BACKGROUND: Selective immunoglobulin (Ig) A deficiency is the most common Ig deficiency in the world. Serum IgA level is reduced, 7 mg/dL (70 μg/mL), thus, associating with a wide range of clinical symptoms and signs that are related directly and indirectly to disturbances in the body immune system. Selective IgA deficiency patients are known to develop antibodies against lacking IgA. Whenever these antibodies are found in an individual's circulating blood, a severe allergic response and anaphylaxis can ensue upon receiving IgA containing blood or blood components. Hence, certain protocols are recommended in populations with increased prevalence of selective IgA deficiency including the use of red blood cell (RBC) washing machines or IgA-deficient blood components. Both measures are costly and require special maintenance procedures. objectives: The aim of this study was to screen for the presence of selective IgA deficiency in a group of blood donors and its probable role in the events of transfusion reactions that frequently occur which may necessitate the application of protocols that involve sophisticated procedures and highly-demanding machines. SUBJECTS AND METHODS: This was a laboratory study that included 300 volunteer blood donors in the National Blood Transfusion Center. They were screened for their serum IgA levels. Related questionnaire was conducted and chemiluminescence immunoassay technique with MAGLUMI 600 series machine was used. This machine is already used by the National Center of Teaching Laboratories for variety of biochemical and immunological assays. Serum IgA levels then were plotted against age, blood group and smoking status. RESULTS: No single case of Selective IgA deficiency was documented. Serum IgA levels showed increased levels with age and smoking demonstrated no significant effect on the Ig levels. CONCLUSION: In light of these results, it does not seem urgent or necessary at this point of time to introduce the highly demanding and expensive RBC washing machines in blood banks in Iraq. We recommend conducting a larger study that is more comprehensive with wider involvement of population, considering age, gender, and ethnicity.
{"title":"Selective immunoglobulin A deficiency in a sample of Iraqi blood donors in the National Blood Transfusion Center-Baghdad","authors":"Shams Mahdi, A. Abdulsalam, A. Rijub-Agha","doi":"10.4103/ijh.ijh_5_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_5_23","url":null,"abstract":"BACKGROUND: Selective immunoglobulin (Ig) A deficiency is the most common Ig deficiency in the world. Serum IgA level is reduced, 7 mg/dL (70 μg/mL), thus, associating with a wide range of clinical symptoms and signs that are related directly and indirectly to disturbances in the body immune system. Selective IgA deficiency patients are known to develop antibodies against lacking IgA. Whenever these antibodies are found in an individual's circulating blood, a severe allergic response and anaphylaxis can ensue upon receiving IgA containing blood or blood components. Hence, certain protocols are recommended in populations with increased prevalence of selective IgA deficiency including the use of red blood cell (RBC) washing machines or IgA-deficient blood components. Both measures are costly and require special maintenance procedures. objectives: The aim of this study was to screen for the presence of selective IgA deficiency in a group of blood donors and its probable role in the events of transfusion reactions that frequently occur which may necessitate the application of protocols that involve sophisticated procedures and highly-demanding machines. SUBJECTS AND METHODS: This was a laboratory study that included 300 volunteer blood donors in the National Blood Transfusion Center. They were screened for their serum IgA levels. Related questionnaire was conducted and chemiluminescence immunoassay technique with MAGLUMI 600 series machine was used. This machine is already used by the National Center of Teaching Laboratories for variety of biochemical and immunological assays. Serum IgA levels then were plotted against age, blood group and smoking status. RESULTS: No single case of Selective IgA deficiency was documented. Serum IgA levels showed increased levels with age and smoking demonstrated no significant effect on the Ig levels. CONCLUSION: In light of these results, it does not seem urgent or necessary at this point of time to introduce the highly demanding and expensive RBC washing machines in blood banks in Iraq. We recommend conducting a larger study that is more comprehensive with wider involvement of population, considering age, gender, and ethnicity.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"12 1","pages":"64 - 70"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46252568","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}
BACKGROUND: Anemia during pregnancy is a public health issue, particularly in underdeveloped countries, and it is linked to unfavorable maternal and neonatal outcomes. The aim of this study was to investigate the prevalence of anemia among pregnant women undergoing prenatal care in Yaqshiid district, Somalia. MATERIALS AND METHODS: From September 2022 to January 2023, a hospital-based cross-sectional study was undertaken at Alkeyraat Voluntary Hospital. Blood samples from pregnant women were checked for malaria and parasites as well as hemoglobin (Hb), erythrocytes, hematocrit, mean cell volume, and hematocrit. Structured surveys collected sociodemographic data. SPSS Version 25.0 was used to analyze the gathered data. Crosstab descriptive and binary logistic regression were used for the analysis. P < 0.05 was considered statistically significant. RESULTS: The prevalence of anemia was 26.7% (95% confidence interval [CI] = 0.086–0.692), of which 20.0% were mildly anemic, 3.3% were moderately anemic, and 3.3% were severely anemic, with a mean (±standard deviation) Hb of 8.38 (±1.90) g/dL. The following factors were found to be associated with anemia: living in a rural area (odds ratio [OR] = 0.337, 95% CI = 0.155–0.732, P = 0.05), having anemia during the second trimester of pregnancy (OR = 0.351, 95% CI = 140–879, P = 0.05), having one or two children (OR = 0.361, 95% CI = 0.150–0.868, P = 0.05), history of abortion (OR = 0.337, 95% CI = 0.155–0.732, P < 0.05), and history of blood transfusion (OR = 0.169, 95% CI = 0.063–0.456, P < 0.05). CONCLUSION: The prevalence of anemia in the present study was low when compared to earlier studies conducted in Bangladesh, Pakistan, Sudan, and Nigeria, among others. Regular visits to maternity care facilities and health education promotion efforts need to be emphasized more to improve rates of success.
