \u0000 \u0000 The predominance of Gram-positive cocci and Burkholderia\u0000 cepacia complex supported the need to review the adherence to infection control policy. The empirical antibiotic protocol should be guided by local antibiogram, and since the high rate of blood stream infection (BSI) with MDR pathogens, a de-escalating strategy utilizing carbapenems – as advised by the ECIL-4 guidelines – would be more appropriate while awaiting culture result. The ability to quickly identify infections and their susceptibility profile is still crucial for choosing antibiotic therapy.\u0000","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141118098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
A. Abdulsalam, Sarah Saad Abd-Al-Majeed, Zahraa Akram Thabit, Saja Hammadi Fahad, Muqdad Al-Mousawi, Hayder Al-Momen
{"title":"Provisional diagnosis of clinically significant hemoglobinopathies and decision on suitability for marriage as part of the premarital screening program in Iraq: Iraqi Society of Hematology Guidelines","authors":"A. Abdulsalam, Sarah Saad Abd-Al-Majeed, Zahraa Akram Thabit, Saja Hammadi Fahad, Muqdad Al-Mousawi, Hayder Al-Momen","doi":"10.4103/ijh.ijh_18_24","DOIUrl":"https://doi.org/10.4103/ijh.ijh_18_24","url":null,"abstract":"","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141114778","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Sambhav Jain, B. Gaur, Manish Sharma, Rupa R. Singh
In preterm newborns, thrombocytopenia is one of the most often observed hematologic findings. Most cases of thrombocytopenia are mild to moderate, self-limiting, and have a short duration; nevertheless, in rare cases, it can result in serious complications including pulmonary hemorrhage that lead to death and morbidity. The objective of this study was to identify the pattern, risk factors, and outcome of thrombocytopenia in preterm neonates hospitalized in a tertiary-level neonatal intensive care unit (NICU). All sick preterm neonates who developed thrombocytopenia within the first 28 days of life admitted to the NICU were included. A platelet count was performed at presentation time and as needed after that. Thrombocytopenia-related morbidities (intraventricular hemorrhage, pulmonary hemorrhage, and sepsis), mortality, and risk factors were analyzed concerning severity (mild, moderate, and severe) and age of thrombocytopenia onset (early and late) in preterm neonates. A total of 100 preterm neonates were admitted to our NICU. Of these, 48% of neonates developed thrombocytopenia. In terms of severity, mild, moderate, and severe thrombocytopenia were present in 62.5%, 37.5%, and 16.7% of newborns, respectively. The prevalent risk factors for late-onset thrombocytopenia (LOT) were necrotizing enterocolitis (NEC) and late-onset sepsis; for early-onset thrombocytopenia, the risk factors were pregnancy-induced hypertension and early-onset sepsis. Neonates with sepsis, severe birth asphyxia, and NEC were significantly associated with severe thrombocytopenia (P < 0.001). Thrombocytopenia-related morbidities and mortality were significantly higher among moderate-to-severe thrombocytopenia cases (P < 0.001). Sepsis was the most common risk factor associated with severe and LOT. Compared to mild/moderate thrombocytopenia, severe thrombocytopenia required more platelet transfusions, was associated with major bleeding manifestations, and had a higher mortality rate. When caring for premature newborns, these issues need to be taken into account.
