The prognostic factors and efficacy of induction chemotherapy in elderly patients with acute myeloid leukemia

xlomafota13 shared this article with you from Inoreader The prognostic factors and efficacy of induction chemotherapy in elderly patients with acute myeloid leukemia Via American Journal of Blood Research Am J Blood Res. 2020 Dec 15;10(6):320-329. eCollection 2020. ABSTRACT BACKGROUND AND OBJECTIVE: Acute myeloid leukemia (AML) is the most common form of hematological malignancy in adults. We aimed to investigate the efficacy of different treatment measures and prognostic factors for elderly patients with AML. METHODS: The clinical data of 65 newly diagnosed elderly patients with AML were retrospectively analyzed. Among them, 45 patients received induction chemotherapy including standard cytarabine regimen (n = 21) and low dose cytarabine regimen (n = 24), and 20 patients received palliative treatment. The efficacy and prognosis were compared between the groups. RESULTS: There were no statistical differences in complete remission, overall survival and the 6-month disease-free survival rates between standard cytarabine group and low dose cytarabine group (P = 0.675, P = 0.775, P = 0.751, respectively). Si gnificant difference in median overall survival and overall survival rate were detected (P < 0.001, P = 0.031, respectively), but no significant difference in early death rate (P = 0.238) was found between induction chemotherapy group and palliative treatment group. Multivariate analysis showed that the white blood cells count ≥ 100.0 × 109/L was associated with early death. CONCLUSIONS: The induction chemotherapy did not increase the early mortality. The low dose cytarabine regimen can be used as the first-line choice for elderly acute myeloid leukemia patients who are not suitable for intensive chemotherapy. PMID:33489440 | PMC:PMC7811900 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Cancer immunotherapy: a promising dawn in cancer research

xlomafota13 shared this article with you from Inoreader Cancer immunotherapy: a promising dawn in cancer research Via American Journal of Blood Research Am J Blood Res. 2020 Dec 15;10(6):375-385. eCollection 2020. ABSTRACT Cancer is a highly proliferative disease, which is caused due to the loss of regulation of cell cycle and apoptosis, DNA damage, faulty repair system etc. The cancer microenvironment plays a pivotal role in disease progression as they contain different types of innate and adaptive immune cells. The most important molecules that establish a correlation between inflammation, innate immunity, adaptive immunity, and cancer are the molecules released by inflammatory cells in cancer microenvironment. These molecules secreted by the immune cells, which might activate a pro-tumorigenic and anti-tumorigenic response in cancer. In inflammatory microenvironment, the equilibrium state of immunosuppressive and immunostimulatory signals are important in tumor suppression. The immunotherapeutic approaches could be more effective in cancer treatment. However, advancement in immunobi ology and cancer are improving the prospects of immunotherapy alone and/or in combination with the conventional therapies. Thus, the review attempts to highlight a promising and futuristic immunotherapeutic approach in combination with conventional treatment modalities. PMID:33489447 | PMC:PMC7811907 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical utility of procalcitonin in bacterial infections in patients undergoing hematopoietic stem cell transplantation

xlomafota13 shared this article with you from Inoreader Clinical utility of procalcitonin in bacterial infections in patients undergoing hematopoietic stem cell transplantation Via American Journal of Blood Research Am J Blood Res. 2020 Dec 15;10(6):339-344. eCollection 2020. ABSTRACT BACKGROUND: Infections are major contributor to morbidity and mortality in patients undergoing bone marrow transplant (BMT). OBJECTIVE: To assess role of serum procalcitonin (PCT) as a useful biomarker for the infections and outcomes in these patients. METHODS: Retrospective observational study. RESULTS: Total 47 patients with febrile episodes were enrolled. Twenty patients underwent autologous BMT and 27 underwent allogeneic BMT. Bacterial infections were documented in 18/47 (38%) patients. Forty patients were neutropenic. The median fever duration was 10 days (range 3-30 days) in positive procalcitonin level group whereas it was 4 days (range 1-18) in negative group. This was statistically significant (P=0.000). Procalcitonin levels were high in 8/9 episodes of sepsis (P=0.029). Intensive care unit transfers and death were significantly higher in PCT positive group as compared to PCT negative group. CONCLUSION: Serum procalcitonin levels provide prognostic information of worse outcome in patients undergoing HSCT. PMID:33489442 | PMC:PMC7811896 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Zamzam water is pathogen-free, uricosuric, hypolipidemic and exerts tissue-protective effects: relieving BBC concerns

