Aseel Majeed Hameed, Zairi Amira, S. Al-alwany, Baan A. Mtashar
Chronic myeloid leukemia (CML) has been well recognized as an exemplary instance of a malignant disease characterized by a distinctive molecular occurrence, namely the presence of the breakpoint cluster region (BCR)-c-ABL oncogene 1 (ABL1) oncogene. The Philadelphia chromosome gives rise to an anomalous fusion gene characterized by atypical kinase activity, resulting in the accumulation of reactive oxygen species and genetic instability that holds significance in the advancement of diseases. The objective of this study was to investigate the detection rate of BCR-ABL1 polymorphism and BCR protein level in a group of Iraqi patients with CML. This study has been carried out on 150 specimens, 120 patients subjected to CML included 20 patients diagnosed as newly diagnosis CML and 100 patients treated with CML. In addition to 30 apparently healthy persons as a control group (normal persons) from the National Center of Hematology/Mustansiryiah University/Baghdad, 65 out of 100 patients on imatinib while 35 nonimatinib (nilotinib and bosutinib). Fresh whole blood and serum were obtained from all patients and controls. We used total DNA genomic extraction extracted from ethylenediaminetetraacetic acid blood for genetic detection of Bcr/Abl Genes Polymorphism by sequencing technique in patients with CML and apparently control groups and used serum for biochemical tests include urea, lactate dehydrogenase (LDH), aspartate transaminase (AST), alanine transaminase (ALT), and creatinine using biochemicals methods (colorimetric and kinetic), respectively, as well as detection BCR protein level using sandwich enzyme-linked immunosorbent assays technique. According to age and sex, the patients’ groups were matching with the control group. Regarding the biochemical parameters (urea creatinine, ALT, AST, and LDH) serum level, there are no significant differences among new diagnosis CML, patients respond to treatments and failure group except in serum level of creatinine between new diagnosis CML group and failure group, there are significant differences (P = 0.01). The present results showed that DNA polymorphism distribution was according to CC; GC; AT; and AA were 32%, 26%, 18%, and 24%, respectively, in patients with CML and 28%; 20%;12%; and 40%, respectively, in the control group. There are significant statistical differences (P < 0.05) between different groups according to the genotyping of BCRABL, the results obtained from the sequenced 429 bp fragments, and the detailed positions of the observed variations are described in the NCBI reference sequences (rs766724113). The samples were submitted in NCBI, and the accession number of nucleotide sequences of BCRABL as new recording: LC 775148, LC 775149, and LC 775150, while regarding with BCR protein, there are significant differences in level between new diagnosis CML and CML on treatment and control groups, P < 0.001 for each comparison while there are no significant differences bet
{"title":"Biochemical and breakpoint cluster region-c-ABL oncogene 1 polymorphism study among Iraqi patients with chronic myeloid leukemia","authors":"Aseel Majeed Hameed, Zairi Amira, S. Al-alwany, Baan A. Mtashar","doi":"10.4103/ijh.ijh_75_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_75_23","url":null,"abstract":"\u0000 \u0000 \u0000 Chronic myeloid leukemia (CML) has been well recognized as an exemplary instance of a malignant disease characterized by a distinctive molecular occurrence, namely the presence of the breakpoint cluster region (BCR)-c-ABL oncogene 1 (ABL1) oncogene. The Philadelphia chromosome gives rise to an anomalous fusion gene characterized by atypical kinase activity, resulting in the accumulation of reactive oxygen species and genetic instability that holds significance in the advancement of diseases.\u0000 \u0000 \u0000 \u0000 The objective of this study was to investigate the detection rate of BCR-ABL1 polymorphism and BCR protein level in a group of Iraqi patients with CML.