Cyclophosphamide, Thalidomide and Dexamethasone (CTD) as First-Line Therapy in Multiple Myeloma Patients: An Experience in a Clinical Haematology Centre in Dakar, Senegal

Introduction: Induction therapy followed by high-dose chemotherapy with autologous stem cell transplantation remains the gold standard for myeloma patients who can tolerate this treatment approach. In a developing country setting, in the absence of availability of bone marrow transplantation, the CTD protocol is an accessible treatment regimen whose efficacy and lower toxicity compared to the Melphalan Prednisone protocol has been reported. This protocol has been administered since 2018 in first line. It’s against this backdrop we perform this study to assess the efficacy of this CTD protocol in first line therapy. Methods: We conducted a descriptive and analytical study including clinical, paraclinical and evolutionary data of 50 patients with MM treated during the period range from 01 September 2018 and 01 July 2022 with the CTD protocol of cyclophosphamide (500 mg at D1, D8 and D15), dexamethasone (40 mg weekly) and thalidomide (100 mg/day) in 28-day cycles. Survival outcomes were estimated by the Kaplan-Meier method. Results: The mean age was 62.3 ± 9.1 years and the sex ratio was 0.7. An advanced prognostic score at diagnosis was found in 73.5% of patients according to the Salmon and Durie score and in 32% according to the ISS. Overall remission was noted in 64%, of which 34% were in very good partial remission and partial remission in 12% of cases. Progression was noted in 4 patients. Treatment-related side effects were mainly peripheral neuropathy and anaemia in 3 patients respectively. The median survival was 38.4 months. The progression-free survival was 60%. An advanced age (≥65 years) is correlated with negative impact on survival (p = 0.04). Conclusion: Cyclophosphamide, thalidomide and dexamethasone give good outcome with less toxicity. Thus, it remains a first-line treatment alternative for newly diagnosed and low-income patients.

Infection in Multiple Myeloma: Microbiological Profile and Prognosis in Senegalese Patients

Introduction: Infections are additional factors of morbidity and mortality in multiple myeloma (MM), and the current recommendation is antibiotic prophylaxis. In sub-Saharan Africa, few data on infectious complications of MM are available. We aim to describe the microbiological features of infections in MM, and their impact on survival in Senegalese patients. Methods: A retrospective (January 2005-January 2022), analytic, multicenter study on infections in patients followed for MM (IMWG criteria) in Senegalese clinical hematology services. The socio-epidemiological, diagnostic, microbiological, evolutionary and survival aspects were analyzed. Results: The study included 106 patients with multiple myeloma who had an infection at admission or during the treatment. Ten patients have the comorbidity (hypertension, lupus, type 2 diabetes). These patients had 136 infectious events identified at diagnosis (79.2%) or during chemotherapy (20.8%). The sites of infection are lung (42.6%), urinary (29.4%), dermatological (6.6%), digestive (5.2%), osteoarticular (4.4%), ear, nose and throat (3.7%), central nervous system (1.5%), or without site. We recorded 26.4% of patients with multi-site infections. The causal pathogens are bacteria (Gram-negative bacilli: 22.1%;Gram positive bacilli: 9.5%, Mycobacterium tuberculosis: 13.3%), parasitique (plasmodium falciparum 6.6%), viruses (SARS-COV2: 2.9%, VZV: 2.2%) and fungal (2.9%). Survival was reduced in patients who had an infection at the time of multiple myeloma diagnosis (p: 0.189) and those who had multiple infectious foci (p: 0.011). Conclusion: Infections in multiple myeloma are more frequent at diagnosis. The germs are varied and mostly bacteria, particularly gram-negative bacteria, and Kochs bacillus. Our study reveals that multiple infectious foci are a poor prognosis factor. It is necessary to evaluate the infectious risk early, and to adopt an antibiotic prophylaxis based on our tropical environment.