背景:妊娠期贫血是一个公共卫生问题，特别是在欠发达国家，它与不利的孕产妇和新生儿结局有关。本研究的目的是调查在索马里Yaqshiid地区接受产前护理的孕妇中贫血的患病率。材料和方法:从2022年9月到2023年1月，在Alkeyraat志愿医院进行了一项基于医院的横断面研究。孕妇的血液样本被检查疟疾和寄生虫，以及血红蛋白(Hb)，红细胞，红细胞比容，平均细胞体积和红细胞比容。结构化调查收集了社会人口统计数据。采用SPSS 25.0版本对收集到的数据进行分析。采用交叉表描述回归和二元逻辑回归进行分析。P < 0.05为差异有统计学意义。结果:贫血患病率为26.7%(95%可信区间[CI] = 0.086 ~ 0.692)，其中轻度贫血20.0%，中度贫血3.3%，重度贫血3.3%，平均(±标准差)Hb为8.38(±1.90)g/dL。下列因素被发现与贫血有关:生活在一个农村(比值比(或)= 0.337,95% CI -0.732 = 0.155, P = 0.05),有贫血在怀孕的第二个三个月(或= 0.351,95% CI = 140 - 879, P = 0.05),有一个或两个孩子(或= 0.361,95% CI = 0.150 - -0.868, P = 0.05),堕胎的历史(或= 0.337,95% CI -0.732 = 0.155, P < 0.05),和历史的输血(或= 0.169,95% CI -0.456 = 0.063, P < 0.05)。结论:与早期在孟加拉国、巴基斯坦、苏丹和尼日利亚等国进行的研究相比，本研究中贫血的患病率较低。需要更多地强调定期访问产妇保健设施和促进健康教育的努力，以提高成功率。
{"title":"Prevalence of anemia and its associated factors among pregnant women in Yaqshiid district, Somalia","authors":"Abdirasak Sharif Ali Mude, AbdElhadi M. Agena","doi":"10.4103/ijh.ijh_13_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_13_23","url":null,"abstract":"BACKGROUND: Anemia during pregnancy is a public health issue, particularly in underdeveloped countries, and it is linked to unfavorable maternal and neonatal outcomes. The aim of this study was to investigate the prevalence of anemia among pregnant women undergoing prenatal care in Yaqshiid district, Somalia. MATERIALS AND METHODS: From September 2022 to January 2023, a hospital-based cross-sectional study was undertaken at Alkeyraat Voluntary Hospital. Blood samples from pregnant women were checked for malaria and parasites as well as hemoglobin (Hb), erythrocytes, hematocrit, mean cell volume, and hematocrit. Structured surveys collected sociodemographic data. SPSS Version 25.0 was used to analyze the gathered data. Crosstab descriptive and binary logistic regression were used for the analysis. P < 0.05 was considered statistically significant. RESULTS: The prevalence of anemia was 26.7% (95% confidence interval [CI] = 0.086–0.692), of which 20.0% were mildly anemic, 3.3% were moderately anemic, and 3.3% were severely anemic, with a mean (±standard deviation) Hb of 8.38 (±1.90) g/dL. The following factors were found to be associated with anemia: living in a rural area (odds ratio [OR] = 0.337, 95% CI = 0.155–0.732, P = 0.05), having anemia during the second trimester of pregnancy (OR = 0.351, 95% CI = 140–879, P = 0.05), having one or two children (OR = 0.361, 95% CI = 0.150–0.868, P = 0.05), history of abortion (OR = 0.337, 95% CI = 0.155–0.732, P < 0.05), and history of blood transfusion (OR = 0.169, 95% CI = 0.063–0.456, P < 0.05). CONCLUSION: The prevalence of anemia in the present study was low when compared to earlier studies conducted in Bangladesh, Pakistan, Sudan, and Nigeria, among others. Regular visits to maternity care facilities and health education promotion efforts need to be emphasized more to improve rates of success.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"12 1","pages":"78 - 83"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47904018","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}
ZahraaMahdi Sareeh, YassminAli Abdul-Kareem, Ali H. Jawad
BACKGROUND: Multiple myeloma is a clonal B-cell malignancy characterized by proliferation of plasma cells that secrete a complete and/or partial monoclonal immunoglobulin protein. It induces dysfunction of cytotoxic T cells that may be responsible for immune evasion and therapeutical failure of immunotherapies. T cells during senescence tend to lose co-stimulatory molecules such as CD27 and CD28 while expressing killer cell lectin-like receptor subfamily G (KLRG-1) and CD57. Therefore, enhanced knowledge about the actual status of T cells in myeloma patients is needed. Objectives: The aims of this study were to detect the senescent cytotoxic T-cell (CD8+) in patients with refractory/resistance multiple myeloma, and to compare it with newly diagnosed multiple myeloma patients, and their implications for cellular therapies. MATERIALS AND METHODS: This is a cross sectional study performed, from January to October 2021. Sixty multiple myeloma patients were sequentially chosen, thirty of them were newly diagnosed patients and another thirty were relapse/refractory who progress after receiving 2 lines of chemotherapy containing bortezomib and immunomodulators. And/or patients progressing after autologous stem cell transplantation. Seventeen apparently healthy age and gender matched adults were enrolled as a control group. Multicolor flow cytometry was utilized for the analyses of surface molecules CD 28 and CD57 on CD 8 positive T-lymphocyte using peripheral blood, subsequently the percentage