جستجوی مقالات مرتبط با کلیدواژه « Hematological Malignancies » در نشریات گروه « پزشکی »

A male patient had suffered miscellaneous ocular symptoms for 20 years with auricular dysmorphosis and was diagnosed with Relapsing Polychondritis (RP) in the ear, nose, joints, and costal cartilage. The patient lost his vision owing to recurrent ocular symptoms for decades. He presented an increased IgA and was diagnosed with monoclonal gammopathy of undetermined significance (MGUS) and treated by prednisone and cyclophosphamide. His ocular symptoms relieved and serum IgA decreased after six months. In conclusion, RP is a systemic disease with a wide range of clinical symptoms and may lead to serious complications.

There are conflicting data regarding the association between plasma concentration of voriconazole (VCZ) and both efficacy and safety. This study investigates the association of VCZ trough plasma level with clinical efficacy and hepatotoxicity in the Iranian population suffering hematological malignancies. This cross-sectional study was performed on adult Iranian patients (age ≥ 18 years) with hematological malignancies undergoing treatment with oral or intravenous VCZ for proven or probable invasive aspergillosis. Plasma concentrations of VCZ were measured at two time points on day 4 and 14 during the study period. A total of 60 VCZ trough concentrations of 30 patients were drawn on days 4 and 14 after the initiation of treatment. There was no definite correlation between the mean plasma concentration of VCZ and VCZ dosage (p = 0.134, r = 0.280). In multivariable model, only plasma concentration of VCZ on day 14 was associated with the incidence of hepatotoxicity (p = 0.013; OR = 1.42, 95% CI = 1.07-3.24). Plasma trough concentration neither on day 4 nor on day 14 was related to the treatment response. No significant association was observed between the mean plasma concentration of VCZ and 3-month patients’ survival (p = 0.696). To conclude, VCZ trough concentration may not be a predictor of treatment response or 3-month patients’ survival. However, the wide inter- and intra-patient variability of VCZ plasma concentration coupled with the observed association between VCZ trough level and the incidence of hepatotoxicity would pose the question regarding the potential benefit of VCZ concentration monitoring.

Cytochrome P450 2C19 (CYP2C19) is widely involved in the metabolism of some medications. On the other hand, recent studies have shown the contribution of the CYP2C19 polymorphisms to different malignancies. We aimed to investigate the association between CYP2C19 polymorphism and occurrence of hematological malignancies by comparing the phenotype distribution of this enzyme in patients and healthy subjects.

150 Iranian patients with hematological malignancies from different ethnicities were recruited. Mutant alleles of the CYP2C19*2 and *3 were examined using PCR-RFLP technique and CYP2C19*17 was genotyped using DNA sequencing analysis.

CYP2C19*17 was the most common allelic variation (24%, 95% CI: 19.17-28.83%) among patients with hematological malignancies, whereas the variant CYP2C19*3 was not detected among our patients. Furthermore, the CYP2C19*1*1 and CYP2C19*1*17 genotypes which respectively represented the “extensive metabolizer” (EM) and Ultra-rapid metabolizer (URM) phenotypes, had the highest incidence.

The results of this study suggested that there may be no association between CYP2C19 polymorphisms and occurrence of hematological malignancies. However, larger well-designed studies are necessary to confirm these results in Iranian populations.

Over the last few decades, there has been a dramatic increase in hematological malignancies (HMs) in the population of Sardinia. It is accepted that oxidative stress biomarkers have been demonstrated to be prognostically important in various neoplastic diseases. The aim of this study is to evaluate serum vitamin E, total antioxidant capacity (TAC), Malondialdehyde (MDA) and reactive oxygen species (ROS) levels in 80 Sardinian patients with different HMs [acute myeloid leukemia (AML)(n=20), myelodysplastic syndromes (MDS) (n=20), Hodgkin lymphoma (HL) (n=20) and non-Hodgkin lymphoma (NHL) (n=20)] on the day of their diagnosis. Samples from all participants were obtained after an overnight fast (at least 10 hours). This study was approved and conducted in accordance with Good Clinical Practice guidelines and the Declaration of Helsinki. Patients and controls provided written, informed consent before entering the study. All study participants’ medical history and their medication were documented upon enrolling. Lower levels of TAC and Vitamin E were observed in most of the studied groups compared to healthy controls (0.41-0.49 mmol/L vs. 0.56 mmol/L) (19.55-28.55 μmol/L vs. 34.51 μmol/L). Moreover, higher average MDA levels were observed in HL and NHL patients compared to healthy controls (16.6 ng/ml-17.8 ng/ml vs. 7.4 ng/ml). Additionally, the ROS values of all studied groups were found elevated. Serum TAC showed significant negative correlations with MDA values (R= -0.51; P<0.001). Statistical significance was observed in all hematological parameters, producing either positive or negative correlation with at least one OS biomarker. The present data suggest that Sardinian patients with HL and NHL on the day of their diagnosis presented the highest OS in comparison to AML and healthy subjects. Moreover, MDS patients presented high OS status. Likewise, our results also indicated that changes in their hematological indices are eminent of their oxidative and antioxidative status.

Cystatin C as a novel marker of kidney function may have some drawbacks in clinical practice. The aim of the present study was to assess the impact of glucocorticoid therapy and hematological malignancies on serum cystatin C level in patients receiving amphotericin B. Forty five adult patients with no history of acute or chronic kidney injury planned to receive conventional amphotericin B for an anticipated duration of at least 1 week for any indication were included. Serum cystatin C as well as creatinine levels were measured at three time points during amphotericin B treatment including days 0, 7, and 14. There was no statistically significant association between hematological malignancies and elevated serum Cys C at days 0 (P = 0.0705), 7 (P = 0.679), and 14 (P = 1). The mean ± SD serum Cys C levels at three time points were comparable between patients received glucocorticoids and those not given glucocorticoids. Our findings suggested that glucocorticoid treatment and hematological malignancies appear to have no significant effect on the serum cystatin C level in patients under amphotericin B treatment.

Splenic infarction occurs due to occlusion of splenic vessels that leads to splenic tissue ischemia and necrosis. There are several reports regarding splenic infarction in patients with acute myelogenous leukemia (AML). Herein, we report a case of acute promyelocytic anemia (AML-M3) who presented with abdominal pain and splenic infarction.