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Article
Outcome of 50 Iraqi Patientswith Acute Lymphoblastic Leukemia Treated by Modified German Multicenter Study Group (GMALL) Protocol

Author: Alaa Fadhil Alwan
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2013 Volume: 12 Issue: 2 Pages: 45-51
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background and aim: Acute lymphoblastic leukemia (ALL) is a lymphoidmalignancy, which arises from bone marrow,appearing in marrow, blood circulation and otherorgans. Treatment outcome have significantly improved since the adaptation of intensification and risk adapted therapy-based on identified prognostic markers. Treatment programs in adult ALL have evolved from the successful strategies employed in pediatric ALL and incorporate multiple active agents into complex regimens. The goal of these doses intensive regimens is rapid cytoreduction with restoration of normal hematopoiesis, The aim of the study was to assess the efficacy of a modified German multicenter study group for Acute Lymphoblastic leukemia (GMALL) protocol in adult acute lymphoblastic leukemia (ALL( in respect to disease free survival (DFS) and overall survival(OS) and to determine the prognostic factors affecting this outcome. Patients and method: A prospective study conducted in the hematology unit in Baghdad Teaching Hospital on 50 patients with newly diagnosed (ALL) between January 2006 to January 2008.A written informed consent were obtained from all patients. All patients were undergone full clinical examination with full laboratory investigations. The diagnosis based on morphology and cytochemical stains (periodic acid-Schiff, Sudan Black) of bone marrow examination. In Modified GMALL, induction phase consist of 2 phases, phase 1 induction was given over 5 weeks with weekly vincristine (VCR), Doxorubicin(DOX), and continuous oral prednisolone(RDN), Phase II induction consisted of 3 doses of weekly cyclophosphamide(CYCLO) alternating with 3 doses of weekly cytosine arabinoside (ARA-C) combined with CNS directed therapy using intrathecal Methotrexate (MTX) with daily 6-mercaptopurine(6-MP) followed by cranial irradiation. Consolidation consisted of weekly VCR and two courses of 5 days Ara-C and Etoposide (ETOP) with dexamethasone (DEXA) over a period of 4 weeks and maintenance therapy of daily 6-MP tablets and weekly MTX tablets. Results: The study included 50 patients with median age of (28.5 years), ranged from 16-71 years. Thirty-one patients (62%) were males, while 19 patients (38%) were females. All patients received modified GMALL protocol; forty-two patients (84%) achieved complete remission (CR). The DFS and median OS were 8.5 months, 10 months respectively. The median OS at 1 year was 54%. Deaths occurred in 19 patients (38%). Infection was the main cause of death.In univariate study analysis, age less than 30 years, absence of hepatomegaly and lymphadenopathy, and peripheral blast percent less than 50% were associated with better OS while presence of lymphadenopathy was considered poor prognostic factors and associated with low CR rate, short DFS, and OS. Conclusion: The modified GMALL protocol produced good induction remission rate but with lower survival rate in comparison to other intensive adult protocols. This study also showed that there are certain bad prognostic factors such as age more than 30 years, hepatomegaly and lymphadenopathy which adversely affect the outcome


Article
A retrospective Study of Testicular Relapse in Acute Lymphoblastic Leukemia

Authors: Ali Jameel Ahmed --- Hafadh Jaleel Hussein --- Yusra Fayyadh Alwan
Journal: Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية ISSN: 16088360 Year: 2013 Volume: 12 Issue: 4 Pages: 511-518
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