Influence of Hemoglobin S Haplotypes on the Responses to Hydroxyurea Treatment in Children with Sickle Cell Disease in Abidjan, Côte d’Ivoire

Background: In Côte d’Ivoire so far, the circulating haplotypes have been inferred on the phenotypic profiling of SCD patients. The impact of the circulating haplotypes on the use of Hydroxyurea has not been assessed yet. Therefore the objective of this study is to identify in Abidjan the HbS haplotypes that modulate HU treatment responses. Methods: In a cross-sectional descriptive and analytical study, children aged 5 to 15 years with SCD, and carrying the hemoglobin phenotypes SSFA2 and SFA2, were recruited into a HU treatment cohort. Various parameters on the haplotypes and the outcomes of the treatment were analyzed. Results: Thirty nine children with SCD were included. The phenotypic profile of the cohort was 86.6% of SSFA2 and 15.4% of SFA2. Three haplotypes were found, the Benin haplotype, the Senegal haplotype, and an atypical one. The participants belonged to three genotypes, Benin/atypical (64.1%), Benin/Senegal (33.3%) and Senegal/Senegal (2.6%). Overall, HU treatment was successful in all haplotypes with 12 out of 39 patients failing treatment after 12 months in the Benin haplotype group. The association between HU treatment success and the Benin haplotype was found in terms of the decrease in the number of white blood cells and the students missing class. Conclusion: The study revealed that inferring haplotype based on the phenotypic profile could be inaccurate. The proportion of atypical haplotype that were not previously described in Côte d’Ivoire was high. All the haplotypes seemed to be associated with HU treatment success but some patients with Benin haplotype did not respond well.

Overview of dyslipidemia and metabolic syndrome in myeloproliferative neoplasms

Myeloproliferative neoplasms(MPNs)occur due to the abnormal proliferation of one or more terminal myeloid cell lines in peripheral blood.Subjects suffering from MPNs display a high burden of cardiovascular risk factors,and thrombotic events are often the cause of death in this population of patients.Herein,we provide a brief overview of dyslipidemia and metabolic syndrome and their epidemiology in MPNs and examine the common molecular mechanisms between dyslipidemia,metabolic syndrome,and MPNs,with a special focus on cardio-vascular risk,atherosclerosis,and thrombotic events.Furthermore,we investigate the impact of dyslipidemia and metabolic syndrome on the occurrence and survival of thrombosis in MPN patients,as well as the management of dyslipidemia in MPNs,and the impact of MPN treatment on serum lipid concentrations,particularly as side/adverse effects reported in the context of clinical trials.

The Influence of Leukocyte and Platelet Concentrate Enrich in Stem Cells on Bone Regeneration Processes:A Clinical and Flow Cytometry Study

This article reports the efficacy of percutaneous autologous leukocyte- and platelet-rich plasma (L-PRP) injection into delayed union site as a minimally invasive method alternative to bone marrow aspirate and open grafting techniques. Each of 15 participants was followed on a regular basis with clinical examinations, roentgenograms. The average time to union was 8.4 weeks after L-PRP injection and the union was achieved in all cases. CD34+/45+ cells counts were increased by 410% and CD34+/45- cells counts were increased by 488% on average in L-PRP. Our investigation showed that L-PRP enrich in stem cells can produce the desired stimulatory response despite a substantial amount of vital bone cells from mesenchymal line. We believe that the using of L-PRP enriched in stem cells, growth factors and antimicrobial proteins might be a promising treatment method in regenerative medicine.

Coagulation abnormalities and their relationship with bleeding manifestations in patients with dengue-A single center observational study

Objective:To evaluate coagulation abnormalities and their relationship with bleeding manifestations among patients with dengue.Methods:This observational study was conducted on 292 adult dengue patients who were admitted to a tertiary care hospital of Western India from July 2021 to June 2022.Coagulation tests including prothrombin time(PT),international normalized ratio(INR),activated partial thromboplastin time(aPTT),fibrinogen,and D-dimer were performed.Patients were monitored for bleeding manifestations.Results:Coagulation abnormalities were reported in 42.8%of the patients.Overall,prolonged aPTT was the most common coagulation abnormality(40.8%),followed by low fibrinogen(38.7%),raised D-dimer(31.2%),raised INR(26.0%)and prolonged PT(19.2%).Bleeding manifestations were present in 19.9%patients.PT,INR,aPTT and D-dimer levels were significantly higher(P<0.01)and fibrinogen level was significantly lower(P<0.001)in patients with bleeding compared to patients without bleeding.Patients with bleeding had a significantly higher rate of all coagulation abnormalities than patients without bleeding(P<0.01).Conclusions:Patients with bleeding showed a significantly higher frequency of coagulation abnormalities compared to patients without bleeding.Patients with dengue should be assessed for coagulation abnormalities.

