scholarly journals Survival Rate of Patients with Acute Leukemia: A Case Study in Iran

2020 ◽  
Author(s):  
Mohammad Ranjbar ◽  
Mohsen Barouni ◽  
Vahid Moazed ◽  
Hossein Fallahzadeh ◽  
Shiva Sheikholeslami
Keyword(s):  
Survival Rate ◽  
Acute Leukemia ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Rank Test ◽  
Registry System ◽  
Kaplan Meier ◽  
Acute Myelogenous ◽  
System Data ◽  
Adult Leukemia

Background: Acute leukemia is a kind of aggressive disease that includes high rates of fatalities in the world, in particular in Iran. This research was done to determine the survival rate of patients with acute leukemia in Iran. Methods: 85 adult patients who were first diagnosed with acute leukemia in Shahid Bahonar hospital of Kerman during March 2012 until March 2013 were evaluated in a retrospective descriptive study to measure the death/life status in a 5-year period (2012-2017). The required data was gathered from medical records of patients, HIS system data, and the cancer registry system, and the Kaplan-Meier estimator and Log Rank test were used to calculate the survival rate using SPSS23. Results: Survival rate was completely 45.9 % for patients with acute adult leukemia. It was 47.08 % in acute myelogenous leukemia (AML) and it was 43.06 % in acute lymphocytic leukemia (ALL). The 1,2,3,4 and 5-year survival of acute leukemia was respectively 87.1 %, 69.4 %, 62.4 %, 56.5 % and 45.9 %. Conclusion: Iran's health system should design and plan to increase the survival of patients with acute leukemia by improving the methods and facilities to diagnose and treat it more quickly and more effectively.

Evaluation of Apaf-1 and procaspases-2, -3, -7, -8, and -9 as potential prognostic markers in acute leukemia

Blood ◽  
2000 ◽  
Vol 96 (12) ◽  
pp. 3922-3931 ◽  
Author(s):  
Phyllis A. Svingen ◽  
Judith E. Karp ◽  
Stan Krajewski ◽  
Peter W. Mesner ◽  
Steven D. Gore ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Prognostic Markers ◽  
Cysteine Proteases ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Paired Samples ◽  
Initiator Caspases ◽  
Cast Doubt ◽  
Acute Myelogenous ◽  
Highly Correlated

Recent studies have suggested that variations in levels of caspases, a family of intracellular cysteine proteases, can profoundly affect the ability of cells to undergo apoptosis. In this study, immunoblotting was used to examine levels of apoptotic protease activating factor-1 (Apaf-1) and procaspases-2, -3, -7, -8, and -9 in bone marrow samples (at least 80% leukemia) harvested before chemotherapy from adults with newly diagnosed acute myelogenous leukemia (AML, 42 patients) and acute lymphocytic leukemia (ALL, 18 patients). Levels of each of these polypeptides varied over a more than 10-fold range between specimens. In AML samples, expression of procaspase-2 correlated with levels of Apaf-1 (Rs = 0.52, P < .02), procaspase-3 (Rs = 0.56,P < .006) and procaspase-8 (Rs = 0.64, P < .002). In ALL samples, expression of procaspases-7 and -9 was highly correlated (Rs = 0.90,P < .003). Levels of these polypeptides did not correlate with prognostic factors or response to induction chemotherapy. In further studies, 16 paired samples (13 AML, 3 ALL), the first harvested before induction therapy and the second harvested at the time of leukemia regrowth, were also examined. There were no systematic alterations in levels of Apaf-1 or procaspases at relapse compared with diagnosis. These results indicate that levels of initiator caspases vary widely among different leukemia specimens but cast doubt on the hypothesis that this variation is a major determinant of drug sensitivity for acute leukemia in the clinical setting.

scholarly journals Reticulin Fibrosis and Bone Infarction in Acute Leukemia. Implications for Prognosis