{"title":"Thrombocytopenia-related outcome and pattern in preterm neonates hospitalized in neonatology unit: A single-center experience","authors":"Sambhav Jain, B. Gaur, Manish Sharma, Rupa R. Singh","doi":"10.4103/ijh.ijh_17_24","DOIUrl":"https://doi.org/10.4103/ijh.ijh_17_24","url":null,"abstract":"\u0000 \u0000 \u0000 In preterm newborns, thrombocytopenia is one of the most often observed hematologic findings. Most cases of thrombocytopenia are mild to moderate, self-limiting, and have a short duration; nevertheless, in rare cases, it can result in serious complications including pulmonary hemorrhage that lead to death and morbidity.\u0000 \u0000 \u0000 \u0000 The objective of this study was to identify the pattern, risk factors, and outcome of thrombocytopenia in preterm neonates hospitalized in a tertiary-level neonatal intensive care unit (NICU).\u0000 \u0000 \u0000 \u0000 All sick preterm neonates who developed thrombocytopenia within the first 28 days of life admitted to the NICU were included. A platelet count was performed at presentation time and as needed after that. Thrombocytopenia-related morbidities (intraventricular hemorrhage, pulmonary hemorrhage, and sepsis), mortality, and risk factors were analyzed concerning severity (mild, moderate, and severe) and age of thrombocytopenia onset (early and late) in preterm neonates.\u0000 \u0000 \u0000 \u0000 A total of 100 preterm neonates were admitted to our NICU. Of these, 48% of neonates developed thrombocytopenia. In terms of severity, mild, moderate, and severe thrombocytopenia were present in 62.5%, 37.5%, and 16.7% of newborns, respectively. The prevalent risk factors for late-onset thrombocytopenia (LOT) were necrotizing enterocolitis (NEC) and late-onset sepsis; for early-onset thrombocytopenia, the risk factors were pregnancy-induced hypertension and early-onset sepsis. Neonates with sepsis, severe birth asphyxia, and NEC were significantly associated with severe thrombocytopenia (P < 0.001). Thrombocytopenia-related morbidities and mortality were significantly higher among moderate-to-severe thrombocytopenia cases (P < 0.001).\u0000 \u0000 \u0000 \u0000 Sepsis was the most common risk factor associated with severe and LOT. Compared to mild/moderate thrombocytopenia, severe thrombocytopenia required more platelet transfusions, was associated with major bleeding manifestations, and had a higher mortality rate. When caring for premature newborns, these issues need to be taken into account.\u0000","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141126858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic lymphocytic leukemia is a mature B-cell malignancy where there is a progressive accumulation of leukemic cells with a distinctive immunophenotype as consequence to defective apoptosis and survival signals derived from the microenvironment. CXC chemokine ligand 13 (CXCL13) chemokines have recently emerged as crucial orchestrators for lymphocyte trafficking and activation. These secreted polypeptides exert their function by binding to specific cell surface receptors and can be divided into two categories: homeostatic and inflammatory. The CXCL13 is an efficacious attractant of naive B-cells in vitro and has been shown to be produced constitutively by stromal cells in lymphoid follicles of human lymph nodes. The CXCL13-CXCR5 axis has been previously shown to contribute to the progression of several malignancies and possibly CLL relapse. The aim of this study to compare the plasma level of CXCL13 in a patient with CLL with healthy normal control and to correlate the plasma level of CXCL13 to beta-2 microglobulin (β2 M) and other hematological parameters in CLL. This cross-sectional study was conducted on 50 CLL patients who were newly diagnosed. A total of 30 healthy individuals were included in this study as a control group. Measurement of plasma CXCL13 and beta-2 microglobulin levels was done by the enzyme-linked immunosorbent assay. Fifty CLL patients were studied and compared with thirty control group of healthy individuals. The mean level of CXCL13 was 67.48 pg/ml in CLL patients while it was 69.2 pg/ml in control, so it is statistically not significant (P = 0.363). The mean level of β2 M was 50.89 ug/ml in CLL patients while it was 50.59 ug/ml in control, so it is statistically not significant (P = 0.702). The percentage of stage A of CLL patients was 22.44%, stage B was18.36%, and stage C was 10.20%. The percentages of lymphadenopathy, splenomegaly, and hepatomegaly were 66%, 32%, and 16%, respectively. The mean of malignant cell percentage in stage A was 55.18%; in stage B, it was 69.28%; and in stage C, it was 81%, so it is statistically significant (P < 0.001). CXCL13 shows no statistically significant between Cd38+ and CD38− and P value was 0.950. There was no correlation in level of CXCL13 between the CLL group and the control group. There was no correlation in level of CXCL13 and β2 M in the CLL group.