xlomafota13 shared this article with you from Inoreader Zamzam water is pathogen-free, uricosuric, hypolipidemic and exerts tissue-protective effects: relieving BBC concerns Via American Journal of Blood Research Am J Blood Res. 2020 Dec 15;10(6):386-396. eCollection 2020. ABSTRACT Zamzam water is the most frequently used drinking water by millions of people in Saudi Arabia. It is carried all the time by millions of pilgrims to their home countries as gifts to close and near relatives and friends. Safety of constituents of Zamzam water is a vital health topic. British Broadcasting Corporation (BBC) raised many health concerns regarding the high serum arsenic and nitrate contents in Zamzam water that may cause cancer. It is role of scientific research to present scientific facts to relieve such concerns. Arsenic is a carcinogen while nitrate causes methemogloinemia that affect oxygen carriage by haemoglobin. An ethical committee approval was obtained. Eighteen white albino mice (40-45 g) were used in this study. Three experimental groups were allocated (six mice per group): tap water group, distilled water group and Zamzam water group. Our data revealed that Zamzam water exerts tissue-protective effects that contradict malignancy. Our data proved that Zamzam water is pathogen-free causing no bacterial growth on CLED agar colonies. Zamzam water consumption for three consecutive months in mice was quite safe for the general health and significantly decreased serum uric acid (p < 0.05) (possibly due to Zamzam-induced urine alkalinisation facilitating uric acid excretion). Regular Zamzam water consumption significantly decreased serum cholesterol (p < 0.05) and serum triglycerides (p < 0.05). Hypolipidemic effects of Zamzam water may be due to its high mineral content facilitating increased lipids metabolism. Our data confirmed safety of prolonged use of Zamzam water comparable to other drinking water types regarding the metabolic and synthetic functions of the liver. Nitrates in Zamzam water are thought to be an original constituent that may be useful (exerting vasodilation, antithrombotic, and i mmunoregulatory effects) and not harmless. This may occur due to high Zamzam content of calcium, magnesium and selenium. Histologically, our data confirmed that Zamzam water was quite safe to renal parenchyma and comparable to other types of drinking water. In conclusion, health concerns raised by BBC regarding Zamzam water safety were a good chance for fruitful scientific research investigations that confirmed safety and beneficial effects of Zamzam water for human health. PMID:33489448 | PMC:PMC7811908 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Increased immature T-cells detected by flow cytometry in post chemotherapeutic patients with acute myeloid leukemia, a case report and small series study

xlomafota13 shared this article with you from Inoreader Increased immature T-cells detected by flow cytometry in post chemotherapeutic patients with acute myeloid leukemia, a case report and small series study Via American Journal of Blood Research Am J Blood Res. 2020 Dec 15;10(6):351-354. eCollection 2020. ABSTRACT Detection of minimal/measurable residual disease (MRD) in bone marrow specimens by flow cytometry is widely used in patients with T cell acute lymphoblastic leukemia (T-ALL). It plays a central role in guiding treatment and assessing prognosis. However, the occurrence of a normal physiologic reactive immature T-cell population in treated bone marrow is unknown. To investigate this, we examined 14 post chemotherapeutic bone marrow specimens with a T-ALL MRD flow cytometry panel. This included 9 acute myeloid leukemia (AML) and 5 T-ALL cases. Immature T-cells are defined as surface CD3 negative cells that coexpress cytoplasmic CD3 (cyCD3) and terminal deoxynucleotidyl transferase (TdT), or as cells that express CD34 with coexpression of multiple T-cell markers. Immature T-cells were present in 1 of 9 AML cases (11%), between day 20-31 post chemotherapy. Follow-up of th is patient who had 4.00% cyCD3+ TdT+ immature T-cells, showed the population gradually decreased to 0.50% at day 31, 0.15% at day 46, and was undetectable (0.00%) at day 116. This population remained undetectable at the most current follow-up on day 147. This pilot study shows that a low level of cyCD3+ TdT+ immature T-cells may be present in post chemotherapeutic regenerating bone marrow and can be detectable by flow cytometry. Thus, extra caution should be taken when interpreting T-ALL MRD results, especially between days 20-31 post chemotherapy. PMID:33489444 | PMC:PMC7811906 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

