Neopteryna jako wskaźnik stanu zapalnego i rozrostu nowotworowego w ostrych białaczkach

2018 ◽  
Vol 21 (1) ◽  
Author(s):  
Jadwiga Nowicka ◽  
Wiesława Nahaczewska ◽  
Iwona Urbanowicz ◽  
Mieczysław Woźniak
Keyword(s):  
Acute Leukemia ◽  
Viral Infections ◽  
Lymphoblastic Leukemia ◽  
Elevated Serum ◽  
Control Group ◽  
Inflammatory Condition ◽  
Acute Leukemias ◽  
Serum Neopterin ◽  
Neopterin Concentration ◽  
Cellular Immune

Introduction. Neopterin (NPT) is a sensitive marker for cellular immune responses. It is a pteridine group compound as a dye substance in insects, lower vertebrata and mammals. Neopterin is released from human monocytes, macrophages and dendritic cells upon stimulation by interferon gamma produced by T-lymphocytes. High neopterin concentrations in serum and urine were shown to be a reliable indicator for the severity of bacterial, viral infections including autoimmune diseases, allograft rejections and various malignant disorders. Aim. The aim of the study was the concentration of the neopterin in acute leukemias may be an endogenous marker of unfavorable processes in acute leukemia for which the growth of the tumor, the coexistence of inflammation. Material and methods. The studies involved 80 patients suffering from acute leukemias including 53 patients with acute myeloid leukemia, 21 patients with acute lymphoblastic leukemia and 6 patients with mixed phenotype acute leukemia. The patients with acute leukemia was analyzed as a group with inflammatory condition and a group without inflammatory condition. The quantitative assessment of serum neopterin level was performed by means of immunoenzymatic test ELISA. Results. Patients with all types of leukemia showed elevated serum neopterin levels in comparison to the control group and significantly elevated neopterin levels in patients with coexisting inflammation compared to the values of these parameters in patients without inflammation. The neopterin concentration was highest in the group of patients diagnosed with acute M4 and M5 leukemia, both without inflammation (32.8 ± 13.6 nmol/l) and with co-existing inflammation (116.57 ± 97.0 nmol/l) (p = 0.00024). Conclusions. Neopterin as a marker of malignant hyperplasia may be used only in cases where inflammation does not occur.

Elevated Serum Neopterin Levels in Acute Rheumatic Fever

Pteridines ◽  
1993 ◽  
Vol 4 (1) ◽  
pp. 39-42 ◽  
Author(s):  
M.Y. Samsonov ◽  
G. Reibnegger ◽  
E.L. Nassonov ◽  
V.A Nassonova ◽  
H. Wachter ◽  
...  
Keyword(s):  
Rheumatic Fever ◽  
Acute Rheumatic Fever ◽  
Elevated Serum ◽  
Predictive Marker ◽  
Serum Neopterin ◽  
Neopterin Concentration ◽  
Aortic Incompetence ◽  
Cellular Immune ◽  
Valve Lesions

Summary A link between acute rheumatic fever (ARF) and autoimmune disorders has been postulated. To investigate this relationship. we performed radioimmunoassay measurements of serum neoplerin levels in patients with ARF. Twenty-five young men with ARF were included in our study. Patients were investigated on 3-7 days after the onset of symptoms and on the 30th-35th days after onset. Serum neopterin levels were elevated (>8.7 nmol/L) in 17 out of 25 patients with ARF. Mean neopterin concentration was significantly higher in ARF patients (10.9± 3.9 nmol/L) compared to healthy controls (5.2± 2.1 nmol/L; p<0.001). After treatment of patients .with antibiotics and indometacin, neopterin levels were normal in 16 of 23 patients. There was an association between higher neopterin concentration and development of aortic incompetence during follow-up (p<0.05). Also a significant correlation between neopterin and haemoglobin levels was observed (R= - 0.40. p = 0.(2). The increased neopterin levels indicate enhanced cellular immune activation in patients with ARF. The data suggest that serum neopterin might he a predictive marker of aortic valve lesions in patients with ARF.

scholarly journals PIM2 and NF-κβ gene expression in a sample of AML and ALL Egyptian patients and its relevance to response to treatment

