Iraqi Journal of Hematology最新文献

{"title":"Assessment of soluble syndecan-1 level in adult patients with de novo acute myeloid leukemia and its correlation with hematological parameters and treatment response","authors":"Riyam Ismael Shaker, Israa M. Al-Bayaa","doi":"10.4103/ijh.ijh_39_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_39_23","url":null,"abstract":"Abstract: BACKGROUND: Syndecan-1 (CD138) is a member of the transmembrane proteoglycans family that is expressed in various normal and malignant tissues. It attracted the attention because of its possible prognostic role when expressed in different tumors as well as its role as a target for therapy by the monoclonal antibody indatuximab coupled with other cytotoxic agents. In acute myeloid leukemia (AML), syndecan-1 was found to be significantly increased either inside leukocytes or as a soluble form in the plasma and it was correlated with overall survival of AML patients and with more bleeding manifestations and impaired platelet function. AIMS: The aims of this study were to assess the level of soluble syndecan-1 (or CD 138) in adult patients with de novo AML compared to the control group and to explore any possible correlation between the level of syndecan-1 with hematological parameters and response to remission induction therapy. PATIENTS AND METHODS: Cross-sectional study recruited 60 newly diagnosed adult AML patients. Moreover, 25 healthy individuals were included as the control group. The peripheral blood and bone marrow smears were examined at presentation for establishing the diagnosis and after remission induction for assessing the treatment response. Plasma syndecan-1 assay was done by sandwich enzyme-linked immunosorbent assay, which was done to patients at time of diagnosis. RESULTS: Plasma syndecan-1 (SDC-1) level of AML patients at presentation was much higher than that in the control group ( P < 0.001); there was also a statistically significant difference in plasma level of syndecan-1 between male and female patients ( P = 0.002). There was no significant difference for plasma (SDC-1) level between different AML French American British (FAB) subtypes; however, the highest level was seen among patients with the M3 subtype. No significant difference for plasma (SDC-1) level was seen between the patients who achieved remission status and patients who failed to achieve remission after chemotherapy and also between patients alive and deceased after 6 months of follow-up. Insignificant correlations were demonstrated between soluble (SDC-1) and the presenting complete blood count (CBC) parameters. CONCLUSIONS: Although the high level of plasma syndecan-1 was demonstrated in patients with AML compared to the control group, there was no significant difference with respect to age, FAB subtype, and type of response to treatment nor with the patient outcome, and also no significant association was established with any of the hematological parameters.","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":"135888502","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}

{"title":"Red blood cell distribution width at diagnosis as a predictor factor in chronic phase-chronic myeloid leukemia patients treated with first-generation tyrosine kinase inhibitors","authors":"Raghad Nabeel Abdul-Latif, Asaad A. Khalaf, Adel S. Aqabi","doi":"10.4103/ijh.ijh_45_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_45_23","url":null,"abstract":"Abstract: BACKGROUND: Chronic myelogenous leukemia is a hematological disorder of stem cells resulting from uncontrolled and unregulated growth of myeloid cells in the bone marrow. Since the introduction of tyrosine kinase inhibitors (TKIs), therapy has dramatically improved survival in these patients. TKIs treatment targeting BCR-ABL significantly improves the prognosis of patients with chronic myelogenous leukemia. To date, the validity of scoring systems is insufficient for predicting prognosis, and there are few studies of scoring systems for predicting treatment response and clinical efficacy of TKIs. OBJECTIVES: The objective of this study was to evaluate the ability of the red blood cell distribution width (RDW) to predict treatment response in chronic myeloid leukemia-chronic phase (CP) patients treated with first-generation TKI. PATIENTS AND METHODS: A prospective and retroprospective cohort study was conducted on chronic myeloid leukemia-CP patients treated with first-generation TKI at Iraqi Hematological Centers. The collection period was from December 2020 to November 2021. Patients were treated with first-generation TKIs as initial therapy and were followed up to assess the response by polymerase chain reaction (PCR). The assessment of RDW was done at baseline and then at 3, 6, 12, and 18 months after initiation of therapy. RESULTS: There were 150 patients included in this study. The mean age of patients was 43.7 ± 14 years (range: 18–84 years). Males were representing 48.6% and females 51.3%. The classification of baseline RDW showed that the majority of patients (53%) had high RDW. The RDW showed significant change over time, in which, it was significantly decreasing over time ( P < 0.05). Association between PCR over time and baseline RDW category showed that the high baseline RDW was associated with higher mean PCR at 3, 6, 12, and 18 months ( P < 0.05). The correlation between RDW at baseline and PCR at 3, 6, 12, and 18 months showed that there was a significant positive weak correlation between baseline RDW and PCR at 6, 12, and 18 months. The association between baseline RDW and the response showed that high baseline RDW was associated with higher failure rate at 6 and 12 months ( P < 0.05). CONCLUSION: RDW could be used in the prediction of response to treatment. Furthermore, high RDW showed significant association with high disease activity score, high white blood cell count, and lower hemoglobin, in addition to association and correlation with PCR level.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136182176","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}