TaibUVID nutritional supplements TaibUVID nutritional supplements (nigella sativa, chamomile and natural honey)

xlomafota13 shared this article with you from Inoreader TaibUVID nutritional supplements help rapid cure of COVID-19 infection and rapid reversion to negative nasopharyngeal swab PCR: for better public prophylaxis and treatment of COVID-19 pandemic Via American Journal of Blood Research Am J Blood Res. 2020 Dec 15;10(6):397-406. eCollection 2020. ABSTRACT Public prophylaxis to decrease the emergence of new daily COVID-19 cases is vital. Adjuvant TaibUVID nutritional supplements are promising home-made or hospital-made supplements suggested for rapidly preventing and treating COVID-19 pandemic. We report here a 44 years old male physician who caught COVID-19 infection at hospital in Egypt with confirmed positive nasopharyngeal swab PCR. Ethical committee approval and informed patient's consent were gained before performing this study. Chest X-ray revealed increased bronchovascular markings. Close follow-up was done with no treatment given and he was sent for home isolation. Few days later, he developed progressive non-productive cough and a sense of difficult breathing with no associated fever or chest pain. An antitussive drug was given to him. The patient read about TaibUVID supplements from social media and started to feel improvement after TaibUVID inhalation therapy (using the heated solution of nigella sativa and chamomile five times a day). He also received a home-made TaibUVID nutritional supplement (nigella sativa, chamomile and natural honey) five times daily for four consecutive days. The next day, he was quite better with mild symptoms. Two days later, nasopharyngeal swab PCR was negative while other patients still had positive nasopharyngeal swabs. As few attacks of mild cough and breathing difficulty existed, he was admitted to hospital. A nasopharyngeal swab PCR was done for him again and the result was negative also. Blood gases were normal. He had lymphocytosis (possibly due to TaibUVID effects) that counteract lymphopenia seen in COVID-19 patients. Biochemical and hematological evaluation were quite normal apart from increased serum chloride and lactate dehydrogenase. There was a mild decrease in serum CO2 and alkaline phosphatase. Chest CT report revealed symmetrical ly inflated both lungs with non-specific focal nodular infiltrates (scattered in basal and medial lung segments) in left lower lobes with faint ground glass opacities. He was discharged home. Few days later, he was quite improved with no symptoms and returned to his work comfortably. In conclusion, TaibUVID nutritional supplements may be effective in rapidly changing the nasopharyngeal swab PCR from positive to negative. TaibUVID nutritional supplements are advisable as a natural, safe and effective prophylaxis to stop COVID-19 infectiousness, transmission and emergence of new cases. Clinical studies to investigate TaibUVID nutritional benefits are strongly recommended. TaibUVID may be promising and recommended for public prophylaxis to decrease emergence of new COVID-19 cases. PMID:33489449 | PMC:PMC7811903 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

TaibUVID nutritional supplements help rapid cure of COVID-19 infection and rapid reversion to negative nasopharyngeal swab PCR: for better public prophylaxis and treatment of COVID-19 pandemic

