Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in Mali according to G...Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in Mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AML and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of AML were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AML is probably underestimated in Mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.展开更多
Myeloid sarcomas(MS)involve extramedullary blast proliferation from one or more myeloid lineages thatreplace the original tissue architecture,and these neoplasias are called granulocytic sarcomas,chloromas or extramed...Myeloid sarcomas(MS)involve extramedullary blast proliferation from one or more myeloid lineages thatreplace the original tissue architecture,and these neoplasias are called granulocytic sarcomas,chloromas or extramedullary myeloid tumors.Such tumors develop in lymphoid organs,bones(e.g.,skulls and orbits),skin,soft tissue,various mucosae,organs,and the central nervous system.Gastrointestinal(GI)involvement is rare,while the occurrence of myeloid sarcomas in patients without leukemia is even rare.Here,we report a case of a 38-year-old man who presented with epigastric pain and progressive jaundice.An upper GI endoscopy had shown extensive multifocal hyperemic fold thickening and the spread of nodular lesions in the body of the stomach.Biopsies from the gastric lesions indicated myeloid sarcoma of the stomach.However,concurrent peripheral blood and bone marrow examinations showed no evidence of acute myeloid leukemia.For diagnosis,the immunohistochemical markers must be checked when evaluating a suspected myeloid sarcoma case.Accurate MS diagnosis determines the appropriate therapy and prognosis.展开更多
<strong>Background: </strong>Disseminated Intravascular Coagulation (DIC) is a life threatening complication frequently observed in acute leukemia. Among the morphological varieties of Acute Myeloid Leukae...<strong>Background: </strong>Disseminated Intravascular Coagulation (DIC) is a life threatening complication frequently observed in acute leukemia. Among the morphological varieties of Acute Myeloid Leukaemia (AML), Acute Promyelocytic Leukaemia (APL) is well established to cause DIC. But there have been reports noted that abnormal DIC parameters also commonly observed in the patients with non-APL AML. This study evaluated the DIC parameters & DIC score according to International Society of Thrombosis and Haemostasis (ISTH) in newly diagnosed non-APL AML patients. <strong>Materials and Methods:</strong> This cross-sectional observational study was conducted in the Department of Haematology, BSMMU, Dhaka, Bangladesh. 48 newly diagnosed non-APL AML patients were enrolled. Platelets count was measured by auto analyzer (Sysmax XT 2000i/Pentra ABX-120DX) as well as checked manually. Prothrombin time, fibrinogen, D-Dimer were measured using STAGO Coagulation analyzer. The ISTH-DIC scoring system was used to calculate DIC score. The statistical analysis was carried out using the Statistical Package for Social Sciences version 24.0 for Windows. Chi-Square test & Fisher exact test was used for categorical variables. Unpaired t-test was used to compare mean between groups. For all statistical tests, p-value less than 0.05 was considered as statistically significant. <strong>Results: </strong>By analyzing 48 newly diagnosed patients with non-APL AML, found that DIC developed in 14.6% patients at presentation. Among the DIC parameters, PT and D-dimer were significantly higher in patients presented with DIC. Patients with DIC exhibit lower expression of CD117, CD34, HLA-DR and statistically significant association with negative expression of HLA-DR (p-value 0.034). No significant association was found between presence of DIC and age, gender, bleeding at presentation, morphological type, WBC count or peripheral blast percentage.<strong> Conclusion:</strong> Abnormalities of DIC parameters in common in patients with AML. A significant portion of patients with DIC have no apparent symptom or bleeding. So, routine screening of DIC parameter at presentation is recommended for early diagnosis & effective management of DIC.展开更多
Leukemia comprises a diverse group of malignancies which is accompanied with genetic disorderliness in hematopoietic cells. We evaluated effective risk factors in recovery process of under treatment patients suffering...Leukemia comprises a diverse group of malignancies which is accompanied with genetic disorderliness in hematopoietic cells. We evaluated effective risk factors in recovery process of under treatment patients suffering from acute myeloblastic leukemia （AML）. This study conducted a cross-sectional descriptive-analytical study on a population of 76 samples obtained non-randomly from patients in Taleghani Hospital （Tehran, Iran）. 30.3% patients resulted in death. According to logistic regression results, sexes [OR = 6.40, 95% CI = （0.27, 3.45）], ALT [OR = 1.03, 95% CI = （0.01, 0.05）] and HCT [OR = 0.55, 95% CI = （-1.12, -0.06）] were recognized as significant in prognoses. We predicted the probability of death with an error of 20.03% based on a prognoses system using support vector machine （SVM） classifier. Using this theory, we experienced an error of 20.03%. 46.6% patients with a positive and 20.8% patients without positive drug history resulted in death, which shows a significant correlation between patients＇ drug history and their death.展开更多
文摘Introduction: Acute myeloblastic leukaemia (AML) is a haematological malignancy with a poor prognosis, despite significant therapeutic progress. This study presents the results of AML management in Mali according to GFAOP recommendations. Methodology: This was a retrospective, cross-sectional study. It included patients aged 0 - 15 years treated in the paediatric oncology unit for AML and followed up between January 2016 and December 2020. Results: During the study period, 85 cases of acute leukaemia were diagnosed in the paediatric oncology unit (including 51 cases of ALL), of which 34 cases of AML were included in this study. The majority were boys (59%). The mean age was 8 years, with extremes of 18 months and 15 years. The mean time to diagnosis was 68 days. In 79% of cases, patients were referred by 1st or 2nd level hospitals. Anaemia was observed in 91% of cases, an infectious syndrome in 68%, haemorrhage in 56% and a tumour syndrome in 85%. The haemogram showed hyperleukocytosis in 15% of cases, thrombocytosis in 22% and severe anaemia in 73%. Death occurred in 85% of cases, most often in the context of sepsis or haemorrhage. Conclusion: AML is probably underestimated in Mali and diagnosis delayed, which may be explained by patient-related factors (lack of knowledge, financial constraints) and a cumbersome referral system. These results suggest the need to implement an appropriate diagnostic and therapeutic strategy, with strong involvement of the political authorities.
