scholarly journals Prevalence and Recurrence Rates of Cytomegalovirus Infection Among Patients With Hematological Diseases in the Western Brazilian Amazon: A Cross-Sectional Study

2021 ◽  
Vol 9 ◽  
Author(s):  
Jean de Melo Silva ◽  
Renato Pinheiro-Silva ◽  
Regiane Costa de Oliveira ◽  
Carlos Eduardo de Castro Alves ◽  
Anderson Nogueira Barbosa ◽  
...  

Cytomegalovirus (CMV) is a worldwide distributed pathogen that may cause serious complications in patients with hematological diseases. This study aimed to serologically characterize CMV infection in patients suffering from hematological diseases in Amazonas state, Brazil. Serum samples from 323 patients were tested for the presence of anti-CMV IgM or IgG antibodies using an enzyme-linked immunosorbent assay. Positive samples for IgM were submitted to the IgG avidity test to differentiate primary infection from recurrent infection. An epidemiological questionnaire was administered to collect the sociodemographic information of the study population. The overall prevalence of CMV infection verified in this study was 91.3%. The highest rates were found in patients suffering from platelet disorders (94.5%), anemia (93.3%), or leukemia (91%). The study population was predominantly composed of individuals with low socioeconomic status. Blood transfusions were more common in patients with anemia or leukemia, but this variable was not correlated with the seropositivity for CMV infection. Measurement of IgG avidity in patients positive for anti-CMV IgM demonstrated a recurrent infection rate of 5.2% (17/323). Over 80% of recurrent infections occurred in patients with acute lymphocytic leukemia (ALL) or anemia. Our findings indicated that CMV infection is highly prevalent in patients from the western Brazilian Amazon who have hematological diseases. The prevalence observed progressively rose with increasing age, whereas anemia or ALL figured as risk factors for the recurrence of CMV infection.

2021 ◽  
Author(s):  
Jean Melo Silva ◽  
Renato Pinheiro-Silva ◽  
Regiane Costa de Oliveira ◽  
Carlos Eduardo De Castro Alves ◽  
Anderson Nogueira Barbosa ◽  
...  

Abstract Purpose: Cytomegalovirus (CMV) is a worldwide distributed pathogen that may cause serious complications in patients with hematological diseases. This study aimed to serologically characterize the CMV infection in patients suffering from hematological diseases in Amazonas, Brazil. Methods: Serum samples from 323 patients were tested for the presence of anti-CMV IgM or IgG antibodies by an enzyme-linked immunosorbent assay. Positive samples for IgM were submitted to the IgG avidity test to differentiate primary infection from recurrent infection. An epidemiological questionnaire was administered to collect sociodemographic information of the study population. Results: The overall prevalence of CMV infection verified in this study was 91.3%. The highest rates were found in patients suffering from platelet disorders (94.5%), anemia (93.3%), or leukemia (91%). The study population was predominantly composed of individuals with low socioeconomic status. Blood transfusions were more often in patients with anemia or leukemia, but it was not correlated with the positivity for CMV infection. Measurement of IgG avidity in patients positive for anti-CMV IgM demonstrated a recurrent infection rate of 5.2% (17/323). Over 80% of recurrent infection occurred in patients with acute lymphocytic leukemia (ALL) or anemia. Conclusions: Our findings indicated that CMV infection is highly prevalent in patients with hematological diseases from the Brazilian western Amazon. The prevalence observed progressively rose with increasing age, whereas anemia or ALL disease figured as risk factors for the recurrence of CMV infection.


Biomolecules ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. 1151
Author(s):  
Lilian Ferrari de Freitas ◽  
Jean de Melo Silva ◽  
Anderson Nogueira Barbosa ◽  
Enzo Miranda Santos ◽  
Renato Pinheiro-Silva ◽  
...  

Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are viruses globally distributed that have been associated with the development and prognosis of many pathologies, including hematological diseases. This study aimed to characterize the epidemiological profile of EBV infection and the infection-correlated hepatic manifestations in patients with hematological diseases of the northern Brazilian state of Amazonas. A total of 228 patients were serologically tested for the presence of anti-EBV and anti-CMV IgG antibodies through an enzyme-linked immunosorbent assay. The coinfection with CMV, sociodemographic and laboratory records of all patients were also assessed. The overall prevalence observed among the study population for EBV infection and EBV/CMV coinfection was 85.09% (95% CI: 0.80–0.90) and 78.51% (95% CI: 0.73–0.84), respectively. The age group 31–40 years old were more susceptible to EBV/CMV coinfection (95% CI: 1.59–93.41, p = 0.011), while young people aged 1–10 years old were less affected for both EBV infection (CI 95%; 0.66–0.91, p = 0.001) and EBV/CMV coinfection (95% CI: 0.52–0.81, p < 0.0001). High serum levels of the liver biomarker ferritin were associated with EBV infection (95% CI: 1.03–1.54, p = 0.031) and EBV/CMV coinfection (95% CI: 1.02–1.70, p = 0.038). Our findings indicated that the elevated prevalence of EBV infection is not associated with the hematological diseases or transfusion rates, but with the socioeconomic status of the study population. Also, this study suggests that the EBV infection and its coinfection with CMV are related to the increase of serum ferritin levels.