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Shymaa Kamal El Din Abed El Rahman ◽  
Sanaa Sayed Abd Elshafy ◽  
Mohamed Samra ◽  
Hala Mohammed Ali ◽  
Rabab Afifi Mohamed
Keyword(s):  
Overall Survival ◽  
Acute Leukemia ◽  
De Novo ◽  
Lymphoblastic Leukemia ◽  
Expression Level ◽  
Response To Treatment ◽  
Control Group ◽  
Poor Overall Survival ◽  
Healthy Control ◽  
Complete Blood Counts

Abstract Background The relation between PIM2 and the transcriptional factor NF κβ have been controversial in literature. The significance of PIM2 and NF-κβ genes expression on the incidence of acute leukemia (AML and ALL) and its relevance to the response rate was evaluated. Sixty de novo acute leukemia patients were stratified in 2 groups: 30 acute myeloid leukemia (AML) and 30 acute lymphoblastic leukemia (ALL) patients and compared to 30 sex- and age-matched controls. The expression level of PIM2 and NF κβ genes was measured using quantitative real-time polymerase chain reaction (QRT-PCR). The patients were followed with clinical examination and complete blood counts. Results The expression level of PIM2 gene was significantly higher in AML patients (P<0.001) compared to the control group. The mean expression level of NF κβ gene was significantly high in AML and ALL patients compared to the healthy control group (P=0.037 and P<0.001; respectively). The overall survival in AML patients was higher in NF κβ gene low expressers compared to high expressers (P=0.047). The number of AML patients who achieved complete remission was significantly higher in PIM2 gene low expressers in comparison to PIM2 gene high expressers (P=0.042). Conclusion PIM2 and NF κβ genes might have a role in the pathogenesis of acute leukemia, poor overall survival, and failure of response to induction therapy.

scholarly journals Initial Diagnostic Workup of Acute Leukemia: Guideline From the College of American Pathologists and the American Society of Hematology

2017 ◽  
Vol 141 (10) ◽  
pp. 1342-1393 ◽  
Author(s):  
Daniel A. Arber ◽  
Michael J. Borowitz ◽  
Melissa Cessna ◽  
Joan Etzell ◽  
Kathryn Foucar ◽  
...  
Keyword(s):  
Genetic Testing ◽  
Acute Leukemia ◽  
Lymphoblastic Leukemia ◽  
Molecular Genetic ◽  
Clinical Information ◽  
Molecular Genetic Testing ◽  
Acute Leukemias ◽  
Prognostic Evaluation ◽  
The Public ◽  
American Society

Context.— A complete diagnosis of acute leukemia requires knowledge of clinical information combined with morphologic evaluation, immunophenotyping and karyotype analysis, and often, molecular genetic testing. Although many aspects of the workup for acute leukemia are well accepted, few guidelines have addressed the different aspects of the diagnostic evaluation of samples from patients suspected to have acute leukemia. Objective.— To develop a guideline for treating physicians and pathologists involved in the diagnostic and prognostic evaluation of new acute leukemia samples, including acute lymphoblastic leukemia, acute myeloid leukemia, and acute leukemias of ambiguous lineage. Design.— The College of American Pathologists and the American Society of Hematology convened a panel of experts in hematology and hematopathology to develop recommendations. A systematic evidence review was conducted to address 6 key questions. Recommendations were derived from strength of evidence, feedback received during the public comment period, and expert panel consensus. Results.— Twenty-seven guideline statements were established, which ranged from recommendations on what clinical and laboratory information should be available as part of the diagnostic and prognostic evaluation of acute leukemia samples to what types of testing should be performed routinely, with recommendations on where such testing should be performed and how the results should be reported. Conclusions.— The guideline provides a framework for the multiple steps, including laboratory testing, in the evaluation of acute leukemia samples. Some aspects of the guideline, especially molecular genetic testing in acute leukemia, are rapidly changing with new supportive literature, which will require on-going updates for the guideline to remain relevant.