of T cells senescent were estimate in CD 8+ T cells with CD28- and CD57+. Results: The mean percentage of senescent CD8 positive T lymphocyte (negative CD28 and positive CD57) were significantly higher in multiple myeloma patients than control (P<0.001). There was no statistically significant difference in percentage of CD8+ T cells between newly diagnosed multiple myeloma and relapsed /refractory cases. However higher percentage of senescent T cells was found in relapsed cases. No significant correlation was found between percentage of CD8 +T cells and patients age, or duration of disease. Conclusion: Percentage of senescent CD 8+ T cells with CD28- and CD 57+were significantly higher in MM patients compared to healthy controls. Percentage of senescent CD 8+ T cells with CD28- and CD 57+were lower in newly diagnosed MM patients compared to relapsed patients but the difference was statistically not significant
{"title":"Detection of senescent CD8+ T-lymphocyte in newly diagnosed and relapsed/refractory multiple myeloma using CD28 and CD57","authors":"ZahraaMahdi Sareeh, YassminAli Abdul-Kareem, Ali H. Jawad","doi":"10.4103/ijh.ijh_6_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_6_23","url":null,"abstract":"BACKGROUND: Multiple myeloma is a clonal B-cell malignancy characterized by proliferation of plasma cells that secrete a complete and/or partial monoclonal immunoglobulin protein. It induces dysfunction of cytotoxic T cells that may be responsible for immune evasion and therapeutical failure of immunotherapies. T cells during senescence tend to lose co-stimulatory molecules such as CD27 and CD28 while expressing killer cell lectin-like receptor subfamily G (KLRG-1) and CD57. Therefore, enhanced knowledge about the actual status of T cells in myeloma patients is needed. Objectives: The aims of this study were to detect the senescent cytotoxic T-cell (CD8+) in patients with refractory/resistance multiple myeloma, and to compare it with newly diagnosed multiple myeloma patients, and their implications for cellular therapies. MATERIALS AND METHODS: This is a cross sectional study performed, from January to October 2021. Sixty multiple myeloma patients were sequentially chosen, thirty of them were newly diagnosed patients and another thirty were relapse/refractory who progress after receiving 2 lines of chemotherapy containing bortezomib and immunomodulators. And/or patients progressing after autologous stem cell transplantation. Seventeen apparently healthy age and gender matched adults were enrolled as a control group. Multicolor flow cytometry was utilized for the analyses of surface molecules CD 28 and CD57 on CD 8 positive T-lymphocyte using peripheral blood, subsequently the percentage of T cells senescent were estimate in CD 8+ T cells with CD28- and CD57+. Results: The mean percentage of senescent CD8 positive T lymphocyte (negative CD28 and positive CD57) were significantly higher in multiple myeloma patients than control (P<0.001). There was no statistically significant difference in percentage of CD8+ T cells between newly diagnosed multiple myeloma and relapsed /refractory cases. However higher percentage of senescent T cells was found in relapsed cases. No significant correlation was found between percentage of CD8 +T cells and patients age, or duration of disease. Conclusion: Percentage of senescent CD 8+ T cells with CD28- and CD 57+were significantly higher in MM patients compared to healthy controls. Percentage of senescent CD 8+ T cells with CD28- and CD 57+were lower in newly diagnosed MM patients compared to relapsed patients but the difference was statistically not significant","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"12 1","pages":"71 - 77"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46813596","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}
BACKGROUND: Hodgkin lymphoma (HL) is an aggressive B-cell lymphoma, considered one of the most curable hematological malignancies. Hasenclever International Prognostic Score was designed to predict 5-year freedom from the progression of HL. D-dimer is a fibrin degradation element, validated as a standard test in suspected thrombotic disorders. Elevated D-dimer levels were found also in a number of cancers. Its role in the prognosis of these cancers as well as in the mechanism of tumor development is still debated. OBJECTIVES: The aim of this study was to assess the reliability of D-dimer level in relation to clinical presentations, standard prognostic markers, and early outcomes in patients with classical HL. PATIENTS AND METHODS: This is a prospective cohort