2002 ◽  
Vol 9 (4) ◽  
pp. 824-827 ◽  
Author(s):  
Harry E. Prince ◽  
Amy L. Leber

ABSTRACT Measurement of cytomegalovirus (CMV)-specific immunoglobulin G (IgG) avidity has proven to be a powerful tool for distinguishing primary from nonprimary CMV infection. An in-house enzyme-linked immunosorbent assay (ELISA) for measuring CMV IgG avidity was validated using 84 sera from pregnant women who had recently seroconverted following primary CMV infection and 74 sera from individuals with past CMV infection (IgG-positive and IgM-negative profile). Of the 84 sera from pregnant women, 73 sera were collected within 120 days of the last IgG-negative sample, and 72 of these 73 sera (99%) exhibited an avidity index (AI) of <50%. In contrast, 71 of 74 (96%) sera from individuals with past CMV infection exhibited CMV AI values of >60%. Thus, low avidity in the in-house ELISA was defined as an AI of ⩽50%, whereas high avidity was defined as an AI of ⩾60%. In additional studies, the relationship between CMV IgG avidity and CMV IgM levels was examined using 64 CMV IgG-positive sera (time since seroconversion unknown) exhibiting equivocal or positive results in a CMV IgM capture ELISA (Diamedix). Of these 64 sera, 29 exhibited IgM index values of ⩾3.0, and 27 of these 29 (93%) exhibited low IgG avidity. A similar trend was observed when a subset of these 64 sera (n = 48) was tested in another CMV IgM capture ELISA (Trinity); of 18 sera with IgM index values of ⩾3.0, 17 (94%) exhibited low IgG avidity. These findings demonstrate the validity of an in-house ELISA for CMV IgG avidity and further show that strong reactivity of CMV IgG-positive sera in either of two CMV IgM capture assays is a reliable indicator of low CMV IgG avidity, and thus, recent CMV infection.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Silvana A. M. Urru ◽  
Stefania Spila Alegiani ◽  
Anna Guella ◽  
Giuseppe Traversa ◽  
Annalisa Campomori

AbstractComparable clinical efficacy and safety of the reference rituximab (MABTHERA) and its biosimilars has been established in randomized trials. However, safety concerns are often raised when switching from reference to biosimilar products and between different biosimilars. In this prospective observational study we aimed at evaluating the safety of switching between reference and biosimilar rituximab (TRUXIMA and RIXATHON) at Trento General Hospital (Italy). All patients (n = 83) with Non Hodgkin’s Lymphoma (NHL, n = 72) and Chronic Lymphocytic Leukemia (CLL, n = 11) who received rituximab between March 2018 and March 2019 were asked to take part in the study. In 2017 and 2018 two tenders were carried out and two different biosimilars became available in the hospital, these were used sequentially. Thus, patients with or without previous treatments with the originator rituximab either received a biosimilar or were switched between different biosimilars. The incidence of adverse events in these groups of patients is described. The study population received 465 rituximab infusions and all received biosimilars. Fifty patients (60%) experienced at least one switch between different biosimilars or between rituximab originator and biosimilar, whereas 33 (40%) received one of the two biosimilars and one patient received reference rituximab. Adverse events (n = 146) were reported in 71 patients (84.5%). Treatment-related grade 3–4 events were reported in 5 patients (5.9%), whereas grade 1 rituximab related infusion events were observed in 6 patients (7.1%). No safety signal emerged in association with the use of a specific biosimilar nor with the practice of switching. Adverse events were similar, in terms of seriousness and frequency, to those described in the literature, providing further support to the clinical safety of rituximab biosimilars.


2020 ◽  
Vol 11 (1) ◽  
pp. 222
Author(s):  
Julian Matthias Metzler ◽  
Daniel Fink ◽  
Patrick Imesch

Ibrutinib is a small-molecule inhibitor of Bruton’s tyrosine kinase, an enzyme central in B cell development. It is indicated as a therapy for certain hematological diseases such as chronic lymphocytic leukemia (CLL), but also exerts off-target effects on several receptors and kinases. In this paper, we hypothesize that ibrutinib may suppress the tumor marker CA-125 in ovarian cancer. The hypothesis is based on an observation of CA-125 normalization in a patient with low-grade serous ovarian cancer who received ibrutinib for concurrent CLL. We propose a mechanistic model explaining this possible drug effect as a foundation for further research.