\u0000 \u0000 \u0000 \u0000 This study has been carried out on 150 specimens, 120 patients subjected to CML included 20 patients diagnosed as newly diagnosis CML and 100 patients treated with CML. In addition to 30 apparently healthy persons as a control group (normal persons) from the National Center of Hematology/Mustansiryiah University/Baghdad, 65 out of 100 patients on imatinib while 35 nonimatinib (nilotinib and bosutinib). Fresh whole blood and serum were obtained from all patients and controls. We used total DNA genomic extraction extracted from ethylenediaminetetraacetic acid blood for genetic detection of Bcr/Abl Genes Polymorphism by sequencing technique in patients with CML and apparently control groups and used serum for biochemical tests include urea, lactate dehydrogenase (LDH), aspartate transaminase (AST), alanine transaminase (ALT), and creatinine using biochemicals methods (colorimetric and kinetic), respectively, as well as detection BCR protein level using sandwich enzyme-linked immunosorbent assays technique.\u0000 \u0000 \u0000 \u0000 According to age and sex, the patients’ groups were matching with the control group. Regarding the biochemical parameters (urea creatinine, ALT, AST, and LDH) serum level, there are no significant differences among new diagnosis CML, patients respond to treatments and failure group except in serum level of creatinine between new diagnosis CML group and failure group, there are significant differences (P = 0.01). The present results showed that DNA polymorphism distribution was according to CC; GC; AT; and AA were 32%, 26%, 18%, and 24%, respectively, in patients with CML and 28%; 20%;12%; and 40%, respectively, in the control group. There are significant statistical differences (P < 0.05) between different groups according to the genotyping of BCRABL, the results obtained from the sequenced 429 bp fragments, and the detailed positions of the observed variations are described in the NCBI reference sequences (rs766724113). The samples were submitted in NCBI, and the accession number of nucleotide sequences of BCRABL as new recording: LC 775148, LC 775149, and LC 775150, while regarding with BCR protein, there are significant differences in level between new diagnosis CML and CML on treatment and control groups, P < 0.001 for each comparison while there are no significant differences bet","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-12-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138593004","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}
Y. Faraj, Khalid Mahdi Salih, Abderrahim Khelif, Elaf Zuhair Hameed
As in other malignancies, different subsets of natural killer (NK) cells play a crucial role in the recognition and lysing of malignant cells in chronic myeloid leukemia (CML). This study aims to identify two subsets of NK, cytotoxic (cluster of differentiation [CD] 16+bright) and cytokine-producing NK (CD56+bright) in newly diagnosed CML patients. This study is conducted on 20 newly diagnosed Iraqi patients (12 males and 8 females) with CML, in chronic phase, at the age range of 17–55 years. Along with patients, 20 healthy subjects (with matched age and gender) were enrolled to act as a control group. To identify NK cells and their subsets in peripheral blood samples, the expression of CD45, CD3, CD56, and CD16 markers was evaluated by flow cytometry technique. Furthermore, the serum level of interferon gamma (IFN-γ) and interleukin (IL)-18 was determined by the enzyme-linked immunosorbent assay technique. The age of patients at the diagnosis of disease is (35.6 ± 12.2 years) and the male: female ratio was 1.5:1. The serum level of IL-18 in newly diagnosed CML patients (30.3 ± 6.5 pg/mL) was significantly (P < 0.0001) higher than those in control group (18.3 ± 7.8 pg/mL), while the serum levels of IFN-γ in newly diagnosed patients are significantly (P = 0.006) dropped down to (89.1 ± 7.2 pg/mL from that in control group (109.4 ± 30.3 pg/mL). The percentage of NK cells in newly diagnosed CML patients is significantly lower than in control group. There is a significant elevation in the cytotoxic NK cells (CD16+bright) subset, and a significant decrease in the cytokine-producing NK subset (CD56+bright) in newly diagnosed patients when compared to those in control group. Although there is an elevation in the percentage of cytotoxic NK cells (CD16+bright) subset of CML patients at the first diagnosis, these cells are not able to recognize and attack malignant cells, which may be due to low expression of their activating receptors and needs more investigation. Furthermore, present results found a low percentage of cytokine-producing NK cells (CD56+bright) and a low level of IFN-γ in CML patients, although there is an elevation in IL-18, which indicates that IL-18 may be not the main stimulator to these cells, so activation pathway of this subset of NK cells needs further investigation.