study enrolled 25 adult patients with newly diagnosed classical HL during a period of 1 year from different hematology centers in Iraq. In addition to clinical parameters, each patient had performed D-dimer assay by the expert specialist at the start of treatment and after the end of delete courses of chemotherapy cycles. RESULTS: An elevated mean D-dimer level was observed (1568.9 ± 1365.73 ng/mL). The stage of the disease showed a significant difference among the patients' groups (P = 0.042). In addition, the mean D-dimer was significantly different between chemotherapy responders and nonresponders (P = 0.004). Only D-dimer showed a significant association as a univariate predictor to prognosis (P = 0.003). CONCLUSION: There is significant a negative strong correlation in mean D-dimer values and the outcome (i.e., mean D-dimer significantly decrease with increased response).
{"title":"Prognostic significance of elevated D-dimer level in classical Hodgkin's Lymphoma","authors":"Waseem F. Al-Tameemi, M. Al-Anssari","doi":"10.4103/ijh.ijh_53_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_53_22","url":null,"abstract":"BACKGROUND: Hodgkin lymphoma (HL) is an aggressive B-cell lymphoma, considered one of the most curable hematological malignancies. Hasenclever International Prognostic Score was designed to predict 5-year freedom from the progression of HL. D-dimer is a fibrin degradation element, validated as a standard test in suspected thrombotic disorders. Elevated D-dimer levels were found also in a number of cancers. Its role in the prognosis of these cancers as well as in the mechanism of tumor development is still debated. OBJECTIVES: The aim of this study was to assess the reliability of D-dimer level in relation to clinical presentations, standard prognostic markers, and early outcomes in patients with classical HL. PATIENTS AND METHODS: This is a prospective cohort study enrolled 25 adult patients with newly diagnosed classical HL during a period of 1 year from different hematology centers in Iraq. In addition to clinical parameters, each patient had performed D-dimer assay by the expert specialist at the start of treatment and after the end of delete courses of chemotherapy cycles. RESULTS: An elevated mean D-dimer level was observed (1568.9 ± 1365.73 ng/mL). The stage of the disease showed a significant difference among the patients' groups (P = 0.042). In addition, the mean D-dimer was significantly different between chemotherapy responders and nonresponders (P = 0.004). Only D-dimer showed a significant association as a univariate predictor to prognosis (P = 0.003). CONCLUSION: There is significant a negative strong correlation in mean D-dimer values and the outcome (i.e., mean D-dimer significantly decrease with increased response).","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"12 1","pages":"28 - 32"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48013241","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}
S. Hindawi, O. Radhwi, M. Badawi, Hanaa Rajab, Fatma Al Mansouri, A. Alzahrani, H. Bukhari, Kholoud Gholam, A. Almalki, Abdulaziz Awadh, Ismat Yagoub, Galila Zaher
BACKGROUND: Therapeutic plasma exchange (TPE) is a treatment option used in many medical conditions. Response rates are variable as some disorders clearly benefit from TPE as first- or second-line therapy. This study aims to summarize our experience at King Abdulaziz University Hospital at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. MATERIALS AND METHODS: In a retrospective fashion, wdemographic data, underlying disease, apheresis-related parameters, and outcomes were collected. RESULTS: Between January 2005 and March 2020, 159 patients with 177 episodes underwent a total of 945 sessions of TPE. The majority of patients (96.8%) undergoing TPE in our center are of categories I to III according to 2019 American Society for Apheresis guidelines. Most patients had neurologic disorders, 74 (46.5%), where myasthenia gravis was the most common indication, 34 (21.4%) patients with response in 44/45 (97.8%) episodes, followed by thrombotic microangiopathies 31 (17.5%) patients with response in 17/34 (50%) episodes, Guillain–Barré syndrome 27 (16.9%) patients with recovery in 20/27 (74.1%) patients, and systemic lupus erythematous 25 (15.7%) patients with recovery in only 11/25 (44%) patients. Complications included hypotension in 29/945 (3.06%) sessions and citrate-induced symptoms in 6/945 (0.6%) sessions. CONCLUSION: Our center complies with the recommended standards of indications for initiating TPE. Neurologic conditions constitute the largest group of patients requiring TPE.