2021 ◽  
pp. 61-65
Author(s):  
Saeed Thabet Nasher ◽  
Fayed Alyousufy ◽  
Khaled Alkubati ◽  
Sadam Al Halimy ◽  
Ramia Al Athwary

There is paucity of information about the prevalence of hematological disorders in Yemen and neighboring countries .This is the rst project to evaluate the relative spectrum of hematological diseases in Taiz and Ibb governorate Yemen ,by method of bone marrow examination which is considered an important valuable diagnostic tool, for evaluation and nal diagnosis of various hematological and non-hematological disorders especially when CBC and peripheral blood lm study and other investigation failed to give a diagnosis . OBJECTIVES: The aim of this study was to evaluate the spectrum of haematological diseases diagnosed by bone marrow examination in Taiz and IBB governorates Yemen between September 2016 and October 2020 .Patients and method : A total of 1108 patients aged between (1 -100 )years old were evaluated by bone marrow examination at referral hematological center in IBB city Yemen . Relevant investigations were performed when needed. After exclusion of 98 patients with normal bone marrow ndings ,a total of 1010 patients had hematological disorders , and their data were analyzed. There were 527 (52.2 %) males and 483(47.8 %) females . A total of 655(64.9%) patients had benign hematological diseases and 355 (35.1% ) patients had malignant hematological diseases . RESULTS :A total of 138 patients had Iron deciency anemia ,107 had immune thrombocytopenic purpura (ITP) , 92 had hypersplenism,84 had Acute lymphoblastic leukemia ,79 had Acute myeloid leukaemia, 71 had megaloblastic anemia 58 had myeloproliferative disorder , 53 had Chronic myeloid leukemia , 45 had hemolytic anemia ,45had visceral leishmaniasis. 44 had malaria, 38 had chronic lymphocytic leukemia 38 had anemia of chronic disease ,25 had aplastic anemia ,25 had myelodysplastic syndromes, ,21 had anemia of infection ,19 had congenital syndroms,7had multiple myeloma ,6 had mixed deciency anemia and 5 had metastatic deposits , 4 had myeloid leukomoid reaction ,4 had lymphoma inltration and 2 had hairy cell leukemia . Sex- and age-related distribution of the various disorders was also presented. CONCLUSION: The anemias of all types were the most frequently encountered diagnosis followed by acute and chronic leukemias , ITP , Hypersplenism , ,myeloproliferative disorder , visceral leishmaniasis , malaria, myelodysplastic syndrome and congenital syndromes respectively. The other haematological disorders were less common. These ndings are comparable with published data in previous studies done in Yemen and other developing countries


1999 ◽  
Vol 6 (4) ◽  
pp. 514-518 ◽  
Author(s):  
Malgorzata Paul

ABSTRACT Traditional serological techniques have some limitations in evaluating the duration of Toxoplasma gondii infection in pregnant women, patients with lymphadenopathy, and older children suspected of having congenital toxoplasmosis. In these three groups of patients, two variants of T. gondii immunoglobulin G (IgG) avidity tests were used: an EIA Kit (Labsystems) and a noncommercial enzyme-linked immunosorbent assay specially elaborated in the laboratory. The avidity of specific IgG in sera from 23 patients with a known recently acquired infection (mainly pregnant women) was low (less than 30%), whereas that in sera from 19 patients with toxoplasmic lymphadenopathy of 3 weeks to 6 months in duration (mean, 8.3 weeks) covered a large range (between 0.2 and 57.8%; mean, 25.7%); high avidity results were observed for 10 of 19 patients (52.6%). The large range of IgG avidity in patients with toxoplasmic lymphadenopathy suggests various durations of infection in these patients, with a tendency for a chronic phase of toxoplasmosis. According to the avidity marker, five patients with lymphadenopathy for less than 3 months did not have a recent Toxoplasma infection. In 6 of 19 patients with lymphadenopathy (31.6%), low IgG avidity values persisted until 5 months after the first serological examination. In all four patients with a documented chronic course of Toxoplasma infection (6 months to 8 years after the first positive serology), high IgG avidity values were observed. Among sera from 10 children and young immunocompetent adults suspected of having ocular reactivation of congenital toxoplasmosis, all had high IgG avidity values (over 40%), suggesting congenitally acquired ocular infection rather than noncongenital infection. In conclusion, the avidity of IgG is a valuable marker of recent toxoplasmosis in pregnant women, suggests the duration of invasion in patients with lymphadenopathy, and may be helpful for differentiation between reactivation of congenital infection and recently acquired ocular toxoplasmosis in immunocompetent patients. A low IgG avidity does not always identify a recent case of toxoplasmosis, but a high IgG avidity can exclude primary infections of less than 5 months’ duration.