Blood ◽  
1964 ◽  
Vol 23 (4) ◽  
pp. 526-544 ◽  
Author(s):  
DONALD W. KUNDEL ◽  
GEORGE BRECHER ◽  
GERALD P. BODEY ◽  
GEOFFREY M. BRITTIN
Keyword(s):  
Acute Leukemia ◽  
Acute Myelogenous Leukemia ◽  
Acute Lymphocytic Leukemia ◽  
Bone Pain ◽  
Needle Aspiration ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Bone Necrosis ◽  
Short Survival ◽  
Acute Myelogenous

Abstract Reticulin fibrosis was found in 21 of 40 patients with acute lymphocytic leukemia when marrows were studied sequentially by Vim-Silverman needle biopsies. Reticulin fibrosis frequently occurred early in the development of the disease. Mild degrees were completely reversible with remission, severe degrees usually persisted, even through remissions. Fibrosis appeared to develop during relapse. Duration of the disease in itself had little influence on the degree of reticulin fibrosis, and collagen fibrosis seldom followed reticulin fibrosis even after many months’ duration. The prognosis of patients with reticulin fibrosis of their marrows was definitely poorer than for the group without increased reticulin. Reticulin fibrosis virtually always prevented successful marrow biopsies by the standard technic of needle aspiration. Bone necrosis occurred in 11 of 75 patients with acute lymphocytic leukemia, but in none of 53 patients with acute myelogenous leukemia studied by Vim-Silverman needle biopsies during life or at autopsy. Bone necrosis was the major cause of severe bone pain and it was always associated with reticulin fibrosis of the marrow. Bone infarcts were not associated with short survival in all cases, but in general the prognosis of patients with bone necrosis was even poorer than that of patients with reticulin fibrosis but without demonstrable infarction.

DNA-RNA measurements in patients with acute leukemia undergoing remission induction therapy.

1985 ◽  
Vol 3 (6) ◽  
pp. 799-808 ◽  
Author(s):  
A M Maddox ◽  
D A Johnston ◽  
B Barlogie ◽  
E Youness ◽  
M Keating ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
S Phase ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Remission Induction ◽  
Newly Diagnosed ◽  
Bone Marrow Biopsies ◽  
Long Duration ◽  
Acute Myelogenous ◽  
The Mean

Prior to therapy, 111 newly diagnosed adult patients with acute leukemia had DNA content measured (cell-cycle distributions) and 91 had RNA content measured using flow cytometry of acridine orange-stained bone marrow biopsies. The RNA index (RI) (ratio of mean RNA in G0/G1 of the sample to the median RNA in G0/G1 of normal lymphocytes) distinguished acute myelogenous leukemia (AML) from acute lymphocytic leukemia (ALL). The mean RI in AML was 2.2 and in ALL 1.5. RI did not predict for achievement of complete remission (CR). In AML the mean S-phase percent was 11.2 in patients who achieved CR and 13.1 in those who failed to respond to therapy, whereas in ALL it was 14.5 in those responding and 8.0 in those not responding (P = .02). In the 77 patients with either AML or ALL who achieved CR, a low pretreatment S-phase percent and a high RI correlated with a long duration of CR. S-phase percent and RI were also measured during remission induction and during maintenance therapy. Between days 8 and 18, the RI of responders decreased. In both AML and ALL an increase in S-phase percent between days 18 and 22, prior to morphological CR, was observed in responders but not in nonresponders. The mean S-phase percent at the time of morphological remission was 17.3. A high S-phase percent at this time correlated with a longer duration of CR. Although neither pretreatment S-phase percent nor RI was found to predict for achievement of CR in AML, both predicted for length of CR. Increases in S-phase percent during therapy indicated recovery of normal hematopoiesis.

scholarly journals Molecular heterogeneity in acute leukemia lineage switch

Blood ◽  
1989 ◽  
Vol 74 (6) ◽  
pp. 2088-2095 ◽  
Author(s):  
GA Gagnon ◽  
CC Childs ◽  
A LeMaistre ◽  
M Keating ◽  
A Cork ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Acute Myelogenous Leukemia ◽  
Single Case ◽  
Cell Receptor ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Molecular Heterogeneity ◽  
Lineage Switch ◽  
Acute Myelogenous ◽  
Chromosomal Changes