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Abstract

ABSTRACT:BACKGROUND:Testicular relapse in ALL usually appear as painless testicular enlargement mostly unilateral. Diagnosed by wedge biopsy. The testis is a frequent site of relapse.OBJECTIVE:To find out the incidence of testicular relapse in ALL, time of diagnosis of testicular relapse, age group more commonly associated with testicular relapse, the association of testicular relapse with other relapses (medullary or extra-medullary), and prognosis of patients with testicular relapse.PATIENTS AND METHODS:Aretrospective study in the central teaching hospital of children in Baghdad- unit of hematology and oncology, during January 2000 – December 2006.Two hundred-four males were studied retrospectively. Informations were obtained from patients' files.RESULTS:The incidence of testicular relapse was in 18 patients represented (8.8%) of total cases of boys with ALL below 15 years. Relapse is mainly unilateral in 15 patients (83.3%) and mostly in the right side in 11 patients (61.1%) of total cases with testicular relapse.There is no significant statistical incidence of relapse with the age of patient represented by 2 cases (6.2%) from (0-2 years), 11 cases (8.2%) from (2-10 years), and 5 cases (13%) more than (10 years). Time of diagnosis of relapse was mainly during the oral maintenance therapy (13) patients (72.5%). Testicular relapse was isolated in 8 patients (44%) and combined with other relapses in 10 patients (56%) of them 7 patients (39%) with bone marrow relapse and 3 patients (17%) with CNS relapse.The outcome of patients with testicular relapse was better after discontinuation of chemotherapy “after three years of treatment” (2 cases diagnosed with relapse both of them still alive) represented (100%), while during the maintenance therapy of 13 patients, 6 (46.2%) of them still alive, 6 patients (46.2%) of them died, and 1 patient (7.6%) with no report, while induction chemotherapy 2 cases 1 (50%) alive and 1 (50%) died). Patients with isolated testicular relapse had better outcome represented by 6 patients (75%) still alive and 2 patients (25%) died, patients with combined relapse had worse outcome, represented by 3 patients (30%) alive, 5 patients (50%) died, and 2 patients (20%) with no report.Incidence of testicular relapse significantly decreased after the introduction of more intensive chemotherapy in Jan 2004 from 9.8% to 3.1%.CONCLUSION:Incidence of testicular relapse decrease with introduction of intensive chemotherapy and had higher incidence during the maintenance therapy, associated with increased incidence with other medullary and extra-medullary relapses, and has better prognosis when it is late and isolated than for early and combined relapse


Article
Malnutrition: A Risk Factor in Childhood Acute Lymphoblastic Leukemia

Author: Sawsan S. Abbas سوسن صباح
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2010 Volume: 52 Issue: 2 Pages: 118-121
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Malnutrition is an adverse prognostic factor in the outcome of children with standard risk acute lymphoblastic leukemia due to a significantly higher rate of bone marrow relapse in the malnourished patients. The event free survival of children with acute lymphoblastic leukemia in developed countries has increased substantially in the last two decades as treatment with intensive protocols has brought the estimated probability of event free survival at 5 years close to 75%. Although the prognosis of acute lymphoblastic leukemia has also been improved in underdeveloped countries, the figures for event free survival are lower, even when aggressive protocols are used. Unfavorable socioeconomic factors could contribute to this observation.Patients and Method: A retrospective study was done on cases of childhood acute Lymphoblastic Leukemia admitted to the Pediatrics Oncology Ward in AL-Kadhimiyia Teaching Hospital over a period of one year from 1st of June 2007 to end of May 2008.Fifty five patients were collected .Informations were taken from the case sheets of the patients and their records in the Pediatric Oncology Clinic. Weight and height were recorded, Using charts of height for age (Ht/Age) and the Z score = -1.28 (10th percentile), the patients were divided into two groups, malnourished and well nourished.Results: Of the studied group, 28 patients (51%) were between 1-10 years. Thirty two patients (58.2%) were males and 23 (41.8%) were females, with male to female ratio of 1.39:1. Thirty Six (65.45%) patients were below 10th percentile (with Z score below – 1.28) i.e. malnourished, and 19 (34.55%) patients above 10th percentile (Z score above – 1.28) i.e. well nourished. Of the malnourished patients, 26(81.2%) patients achieved complete remission, while in comparison to well nourished patients, 16(84.2%) patients achieved complete remission. The result is statistically not significant (p. value > 0.05). During follow up, of the 42(82.3%) patients that achieved complete remission, 12(28.57%) relapsed, 9(34.62%) of them were malnourished. Death occurred in 7 (16.67%) patients, 6 (23.08%) of them were malnourished. Three patients (7.14%) discontinue treatment, 1(3.84%) of them was malnourished. Twenty (47.62%) patients remained with continuous complete remission, 10 (38.46%) patients were malnourished and another 10(62.5%) were well nourished. Using the Chi square, the results were statistically not significant (p. value> 0.05). Conclusion: From this study, it was concluded that malnutrition in children with acute lymphoblastic leukemia is considered an important risk factor. Although malnourished children achieved complete remission but a high percentage of them relapsed or died.Key words: Malnutrition, childhood, Acute Lymphoblastic Leukemia