{"title":"Outcomes of therapeutic plasma exchange: A 15-year tertiary center experience","authors":"S. Hindawi, O. Radhwi, M. Badawi, Hanaa Rajab, Fatma Al Mansouri, A. Alzahrani, H. Bukhari, Kholoud Gholam, A. Almalki, Abdulaziz Awadh, Ismat Yagoub, Galila Zaher","doi":"10.4103/ijh.ijh_2_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_2_23","url":null,"abstract":"BACKGROUND: Therapeutic plasma exchange (TPE) is a treatment option used in many medical conditions. Response rates are variable as some disorders clearly benefit from TPE as first- or second-line therapy. This study aims to summarize our experience at King Abdulaziz University Hospital at King Abdulaziz University Hospital, Jeddah, Saudi Arabia. MATERIALS AND METHODS: In a retrospective fashion, wdemographic data, underlying disease, apheresis-related parameters, and outcomes were collected. RESULTS: Between January 2005 and March 2020, 159 patients with 177 episodes underwent a total of 945 sessions of TPE. The majority of patients (96.8%) undergoing TPE in our center are of categories I to III according to 2019 American Society for Apheresis guidelines. Most patients had neurologic disorders, 74 (46.5%), where myasthenia gravis was the most common indication, 34 (21.4%) patients with response in 44/45 (97.8%) episodes, followed by thrombotic microangiopathies 31 (17.5%) patients with response in 17/34 (50%) episodes, Guillain–Barré syndrome 27 (16.9%) patients with recovery in 20/27 (74.1%) patients, and systemic lupus erythematous 25 (15.7%) patients with recovery in only 11/25 (44%) patients. Complications included hypotension in 29/945 (3.06%) sessions and citrate-induced symptoms in 6/945 (0.6%) sessions. CONCLUSION: Our center complies with the recommended standards of indications for initiating TPE. Neurologic conditions constitute the largest group of patients requiring TPE.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"12 1","pages":"20 - 27"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48060394","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}
BACKGROUND: Trace elements normally appear in low concentrations in the human body and play an important role in the enzyme systems in many metabolic processes. Trace elements, mostly selenium (Se) and zinc (Zn), were involved in the defense against oxidative stress in cells. Oxidation could lead to the generation of free radicals that have been involved in the pathogenesis of many diseases, including leukemia. While Cu at the physiological level provides cellular health and at higher than the physiological level causes angiogenesis and a higher incidence of cancers. Objectives: The aim of this study was to measure the essential trace elements (selenium, zinc, and copper) in the serum of adult patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) and their relation to some clinical and laboratory parameters. Materials and Methods: This case–control study comprised 39 adult patients with de novo acute leukemia (AL) (28 patients with AML and 11 patients with ALL) conducted from January to June 2022. The patients were collected from Iraqi Center for Hematology in Baghdad Teaching Hospital in Medical City. A total of 40 apparently healthy adults were included in this study as a control group. Peripheral blood and bone marrow smears were examined at the presentation for establishing the diagnosis. The serum level of selenium, zinc, and copper was measured by a microplate reader for both patients and the control group, before starting chemotherapy. Immunophenotyping and renal function tests (RFTs) were taken from the patient's files. RESULTS: There was a statistically lower median level of selenium among the patients group in comparison to the control group (P < 0.001), while both zinc and copper did not show statistical difference between both groups (P > 0.05). Only hemoglobin (Hb) showed a significant negative correlation between patients with AL and the level of selenium. There was a significantly lower zinc level among the abnormal RFT group in comparison to the normal group. CONCLUSIONS: There was a significantly lower serum selenium level in AL patients than in the control group. Selenium level showed a negative correlation with Hb among AL patients only, in which an increase in selenium level was associated with a decrease in Hb level among AL patients. There was no significant difference in the serum level of zinc and copper between AL patients and the control group. There was a significantly lower zinc level among the abnormal RFT group in comparison to the normal group.