Acute Leukemia

2016 ◽  
Author(s):  
Richard A. Larson ◽  
Roland B Walter
Keyword(s):  
Acute Myeloid Leukemia ◽  
Acute Lymphoblastic Leukemia ◽  
Acute Leukemia ◽  
Myeloid Leukemia ◽  
Who Classification ◽  
Lymphoblastic Leukemia ◽  
World Health ◽  
Acute Leukemias ◽  
Acute Myeloid

The acute leukemias are malignant clonal disorders characterized by aberrant differentiation and proliferation of transformed hematopoietic progenitor cells. These cells accumulate within the bone marrow and lead to suppression of the production of normal blood cells, with resulting symptoms from varying degrees of anemia, neutropenia, and thrombocytopenia or from infiltration into tissues. They are currently classified by their presumed cell of origin, although the field is moving rapidly to genetic subclassification. This review covers epidemiology; etiology; classification of leukemia by morphology, immunophenotyping, and cytogenetic/molecular abnormalities; cytogenetics of acute leukemia; general principles of therapy; acute myeloid leukemia; acute lymphoblastic leukemia; and future possibilities. The figure shows the incidence of acute leukemias in the United States. Tables list World Health Organization (WHO) classification of acute myeloid leukemia and related neoplasms, expression of cell surface and cytoplasmic markers for the diagnosis of acute myeloid leukemia and mixed-phenotype acute leukemia, WHO classification of acute lymphoblastic leukemia, WHO classification of acute leukemias of ambiguous lineage, WHO classification of myelodysplastic syndromes, European LeukemiaNet cytogenetic and molecular genetic subsets in acute myeloid leukemia with prognostic importance, cytogenetic and molecular subtypes of acute lymphoblastic leukemia, terminology used in leukemia treatment, and treatment outcome for adults with acute leukemia. This review contains 1 highly rendered figure, 9 tables, and 117 references.

scholarly journals Clonal Evolution of B-Cell Acute Lymphoblastic Leukemia with del(9)(p13p21) into Mixed Phenotype Acute Leukemia Presenting as an Isolated Testicular Relapse

Reports ◽  
2019 ◽  
Vol 2 (3) ◽  
pp. 18 ◽  
Author(s):  
Miller ◽  
Park ◽  
Saxe ◽  
Lew ◽  
Raikar
Keyword(s):  
Acute Lymphoblastic Leukemia ◽  
Acute Leukemia ◽  
B Cell ◽  
Lymphoblastic Leukemia ◽  
Clonal Evolution ◽  
Acute Leukemias ◽  
Cytogenetic Aberrations ◽  
Mixed Phenotype Acute Leukemia ◽  
Cell Acute Lymphoblastic Leukemia ◽  
Mixed Phenotype

Lineage switch in acute leukemias is a well-reported occurrence; however, most of these cases involve a switch from either lymphoid to myeloid or myeloid to lymphoid lineage. Here, we report a case of a 14-year-old male with B-cell acute lymphoblastic leukemia (B-ALL) who initially responded well to standard chemotherapy but then later developed mixed phenotype acute leukemia (MPAL) at relapse, likely reflecting a clonal evolution of the original leukemia with a partial phenotypic shift. The patient had a del(9)(p13p21) in his leukemia blasts at diagnosis, and the deletion persisted at relapse along with multiple additional cytogenetic aberrations. Interestingly, the patient presented with an isolated testicular lesion at relapse, which on further analysis revealed both a lymphoid and myeloid component. Unfortunately, the patient did not respond well to treatment at relapse and eventually succumbed to his disease. To our knowledge, an isolated extramedullary MPAL at relapse in a patient with previously diagnosed B-ALL has not been reported in the literature before.

scholarly journals Characterization of Thy-1 (CDw90) expression in CD34+ acute leukemia

Blood ◽  
1995 ◽  
Vol 86 (1) ◽  
pp. 60-65 ◽  
Author(s):  
JT Holden ◽  
RB Geller ◽  
DC Farhi ◽  
HK Holland ◽  
LL Stempora ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Stem Cell ◽  
Acute Leukemia ◽  
Lymphoblastic Leukemia ◽  
Blast Crisis ◽  
Myelogenous Leukemia ◽  
Acute Leukemias ◽  
Hematopoietic Stem