Article
Viral hepatitis markers screen in children with cute Lymphoblastic Leukemia

Author: Mazin F. Al-Jadiry
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2008 Volume: 50 Issue: 2 Pages: 223-230
Publisher: Baghdad University جامعة بغداد

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Abstract

Background:Patients treated for pediatric malignancy are at high risk of parenterally transmittedviral hepatitis.Objectives:To detect the seroprevalence of hepatitis B and C viral infections in children withAcute Lymphoblastic Leukemia & identify some variables that could affect itsprevalence in these patients.Patients and Methods:One hundred fifty pediatric acute lymphoblastic leukemia patients, presented toChildren Welfare Teaching Hospital, Baghdad, during the period from March 11th2007 to July 31st 2007 were enrolled in this study; they were 103 males, 47 females,aged (2.25 months- 16 years). Sera of these patients were investigated for hepatitismarkers including HBsAg and Anti HCV antibody.ResultsThe majority of patients were from Baghdad 104 (69.33%). Almost all childrenreceived 3 doses of hepatitis B vaccine according to the national Iraqi vaccinationschedule & 111 (74%) of them received another course of vaccination during theiradmission to the oncology unit at CWTH.Screening for hepatitis B virus infection was positive in 54 (36%) of cases while forhepatitis C virus infection was positive in 4 (3.25%) of cases.ConclusionMultiple blood transfusions and prolonged duration of observation of patients showedsignificant statistical impact on the incidence of HBV infection.


Article
Effectiveness of Modified UKALL protocols in Children with Acute

Author: Hasanein H. Ghali
Journal: Mustansiriya Medical Journal مجلة المستنصرية الطبية ISSN: 20701128 22274081 Year: 2014 Volume: 13 Issue: 2 Pages: 53-60
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background:Acute Lymphoblastic Leukaemia (ALL) is the most common diagnosisin childhood cancer. Cure is possible and even likely. Aims of study: To evaluatethe effectiveness of modified UKALL protocols in a setting with limited resourcesand to define an event free survival of Acute Lymphoblastic Leukemia in childrenaged 1 ‐15 years who were committed to finish treatment.Methods: This is a retrospective study that reviewed 559 children with newlydiagnosed ALL between 1 and 15 years of age during the period: January 1st, 2000to December 31st, 2009 who were committed to finish treatment protocol. Allpatients were treated with regimens modified from Medical Research Councilprotocol (United Kingdom Acute Lymphoblastic Leukemia‐ UKALL‐ protocols).The Event Free Survival (EFS) was measured using Kaplan – Meier method with atotal duration of observation till December 31st 2011 (a minimum of two years poststarting treatment) and data were processed and tabulated using SPSS (StatisticalPackage for the Social Sciences) .Results:The majority of treated children (348, 62.2%) were standard risk group;remission induction was achieved in 461(82.4%) patients. Eleven patients (1.9%)were poor responders. Death during first 60 days from treatment was reported in87 (15.5%) patients and death in complete remission (CR) was reported in 49 (8.7%)patients. The major presumptive causes of death were infection/sepsis followedby bleeding. Of 559 patients; 302(54%) remained in continuous complete remissionwith a median follow up time of 52.5 months (range from 23.9 months‐ 11.6 years).There was a significant difference in EFS between Standard Risk group (61.2%) andHigh Risk group (42.2%) after induction (P=0.02) and in later phases of therapy(P=0.0002). Increased relapse rate in high risk group was the reason behind thedifference in EFS (P=0.0004) between two groups. Relapses were documented in110(19.6%) patients and the bone marrow (51.8%) was the main site of relapsefollowed by CNS (27.2%).Conclusion:The study showed lower ALL EFS than that of recognized cancercenters.