与其他恶性肿瘤一样，不同亚群的自然杀伤（NK）细胞在慢性髓性白血病（CML）中识别和溶解恶性细胞的过程中起着至关重要的作用。 本研究旨在确定新诊断的 CML 患者中的两个 NK 亚群，即细胞毒性 NK（分化簇 [CD] 16+亮）和细胞因子生成 NK（CD56+亮）。 这项研究的对象是 20 名新确诊的伊拉克慢性骨髓性白血病患者（12 男 8 女），年龄在 17-55 岁之间。除患者外，还招募了 20 名健康受试者（年龄和性别匹配）作为对照组。为了识别外周血样本中的 NK 细胞及其亚群，采用流式细胞术评估了 CD45、CD3、CD56 和 CD16 标记的表达。此外，血清中γ干扰素（IFN-γ）和白细胞介素（IL）-18的水平是通过酶联免疫吸附测定法测定的。 患者确诊时的年龄为（35.6 ± 12.2 岁），男女比例为 1.5:1。新诊断的 CML 患者血清中 IL-18 的水平（30.3 ± 6.5 pg/mL）明显高于对照组（18.3 ± 7.8 pg/mL）（P < 0.0001），而新诊断的患者血清中 IFN-γ 的水平则明显下降（P = 0.006），从对照组（109.4 ± 30.3 pg/mL）降至（89.1 ± 7.2 pg/mL）。新诊断的 CML 患者的 NK 细胞比例明显低于对照组。与对照组相比，新诊断患者的细胞毒性 NK 细胞亚群（CD16+亮）明显增加，而细胞因子产生 NK 亚群（CD56+亮）明显减少。 虽然 CML 患者初诊时细胞毒性 NK 细胞（CD16+bright）亚群的比例有所升高，但这些细胞并不能识别和攻击恶性细胞，这可能是由于它们的激活受体表达较低所致，需要进一步研究。此外，本研究结果发现，CML 患者中产生细胞因子的 NK 细胞（CD56+bright）比例较低，IFN-γ 水平较低，但 IL-18 有所升高，这表明 IL-18 可能不是刺激这些细胞的主要因素，因此需要进一步研究这些 NK 细胞亚群的活化途径。
{"title":"Subsets of natural killer cells in chronic myeloid leukemia and their relation with some inflammatory cytokines","authors":"Y. Faraj, Khalid Mahdi Salih, Abderrahim Khelif, Elaf Zuhair Hameed","doi":"10.4103/ijh.ijh_77_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_77_23","url":null,"abstract":"As in other malignancies, different subsets of natural killer (NK) cells play a crucial role in the recognition and lysing of malignant cells in chronic myeloid leukemia (CML). This study aims to identify two subsets of NK, cytotoxic (cluster of differentiation [CD] 16+bright) and cytokine-producing NK (CD56+bright) in newly diagnosed CML patients. This study is conducted on 20 newly diagnosed Iraqi patients (12 males and 8 females) with CML, in chronic phase, at the age range of 17–55 years. Along with patients, 20 healthy subjects (with matched age and gender) were enrolled to act as a control group. To identify NK cells and their subsets in peripheral blood samples, the expression of CD45, CD3, CD56, and CD16 markers was evaluated by flow cytometry technique. Furthermore, the serum level of interferon gamma (IFN-γ) and interleukin (IL)-18 was determined by the enzyme-linked immunosorbent assay technique. The age of patients at the diagnosis of disease is (35.6 ± 12.2 years) and the male: female ratio was 1.5:1. The serum level of IL-18 in newly diagnosed CML patients (30.3 ± 6.5 pg/mL) was significantly (P < 0.0001) higher than those in control group (18.3 ± 7.8 pg/mL), while the serum levels of IFN-γ in newly diagnosed patients are significantly (P = 0.006) dropped down to (89.1 ± 7.2 pg/mL from that in control group (109.4 ± 30.3 pg/mL). The percentage of NK cells in newly diagnosed CML patients is significantly lower than in control group. There is a significant elevation in the cytotoxic NK cells (CD16+bright) subset, and a significant decrease in the cytokine-producing NK subset (CD56+bright) in newly diagnosed patients when compared to those in control group. Although there is an elevation in the percentage of cytotoxic NK cells (CD16+bright) subset of CML patients at the first diagnosis, these cells are not able to recognize and attack malignant cells, which may be due to low expression of their activating receptors and needs more investigation. Furthermore, present results found a low percentage of cytokine-producing NK cells (CD56+bright) and a low level of IFN-γ in CML patients, although there is an elevation in IL-18, which indicates that IL-18 may be not the main stimulator to these cells, so activation pathway of this subset of NK cells needs further investigation.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-11-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139198023","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}
M. Indu, Ravindra Kanthaliya, Swati Jami, Brijesh Sharma, D. S. Chauhan, Jyoti Garg, Jyotsana P Lalita
A 23-year-old male was misdiagnosed as a case of tubercular lymphadenitis based on fever with B-symptoms and finding of epithelioid granuloma on fine-needle aspiration of mesenteric lymph node and was started on antitubercular treatment from an outside hospital. Since the patient had progression of symptoms, we re-evaluated the case. Contrast-enhanced computed tomography showed multiple conglomerated necrotic cervical, peritoneal lymph nodes, hepatosplenomegaly, and multiple mixed sclerotic lytic lesions in multiple vertebral bodies and pelvis. An excision lymph node biopsy was suggestive of a nodular sclerosis variant of Hodgkin’s lymphoma. A bone marrow study was performed subsequent to new-onset bicytopenia. Bone marrow aspiration was dry and bone marrow biopsy showed myelofibrosis. Thus, a diagnosis of myelofibrosis secondary to Hodgkin’s lymphoma was made.