{"title":"Sarcoidosis presenting with bicytopenia due to bone marrow granuloma","authors":"Mansoor C. Abdulla","doi":"10.4103/ijh.ijh_62_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_62_23","url":null,"abstract":"Abstract: A 55-year-old homemaker presented with low-grade fever, fatigue, and loss of weight for 2 months. She had hepatosplenomegaly, mediastinal lymphadenopathy, cytopenias, hypercalcemia with normal parathormone, and noncaseating granulomas in bone marrow and lymph node biopsy. The patient was diagnosed to have sarcoidosis with bone marrow involvement (histopathology showing noncaseating granuloma and high serum angiotensin-converting enzyme after ruling out other causes of granulomatous disorders by appropriate tests). She was managed with prednisolone 20 mg daily which was reduced and stopped after 3 months. On follow-up, she was asymptomatic and her blood counts were normal. Diagnosis of sarcoidosis should be considered always after ruling out other causes since it can mimic lymphoproliferative disorders and granulomatous infections. The initial presentation of sarcoidosis with bicytopenia due to bone marrow granulomas is extremely rare and physicians should have awareness of such atypical presentations.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136182961","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}

{"title":"Evaluation of Vitamin D level in thalassemia patients: The experience of a single center","authors":"Alaa M. Al-Rubae, Ahmed I. Ansaf, Safa A. Faraj","doi":"10.4103/ijh.ijh_57_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_57_23","url":null,"abstract":"Abstract BACKGROUND: Beta-thalassemia, a hereditary blood disease transmitted through families, has become increasingly relevant with rising life expectancies, leading to bone disease being a significant cause of morbidity. Among the symptoms observed in these patients, bone pain and back pain are frequently reported. Vitamin D is believed to play a crucial role in reducing these symptoms. AIM: The objective of this study was to assess the Vitamin D levels in thalassemic patients and investigate potential correlations with other factors. PATIENTS AND METHODS: A cross-sectional study was conducted, involving a random selection of 48 patients with beta-thalassemia (major and intermediate types) aged 7 years and above. The patients were registered at the Hereditary Blood Disease Center in Wasit province, located in the South of Iraq, during the period from January to May 2022. Demographic data, including age, sex, address, diagnosis, type of chelation therapy, and frequency of blood transfusions, were collected from patients' files. Biochemical data, such as mean hemoglobin, mean serum ferritin, mean serum calcium, and Vitamin D levels at the time of the study, were also recorded. Vitamin D levels below 30 ng/ml were considered low level or deficiency, whereas 30 ng/ml and above were considered normal, as indicated by the kit manufacturer. Furthermore, the height, weight, and body mass index were evaluated in the studied patients with their written consent. SPSS version (23) was employed for data management and statistical analysis, utilizing a significant P = 0.05 and the Pearson's correlation. RESULTS: The study revealed that 42 patients (87.5%) had low Vitamin D levels (below 30 ng/ml). The mean Vitamin D level was 18.23 ng/ml, with a maximum reading of 45 ng/ml. It was observed that Vitamin D deficiency was more prevalent in younger patients and those with higher ferritin levels, although the differences were not statistically significant. CONCLUSION: Vitamin D deficiency is common in patients with B-thalassemia, as indicated by this study","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"136013928","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}