Abstract Six cases of acute leukemia that underwent lineage switch from acute lymphocytic leukemia to acute myelogenous leukemia are reported. The mean age of the patients was 24 years, time to conversion was 36 months, and survival after conversion was only 3 months. Of the three cases which showed abnormal metaphases at both diagnosis and conversion, two (cases 2, 5) showed related cytogenetic abnormalities, and the third showed (case 3) independent chromosomal changes. Molecular analysis for immunoglobulin heavy chain and T-cell receptor beta chain genes showed that five of the six cases had rearrangement of at least one of these lymphoid associated genes at conversion to acute myelogenous leukemia. The single case (case 3) in which there were no lymphoid gene rearrangements at conversion was also the only case in which independent karyotypic abnormalities at diagnosis and conversion were demonstrated. Our findings suggest that lineage switch can represent either relapse of the original clone with heterogeneity at the molecular level or the emergence of a second new leukemic clone without molecular heterogeneity.

scholarly journals 5-Azacytidine: A New Active Agent for the Treatment of Acute Leukemia

Blood ◽  
1973 ◽  
Vol 42 (3) ◽  
pp. 359-365 ◽  
Author(s):  
Myron Karon ◽  
Lance Sieger ◽  
Suzanne Leimbrock ◽  
Jerry Z. Finklestein ◽  
Mark E. Nesbit ◽  
...  
Keyword(s):  
Complete Remission ◽  
Acute Leukemia ◽  
Acute Myelogenous Leukemia ◽  
Acute Lymphocytic Leukemia ◽  
Active Agent ◽  
Maximum Tolerated Dose ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Acute Myelogenous ◽  
Important Addition

Abstract Thirty-seven children with acute leukemia were treated with 5-azacytidine in 5-day courses given every 14 days. Six out of 14 children with acute myelogenous leukemia who were adequately treated achieved an M1 marrow. Five of these subsequently developed complete remissions lasting 8 mo, 6 mo, 3 mo, 2 mo, and 2 mo. Of 22 children with acute lymphocytic leukemia, one achieved an M1 marrow and one an M2 marrow. The former attained a complete remission which lasted 3 mo. The maximum tolerated dose is between 150 to 200 mg/sq m on a daily x 5 schedule given every 14 days. The impressive activity of 5-aza-C in patients with acute myelogenous leukemia resistant to cytosine arabinoside indicates that this drug will become an important addition to the therapeutic armamentaria against this type of leukemia.

scholarly journals Significance of the P210 versus P190 molecular abnormalities in adults with Philadelphia chromosome-positive acute leukemia

Blood ◽  
1991 ◽  
Vol 78 (9) ◽  
pp. 2411-2418 ◽  
Author(s):  
HM Kantarjian ◽  
M Talpaz ◽  
K Dhingra ◽  
E Estey ◽  
MJ Keating ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Philadelphia Chromosome ◽  
Chronic Phase ◽  
Complete Response ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Karyotypic Analysis ◽  
Molecular Abnormalities ◽  
Acute Myelogenous ◽  
Prognostic Implications

Abstract We investigated the significance of p210 and p190 molecular abnormalities in 32 adults with Philadelphia chromosome (Ph)-positive acute leukemia. p210 was detected in 15 patients (47%), p190 in 16 (50%), and both in one (3%). p210 was noted in 11 of 24 patients (46%) with acute lymphocytic leukemia, and in four of eight patients (50%) with acute myelogenous or undifferentiated leukemia. Among 29 patients with untreated disease (p210, 14 patients; p190, 15 patients), no significant differences in the two molecularly distinct groups were observed by pretreatment characteristics including age, degree of organomegaly, anemia, leukocytosis, thrombocytopenia, occurrence of karyotypic abnormalities in addition to Ph, or residual diploid metaphases. Complete response (CR) rates were also similar. Although the remission duration tended to be longer with p190 (P = .08), the differences were minor (median duration 29 v 20 weeks) and not paralleled by differences in survival rate. In 10 patients studied by karyotypic analysis in remission, two of four patients with p190 and two of six patients with p210 showed 100% normal metaphases. One of the seven patients (14%) with p210 who achieved CR manifested a morphologic picture of second chronic-phase chronic myelogenous leukemia lasting for 1 month. We conclude that the molecular studies in Ph-positive acute leukemia are not associated with significantly different clinico- laboratory, karyotypic, or prognostic implications.