一名 23 岁的男性因发热伴 B 型症状，以及肠系膜淋巴结细针穿刺发现上皮样肉芽肿而被误诊为结核性淋巴结炎，并开始在外院接受抗结核治疗。由于患者症状加重，我们对病例进行了重新评估。对比增强计算机断层扫描显示，患者颈部、腹膜淋巴结多发聚集性坏死，肝脾肿大，多个椎体和骨盆多发混合性硬化性淋巴结病变。切除淋巴结活检提示为霍奇金淋巴瘤的结节硬化变异型。由于新出现的全血细胞减少症，患者接受了骨髓检查。骨髓抽吸呈干性，骨髓活检显示骨髓纤维化。因此，诊断为继发于霍奇金淋巴瘤的骨髓纤维化。
{"title":"Myelofibrosis secondary to Hodgkin’s lymphoma: A case report","authors":"M. Indu, Ravindra Kanthaliya, Swati Jami, Brijesh Sharma, D. S. Chauhan, Jyoti Garg, Jyotsana P Lalita","doi":"10.4103/ijh.ijh_37_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_37_23","url":null,"abstract":"A 23-year-old male was misdiagnosed as a case of tubercular lymphadenitis based on fever with B-symptoms and finding of epithelioid granuloma on fine-needle aspiration of mesenteric lymph node and was started on antitubercular treatment from an outside hospital. Since the patient had progression of symptoms, we re-evaluated the case. Contrast-enhanced computed tomography showed multiple conglomerated necrotic cervical, peritoneal lymph nodes, hepatosplenomegaly, and multiple mixed sclerotic lytic lesions in multiple vertebral bodies and pelvis. An excision lymph node biopsy was suggestive of a nodular sclerosis variant of Hodgkin’s lymphoma. A bone marrow study was performed subsequent to new-onset bicytopenia. Bone marrow aspiration was dry and bone marrow biopsy showed myelofibrosis. Thus, a diagnosis of myelofibrosis secondary to Hodgkin’s lymphoma was made.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139249271","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}
Amira M. N. Abdelrahman, Naglaa M. Hassan, Magda Abd El-Aziz Zidan, Ahmed Elsayed Aly Ibrahem
Abstract: BACKGROUND: Due to their impact on crucial steps in hematopoiesis, long noncoding RNAs (lncRNAs) deregulation potentially accelerates the growth and development of blood cancers like acute myeloid leukemia (AML). The study aimed to look into different expression patterns, prognostic value, and clinical importance of lncRNA small nucleolar RNA host gene 5 ( SNHG5) and promoter of cyclin-dependent kinase inhibitor 1A antisense DNA damage-activated RNA ( PANDAR ) genes in Egyptian adult patients with AML. SUBJECTS AND METHODS: The case–control study was conducted between 2019 and 2022 at the Clinical Pathology Department at the National Cancer Institute, Cairo University, Egypt. The study involved 80 recently diagnosed patients with AML and 20 healthy controls. Real-time quantitative reverse transcription polymerase chain reaction was used to assess the levels of expression of SNHG5 and PANDAR genes. RESULTS: In comparison to healthy controls, there was a significantly higher SNHG5 gene expression ( P = 0.026) and PANDAR expression ( P < 0.001) in patients’ bone marrow samples. The study of the correlations revealed a significant positive association between SNHG5 and PANDAR genes in AML patients. The overall survival (OS) was significantly better in the low SNHG5 gene expression group than in the high SNHG5 gene expression group. No significant difference was detected regarding the disease-free survival (DFS) between patients with low expression and high expression of the SNHG5 gene . No significant variation between high PANDAR gene and low PANDAR gene expression regarding OS and DFS. CONCLUSION: SNHG5 and PANDAR may have a pathogenic role in AML, and their overexpression might be considered a marker for diagnosis in AML patients in Egypt. SNHG5 expression can be used as a predictor for OS, while PANDAR expression cannot be used as a predictor for OS or DFS in patients.