{"title":"Assessment of CXCL13 plasma level in chronic lymphocytic leukemia and its relation to other prognostic markers","authors":"Omer Muhi Shareef, Bassam Muhammad Hameed","doi":"10.4103/ijh.ijh_9_24","DOIUrl":"https://doi.org/10.4103/ijh.ijh_9_24","url":null,"abstract":"\u0000 \u0000 \u0000 Chronic lymphocytic leukemia is a mature B-cell malignancy where there is a progressive accumulation of leukemic cells with a distinctive immunophenotype as consequence to defective apoptosis and survival signals derived from the microenvironment. CXC chemokine ligand 13 (CXCL13) chemokines have recently emerged as crucial orchestrators for lymphocyte trafficking and activation. These secreted polypeptides exert their function by binding to specific cell surface receptors and can be divided into two categories: homeostatic and inflammatory. The CXCL13 is an efficacious attractant of naive B-cells in vitro and has been shown to be produced constitutively by stromal cells in lymphoid follicles of human lymph nodes. The CXCL13-CXCR5 axis has been previously shown to contribute to the progression of several malignancies and possibly CLL relapse.\u0000 \u0000 \u0000 \u0000 The aim of this study to compare the plasma level of CXCL13 in a patient with CLL with healthy normal control and to correlate the plasma level of CXCL13 to beta-2 microglobulin (β2 M) and other hematological parameters in CLL.\u0000 \u0000 \u0000 \u0000 This cross-sectional study was conducted on 50 CLL patients who were newly diagnosed. A total of 30 healthy individuals were included in this study as a control group. Measurement of plasma CXCL13 and beta-2 microglobulin levels was done by the enzyme-linked immunosorbent assay.\u0000 \u0000 \u0000 \u0000 Fifty CLL patients were studied and compared with thirty control group of healthy individuals. The mean level of CXCL13 was 67.48 pg/ml in CLL patients while it was 69.2 pg/ml in control, so it is statistically not significant (P = 0.363). The mean level of β2 M was 50.89 ug/ml in CLL patients while it was 50.59 ug/ml in control, so it is statistically not significant (P = 0.702). The percentage of stage A of CLL patients was 22.44%, stage B was18.36%, and stage C was 10.20%. The percentages of lymphadenopathy, splenomegaly, and hepatomegaly were 66%, 32%, and 16%, respectively. The mean of malignant cell percentage in stage A was 55.18%; in stage B, it was 69.28%; and in stage C, it was 81%, so it is statistically significant (P < 0.001). CXCL13 shows no statistically significant between Cd38+ and CD38− and P value was 0.950.\u0000 \u0000 \u0000 \u0000 There was no correlation in level of CXCL13 between the CLL group and the control group. There was no correlation in level of CXCL13 and β2 M in the CLL group.\u0000","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141126977","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Chronic myeloid leukemia (CML) is a type of myeloproliferative neoplasm characterized by the excessive accumulation of malignant myeloid cells in the bone marrow and peripheral blood. This condition is primarily triggered by a specific chromosomal translocation known as t(9;22) (q34.13;q11.23), which leads to the formation of the BCR-ABL fusion gene. The treatment landscape for CML has undergone significant changes with the approval of tyrosine kinase inhibitors (TKIs) targeting the BCR-ABL1 kinase activity. One such inhibitor is bosutinib, which has been available for several years to treat patients with chronic, accelerated, and blast-phase CML who have shown resistance or intolerance to previous therapies. The aim of this study was to assess efficacy and safety of Bosutinib as a 2nd line therapy in CML patients, in addition to effect of adherence to treatment on patients response. Eighty-five patients with CML were enrolled in a prospective cohort study from October 2021 to October 2022 at Hematology Center in Medical City Complex – Baghdad. All patients failed to at least one TKI, and all of them started escalated dose of bosutinib. The patients were followed-up by assessing molecular and cytogenetic response at 3 and 6 months and monitored carefully for adverse events (AEs) which were graded by common terminology IX criteria for AEs version 5. Adherence to bosutinib was also monitored by a specific adherence scale to optimize the response rate to treatment. The mean age of patients was 47.3 ± 14.9 (range: 18–77), with male:female ratio 1.4:1. Status of CML patients showed that 89.4% were in the chronic phase, 5.8% in accelerated phase, and 4.7% in blast phase. Regarding the number of previous TKIs before bosutinib, 72.9% of patients failed to prior one TKI (imatinib). At 6 months (72.3%), patients achieve optimal response according to European Leukemia Net criteria 2013. Gastrointestinal symptoms and dermatological manifestations were the most common nonhematological AEs of bosutinib. According to 9-item Morisky Medication Adherence Scale, 42% of patients were adherent to medication which showed a significant association with a higher number of optimal response (P = 0.0001). Bosutinib is effective with a high and promising response as a subsequent line treatment in CML patients, and it is generally safe and associated with mild-to-moderate tolerable and manageable AEs. Adherence to the drug plays a significant role in optimal response to bosutinib.