Thy-1 (CDw90) is a phosphatidylinositol-anchored cell surface molecule which, when coexpressed with CD34 in normal human bone marrow, identifies a population of immature cells that includes putative hematopoietic stem cells. To date, the characterization of Thy-1 expression has been confined largely to normal tissues and cell lines. In this study, we evaluated the frequency and intensity of Thy-1 expression as defined by reactivity with the anti-Thy-1 antibody 5E10 in 38 cases of CD34+ acute leukemia (21 acute myelogenous leukemia [AML], 8 chronic myelogenous leukemia [CML] in blast crisis, and 9 acute lymphoblastic leukemia [ALL]). In 34 of 38 cases (89%) the CD34+ cells lacked expression of the Thy-1 antigen. High-density Thy-1 expression was found in 1 case of CML in lymphoid blast crisis, and low- density Thy-1 expression was identified on a portion of the leukemic cells in 2 cases of AML with myelodysplastic features, and 1 case of CML in myeloid blast crisis, suggesting a possible correlation between Thy-1 expression and certain instances of stem cell disorders such as CML and AML with dysplastic features. In contrast, the dissociation of Thy-1 and CD34 expression in the majority of acute leukemias studied suggests that the development of these leukemias occurs at a later stage than the hematopoietic stem cell. Characterization of Thy-1 expression in acute leukemia may eventually provide insights into the origin of the disease. In addition, separation of leukemic blasts from normal stem cells based on Thy-1 expression may prove useful in assessing residual disease, as well as in excluding leukemic blasts from stem cell preparations destined for autologous bone marrow or peripheral stem cell transplantation.

The Reliability and Specificity of c-kit for the Diagnosis of Acute Myeloid Leukemias and Undifferentiated Leukemias

Blood ◽  
1998 ◽  
Vol 92 (2) ◽  
pp. 596-599 ◽  
Author(s):  
M.C. Bene ◽  
M. Bernier ◽  
R.O. Casasnovas ◽  
G. Castoldi ◽  
W. Knapp ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
De Novo ◽  
Lymphoblastic Leukemia ◽  
Cell Lineage ◽  
Specific Marker ◽  
Acute Leukemias ◽  
Routine Basis ◽  
Immunological Classification ◽  
B Lineage ◽  
Acute Myeloid

Abstract We document findings on c-kit (CD117) expression in 1,937 pediatric and adult de novo acute leukemia cases, diagnosed in five single European centers. All cases were well characterized as to the morphologic, cytochemical, and immunologic features, according to the European Group for the Immunological Classification of Leukemias (EGIL). The cases included 1,103 acute myeloid leukemia (AML), 819 acute lymphoblastic leukemia (ALL), 11 biphenotypic acute leukemia (BAL), and 4 undifferentiated (AUL). c-kit was expressed in 741 (67%) AML cases, regardless of the French-American-British (FAB) subtype, one third of BAL, all four AUL, but only in 34 (4%) of ALL cases. The minority of c-kit+ ALL cases were classified as: T-cell lineage (two thirds), mainly pro-T–ALL or T-I, and B lineage (one third); cells from 62% of these ALL cases coexpressed other myeloid markers (CD13, CD33, or both). There were no differences in the frequency of c-kit+ AML or ALL cases according to age being similar in the adult and pediatric groups. Our findings demonstrate that c-kit is a reliable and specific marker to detect leukemia cells committed to the myeloid lineage, and therefore should be included in a routine basis for the diagnosis of acute leukemias to demonstrate myeloid commitment of the blasts. c-kit expression should score higher, at least one point, in the system currently applied to the diagnosis of BAL, as its myeloid specificity is greater than CD13 and CD33. Findings in ALL and AUL suggest that c-kit identifies a subgroup of cases, which may correspond to leukemias either arising from early prothymocytes and/or early hematopoietic cells, both able to differentiate to the lymphoid and myeloid pathways.

Use of Erythropoietin (EPO) in Children with Malignancies.