{"title":"Trace elements (selenium, copper and zinc) in de novo acute leukemia: serum levels and their relation with some clinical and laboratory parameters","authors":"Nabaa Jaber, M. Alwash","doi":"10.4103/ijh.ijh_33_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_33_23","url":null,"abstract":"BACKGROUND: Trace elements normally appear in low concentrations in the human body and play an important role in the enzyme systems in many metabolic processes. Trace elements, mostly selenium (Se) and zinc (Zn), were involved in the defense against oxidative stress in cells. Oxidation could lead to the generation of free radicals that have been involved in the pathogenesis of many diseases, including leukemia. While Cu at the physiological level provides cellular health and at higher than the physiological level causes angiogenesis and a higher incidence of cancers. Objectives: The aim of this study was to measure the essential trace elements (selenium, zinc, and copper) in the serum of adult patients with acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) and their relation to some clinical and laboratory parameters. Materials and Methods: This case–control study comprised 39 adult patients with de novo acute leukemia (AL) (28 patients with AML and 11 patients with ALL) conducted from January to June 2022. The patients were collected from Iraqi Center for Hematology in Baghdad Teaching Hospital in Medical City. A total of 40 apparently healthy adults were included in this study as a control group. Peripheral blood and bone marrow smears were examined at the presentation for establishing the diagnosis. The serum level of selenium, zinc, and copper was measured by a microplate reader for both patients and the control group, before starting chemotherapy. Immunophenotyping and renal function tests (RFTs) were taken from the patient's files. RESULTS: There was a statistically lower median level of selenium among the patients group in comparison to the control group (P < 0.001), while both zinc and copper did not show statistical difference between both groups (P > 0.05). Only hemoglobin (Hb) showed a significant negative correlation between patients with AL and the level of selenium. There was a significantly lower zinc level among the abnormal RFT group in comparison to the normal group. CONCLUSIONS: There was a significantly lower serum selenium level in AL patients than in the control group. Selenium level showed a negative correlation with Hb among AL patients only, in which an increase in selenium level was associated with a decrease in Hb level among AL patients. There was no significant difference in the serum level of zinc and copper between AL patients and the control group. There was a significantly lower zinc level among the abnormal RFT group in comparison to the normal group.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"12 1","pages":"105 - 110"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41577429","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}
Vrushali Raut, H. Khurana, Barun K. Chakrabarty, B. Asthana
Blast ploidy is a distinctive cytogenomic feature related to the prognostic outcome of acute lymphoblastic leukemia (ALL) patients. Near tetraploidy (NT) (81–103 chromosomes) is a very rare ploidy anomaly in (ALL). It is observed in approximately 1% of childhood B-cell precursor ALL (BCP-ALL). In T-ALL specifically in adult T-ALL, it is furthermore rare entity. Only few case reports are found in the existing literature. Compared to BCP-ALL, T-ALL lacks recurrent genetic anomalies with independent prognostic value. Although B-cell ALL associated with NT is related to a standard cytogenomic risk, the prognostic outcome of NT in T-cell ALL is yet to be determined. Conventional karyotyping of this entity is difficult to perform and interpret. Thus, it is recommended that karyotype results should be supplemented by fluorescence in situ hybridization. Herewith, we present an adult T-ALL case detected with NT karyotype with emphasis on prognostic significance.