xlomafota13 shared this article with you from Inoreader TaibUVID nutritional supplements help rapid cure of COVID-19 infection and rapid reversion to negative nasopharyngeal swab PCR: for better public prophylaxis and treatment of COVID-19 pandemic Via American Journal of Blood Research Am J Blood Res. 2020 Dec 15;10(6):397-406. eCollection 2020. ABSTRACT Public prophylaxis to decrease the emergence of new daily COVID-19 cases is vital. Adjuvant TaibUVID nutritional supplements are promising home-made or hospital-made supplements suggested for rapidly preventing and treating COVID-19 pandemic. We report here a 44 years old male physician who caught COVID-19 infection at hospital in Egypt with confirmed positive nasopharyngeal swab PCR. Ethical committee approval and informed patient's consent were gained before performing this study. Chest X-ray revealed increased bronchovascular markings. Close follow-up was done with no treatment given and he was sent for home isolation. Few days later, he developed progressive non-productive cough and a sense of difficult breathing with no associated fever or chest pain. An antitussive drug was given to him. The patient read about TaibUVID supplements from social media and started to feel improvement after TaibUVID inhalation therapy (using the heated solution of nigella sativa and chamomile five times a day). He also received a home-made TaibUVID nutritional supplement (nigella sativa, chamomile and natural honey) five times daily for four consecutive days. The next day, he was quite better with mild symptoms. Two days later, nasopharyngeal swab PCR was negative while other patients still had positive nasopharyngeal swabs. As few attacks of mild cough and breathing difficulty existed, he was admitted to hospital. A nasopharyngeal swab PCR was done for him again and the result was negative also. Blood gases were normal. He had lymphocytosis (possibly due to TaibUVID effects) that counteract lymphopenia seen in COVID-19 patients. Biochemical and hematological evaluation were quite normal apart from increased serum chloride and lactate dehydrogenase. There was a mild decrease in serum CO2 and alkaline phosphatase. Chest CT report revealed symmetrical ly inflated both lungs with non-specific focal nodular infiltrates (scattered in basal and medial lung segments) in left lower lobes with faint ground glass opacities. He was discharged home. Few days later, he was quite improved with no symptoms and returned to his work comfortably. In conclusion, TaibUVID nutritional supplements may be effective in rapidly changing the nasopharyngeal swab PCR from positive to negative. TaibUVID nutritional supplements are advisable as a natural, safe and effective prophylaxis to stop COVID-19 infectiousness, transmission and emergence of new cases. Clinical studies to investigate TaibUVID nutritional benefits are strongly recommended. TaibUVID may be promising and recommended for public prophylaxis to decrease emergence of new COVID-19 cases. PMID:33489449 | PMC:PMC7811903 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Extramedullary manifestations in acute lymphoblastic leukemia in children: a systematic review and guideline-based approach of treatment

xlomafota13 shared this article with you from Inoreader Extramedullary manifestations in acute lymphoblastic leukemia in children: a systematic review and guideline-based approach of treatment Via American Journal of Blood Research Am J Blood Res. 2020 Dec 15;10(6):360-374. eCollection 2020. ABSTRACT OBJECTIVE: Acute lymphoblastic leukemia (ALL) may present with signs and symptoms related to extramedullary involvement, therefore, leads to delayed diagnosis of ALL in children. This study aims to consider the extramedullary manifestations of ALL in children and their proper treatment. METHOD: The databases were searched for all relevant subjects including "acute lymphoblastic leukemia", "clinical presentation", "unusual presentation", "childhood acute lymphoblastic leukemia", "presenting features of ALL", "extramedullary presentation", and "atypical presentation" from April 1968 to June 2020. The Inclusion criteria for this review study were all cases reported, case series, and studies about extramedullary presentations of ALL in pediatrics. Eighty-seven studies had inclusion criteria. All reported studies were analyzed given their extramedullary presentation s, age, sex, treatment option, and prognostic factors. A two-sided P-value less than 0.05 was considered statistically significant. RESULT: In this review study, the extramedullary initial signs and symptoms of ALL were related to musculoskeletal system 17 (19.5%) especially bony symptoms and hypercalcemia. The additional extramedullary presentations of ALL in order of frequency include; renal involvement, 17 (19.5%), hepatic symptom 12 (13.8%), orbital presentation 10 (11.5%), neurologic signs 8 (9%), dermatological manifestations 5 (5.8%), oral presentations 5 (5.8%), hypereosinophilia 5 (5.8%), abdominal manifestation 3 (3.5%), pericardial involvement 2 (2.3%), and the other miscellaneous presentations 3 (3.5%). CONCLUSION: The clinicians must become familiar with these extramedullary presentations of ALL in pediatrics to avoid the delayed diagnosis of this disease and increase the probable chance of survival by early detection. PMID:33489446 | PMC:PMC7811904 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Bortezomib induced pulmonary toxicity: a case report and review of the literature