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 5533-5533
Author(s):  
Gabor T. Kovacs ◽  
Judit Muller ◽  
Monika Csoka ◽  
Eszter Vonnak ◽  
Hajna Erlaky ◽  
...  
Keyword(s):  
Pediatric Population ◽  
Lymphoblastic Leukemia ◽  
Elevated Serum ◽  
Serum Levels ◽  
Control Group ◽  
Recombinant Erythropoietin ◽  
Malignant Diseases ◽  
Human Erythropoietin ◽  
Unsuccessful Treatment ◽  
The Mean

Abstract Recombinant erythropoietin is widely used for the treatment of anemia in malignant diseases in adults. There are only limited data of its use in pediatric population. In this study we analysed the effectiveness and tolerability of recombinant human erythropoietin (NeoRecormon) in children with malignant diseases. 80 children with malignant diseases were analysed. 40 patients (15 girls, 25 boys) received EPO in a mean dosage of 144.5±14.1 IU/kg three times a week. The mean age of the EPO-treated patients was 8.8 (2.5–16) years. 26 children had acute lymphoblastic leukemia and 14 patients had solid tumor. Match-paired, retrospective control patients (n=40) with similar diagnosis were used for the data analysis as control group (C). The mean duration of EPO treatment was 5.8 months (3–8 mo). In 6 patients the therapy was ceased due to elevated serum hemoglobin (Hb) (>130 g/L), in 6 patients the dose was increased up to 200 IU/kg three times a week, and 5 patients discontinued the therapy (2 died, 3 unsuccessful treatment). The mean amount of erythrocyte transfusion in the first 3 months of chemotherapy (CT) was 4.1±3.1 U/patient in the EPO group, and 8.0±4.2 in C, and during 6 months of CT 4.5±3.4 with EPO, and 11.6±7.1 in C (p<0.05). Soluble transferrine receptor (STFR) levels in serum increased in the EPO group after 2 weeks of therapy from 3.2±2.0 up to 4.8±2.9 (p<0.05). In general in 26/40 patients a significant elevation of the Hb levels and decrease of the need of erythrocyte transfusions could be detected. In 22 patients the STFR levels increased more than 50 % after 2 weeks of therapy. In this subgroup 18/22 children responded to EPO therapy. All patients tolerated the therapy well, no severe side effects were detected. In summary, EPO treatment is effective in about 2/3 of pediatric oncology patients. The therapy is well-tolerated. Increase in the STFR serum levels might be a useful marker for the effectiveness of EPO in children.

Incidence of Venothromboembolism (VTE) in Patients (pts) with Acute Lymphocytic Leukemia (ALL), Burkitt’s Leukemia/Lymphoma (BL) or Lymphoblastic Leukemia (LL).

Blood ◽  
2006 ◽  
Vol 108 (11) ◽  
pp. 4534-4534
Author(s):  
Khanh D. Vu ◽  
Deborah A. Thomas ◽  
Julie C. Hubbard ◽  
Stefan Faderl ◽  
Jorge Cortes ◽  
...  
Keyword(s):  
Acute Leukemia ◽  
Upper Extremity ◽  
Lymphoblastic Leukemia ◽  
Bleeding Complications ◽  
Cell Transplant ◽  
Thromboembolic Events ◽  
Maintenance Chemotherapy ◽  
Acute Leukemias ◽  
Vte Prophylaxis ◽  
Increased Risk