{"title":"Treatment outcome of the tyrosine kinase inhibitor (bosutinib) in previously treated chronic myeloid leukemia patients (sample of Iraqi patients)","authors":"Anfal Mumtaz Ahmed, B. Matti","doi":"10.4103/ijh.ijh_59_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_59_23","url":null,"abstract":"\u0000 \u0000 \u0000 Chronic myeloid leukemia (CML) is a type of myeloproliferative neoplasm characterized by the excessive accumulation of malignant myeloid cells in the bone marrow and peripheral blood. This condition is primarily triggered by a specific chromosomal translocation known as t(9;22) (q34.13;q11.23), which leads to the formation of the BCR-ABL fusion gene. The treatment landscape for CML has undergone significant changes with the approval of tyrosine kinase inhibitors (TKIs) targeting the BCR-ABL1 kinase activity. One such inhibitor is bosutinib, which has been available for several years to treat patients with chronic, accelerated, and blast-phase CML who have shown resistance or intolerance to previous therapies.\u0000 \u0000 \u0000 \u0000 The aim of this study was to assess efficacy and safety of Bosutinib as a 2nd line therapy in CML patients, in addition to effect of adherence to treatment on patients response.\u0000 \u0000 \u0000 \u0000 Eighty-five patients with CML were enrolled in a prospective cohort study from October 2021 to October 2022 at Hematology Center in Medical City Complex – Baghdad. All patients failed to at least one TKI, and all of them started escalated dose of bosutinib. The patients were followed-up by assessing molecular and cytogenetic response at 3 and 6 months and monitored carefully for adverse events (AEs) which were graded by common terminology IX criteria for AEs version 5. Adherence to bosutinib was also monitored by a specific adherence scale to optimize the response rate to treatment.\u0000 \u0000 \u0000 \u0000 The mean age of patients was 47.3 ± 14.9 (range: 18–77), with male:female ratio 1.4:1. Status of CML patients showed that 89.4% were in the chronic phase, 5.8% in accelerated phase, and 4.7% in blast phase. Regarding the number of previous TKIs before bosutinib, 72.9% of patients failed to prior one TKI (imatinib). At 6 months (72.3%), patients achieve optimal response according to European Leukemia Net criteria 2013. Gastrointestinal symptoms and dermatological manifestations were the most common nonhematological AEs of bosutinib. According to 9-item Morisky Medication Adherence Scale, 42% of patients were adherent to medication which showed a significant association with a higher number of optimal response (P = 0.0001).\u0000 \u0000 \u0000 \u0000 Bosutinib is effective with a high and promising response as a subsequent line treatment in CML patients, and it is generally safe and associated with mild-to-moderate tolerable and manageable AEs. Adherence to the drug plays a significant role in optimal response to bosutinib.\u0000","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-05-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140969909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Hana Kamal Yalda Kaka, Ahmed K. Yassin, Kawa Muhamedamin Hasan
Hairy cell leukemia (HCL) is a rare chronic B-cell lymphoproliferative disorder. Modern therapy with purine analogs and immunotherapy can provide long-term remission, but the risk of recurrence remains about 40%–50%. The aim of this study was to evaluate the outcome of patients with HCL who received treatment in Nanakali Hospital. A retrospective cross-sectional study was carried out on 50 patients of HCL diagnosed from 2004 to 2022 in Nanakali Hospital in Erbil City, Kurdistan Region, Iraq. Demographics, clinical presentation, treatment data, complications, response, recurrence, and survival data were collected from medical records. The results were presented with descriptive statistics. Variables were compared by Chi-square analysis. The mean age was 52.64 ± 12.37 years, and 84% were male. The most common presenting symptoms were splenomegaly (18%) and fatigue (14%). The majority (69.6%) received cladribine; the response rate was 73.9%, with a complete remission (67.4%). 47.8% had recurrent disease. The most common adverse effects were febrile neutropenia (58.7%) and Grade III and IV hematologic toxicity (41.3%). The results were significantly associated with ANC pretreatment (P = 0.019), comorbidity (P = 0.001), and treatment response (P = 0.004). Cladribine–rituximab combination resulted in complete remission (100%). Ten-year overall survival was 70%. The results were broadly consistent with literature reports, demonstrating the efficacy and safety of cladribine with/without rituximab as first-line therapy for HCL but with a 30% mortality of concern. Further studies should identify modifiable factors that affect poor prognosis in subgroups to guide improvements in risk management of HCL.