xlomafota13 shared this article with you from Inoreader Bortezomib induced pulmonary toxicity: a case report and review of the literature Via American Journal of Blood Research Am J Blood Res. 2020 Dec 15;10(6):407-415. eCollection 2020. ABSTRACT Bortezomib is widely used in the treatment of Multiple Myeloma. While the most common side effects are neurological and gastrointestinal related complications, severe pulmonary problems are rarely described. The present case is a 72-year old male with multiple myeloma, who received Lenalidomide, Bortezomib, and Dexamethasone (RVD) combination regimen. He underwent 30 Gy palliative radiotherapy to the thoracic 5-9 and lumbar L1-3 vertebra due to pain and fracture risk. During the third cycle, he was admitted to hospital with dyspnea and dizziness. The thoracic CT revealed bilateral pleural effusions, a diffuse reticular pattern on the parenchyma, and ground-glass opacities that were compatible with drug-induced lung injury. The microbiological and molecular analysis excluded infectious disease, and lung biopsy confirmed the diagnosis of Bortezomib Lung Injury. The tim e from the first dose of Bortezomib to the lung injury was 57 days, and it was five days from the last dose of Bortezomib. His symptoms were refractory to IV steroids and supportive care. Our patient was lost despite steroids and intensive care support. Even Bortezomib induced lung injury is a rare adverse effect, based on high mortality rate, we would like to emphasize the clinical importance of this clinical scenario in light of the published literature and our presented case. PMID:33489450 | PMC:PMC7811899 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Outcomes of adult critically ill patients with hemophagocytic lymphohistiocytosis in united states-analysis from an administrative database from 2007 to 2015

xlomafota13 shared this article with you from Inoreader Outcomes of adult critically ill patients with hemophagocytic lymphohistiocytosis in united states-analysis from an administrative database from 2007 to 2015 Via American Journal of Blood Research Am J Blood Res. 2020 Dec 15;10(6):330-338. eCollection 2020. ABSTRACT BACKGROUND: Severe infections caused by the novel coronavirus 2 display similarities to secondary hemophagocytic lymphohistiocytosis (HLH). However, HLH is a rare disease and has not been well described in critically ill patients. METHODS: We used the Nationwide Inpatient Sample (NIS), the largest all-payer inpatient care database publicly available in the United States to identify all adult discharges with Hemophagocytic syndrome (ICD-9 CM code 288.4) between 2007 and 2015. Critical illness was considered present if patient had either ICD-9 CM code indicating the requirement of invasive mechanical ventilation or the presence of shock. We used ICD-9-CM codes to identify various infections (inf-HLH), malignancies (mal-HLH) and autoimmune diseases associated with HLH (MAS-HLH) and classified them in their respective groups. Primary outcome was in-hospital mortali ty in critically ill patients. We developed multivariable regression model to examine variables associated with mortality in critically ill HLH patients. P value was kept at < 0.05. RESULTS: Of the 7420 (95% CI 6959-7881) estimated discharges with HLH, 2313 (31%) were critically ill. Of the critically ill patients, 442 (34%) were mal-HLH, 422 (43.3%) were inf-HLH, 403 (30.7%) were MAS-HLH and 1046 (27.3%) were unable to be classified. In hospital mortality rates were 6.4% in non-critically ill and 48.4% in critically ill patients. Among the subtypes of HLH, in-hospital mortality was 53% in mal-HLH, 49.4% in inf-HLH, 26% in MAS-HLH and 54.6% in unclassified group. On multivariable regression analysis, development of acute renal failure requiring hemodialysis (OR 2.06, 95% CI 1.29-3.3, P=0.002) and acute hepatic failure (OR 2.21, 95% CI 1.38-3.52, P=0.001) were significantly associated with higher mortality. CONCLUSION: Inpatient mortality of critically ill patie nts is remarkably high. Patients with MAS-HLH had better outcomes when compared to other groups of HLH. PMID:33489441 | PMC:PMC7811911 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.