{"title":"A T-cell adult acute lymphoblastic leukemia harboring a rare near-tetraploid karyotype","authors":"Vrushali Raut, H. Khurana, Barun K. Chakrabarty, B. Asthana","doi":"10.4103/ijh.ijh_26_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_26_23","url":null,"abstract":"Blast ploidy is a distinctive cytogenomic feature related to the prognostic outcome of acute lymphoblastic leukemia (ALL) patients. Near tetraploidy (NT) (81–103 chromosomes) is a very rare ploidy anomaly in (ALL). It is observed in approximately 1% of childhood B-cell precursor ALL (BCP-ALL). In T-ALL specifically in adult T-ALL, it is furthermore rare entity. Only few case reports are found in the existing literature. Compared to BCP-ALL, T-ALL lacks recurrent genetic anomalies with independent prognostic value. Although B-cell ALL associated with NT is related to a standard cytogenomic risk, the prognostic outcome of NT in T-cell ALL is yet to be determined. Conventional karyotyping of this entity is difficult to perform and interpret. Thus, it is recommended that karyotype results should be supplemented by fluorescence in situ hybridization. Herewith, we present an adult T-ALL case detected with NT karyotype with emphasis on prognostic significance.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"12 1","pages":"115 - 118"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48632371","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}
AhmedShemran Alwataify, Zena Aljanabi, A. Mahdi, Ali Jawaad
BACKGROUND: Portal vein thrombosis (PVT) is one of the important complication postsplenectomies which is considered part of treatment if hypersplenism developed. It can be diagnosed clearly with advance in the quality of X-ray. It is usually associated with prolonged prothrombin time and increased level of D-dimer and alkaline phosphatase. The treatment includes regular blood transfusion and antithrombotic agents Objectives: The aim was to evaluate incidence of PVT in β-thalassemia patients and its association with splenectomy and nonsplenectomy patients PATIENTS AND METHODS: A cross-sectional study was conducted at Babylon hereditary blood disease center, for 12 months beginning from the first of June 2020, and ending in June 2021. It includes 150 patients with β-thalassemia, they classified 70 patients with splenectomy as the first group and 80 patients without splenectomy as the second group, their age ranged between 3 and 18 years. Doppler ultrasound was done for all patients by a single radiologist to confirm the presence or absence of thrombosis in the portal vein. RESULTS: The results showed that 4.6% of patients had PVT and its incidence increased with age older than 10 years, history of splenectomy, high platelets count, high serum ferritin, low Hb, high white blood count. Abdominal pain was the most common symptoms. CONCLUSION: PVT occurred in 4.6% and the major risk are splenectomy and older 10 years of age. The Doppler ultrasound is considered as simple, noninvasive technique for the detection of thrombus.
{"title":"Incidence of portal vein thrombosis in patients with β-thalassemia","authors":"AhmedShemran Alwataify, Zena Aljanabi, A. Mahdi, Ali Jawaad","doi":"10.4103/ijh.ijh_51_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_51_22","url":null,"abstract":"BACKGROUND: Portal vein thrombosis (PVT) is one of the important complication postsplenectomies which is considered part of treatment if hypersplenism developed. It can be diagnosed clearly with advance in the quality of X-ray. It is usually associated with prolonged prothrombin time and increased level of D-dimer and alkaline phosphatase. The treatment includes regular blood transfusion and antithrombotic agents Objectives: The aim was to evaluate incidence of PVT in β-thalassemia patients and its association with splenectomy and nonsplenectomy patients PATIENTS AND METHODS: A cross-sectional study was conducted at Babylon hereditary blood disease center, for 12 months beginning from the first of June 2020, and ending in June 2021. It includes 150 patients with β-thalassemia, they classified 70 patients with splenectomy as the first group and 80 patients without splenectomy as the second group, their age ranged between 3 and 18 years. Doppler ultrasound was done for all patients by a single radiologist to confirm the presence or absence of thrombosis in the portal vein. RESULTS: The results showed that 4.6% of patients had PVT and its incidence increased with age older than 10 years, history of splenectomy, high platelets count, high serum ferritin, low Hb, high white blood count. Abdominal pain was the most common symptoms. CONCLUSION: PVT occurred in 4.6% and the major risk are splenectomy and older 10 years of age. The Doppler ultrasound is considered as simple, noninvasive technique for the detection of thrombus.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"12 1","pages":"57 - 63"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44147025","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}
BACKGROUND: Angiopoietin-2 (ANG-2) regulates angiogenesis and enhances the formation of new vessels in tumors by boosting the effect of vascular endothelial growth factor as part of dynamic neovascularization. ANG-2 is a marker of disease progression and therapy response in multiple myeloma (MM). OBJECTIVES: The study aimed to assess the level of ANG-2 in MM patients at diagnosis and in remission state and elaborate on its correlation with interleukin-6 (IL-6) and beta-2 microglobulin (B2M) levels. PATIENTS, MATERIALS, AND METHODS: Sixty MM patients; 20 newly diagnosed (ND), and 40 patients in remission were included. Twenty healthy individuals were included as a control group. Plasma levels of ANG-2, B2M, and IL-6 were tested by enzyme-linked immunosorbent assay. RESULTS: There are significant statistical differences between ND patients and those in remission in hemoglobin, neutrophil count, blood urea, serum creatinine, glomerular filtration rate, B2M, IL6, and ANG-2 (P = 0.001, 0.033, 0.005, 0.001, 0.001, 0.001, 0.004, and 0.001, respectively). ANG-2 showed significant positive correlations with B2M (P = 0.001) and IL-6 (P = 0.012). CONCLUSION: The low ANG-2 level in the remission group with an insignificant difference from that in the control group with a high level in the untreated patients renders it a useful indicator for treatment response follow-up in MM. The positive correlation of ANG-2 with B2M and IL-6 reflects the active angiogenesis with a high tumor burden and disease progression.