Author(s):  
Т.Н. Жевак ◽  
Н.П. Чеснокова ◽  
Т.В. Шелехова ◽  
О.Е. Царева ◽  
И.А. Будник ◽  
...  

Цель. Изучить закономерности изменения экспрессии интерлейкина-10 и интерлейкина-24, обладающих иммуномодулирующим эффектом, при развитии B-клеточного хронического лимфолейкоза. С учетом этого выявить информативные прогностические критерии развития гемобластоза и/или нового подхода к терапии заболевания. Методы. У 120 больных с разными стадиями В-клеточного хронического лимфолейкоза методом твердофазного иммуноферментного анализа исследована динамика уровней интерлейкина-10 и интерлейкина-24 в сыворотке крови. Результаты. Обнаружено закономерное повышение содержания интерлейкина-10 и интерлейкина-24 в сыворотке крови пациентов уже на начальной стадии B-клеточного хронического лимфолейкоза и сохранение их достоверно высоких уровней на последующих стадиях заболевания. Заключение. Обнаруженный нами факт повышения содержания интерлейкина-10 в сыворотке крови пациентов с В-клеточным хроническим лимфолейкозом является фактором риска снижения противоопухолевой защиты организма вследствие подавления им механизмов клеточного иммунитета и способности ингибировать апоптоз малигнизированных клеток. Напротив, повышение экспрессии интерлейкина-24, обладающего проапоптотической активностью и стимулирующего дифференцировку клеток, может способствовать повышению эффективности механизмов противоопухолевой резистентности организма. Устранение дисбаланса продукции и/или содержания указанных цитокинов в сыворотке крови может создать условия повышения эффективности терапии пациентов с В-клеточным хроническим лимфолейкозом. Aim. To study serum levels of immunosuppressive cytokines (interleukin (IL)-10 and IL-24) in patients with B-cell chronic lymphocytic leukemia for assessment of the disease progression and elaboration of a new treatment strategy. Methods. 120 patients with B-cell chronic lymphocytic leukemia were enrolled in the study and divided into four groups according to the disease stage (Rai stage I-IV). Control group included 30 healthy volunteers. Concentrations of IL-10 and IL-24 were measured in serum using the enzyme-linked immunosorbent assay (ELISA). Results. Serum levels of IL-10 and IL-24 levels were significantly increased in all patient groups compared to the control. No difference in the cytokines levels between the patient groups was observed. Conclusion. In patients with B-cell chronic lymphocytic leukemia, the increased serum level of IL-10 might impair the antitumor defence by inhibiting the cell immune response and preventing apoptosis of malignant lymphocytes. On the other hand, the increased serum level of IL-24 might oppose these effects by promoting cellular differentiation and inducing apoptosis in malignant cells. Therefore, correction of IL-10/IL-24 imbalance may be a beneficial therapeutic strategy for patients with B-cell chronic lymphocytic leukemia.


2005 ◽  
Vol 31 (1) ◽  
pp. 38-42 ◽  
Author(s):  
KHOSROW MEHRANY ◽  
ROGER H. WEENIG ◽  
MARK R. PITTELKOW ◽  
RANDALL K. ROENIGK ◽  
CLARK C. OTLEY

1991 ◽  
Vol 11 (9) ◽  
pp. 4710-4716
Author(s):  
M Kelliher ◽  
A Knott ◽  
J McLaughlin ◽  
O N Witte ◽  
N Rosenberg

Two forms of activated BCR/ABL proteins, P210 and P185, that differ in BCR-derived sequences, are associated with Philadelphia chromosome-positive leukemias. One of these diseases is chronic myelogenous leukemia, an indolent disease arising in hematopoietic stem cells that is almost always associated with the P210 form of BCR/ABL. Acute lymphocytic leukemia, a more aggressive malignancy, can be associated with both forms of BCR/ABL. While it is virtually certain that BCR/ABL plays a central role in both of these diseases, the features that determine the association of a particular form with a given disease have not been elucidated. We have used the bone marrow reconstitution leukemogenesis model to test the hypothesis that BCR sequences influence the ability of activated ABL to transform different types of hematopoietic cells. Our studies reveal that both P185 and P210 induce a similar spectrum of hematological diseases, including granulocytic, myelomonocytic, and lymphocytic leukemias. Despite the similarity of the disease patterns, animals given P185-infected marrow developed a more aggressive disease after a shorter latent period than those given P210-infected marrow. These data demonstrate that the structure of the BCR/ABL oncoprotein does not affect the type of disease induced by each form of the oncogene but does control the potency of the oncogenic signal.


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