Abstract Background: Pts with cancer are at increased risk of thromboembolic events with potentially life-threatening consequences. The incidence of VTE in cancer pts has been estimated at 1 in 250. Although most of these episodes are associated with solid tumors, VTE is also observed in pts with acute leukemias, even in the presence of thrombocytopenia. Anticoagulation in this pt population can be particularly problematic if pts are undergoing myelosuppressive chemotherapy. VTE prophylaxis is often not given because of the perceived high risk of bleeding with a presumed low risk of VTE. Method: As little is known about the incidence and significance of VTE in pts with acute leukemia, we conducted a retrospective chart review of 223 pts with ALL, BL, or LL who received a hyper-CVAD regimen (fractionated cyclophosphamide, vincristine, doxorubicin, dexamethasone alternating with methotrexate and cytarabine) with or without rituximab, maintenance chemotherapy (with L-asparaginase only months #7 & 18), allogeneic stem cell transplant (SCT), or salvage chemotherapy at our institution from November 1999 to May 2005. The median observation period was 112 weeks (range 1–328). Results: The median age was 51 yrs (range 19–75). 70% were ALL, (50% were Philadelphia positive ALL), 20% Burkitt’s or Burkitt’s-like, and 10% LL. Thirty nine of 223 pts (18%) had confirmed VTE by imaging studies: 12.5% prior to or at the time of diagnosis, 57.5% during consolidation chemotherapy, and 27.5% during maintenance chemotherapy, SCT, or supportive care. Location of VTE varied by site: 3/39 (8%) pulmonary embolus, 16/39 (41%) lower extremity, 2/39 (5%) central venous catheter (CVC), and 18/39 (46%) upper extremity. Two of the 18 with upper extremity VTEs did not have CVC, and an additional 2 had bilateral upper extremity thromboses. The platelet counts were reviewed near the time of VTE diagnosis: 22/39 (56%) had greater than 100 × 109/L, 17/39 (44%) were less than that value, with 76% below 50,000 × 109/L. Conclusion: Pts with ALL, BL, and LL undergoing therapy are at risk for developing VTE. Thrombocytopenia does not preclude development of VTE. A more detailed analysis will be forthcoming regarding the risk factors for VTE in this pt population, the current medical practices and bleeding complications with VTE prophylaxis and treatment, and the effect on therapy administration and overall survival. Practice guidelines for management of acute leukemia pts with thromboembolic events should be pursued.

The Serum Fas and Fas Ligand levels in Childhood Acute Leukemias.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 4724-4724
Author(s):  
Alev Kiziltas ◽  
Bulent Antmen ◽  
Ilgen Sasmaz ◽  
Yurdanur Kilinc ◽  
Mustafa Yilmaz ◽  
...  
Keyword(s):  
Fas Ligand ◽  
Conflicts Of Interest ◽  
Cytotoxic T Cells ◽  
Lymphoblastic Leukemia ◽  
Serum Levels ◽  
Control Group ◽  
Extrinsic Pathway ◽  
Acute Leukemias ◽  
Mean Values ◽  
The Mean

Abstract Abstract 4724 Aim Abnormalities and alterations in apoptosis mechanism may lead to cancer development. Cystean proteases enzymes, called caspases, appear to be involved in both the initial signaling events. There are many proteins that trigger intrinsic and extrinsic pathway and induce apoptosis signals. Fas and its specific ligand that known as Fas Ligand are the best defined dead receptors and have functions in apoptosis regulation with many tumor types. Fas binds the ligand on the cytotoxic T cells and start apoptosis. Objectives of this study were to determine serum levels of Fas and Fas Ligand at the time of diagnosis in childhood acute leukemias that may be play important role in apoptosis mechanism. Patients and Methods In this study, we investigated serum Fas and Fas Ligand levels by using ELISA method in childhood acute leukemias. Twenty-nine cases with acute lymphoblastic leukemia and twenty-three cases with acute myeloblastic leukemia at the ages of 1-18 years are included this study. The age distrubition of the control group varied 1-15 years consisted of twenty-seven children. We investigated serum Fas and Fas Ligand levels at the time of diagnosis from peripheral blood samples. Results The comparison of the mean values of Fas and Fas Ligand levels in acute leukemia patients groups and control group have shown important difference as statistically (p<0,05). The mean values of Fas and Fas Ligand levels were higher in ALL and AML patients. The comparison of the mean values of Fas and Fas ligand levels in ALL and AML patients have shown no difference (p>0,05). The comparison of the Fas levels in ALL patients according to immunophenotypes; CALLA(+) B-ALL have higher mean level than T-ALL and shown important difference as statistically (p<0,05). The comparison of the mean values of Fas level at the diagnosis in ALL patients who had relapsed and patients who had remission have shown important difference (p<0,05). The mean values of Fas level were found higher in relapsed ALL patients. In these results showed that Fas and Fas ligand may play important role in apoptosis mechanism. Disclosures: No relevant conflicts of interest to declare.

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