Article
Gender Disparity in Clinical Presentation, Immunophenotyping, and Early Steroid Response in Pediatric Acute Lymphoblastic Leukemia Patients

Authors: Dr. Balsam Fadhil Abid Salih --- Dr. Subh Salem Al-Mudallel --- Sajed Saad Mohammed
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2013 Volume: 2 Issue: 1 Pages: 14-26
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Background: Acute leukemia is the most common type of childhood cancer, of which acutelymphocytic leukemia (ALL) comprises 78% of cases. Incidence rate, prognosis and survival ofchildhood ALL patients differ according to gender. Despite overall improvements in survival ofchildren with ALL, male children still experience poorer survival.Objective is to explore differences between male and female pediatric patients with newly diagnosedALL regarding their presenting clinical features, ALL immunophenotype, and early steroidresponse.Methods: This study was prospectively designed to include 60 newly diagnosed pediatric ALLpatients from April 2011 to March 2013. Each patient was assessed clinically at admission andat the end of a 7-day prednisone prophase to be classified as a prednisone-good responder(<1000/μL peripheral blood blasts on day 8) or a prednisone-poor responder (>1000/μL).Immunophenotype was determined by immunocytochemical staining of bone marrow aspiratesfor cCD79a (specific for B-cells) and cCD3 (specific for T-cells).Results: The study group consisted of 38 males and 22 females. The median age was 62.5 months formales and 41.5 months for females. Splenomegaly was found in 71% of males versus 63.6% offemales, hepatomegaly in 68.4% of males versus 45.5% of females, mediastinal masses weredetected in 6 males and 3 females, and CNS disease affected 5 patients, 3 males and 2 females(p>0.05). WBC mean count was 63.7815.98 x109/L in males and 49.221.87 x109/L infemales, the mean Hb was 8.750.53 g/dl in males and 7.910.34 g/dl in females (p>0.05).75.8% of male patients were B-ALL and 24.3% were T-ALL, and 76.5% of females were BALLand 23.5% were T-ALL. 86.8% of male patients and 86.4% of female patients were goodsteroid responders (p > 0.05).Conclusions: Pediatric male patients were more frequent and older than females, and presented withclinical and hematological features considered to be of poor prognosis more than females. Nosignificant difference was observed regarding ALL immunophenotypes and early steroidresponse.


Article
Prognostic value of myeloid antigens expression in childhood acute lymphoblastic leukemia