{"title":"The study of long noncoding RNA SNHG5 and PANDAR genes expression in newly diagnosed egyptian adult acute myeloid leukemia patients","authors":"Amira M. N. Abdelrahman, Naglaa M. Hassan, Magda Abd El-Aziz Zidan, Ahmed Elsayed Aly Ibrahem","doi":"10.4103/ijh.ijh_65_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_65_23","url":null,"abstract":"Abstract: BACKGROUND: Due to their impact on crucial steps in hematopoiesis, long noncoding RNAs (lncRNAs) deregulation potentially accelerates the growth and development of blood cancers like acute myeloid leukemia (AML). The study aimed to look into different expression patterns, prognostic value, and clinical importance of lncRNA small nucleolar RNA host gene 5 ( SNHG5) and promoter of cyclin-dependent kinase inhibitor 1A antisense DNA damage-activated RNA ( PANDAR ) genes in Egyptian adult patients with AML. SUBJECTS AND METHODS: The case–control study was conducted between 2019 and 2022 at the Clinical Pathology Department at the National Cancer Institute, Cairo University, Egypt. The study involved 80 recently diagnosed patients with AML and 20 healthy controls. Real-time quantitative reverse transcription polymerase chain reaction was used to assess the levels of expression of SNHG5 and PANDAR genes. RESULTS: In comparison to healthy controls, there was a significantly higher SNHG5 gene expression ( P = 0.026) and PANDAR expression ( P < 0.001) in patients’ bone marrow samples. The study of the correlations revealed a significant positive association between SNHG5 and PANDAR genes in AML patients. The overall survival (OS) was significantly better in the low SNHG5 gene expression group than in the high SNHG5 gene expression group. No significant difference was detected regarding the disease-free survival (DFS) between patients with low expression and high expression of the SNHG5 gene . No significant variation between high PANDAR gene and low PANDAR gene expression regarding OS and DFS. CONCLUSION: SNHG5 and PANDAR may have a pathogenic role in AML, and their overexpression might be considered a marker for diagnosis in AML patients in Egypt. SNHG5 expression can be used as a predictor for OS, while PANDAR expression cannot be used as a predictor for OS or DFS in patients.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135429943","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}
Abstract: BACKGROUND: Patients with hemoglobinopathies are considered as immunocompromised; however, it is unclear if they are more susceptible to COVID-19 infection and experience a more severe illness course. AIMS OF STUDY: The aims of this study were to evaluate the clinical presentation and severity of COVID-19 among pediatric patients with hemoglobinopathies, assess risk factors, and outcome among studied patients. PATIENTS AND METHODS: An analytical, cross-sectional study has been carried out on children and adolescents with hemoglobinopathies, for the period from the first of May 2021 to September 2022. In addition to patient’s data and thorough physical examination, patients were followed concerning the course, complications, and disease outcome. Investigations included complete blood count, inflammatory markers, liver, and renal function tests. RESULTS: Out of 42 patients with hemoglobinopathies and COVID-19, the majority of patients 35 (83.3%) gave a history of COVID-19 exposure, with a median of 5 days for the presentation since exposure and 23 (54.8%) needed hospitalization. All studied patients had fever, followed by cough in 36 (85.7%) and shortness of breath (42.9%). No death was reported in studied patients. The lymphocyte count was significantly lower and C-reactive protein and D-dimer levels were significantly higher in sickle cell disease (SCD) patients with COVID-19 as compared to thalassemia patients, P < 0.05. Twenty-two patients (52.4%) had mild COVID-19 disease, 12 (28.6%) moderate, and 8 (19%) with severe disease. Regression analysis revealed that acute chest syndrome (ACS) as COVID-19 infection presentation, high white blood cells count, and elevated total serum bilirubin were significant variables associated with severe COVID-19 infection, P < 0.05. CONCLUSION: The clinical course of hemoglobinopathy patients with COVID-19 infection is similar to that in the general population and no death was reported among studied patients. However, clinicians treating patients with SCD need to be aware of COVID-19 infection when diagnosing ACS.
{"title":"COVID-19 infection among pediatric patients with hemoglobinopathies in Basrah, Iraq","authors":"Nael Sameer Faisal, Meaad Kadhum Hassan","doi":"10.4103/ijh.ijh_74_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_74_23","url":null,"abstract":"Abstract: BACKGROUND: Patients with hemoglobinopathies are considered as immunocompromised; however, it is unclear if they are more susceptible to COVID-19 infection and experience a more severe illness course. AIMS OF STUDY: The aims of this study were to evaluate the clinical presentation and severity of COVID-19 among pediatric patients with hemoglobinopathies, assess risk factors, and outcome among studied patients. PATIENTS AND METHODS: An analytical, cross-sectional study has been carried out on children and adolescents with hemoglobinopathies, for the period from the first of May 2021 to September 2022. In addition to patient’s data and thorough physical examination, patients were followed concerning the course, complications, and disease outcome. Investigations included complete blood count, inflammatory markers, liver, and renal function tests. RESULTS: Out of 42 patients with hemoglobinopathies and COVID-19, the majority of patients 35 (83.3%) gave a history of COVID-19 exposure, with a median of 5 days for the presentation since exposure and 23 (54.8%) needed hospitalization. All studied patients had fever, followed by cough in 36 (85.7%) and shortness of breath (42.9%). No death was reported in studied patients. The lymphocyte count was significantly lower and C-reactive protein and D-dimer levels were significantly higher in sickle cell disease (SCD) patients with COVID-19 as compared to thalassemia patients, P < 0.05. Twenty-two patients (52.4%) had mild COVID-19 disease, 12 (28.6%) moderate, and 8 (19%) with severe disease. Regression analysis revealed that acute chest syndrome (ACS) as COVID-19 infection presentation, high white blood cells count, and elevated total serum bilirubin were significant variables associated with severe COVID-19 infection, P < 0.05. CONCLUSION: The clinical course of hemoglobinopathy patients with COVID-19 infection is similar to that in the general population and no death was reported among studied patients. However, clinicians treating patients with SCD need to be aware of COVID-19 infection when diagnosing ACS.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135975614","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}