{"title":"Evaluation of angiopoietin-2 level in patients with multiple myeloma at presentation and in remission state","authors":"Z. Salih, Haithem A Al-Rubaie","doi":"10.4103/ijh.ijh_23_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_23_23","url":null,"abstract":"BACKGROUND: Angiopoietin-2 (ANG-2) regulates angiogenesis and enhances the formation of new vessels in tumors by boosting the effect of vascular endothelial growth factor as part of dynamic neovascularization. ANG-2 is a marker of disease progression and therapy response in multiple myeloma (MM). OBJECTIVES: The study aimed to assess the level of ANG-2 in MM patients at diagnosis and in remission state and elaborate on its correlation with interleukin-6 (IL-6) and beta-2 microglobulin (B2M) levels. PATIENTS, MATERIALS, AND METHODS: Sixty MM patients; 20 newly diagnosed (ND), and 40 patients in remission were included. Twenty healthy individuals were included as a control group. Plasma levels of ANG-2, B2M, and IL-6 were tested by enzyme-linked immunosorbent assay. RESULTS: There are significant statistical differences between ND patients and those in remission in hemoglobin, neutrophil count, blood urea, serum creatinine, glomerular filtration rate, B2M, IL6, and ANG-2 (P = 0.001, 0.033, 0.005, 0.001, 0.001, 0.001, 0.004, and 0.001, respectively). ANG-2 showed significant positive correlations with B2M (P = 0.001) and IL-6 (P = 0.012). CONCLUSION: The low ANG-2 level in the remission group with an insignificant difference from that in the control group with a high level in the untreated patients renders it a useful indicator for treatment response follow-up in MM. The positive correlation of ANG-2 with B2M and IL-6 reflects the active angiogenesis with a high tumor burden and disease progression.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"12 1","pages":"8 - 12"},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43159987","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}
Pernicious anemia (PA) is an autoimmune disease due to vitamin B12 deficiency secondary to Intrinsic Factor deficiency. A 65-year-old man presented with left lower limb swelling and pain for one week. He had loss of appetite and fatigue for one month. Investigations showed lower limb deep vein thrombosis and bicytopenia. On further evaluation, he was found to have PA, duodenal carcinoids, and primary biliary cirrhosis. He was managed with heparin (followed by warfarin), parenteral Vitamin B12, and ursodeoxycholic acid. He was referred to the gastroenterology department for management of duodenal carcinoid. On follow-up his blood counts were normal. We present a patient with PA who had three unusual associations simultaneously at the time of presentation which was never reported in the literature previously, to the best of our knowledge.
{"title":"Pernicious anemia with unusual associations","authors":"C. Mansoor","doi":"10.4103/ijh.ijh_20_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_20_22","url":null,"abstract":"Pernicious anemia (PA) is an autoimmune disease due to vitamin B12 deficiency secondary to Intrinsic Factor deficiency. A 65-year-old man presented with left lower limb swelling and pain for one week. He had loss of appetite and fatigue for one month. Investigations showed lower limb deep vein thrombosis and bicytopenia. On further evaluation, he was found to have PA, duodenal carcinoids, and primary biliary cirrhosis. He was managed with heparin (followed by warfarin), parenteral Vitamin B12, and ursodeoxycholic acid. He was referred to the gastroenterology department for management of duodenal carcinoid. On follow-up his blood counts were normal. We present a patient with PA who had three unusual associations simultaneously at the time of presentation which was never reported in the literature previously, to the best of our knowledge.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":"11 1","pages":"189 - 191"},"PeriodicalIF":0.1,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45854791","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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