{"title":"Immunoglobulin G4-related disease mimicking lymphoma: Challenging to diagnose","authors":"Aria Namiq Chaqmachi, Brwa Ali Hussein","doi":"10.4103/ijh.ijh_61_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_61_23","url":null,"abstract":"Abstract Practically, all major organ systems can be impacted by an immune-mediated fibro-inflammatory condition known as immunoglobulin G4-related disease (IgG4-RD). Even though it is not unusual, the level of orbital involvement in IgG4-RD can change depending on where the lymphoplasmacytic infiltrate is located. We address a case of IgG4-RD in this study who presented with large bilateral upper and lower eyelids swelling, mediastinal lymphadenopathy, and elevated serum IgG4. It was necessary to do a histopathology examination to confirm the diagnosis of the IgG4-RD and rule out any possible mimicking hematological conditions. In conclusion, this case report emphasizes the value of clinical symptoms and imaging in reducing the number of potential diagnoses, although biopsy remains a gold standard to confirm the diagnosis of IgG4-RD.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135865900","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}

{"title":"Positive malaria rapid test in asymptomatic blood donor – Undetectable parasitemia or false positive?","authors":"Soumee Banerjee, H. M. Ashok","doi":"10.4103/ijh.ijh_52_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_52_23","url":null,"abstract":"Abstract A 35-year-old male, first-time whole blood donor, cleared for donation by physical examination and donor questionnaire, tested reactive for malaria by rapid diagnostic test (RDT). Tests done in triplicate with bag segment samples gave the same results. He had no history of travel to endemic areas or of features suggestive of or a confirmed diagnosis of malaria or its treatment. There was also no history of any prolonged illness or medications. Repeat physical examination was unremarkable, he had no history of fever postdonation and repeat samples showed a normal hemogram, negative for malaria parasite by thick and thin smears and RDT. Further work-up, such as nucleic acid testing or quantitative polymerase chain reaction, was not done due to financial constraints and nonsuggestive history, physical examination, and laboratory tests. The unit was discarded, however, since asymptomatic, low-dose parasitemia could not be ruled out, it could not be definitively labeled false positive.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2023-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135865668","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}

{"title":"Impact of the Multidrug resistance 1 gene polymorphisms on the outcome of therapy in childhood acute leukemia in Duhok province/Iraq","authors":"Adil A. Eissa, ShamoniRobin Bathyon","doi":"10.4103/ijh.ijh_27_23","DOIUrl":"https://doi.org/10.4103/ijh.ijh_27_23","url":null,"abstract":"BACKGROUND: The multidrug resistance (MDR1) gene's polymorphism affects the metabolism and pharmacokinetics of chemotherapeutic agents and smooth drug resistance formation in malignancies and the current study aimed to evaluate the probable impact of MDR-1 gene polymorphisms (C3435T, G2677A/T) on the clinical outcome of childhood acute lymphoblastic leukemia (ALL) in Duhok/Iraq. MATERIALS AND METHODS: All enrolled patients were assessed for MDR-1 (C3435T, G2677A/T) single-nucleotide polymorphisms by means of a polymerase chain reaction followed by enzyme digestion (RFLP-PCR) assay. Response to chemotherapy was assessed by flow cytometry. RESULTS: Sixty-two patients with ALL enrolled in the current study, with a median age of 7.0 years. The main clinical features at presentations were nonspecific in the form of fatigue and loss of energy. Majority of leukemia were of B-cell origin 88.71%. Majority of patients had low hemoglobin, low platelets, and high white blood cell count mainly of blasts at presentation. Sixty-one percent of patients achieved negative minimal residual disease (MRD) after 1–2 courses of chemotherapy. The alleles frequencies at position of 2677 nucleotide were G: 24/124 (19.35%); A: 52/124 (41.94%); T: 48/124 (38.71%); and for the C3435T, frequency of C and T alleles was 54.84%, 45.16%, respectively. Achievement of negative MRD following 1–2 courses of induction, appeared significantly correlated with the age of patients at presentation. All other parameters including, sex, hematological parameters at presentation; studied polymorphism in the MDR-1 gene; and subtype of ALL were not associated significantly with MRD achievement. CONCLUSION: Polymorphic variation in MDR-1 gene, in comparison to solid tumors and chronic hematopoietic malignancies, does not have an impact on MRD achievement in ALL.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44691611","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}

{"title":"Can blood collection and transport vehicles be feasible supplements to conventional blood collection strategies?","authors":"Soumee Banerjee, H. Ashok","doi":"10.4103/ijh.ijh_57_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_57_22","url":null,"abstract":"","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43983060","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}