毛细胞白血病（HCL）是一种罕见的慢性 B 细胞淋巴增生性疾病。使用嘌呤类似物和免疫疗法的现代疗法可使病情得到长期缓解，但复发风险仍高达40%-50%。本研究旨在评估在纳纳卡利医院接受治疗的 HCL 患者的疗效。 本研究对伊拉克库尔德地区埃尔比勒市纳纳卡利医院 2004 年至 2022 年期间确诊的 50 名 HCL 患者进行了回顾性横断面研究。研究人员从病历中收集了患者的人口统计学特征、临床表现、治疗数据、并发症、反应、复发和存活数据。结果采用描述性统计。变量比较采用卡方分析。 平均年龄为（52.64±12.37）岁，84%为男性。最常见的症状是脾肿大（18%）和乏力（14%）。大多数患者（69.6%）接受了克拉利宾治疗；应答率为 73.9%，其中完全缓解率为 67.4%。47.8%的患者病情复发。最常见的不良反应是发热性中性粒细胞减少（58.7%）和 III 级和 IV 级血液学毒性（41.3%）。结果与治疗前的ANC（P = 0.019）、合并症（P = 0.001）和治疗反应（P = 0.004）明显相关。克拉利宾-利妥昔单抗联合治疗可获得完全缓解（100%）。十年总生存率为 70%。 研究结果与文献报道基本一致，证明了克拉利宾联合/不联合利妥昔单抗作为HCL一线疗法的有效性和安全性，但30%的死亡率令人担忧。进一步的研究应找出影响亚组不良预后的可改变因素，以指导改善HCL的风险管理。
{"title":"Outcome of Hairy Cell Leukemia: A Single-center Study","authors":"Hana Kamal Yalda Kaka, Ahmed K. Yassin, Kawa Muhamedamin Hasan","doi":"10.4103/ijh.ijh_19_24","DOIUrl":"https://doi.org/10.4103/ijh.ijh_19_24","url":null,"abstract":"\u0000 \u0000 \u0000 Hairy cell leukemia (HCL) is a rare chronic B-cell lymphoproliferative disorder. Modern therapy with purine analogs and immunotherapy can provide long-term remission, but the risk of recurrence remains about 40%–50%. The aim of this study was to evaluate the outcome of patients with HCL who received treatment in Nanakali Hospital.\u0000 \u0000 \u0000 \u0000 A retrospective cross-sectional study was carried out on 50 patients of HCL diagnosed from 2004 to 2022 in Nanakali Hospital in Erbil City, Kurdistan Region, Iraq. Demographics, clinical presentation, treatment data, complications, response, recurrence, and survival data were collected from medical records. The results were presented with descriptive statistics. Variables were compared by Chi-square analysis.\u0000 \u0000 \u0000 \u0000 The mean age was 52.64 ± 12.37 years, and 84% were male. The most common presenting symptoms were splenomegaly (18%) and fatigue (14%). The majority (69.6%) received cladribine; the response rate was 73.9%, with a complete remission (67.4%). 47.8% had recurrent disease. The most common adverse effects were febrile neutropenia (58.7%) and Grade III and IV hematologic toxicity (41.3%). The results were significantly associated with ANC pretreatment (P = 0.019), comorbidity (P = 0.001), and treatment response (P = 0.004). Cladribine–rituximab combination resulted in complete remission (100%). Ten-year overall survival was 70%.\u0000 \u0000 \u0000 \u0000 The results were broadly consistent with literature reports, demonstrating the efficacy and safety of cladribine with/without rituximab as first-line therapy for HCL but with a 30% mortality of concern. Further studies should identify modifiable factors that affect poor prognosis in subgroups to guide improvements in risk management of HCL.\u0000","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140982672","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Yusra Ghiath Yaseen, B. Mtashar, Abbas Hashim Abdulsalam, Y. Faraj
{"title":"Light transmission aggregometry: Useful but difficult diagnostic tool","authors":"Yusra Ghiath Yaseen, B. Mtashar, Abbas Hashim Abdulsalam, Y. Faraj","doi":"10.4103/ijh.ijh_46_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_46_23","url":null,"abstract":"","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2024-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141015281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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