Abstract: BACKGROUND: Hemophilia is an inherited bleeding disorder that could cause many complications, one of which is hemarthrosis. Neutrophils are the predominant immune cells that infiltrate joints after hemorrhage. Tissue injury is often accompanied by the production of neutrophil extracellular traps (NETs), which are DNA constructs containing attached granular enzymes. AIMS OF STUDY: The aim of this study was to identify the presence of neutrophil extracellular traps including the neutrophil elastase (NE) and myeloperoxidase (MPO), in patients with hemophilia A presented with hemarthrosis. SUBJECTS AND METHODS: During a period of 8 months from November 2022 to June 2023, 50 persons were recruited cross-sectional study was conducted. In the current study, a sample of 25 individuals with hemophilia A presenting with hemarthrosis were included. Additionally, a control group of 25 unrelated, almost healthy persons,matched in terms of age and sex were also included. NE and MPO levels in blood were measured by flow cytometry technique. RESULTS: The level of MPO and NE in the blood was significantly higher in hemophilia A patients than controls. In the results of hemophilia A patients, the mean and standard deviation of MPO were 3253.36 +_1865.48, while for NE it was 5229.08+_2667.43. These values were found to be statistically significant P <0.05 when compared to the control group. In the control group, the mean and standard deviation of MPO were 2285.48+_811.89, and for NE, it was 3816.92+_1890.45. CONCLUSIONS: Patients with hemarthrosis had a considerably increase level of NETs in their blood than healthy individuals, and these findings indicate a function of NETs in the pathology of hemophilia A with hemarthrosis.
{"title":"Elucidating the involvement of neutrophil extracellular traps in hemarthrosis pathophysiology","authors":"Rusul Qasim Mohammed, Abeer Anwer Ahmed","doi":"10.4103/ijh.ijh_63_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_63_23","url":null,"abstract":"Abstract: BACKGROUND: Hemophilia is an inherited bleeding disorder that could cause many complications, one of which is hemarthrosis. Neutrophils are the predominant immune cells that infiltrate joints after hemorrhage. Tissue injury is often accompanied by the production of neutrophil extracellular traps (NETs), which are DNA constructs containing attached granular enzymes. AIMS OF STUDY: The aim of this study was to identify the presence of neutrophil extracellular traps including the neutrophil elastase (NE) and myeloperoxidase (MPO), in patients with hemophilia A presented with hemarthrosis. SUBJECTS AND METHODS: During a period of 8 months from November 2022 to June 2023, 50 persons were recruited cross-sectional study was conducted. In the current study, a sample of 25 individuals with hemophilia A presenting with hemarthrosis were included. Additionally, a control group of 25 unrelated, almost healthy persons,matched in terms of age and sex were also included. NE and MPO levels in blood were measured by flow cytometry technique. RESULTS: The level of MPO and NE in the blood was significantly higher in hemophilia A patients than controls. In the results of hemophilia A patients, the mean and standard deviation of MPO were 3253.36 +_1865.48, while for NE it was 5229.08+_2667.43. These values were found to be statistically significant P <0.05 when compared to the control group. In the control group, the mean and standard deviation of MPO were 2285.48+_811.89, and for NE, it was 3816.92+_1890.45. CONCLUSIONS: Patients with hemarthrosis had a considerably increase level of NETs in their blood than healthy individuals, and these findings indicate a function of NETs in the pathology of hemophilia A with hemarthrosis.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135975436","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}
AbdulFattah Fararjeh, Ola M. AL-Sanabra, Ammar Abu Ghalyoun, Raghad Al-Amro, Suhaib Khater, Jameel Bzour
Abstract BACKGROUND: Compared to other blood cells, adult red blood cells have a higher concentration of microRNAs (miRNAs). The effectiveness of preserved blood cells following transfusion is affected by a variety of factors, like changes in miRNA levels. One day, these small RNAs might help determine the efficacy and safety of blood products. AIMS: This study sought to identify the miRNA present in both fresh blood and stored blood because there is growing evidence that these cells are enriched with miRNAs. MATERIALS AND METHODS: Blood samples were taken from three healthy donors to detect the expression of miRNAs using illumina platform for RNA sequencing. Total RNA was isolated from stored units at 0, 14, 21, and 28 days, respectively. Bioinformatics analysis has been carried out to analyze the miRNAs. RESULTS: The majority of miRNA expression was decreased in time-dependent manner, particularly after day 14 of packed blood cells (PBCs) storage such as hsa-miR-20a-5p, hsa-miR-17-5p, and hsa-miR-423-3p. While other miRNAs such as hsa-miR-320a-3p, hsa-miR-186-5p, and hsa-miR-486-5p, showed a significant re-upregulated after day 21. CONCLUSION: In summary, the PBCs at days 14 and 21 had the lowest levels of miRNAs, which may indicate less of a relationship with storage lesions. However, older PBCs displayed significant levels of miRNAs, which could indicate storage lesions or cause a number of clinical issues for the recipients.