{"title":"Presentations of acute leukemia among patients at National Health Laboratory, Asmara, Eritrea: A descriptive cross-sectional study","authors":"Amin A. Alamin","doi":"10.4103/ijh.ijh_55_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_55_22","url":null,"abstract":"BACKGROUND: Acute leukemias are a group of potentially fatal hematological malignancies. The purpose of this study was to evaluate the clinical presentation of acute leukemia and estimate the frequency of its signs and symptoms in Asmara, Eritrea. PATIENTS AND METHODS: A retrospective cross-sectional study was conducted consecutively included all of the patients with the diagnosis of acute leukemia at the National Health Laboratory, Asmara, Eritrea, from December 2015 to July 2017. The laboratory and medical data of the patients were obtained using a structured questionnaire based on age, gender, presenting complaints, and clinical findings. RESULTS: Twenty cases who were reviewed acute lymphoblastic leukemia constituted (60%), while acute myeloid leukemia (AML) accounted for 40% of the cases studied. The female patients were more than males (55% vs. 45%). Acute leukemia mainly affected those aged 1–10 years (45%), while the least affected were those aged over 40 years (5%). Acute lymphoid leukemia mainly affects those aged 1–10 years (58.3%), while those aged 20–30 years and over 40 years are unaffected (0%). AML mainly affects those aged 1–10 years and 21–40 years (25%), while those aged 11–20 years and over 40 years being the least affected (12.5%). The most familiar presenting complaint for acute leukemia was fever (70%), followed by fatigue (40%). Splenomegaly (70%), hepatomegaly (40%), and lymphadenopathy (40%) were the most typical physical examination findings. CONCLUSIONS: Acute lymphoblastic leukemia is the most typical kind of acute leukemia affecting the people of Asmara, Eritrea. The young population suffers the most, and fever, fatigue, and pallor are the primary presenting complaints. Splenomegaly, hepatomegaly, and lymphadenopathy are the main physical examination findings among patients with acute leukemia.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46011571","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}

{"title":"Evaluation of plasma progranulin level and the estimation of its prognostic role in adult patients with de novo acute myeloid leukemia","authors":"F. Hussein, A. Ahmed","doi":"10.4103/ijh.ijh_58_22","DOIUrl":"https://doi.org/10.4103/ijh.ijh_58_22","url":null,"abstract":"BACKGROUND: Acute Myeloid leukemia (AML) is a clonal, malignant disease of hematopoietic tissues that is characterized by the accumulation of blast cells, principally in the marrow, and impaired production of normal blood cells. Progranulin (PGRN) is a multifunctional secreted glycoprotein implicated in tumorigenesis, development, inflammation, and repair. High PGRN expression was reported as a prognostic marker in many types of nonhematological and limited hematological malignancies. AIM OF STUDY: To evaluate the level and prognostic significance of PGRN in adult patients with de novo acute myeloid leukemia. PATIENTS, MATERIALS AND METHODS: This analytic cross-sectional study was conducted on 60 adult de novo AML patients who were newly diagnosed from December 2021 to October 2022 in the Haematology Department of Baghdad Teaching Hospital in Medical City. A total of 28 healthy individuals were included in this study as a control group. The diagnosis was based on morphology, immunophenotyping, and genetic studies of the peripheral blood and/or bone marrow aspirate samples in the National Center of Teaching Laboratories of the Medical City in Baghdad. Measurement of plasma PGRN level was done by double-sandwich enzyme-linked immunosorbent assay (ELISA) technique using PGRN ELISA kit. RESULTS: Plasma PGRN level was significantly higher in AML patients than in controls, and also was higher in patients who did not achieve remission. Plasma PGRN level shows a strong positive correlation with the peripheral and bone marrow blast percentages and insignificant correlation with age, gender, total leukocyte count, hemoglobin level, and platelets. There was a statistically significant difference in the median of plasma PGRN level between M3 and non-M3 groups. CONCLUSIONS: PGRN is higher in AML patients at diagnosis than in the control group, with plasma level more in those with poor response to treatment and may be used as an independent risk factor in those patients.","PeriodicalId":53847,"journal":{"name":"Iraqi Journal of Hematology","volume":null,"pages":null},"PeriodicalIF":0.1,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41831582","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}