Authors: Aula Mahmood Ibrahim --- Bassam M. Hameed
Journal: Iraq Joural of Hematology المجلة العراقية لامراض الدم ISSN: 20728069/25432702 Year: 2017 Volume: 6 Issue: 1 Pages: 12-16
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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BACKGROUND: Leukemic blasts in acute lymphoblastic leukemia (ALL) may have immunologicalfeatures of both lymphoid and myeloid lineages known as aberrant myeloid antigens expression inALL, which are explained as abnormal genetic program of leukemic cells that lead to lineage infidelity.In this study, CD13, CD14, and CD33 (which are the most frequent myeloid antigens associated withaberrant antigens expression in ALL) were investigated.OBJECTIVES: To evaluate the occurrence of aberrant myeloid antigens expression in childhoodALL and its effects on complete remission and other parameters.MATERIALS AND METHODS: This study was conducted on 31 pediatric patients with newlydiagnosed de novo ALL (27 B‑ALL, 4 T‑ALL) in Children Welfare Teaching Hospital/Medical Cityof Baghdad; diagnosis of ALL based on morphology and cytochemistry, CD13, CD14, CD33 wereinvestigated as myeloid antigens using four‑color flow cytometry.RESULTS: Five cases of ALL (16.13%) out of 31 cases were confirmed to have aberrant myeloidantigens expression (CD13 was expressed in all five cases, CD33 was expressed in three cases,and CD14 was not expressed in any of these five cases). Complete remission was achieved in90.30% (28 patients) and all cases with aberrant myeloid antigens expression achieved completeremission; however, despite this, there was no significant difference in complete remission betweenmyeloid‑positive (MY+) and myeloid‑negative (MY−) cases, P > 0.05. Regarding other parameters,there were significant statistical differences in lactate dehydrogenase (LDH), hemoglobin value, andbone marrow (B.M.) blasts percent at diagnosis between MY+ and MY− cases, P < 0.05; however,there was no significant differences in leukocytes count, platelets count, peripheral blood blast percentat diagnosis, age, and gender, P > 0.05.CONCLUSIONS: The most frequent aberrant myeloid antigens expression in childhood ALL is CD13and less frequently is CD33 while CD14 showed no expression; myeloid antigens expression in ALLmay have better prognosis as they have lower B.M. blast percent and LDH value.


Article
Coagulopathy in Adult Acute Leukemia at Presentation in National Center of Hematology (NCH), Baghdad
تجلط الدم لدى المرضى البالغين المصابين بسرطان الدم الحاد في المركز الوطني لبحوث وعلاج امراض الدم / بغداد

Author: Abdulsalam Hatim Mohmmed د. عبد السلام حاتم محمد
Journal: IRAQI JOURNALOF COMMUNITY MEDICINE المجلة العراقية لطب المجتمع ISSN: 16845382 Year: 2013 Volume: 26 Issue: 2 Pages: 114-117
Publisher: Al-Mustansyriah University الجامعة المستنصرية

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Abstract: Background: Malignancy is associated with a hypercoagulable state and a high risk for thrombohemorrhagic complications, clinical complications may range from localized thrombosis more in solid tumors to bleeding of varying degrees of severity because of disseminated intravascular coagulation (D.I.C.) as in acute leukemia. Aim of the study: To search for the real cause of coagulopathy (bleeding or thrombosis) in patients with acute leukemia.Materials and methods: This study was conducted at the NCH between January 2010 and September 2011, 96 patients with acute leukemia where evaluated prospectively for hemostatic abnormality at presentation of which 43 (44.79 %) had acute lymphoblastic leukemia (ALL) and 53 (55.21 %) had acute myeloid leukemia of which 14 (14.58) were cases of Acute Promyelocytic Leukemia (APL).Results: At presentation 2 patients (2.3 %) with AML (M3, APL) subtype had bleeding manifestation (signs of intracranial hemorrhage) and died with in 24-48 hours in spite of urgent supportive managements, (94)patients (97.9 %) had variable abnormalities of coagulation indices which include prothrombin time (P.T.) , partial thromboplastin time (P.T.T.), plasma fibrinogen level and Factor VII levels, ranging from normal indices specially in ALL to slight increment in AML mainly M2 to moderate increase in some patients with M3 (bleeding manifestations noticed to be associated more in few AML M3 this was attributed to the procoagulant activity of cytoplasmic granules in the malignant promyelocytes. Conclusion: From the results obtained in this study which shows that the cause of bleeding is mostly associated with low platelets count , but not due to coagulation factors defects (as only PT was increased in some cases of AML) .Key words: Acute lymphoblastic leukemia, acute myeloid leukemia, acute promyelocytic leukemia.