{"title":"MicroRNA Molecular Profiling Reveals Increase Expression of hsa-miR-186-5p, hsa-miR-320a-3p, and hsa-miR-486-5p With Storage Time in Packed Blood Cells","authors":"AbdulFattah Fararjeh, Ola M. AL-Sanabra, Ammar Abu Ghalyoun, Raghad Al-Amro, Suhaib Khater, Jameel Bzour","doi":"10.4103/ijh.ijh_42_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_42_23","url":null,"abstract":"Abstract BACKGROUND: Compared to other blood cells, adult red blood cells have a higher concentration of microRNAs (miRNAs). The effectiveness of preserved blood cells following transfusion is affected by a variety of factors, like changes in miRNA levels. One day, these small RNAs might help determine the efficacy and safety of blood products. AIMS: This study sought to identify the miRNA present in both fresh blood and stored blood because there is growing evidence that these cells are enriched with miRNAs. MATERIALS AND METHODS: Blood samples were taken from three healthy donors to detect the expression of miRNAs using illumina platform for RNA sequencing. Total RNA was isolated from stored units at 0, 14, 21, and 28 days, respectively. Bioinformatics analysis has been carried out to analyze the miRNAs. RESULTS: The majority of miRNA expression was decreased in time-dependent manner, particularly after day 14 of packed blood cells (PBCs) storage such as hsa-miR-20a-5p, hsa-miR-17-5p, and hsa-miR-423-3p. While other miRNAs such as hsa-miR-320a-3p, hsa-miR-186-5p, and hsa-miR-486-5p, showed a significant re-upregulated after day 21. CONCLUSION: In summary, the PBCs at days 14 and 21 had the lowest levels of miRNAs, which may indicate less of a relationship with storage lesions. However, older PBCs displayed significant levels of miRNAs, which could indicate storage lesions or cause a number of clinical issues for the recipients.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136068221","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}
Abstract BACKGROUND: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, reports of false-positive serological test results were reported in COVID-19 patients. Typhidot IgM test is reported in a few studies to give false-positive results in various viral illnesses in the past. The aim of this study was to estimate the typhidot IgM positivity rate in reverse transcription-polymerase chain reaction (RT-PCR)-confirmed COVID-19 patients. MATERIALS AND METHODS: The present study was a cross-sectional study conducted at a tertiary care hospital. All symptomatic patients having fever that were admitted between April 1, 2021, and July 15, 2021, with a confirmed RT-PCR-positive result for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were included in the study. Serological testing was done by typhoid IgM/IgG rapid diagnostic test for all SARS-CoV-2 RT-PCR-positive patients. The primary outcome studied was to estimate the typhidot IgM positivity rate among RT-PCR-confirmed COVID-19 patients. The secondary outcome studied was to determine the correlation between SARS-CoV-2 RT PCR cycle threshold (CT) value and typhidot-positive result. RESULTS: Three hundred and five (17.99%) out of 1695 samples of confirmed COVID-19 patients were positive for typhoid serology by typhidot IgM test. However, upon performing Point-Biserial correlation analysis ( P = 0.832, r = 0.021), no correlation was seen between RT-PCR CT value and typhidot result. CONCLUSIONS: Typhidot test is a nonspecific diagnostic test for typhoid fever which can be false positive in COVID-19 patients. Hence, physicians should take this into consideration to avoid misdiagnosis and delay in accurate treatment of acute febrile illness cases, especially in the present scenario of COVID-19 endemicity.