基金Supported by the National Natural Science Foundation of China,No.81370511the Natural Science Foundation of Guangdong Province,No.S2011020002348Fundamental Research Funds for the Central Universities,No.82000-3281901
文摘Myeloid sarcomas(MS)involve extramedullary blast proliferation from one or more myeloid lineages thatreplace the original tissue architecture,and these neoplasias are called granulocytic sarcomas,chloromas or extramedullary myeloid tumors.Such tumors develop in lymphoid organs,bones(e.g.,skulls and orbits),skin,soft tissue,various mucosae,organs,and the central nervous system.Gastrointestinal(GI)involvement is rare,while the occurrence of myeloid sarcomas in patients without leukemia is even rare.Here,we report a case of a 38-year-old man who presented with epigastric pain and progressive jaundice.An upper GI endoscopy had shown extensive multifocal hyperemic fold thickening and the spread of nodular lesions in the body of the stomach.Biopsies from the gastric lesions indicated myeloid sarcoma of the stomach.However,concurrent peripheral blood and bone marrow examinations showed no evidence of acute myeloid leukemia.For diagnosis,the immunohistochemical markers must be checked when evaluating a suspected myeloid sarcoma case.Accurate MS diagnosis determines the appropriate therapy and prognosis.
文摘<strong>Background: </strong>Disseminated Intravascular Coagulation (DIC) is a life threatening complication frequently observed in acute leukemia. Among the morphological varieties of Acute Myeloid Leukaemia (AML), Acute Promyelocytic Leukaemia (APL) is well established to cause DIC. But there have been reports noted that abnormal DIC parameters also commonly observed in the patients with non-APL AML. This study evaluated the DIC parameters & DIC score according to International Society of Thrombosis and Haemostasis (ISTH) in newly diagnosed non-APL AML patients. <strong>Materials and Methods:</strong> This cross-sectional observational study was conducted in the Department of Haematology, BSMMU, Dhaka, Bangladesh. 48 newly diagnosed non-APL AML patients were enrolled. Platelets count was measured by auto analyzer (Sysmax XT 2000i/Pentra ABX-120DX) as well as checked manually. Prothrombin time, fibrinogen, D-Dimer were measured using STAGO Coagulation analyzer. The ISTH-DIC scoring system was used to calculate DIC score. The statistical analysis was carried out using the Statistical Package for Social Sciences version 24.0 for Windows. Chi-Square test & Fisher exact test was used for categorical variables. Unpaired t-test was used to compare mean between groups. For all statistical tests, p-value less than 0.05 was considered as statistically significant. <strong>Results: </strong>By analyzing 48 newly diagnosed patients with non-APL AML, found that DIC developed in 14.6% patients at presentation. Among the DIC parameters, PT and D-dimer were significantly higher in patients presented with DIC. Patients with DIC exhibit lower expression of CD117, CD34, HLA-DR and statistically significant association with negative expression of HLA-DR (p-value 0.034). No significant association was found between presence of DIC and age, gender, bleeding at presentation, morphological type, WBC count or peripheral blast percentage.<strong> Conclusion:</strong> Abnormalities of DIC parameters in common in patients with AML. A significant portion of patients with DIC have no apparent symptom or bleeding. So, routine screening of DIC parameter at presentation is recommended for early diagnosis & effective management of DIC.
文摘Leukemia comprises a diverse group of malignancies which is accompanied with genetic disorderliness in hematopoietic cells. We evaluated effective risk factors in recovery process of under treatment patients suffering from acute myeloblastic leukemia （AML）. This study conducted a cross-sectional descriptive-analytical study on a population of 76 samples obtained non-randomly from patients in Taleghani Hospital （Tehran, Iran）. 30.3% patients resulted in death. According to logistic regression results, sexes [OR = 6.40, 95% CI = （0.27, 3.45）], ALT [OR = 1.03, 95% CI = （0.01, 0.05）] and HCT [OR = 0.55, 95% CI = （-1.12, -0.06）] were recognized as significant in prognoses. We predicted the probability of death with an error of 20.03% based on a prognoses system using support vector machine （SVM） classifier. Using this theory, we experienced an error of 20.03%. 46.6% patients with a positive and 20.8% patients without positive drug history resulted in death, which shows a significant correlation between patients＇ drug history and their death.