مابين كانون الثاني 2010 وايلول 2011 تم فحص (96) مريضاً يعانون من سرطان الدم الحاد حيث تم اجراء تقييم مستقبلي لحالات شذوذ تجلط الدم في المركز اعلاه منهم (43)مريضاً (44,79%)يعانون من سرطان الدم اللمفاوي الحاد (ALL) و (53)مريضاً (55,21%) يعانون من سرطان الدم النقياني الحاد (AML) منهم (14) مريضاً (14,58%) يعانون من سرطان السلانف النقويه الحاده (APL) . في هذه الدراسه مريضان (2,3%) من مرضى سرطان السلانف النقويه الحادة (APL) اظهرا علامات نزيف حاد (علامات نزيف داخل الجمجمة) وتوفيا في ظرف 24-48 ساعه على الرغم من اجراء المحاولات الداعمة العاجله .(94)مريضاً (97,9%) أظهروا شذوذ متغير من المؤشرات التي تشمل اوقات التخثر مثل وقت البروثرومبين (P.T)، وقت جزيئية الثرومبوبلاستين (P.T.T)، مستوى الفايبرينوجين في البلازما ومستوى العامل السابع في مصل الدم، يتراوح هذا الشذوذ بين المستويات الطبيعية في كل شيئ خصوصاً في مرضى سرطان الدم اللمفاوي الحاد الى زيادة طفيفه في مرضى سرطان الدم النقياني الحاد }خصوصاً النوع الثاني منه (AML/M2){ الى زيادة متوسطة خصوصاً في النوع الثالث }(APL)AML/M3 { وقد عزي ذلك الى فعالية الحبيبات السايتوبلازمه الموجودة في الخلايا السرطانية .


Article
Determination of Advanced Oxidation Protein Products, E3 SUMO-Protein Ligase NSE2[NSMCE2], as a Marker to Predict Child Acute Lymphoblastic Leukemia
تقدير تركيز نواتج الاكسدة العالية البروتين AOPP)) وانزيم E3 SUMO-Protein Ligase NSE2[NSMCE2] في الاطفال المصابين بسرطان الدم الليمفاوي الحاد

Authors: Wesen Adel Mehdi وسن عادل مهدي --- Alaa Shawqi Abdulbari الاء شوقي عبد الباري
Journal: Baghdad Science Journal مجلة بغداد للعلوم ISSN: 20788665 24117986 Year: 2014 Volume: 11 Issue: 1 Pages: 128-138
Publisher: Baghdad University جامعة بغداد

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Abstract

Acute lymphoblastic leukemia (ALL) is a cancer of the blood and bone marrow (spongy tissue in the center of bone). In ALL, too many bone marrow stem cells develop into a type of white blood cell called lymphocytes. These abnormal lymphocytes are not able to fight infection very well. The aim of this study was to investigate possible links between E3 SUMO-Protein Ligase NSE2 [NSMCE2] and increase DNA damage in the childhood patients with Acute lymphoblastic leukemia (ALL). Laboratory investigations including hemoglobin(Hb) ,white blood cell (WBC) , serum total protein , albumin ,globulin , in addition to serum total antioxidant activity (TAA) , Advanced oxidation protein products(AOPP) and E3 SUMO-Protein Ligase NSE2[NSMCE2]. Blood samples were collected from 60 patients diagnosed to Acute lymphoblastic leukemia (ALL) after one month treatment with induction therapy. Age and sex matched 30 healthy persons selected as control.serum total protein , albumin and globulin showed A significant decrease in patients group when compared to control group( P<0.01,P<0.05and P <0.05)respectively, total antioxidant activity (TAA) showed A significant decrease in patients group when compared to control group( P<0.001), while AOPP,NSMCE2 , showed a significant increase in patients group in comparison to control group ( P<0.001).Conclusions: The results from this study showed a significant increase in NSMCE2, AOPP, NSMCE2 /TAA ratio ,NSMCE2/S. protein ratio and AOPP/ S.Protein ratio. These results in the present study are shown for the first time to the best of our knowledge. These parameters may play a role in developments of change DNA damage in the childhood patients with Acute lymphoblastic leukemia (ALL)