{"title":"False-positive typhidot IgM assay in COVID-19 patients: A potential public health problem in tropical countries during COVID-19 endemic phase","authors":"Yashik Bansal, Niharika Singh, Shivani Chaudhary, Naveen Bansal","doi":"10.4103/ijh.ijh_70_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_70_23","url":null,"abstract":"Abstract BACKGROUND: Since the beginning of the coronavirus disease 2019 (COVID-19) pandemic, reports of false-positive serological test results were reported in COVID-19 patients. Typhidot IgM test is reported in a few studies to give false-positive results in various viral illnesses in the past. The aim of this study was to estimate the typhidot IgM positivity rate in reverse transcription-polymerase chain reaction (RT-PCR)-confirmed COVID-19 patients. MATERIALS AND METHODS: The present study was a cross-sectional study conducted at a tertiary care hospital. All symptomatic patients having fever that were admitted between April 1, 2021, and July 15, 2021, with a confirmed RT-PCR-positive result for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) were included in the study. Serological testing was done by typhoid IgM/IgG rapid diagnostic test for all SARS-CoV-2 RT-PCR-positive patients. The primary outcome studied was to estimate the typhidot IgM positivity rate among RT-PCR-confirmed COVID-19 patients. The secondary outcome studied was to determine the correlation between SARS-CoV-2 RT PCR cycle threshold (CT) value and typhidot-positive result. RESULTS: Three hundred and five (17.99%) out of 1695 samples of confirmed COVID-19 patients were positive for typhoid serology by typhidot IgM test. However, upon performing Point-Biserial correlation analysis ( P = 0.832, r = 0.021), no correlation was seen between RT-PCR CT value and typhidot result. CONCLUSIONS: Typhidot test is a nonspecific diagnostic test for typhoid fever which can be false positive in COVID-19 patients. Hence, physicians should take this into consideration to avoid misdiagnosis and delay in accurate treatment of acute febrile illness cases, especially in the present scenario of COVID-19 endemicity.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136103204","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}
Abstract Waldenstrom macroglobulinemia (WM) is a rare, chronic, and indolent B-cell lymphoproliferative disorder characterized by bone marrow infiltration by small lymphocytes, lymphoplasmacytoid cells, and plasma cells along with the presence of a detectable monoclonal immunoglobulin M. It represents 1%–2% of hematological malignancies with an overall incidence of 3–4 cases/million persons/year. Some deletions are associated with a more aggressive IgM gammopathy and have a high probability of symptomatic transformation. 6q deletion, the most common cytogenetic abnormality, which is present in 42% of cases whereas 11q deletion is rare in WM and is present in only 8% of cases. We are presenting a case of a 70-year-old male patient diagnosed as WM with 11q deletion.
{"title":"Waldenstrom macroglobulinemia with 11q deletion: A rarely diagnosed entity with review of literature","authors":"Ranjana Giri, Pallavi Mishra, Mouli Mishra, Nageswar Sahu, Biswajit Bhuyan","doi":"10.4103/ijh.ijh_51_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_51_23","url":null,"abstract":"Abstract Waldenstrom macroglobulinemia (WM) is a rare, chronic, and indolent B-cell lymphoproliferative disorder characterized by bone marrow infiltration by small lymphocytes, lymphoplasmacytoid cells, and plasma cells along with the presence of a detectable monoclonal immunoglobulin M. It represents 1%–2% of hematological malignancies with an overall incidence of 3–4 cases/million persons/year. Some deletions are associated with a more aggressive IgM gammopathy and have a high probability of symptomatic transformation. 6q deletion, the most common cytogenetic abnormality, which is present in 42% of cases whereas 11q deletion is rare in WM and is present in only 8% of cases. We are presenting a case of a 70-year-old male patient diagnosed as WM with 11q deletion.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136067767","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}
Abstract: A 68-year-old man presented with a low-grade fever for one month. He had loss of appetite and had lost 6 kilograms of weight in the last two months. He was evaluated and found to have miliary tuberculosis with pancytopenia. The bone marrow revealed Gelatinous transformation of bone marrow and there was no evidence of other causes of pancytopenia like histiocytic hyperplasia, maturation arrest, or infiltration of the bone marrow. The pancytopenia improved with anti-tubercular treatment showing the reversible nature of the disease. To conclude, multiple mechanisms can result in pancytopenia in tuberculosis. A bone marrow study can reveal most of them including rare causes like GTBM.
{"title":"Reversible gelatinous transformation of bone marrow – A rare and reversible cause of pancytopenia in tuberculosis","authors":"Mansoor C. Abdulla","doi":"10.4103/ijh.ijh_58_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_58_23","url":null,"abstract":"Abstract: A 68-year-old man presented with a low-grade fever for one month. He had loss of appetite and had lost 6 kilograms of weight in the last two months. He was evaluated and found to have miliary tuberculosis with pancytopenia. The bone marrow revealed Gelatinous transformation of bone marrow and there was no evidence of other causes of pancytopenia like histiocytic hyperplasia, maturation arrest, or infiltration of the bone marrow. The pancytopenia improved with anti-tubercular treatment showing the reversible nature of the disease. To conclude, multiple mechanisms can result in pancytopenia in tuberculosis. A bone marrow study can reveal most of them including rare causes like GTBM.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135888881","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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