scholarly journals Molecular heterogeneity in acute leukemia lineage switch

Blood ◽  
1989 ◽  
Vol 74 (6) ◽  
pp. 2088-2095 ◽  
Author(s):  
GA Gagnon ◽  
CC Childs ◽  
A LeMaistre ◽  
M Keating ◽  
A Cork ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Acute Myelogenous Leukemia ◽  
Single Case ◽  
Cell Receptor ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Molecular Heterogeneity ◽  
Lineage Switch ◽  
Acute Myelogenous ◽  
Chromosomal Changes

Six cases of acute leukemia that underwent lineage switch from acute lymphocytic leukemia to acute myelogenous leukemia are reported. The mean age of the patients was 24 years, time to conversion was 36 months, and survival after conversion was only 3 months. Of the three cases which showed abnormal metaphases at both diagnosis and conversion, two (cases 2, 5) showed related cytogenetic abnormalities, and the third showed (case 3) independent chromosomal changes. Molecular analysis for immunoglobulin heavy chain and T-cell receptor beta chain genes showed that five of the six cases had rearrangement of at least one of these lymphoid associated genes at conversion to acute myelogenous leukemia. The single case (case 3) in which there were no lymphoid gene rearrangements at conversion was also the only case in which independent karyotypic abnormalities at diagnosis and conversion were demonstrated. Our findings suggest that lineage switch can represent either relapse of the original clone with heterogeneity at the molecular level or the emergence of a second new leukemic clone without molecular heterogeneity.

scholarly journals Significance of the P210 versus P190 molecular abnormalities in adults with Philadelphia chromosome-positive acute leukemia

Blood ◽  
1991 ◽  
Vol 78 (9) ◽  
pp. 2411-2418 ◽  
Author(s):  
HM Kantarjian ◽  
M Talpaz ◽  
K Dhingra ◽  
E Estey ◽  
MJ Keating ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Philadelphia Chromosome ◽  
Chronic Phase ◽  
Complete Response ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Karyotypic Analysis ◽  
Molecular Abnormalities ◽  
Acute Myelogenous ◽  
Prognostic Implications

We investigated the significance of p210 and p190 molecular abnormalities in 32 adults with Philadelphia chromosome (Ph)-positive acute leukemia. p210 was detected in 15 patients (47%), p190 in 16 (50%), and both in one (3%). p210 was noted in 11 of 24 patients (46%) with acute lymphocytic leukemia, and in four of eight patients (50%) with acute myelogenous or undifferentiated leukemia. Among 29 patients with untreated disease (p210, 14 patients; p190, 15 patients), no significant differences in the two molecularly distinct groups were observed by pretreatment characteristics including age, degree of organomegaly, anemia, leukocytosis, thrombocytopenia, occurrence of karyotypic abnormalities in addition to Ph, or residual diploid metaphases. Complete response (CR) rates were also similar. Although the remission duration tended to be longer with p190 (P = .08), the differences were minor (median duration 29 v 20 weeks) and not paralleled by differences in survival rate. In 10 patients studied by karyotypic analysis in remission, two of four patients with p190 and two of six patients with p210 showed 100% normal metaphases. One of the seven patients (14%) with p210 who achieved CR manifested a morphologic picture of second chronic-phase chronic myelogenous leukemia lasting for 1 month. We conclude that the molecular studies in Ph-positive acute leukemia are not associated with significantly different clinico- laboratory, karyotypic, or prognostic implications.

scholarly journals Prevalence of Acute and Chronic Forms of Leukemia in Various Regions of Khyber Pakhtunkhwa, Pakistan: Needs Much More to be done!

