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C- Reactive protein and iron status in Iraqi patients with acute myeloid leukemia before and after treatment

Authors: Khitam Abdul Wahab Ali --- Alaa Fadhil Alwan --- Hiba Ammar Mohammed
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2015 Volume: 4 Issue: 1 Pages: 101-118
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract

Background: Acute Myeloid Leukemia (AML) is a clonal hematopoietic disorder, leading to apremature arrest of the normal differentiation of stem cells. C - reactive protein (CRP) is a markerof inflammation. Serum level of C-reactive protein may be increase in patients with AML. Thisassociation between CRP levels and acute myeloid leukemia influenced by multiple factors.Acute myeloid leukemia commonly associated with iron overload. Many factors are participatingto the hyperferritinemia associated with AML, inflammation chemotherapy, blood transfusionand ferritin hepatic clearance disordersObjectives: To assess serum C-reactive protein (CRP) and iron status (serum Iron, Total ironbinding capacity, serum ferritin levels) in patients with acute myeloid leukemia (AML) beforeand after chemotherapyMaterials and Methods: A prospective cohort study included 58 patients (30 male and 28female) with acute myeloid leukemia with age range (15-65 years). Patients divided into twogroups: Group (1) Patients with AML before starting chemotherapy. Group (2) the patients after 4weeks of chemotherapy In addition to 43 healthy subjects (24 male and 19 female) wereincluded. They were age and sex matched to patients group and considered as controls as(Group 3). This study conducted at the National Center of Hematology and Baghdad TeachingHospital in the Medical City from February 2014 to June 2014. All patients were subjected tocomplete history and physical examination. Diagnosis as AML patients was established bycomplete blood count and blood film, bone morrow aspiration and biopsy. C-reactive proteins.iron, s.total iron binding capacity and s. ferritin were estimated for all .Results: Serum CRP levels increased in AML patients before and after treatment , while therewere a significant increase in mean serum ferritin levels observed in (Group 2) compared tonewly diagnosis patients (Group 1)(P<0.002) and the levels were significantly higher in newlydiagnosis group compared to healthy controls (P<0.015). Patients with (AML) during remissionshow significant decrease in iron levels compared to newly diagnosis group (P<0.0001), whilelevels in healthy controls recorded higher values than both (Group 2) and (Group 1) (P<0.0001).Serum total iron binding capacity (TIBC ) levels showed a significant decrease in (Group 2) aftertreatment compared to (Group 1) before treatment(P<0.0001) but the levels were significantlyhigher in healthy controls compared to (Group 1) and (Group 2) (P<0.0001)Conclusion: CRP does not predict response to chemotherapy while it may be of benefit inpredicting infection or inflammation in patient with AML post chemotherapy. Regarding Ironstatus: s.ferritin increase significantly post chemotherapy while s.iron and TIBC decrease.

Keywords

CRP --- iron status --- AML


Article
Serum Vascular Endothelial Growth Factor Levels in Iraqi Patients with Newly Diagnosed Acute Leukemia

Authors: Abass F. Hasson --- Najlaa B. Alawadi --- Saba S. Mallouh
Journal: Medical Journal of Babylon مجلة بابل الطبية ISSN: 1812156X 23126760 Year: 2015 Volume: 12 Issue: 1 Pages: 8-16
Publisher: Babylon University جامعة بابل

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Abstract

Acute leukemia is an aggressive disorder which need a new therapeutic approaches to improve the response to treatment. Angiogenesis seems to be important both for leukemogenesis and susceptibility to intensive chemotherapy, and antiangiogenic strategies may therefore be considered for the treatment of acute leukemia.This study aim to assess serum VEGF levels in Iraqi patients with a newly diagnosed acute leukemias and to find the relation between VEGF levels and other hematological parameters. This case-control study included 96 subjects who attended Marjan Teaching Hospital in Babil/Iraq during the period from Nov 2013 to Aug 2014.They divided into two groups; patient group included 48 patients newly diagnosed with acute leukemia (32 of them had AML and 16 had ALL) and control group included 48 normal volunteers. Complete blood count and serum VEGF (ELISA) were done for all while bone marrow examination was done for patients only. Mean serum VEGF was significantly higher in patients than controls (643.8 ±121.1 ng/dl vs. 203.4 ±51.8 ng/dl respectively and P-value < 0.001) and a higher levels were found in patients with ALL compared to AML and in males compared to females. No statistically significant age differences were found between patients and controls, while majority of patients (61.9%) and controls (63.4%) were males. Mean PCV was significantly lower in patients than controls (P-value < 0.01), Mean WBC count was significantly higher in patients than controls (P-value < 0.01) and mean platelets count was significantly lower in patients than controls (P-value < 0.01).This study concluded that serum VEGF in patients with acute leukemia was high compared to controls and a significant correlation was found between serum VEGF levels and both PCV and gender.

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