سرطان الدم الليمفاوي الحاد نوع من سرطان الدم ونخاع العظم (نسيج اسفنجي في وسط العظام)فيه عدد كبير جدا من الخلايا الجذعية تتطور الى نوع من خلايا الدم البيضاء والتي تسمى الخلايا الليمفاوية . هذه الخلايا الليمفاوية غير الطبيعية ليست قادرة على مكافحة العدوى بشكل جيد. الهدف من الدراسة كان التحقق من وجود ارتباط بين انزيم NSE2 وزيادة التكسير في الحامض النووي في الاطفال المصابين بسرطان الدم الليمفاوي الحاد.تم قياس الهيموغلوبين ،خلايا الدم البيضاء، البروتين الكلي في مصل الدم ،الألبومين والجلوبيلين ، بالإضافة الى نشاط مضادات الاكسدة الكلية في المصل و AOPP و NSE2. تم تجميع العينات من 60 مريض تم تشخيصهم بسرطان الدم الليمفاوي الحاد بعد شهر من اخذ الجرعه الاولى من العلاج الكيمياوي ،وتم اخذ 30 شخص بنفس الجنس والعمر تم اختيارهم كمجموعة سيطرة.لقد اظهرت الدراسة حصول نقصان في البروتين الكلي والالبومين والجلوبيلين مقارنة مع مجموعة السيطرة .واظهرت النتائج ايضا انخفاض ملحوظ في مضادات الاكسدة الكلية بينما كانت هناك زيادة ملحوظة في مستوى AOPP و NSE2.اظهرت النتائج افي الدراسة الحالية زياده ملحوظه في AOPP و NSE2 والعلاقة بينNSMCE2 /TAA ,NSMCE2/S. protein و AOPP/ S.Protein وهذه النتائج ظاهرة لأول مرة على حد علمنا ، قد تكون هذه المعايير تلعب دور في تطورات تلف الحامض النووي في الاطفال المصابين بسرطان الدم الليمفاوي الحاد.


Article
Serological and molecular detection of parvovirus b19 in children with acute lymphoblastic leukemia

Authors: Mazin F. Al-Jadiry --- Shatha F. Abdullah شذى فاروق --- Iqbal M. Abdullah
Journal: Journal of the Faculty of Medicine مجلة كلية الطب ISSN: 00419419 Year: 2014 Volume: 56 Issue: 3 Pages: 318-321
Publisher: Baghdad University جامعة بغداد

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Abstract

Background: Human parvovirus B19 (B19V) is the only human pathogenic parvovirus, It is highly erythrotropic and preferentially replicates in erythroid progenitor cells (EPCs). Recently the effects of B19 infection have been well studied in children with acute lymphoblastic leukemia (ALL). Objective: To detect parvovirus B19 among children with ALL.Methods: A cross sectional study involved forty five patients with ALL (21 patients were newly diagnosed ALL and 24 children who underwent chemotherapy) who were attending department of oncology in Children's Welfare Teaching Hospital in Baghdad Medical City between December 2012 and April 2013, compared to forty five of apparently healthy children as a control group, age and sex were matched. A serological and molecular detection of parvovirus B19 were done using enzyme linked immunosorbant assay (ELISA) and Real-time PCR.Results: B19-IgM, IgG and DNA were detected in study cases as (15.6%, 40% and 13.3%) compared to control group (4.4%, 13 % and 0%) respectively. B19-IgG and B19-IgM were detected in newly diagnosed cases in (41.7% and 19.05%) as well as in (38.1% and 12. 5%) of cases on chemotherapy respectively, all cases with B19-DNA signals were underwent chemotherapy (25%) with mean viral load of (36x104 copies/ml).Conclusion: children who suffering from ALL are at increased risk of B19 infection. Notable percentage of persistent B19 infection was recorded among children with ALL who are receiving ongoing treatment.Key words: parvovirus B19, acute lymphoblastic leukemia (ALL), real time PCR.

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