2019 ◽  
Vol 18 (2) ◽  
pp. 222-227
Author(s):  
Shujaat Ahmad ◽  
Kifayatullah ◽  
Kiramat Ali Shah ◽  
Haya Hussain ◽  
Anwar Ul Haq ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Research Study ◽  
Medical Science ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Female Ratio ◽  
Chronic Leukemia ◽  
Khyber Pakhtunkhwa ◽  
Acute Myelogenous ◽  
Male Patients

Background and objective: Leukemia is one of the fatal diseases and their morbidity and mortality rates increases day by day all over the world. This piece of research study was designed in order to find out the prevalence of different types of leukemia in Khyber Pakhtunkhwa, Pakistan during January 2015 to December 2016. Material and Method: The retrospective research study was carried out at Institute of Radiotherapy and Nuclear Medicine (IRNUM) Peshawar. A data of 400 admitted patients of leukemia were evaluated. Result: It was observed that acute leukemia (80%) was more prevalent than chronic leukemia (20%). Amongst types of leukemia, Acute Lymphocytic Leukemia (ALL) 49.5% (n=198) was more prevalent than Acute Myelogenous Leukemia (AML) 31.25% (n=125), Chronic Myelogenous Leukemia (CML) 10% (n=40) and Chronic Lymphocytic Leukemia (CLL) 9.25% (n=37) was less prevalent in this study. It was also found that leukemia was more prevalent in male patients 64.5% (n=258) as compared to females 35.5% (n=142) and male to female ratio was 1.8:1. Most of the patients were under the age of 20 years. Conclusion: Acute leukemia was more prevalent than chronic leukemia during this study in this part of the country and needs to be address. Bangladesh Journal of Medical Science Vol.18(2) 2019 p.222-227

Evaluation of Apaf-1 and procaspases-2, -3, -7, -8, and -9 as potential prognostic markers in acute leukemia

Blood ◽  
2000 ◽  
Vol 96 (12) ◽  
pp. 3922-3931 ◽  
Author(s):  
Phyllis A. Svingen ◽  
Judith E. Karp ◽  
Stan Krajewski ◽  
Peter W. Mesner ◽  
Steven D. Gore ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Prognostic Markers ◽  
Cysteine Proteases ◽  
Lymphocytic Leukemia ◽  
Myelogenous Leukemia ◽  
Paired Samples ◽  
Initiator Caspases ◽  
Cast Doubt ◽  
Acute Myelogenous ◽  
Highly Correlated

Abstract Recent studies have suggested that variations in levels of caspases, a family of intracellular cysteine proteases, can profoundly affect the ability of cells to undergo apoptosis. In this study, immunoblotting was used to examine levels of apoptotic protease activating factor-1 (Apaf-1) and procaspases-2, -3, -7, -8, and -9 in bone marrow samples (at least 80% leukemia) harvested before chemotherapy from adults with newly diagnosed acute myelogenous leukemia (AML, 42 patients) and acute lymphocytic leukemia (ALL, 18 patients). Levels of each of these polypeptides varied over a more than 10-fold range between specimens. In AML samples, expression of procaspase-2 correlated with levels of Apaf-1 (Rs = 0.52, P &lt; .02), procaspase-3 (Rs = 0.56,P &lt; .006) and procaspase-8 (Rs = 0.64, P &lt; .002). In ALL samples, expression of procaspases-7 and -9 was highly correlated (Rs = 0.90,P &lt; .003). Levels of these polypeptides did not correlate with prognostic factors or response to induction chemotherapy. In further studies, 16 paired samples (13 AML, 3 ALL), the first harvested before induction therapy and the second harvested at the time of leukemia regrowth, were also examined. There were no systematic alterations in levels of Apaf-1 or procaspases at relapse compared with diagnosis. These results indicate that levels of initiator caspases vary widely among different leukemia specimens but cast doubt on the hypothesis that this variation is a major determinant of drug sensitivity for acute leukemia in the clinical setting.

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