A Rare Entity of Accelerated Chronic Lymphocytic Leukemia: A Report of Two Cases and Review of Literature

Background: Accelerated-chronic lymphocytic leukemia (A-CLL) is a rare disease entity as it represents less than 1% of all reported cases of chronic lymphoid leukemia (CLL). Moreover, it is most likely an under diagnosed entity due to its rarity and the non-standardized practice of lymph node biopsy in CLL. Purpose: The aims of our work are to establish the diagnosis of A-CLL and to study the prognosis and treatment of this rare entity. Method: here, we report the clinical presentation and the follow up of two cases of A-CLL. Results: Distinguishing Richter transformation (RT) from A-CLL is important as it may result in a major change in disease management. The prognosis of A-CLL is intermediate between CLL and RT. The prognosis is mainly poor due to a predominance of poor prognostic markers including an increasing number of p53-positive cases. Conclusion: To this date, no prospective study has been led to define the best treatment for A-CLL. The shorter survival of A-CLL when compared to typical CLL implies the need of a more aggressive treatment.

Extranodal Locatio of Lymphoma: Presentation and Evolutionary in Senegalese Patients

Introduction: The frequency of extranodal involvement in lymphoma is not rare, but variously described by authors in Africa. The objective of our work is to describe the profile of patients followed for lymphoma with extranodal locations. Methods: We conducted a descriptive, retrospective and analytic study at the clinical hematology department of Dalal Jamm Hospital, from September 2016 to June 2022. We included patients with a diagnosis of lymphoma immunohistochemistry, with extranodal involvement. The epidemiological, diagnostic, prognostic and survival aspects were studied. Results: Fifty-two (52) patients with extranodal localizations of their lymphoma were included. The mean age was 44.2 ± 17.6 years and the sex ratio was 1.2. The average time to diagnostic was 9.4 ± 3.6 months. We found a performance status ≥ 2 in 65.4% and at least one B symptom in 71.2% of cases. The extranodal manifestations were digestive (19%), cutaneous (17.5%), pleuropulmonary (17.5%), bone marrow (4.8%), thyroid (1.6%), parotid gland (1.6%) and breast (1.6%). Patients presented with Hodgkin’s lymphoma (HL) in 19.2% of cases and non-Hodgkin’s lymphoma (NHL) in 80.8% of cases. At the end of the extension checkup reviews, 61.5% were at an advanced stage and prognostic indices were unfavorable in 32% of patients. Conventional chemotherapy was conducted in 63.5% of patients of which 24 had NHL and 9 had HL. Immuno-chemoterapy was used in 26.9% of patients (13 cases of NHL, 1 case of HL). During the follow-up, we noted only 29.7% of complete remission. The median overall survival was 25.1 months [23.5 - 34.1 months] in HL group and 20.5 months [18.7 - 72.2 months] in NHL patients (p = 0.14). Conclusion: Our study shows that extranodal involvements of lymphomas are various, encountered more during NHL. In our practice, diagnosis is generally made at an advanced stage, with poor response to treatment.

Prevalence and Associated Factors of Viral Hepatitis C among Burundian Population during a Screening Campaign: A Cross-Sectional Study Carried out in Burundi

Approximately 180 million people worldwide are affected by Viral hepatitis C, with 350,000 to 500,000 deaths yearly. The present study sought to investigate the prevalence and associated factors of viral hepatitis C (VHC) among the Burundian population during a screening campaign. A total of 629 participants took part in the study, and the prevalence of viral hepatitis C was (8.11%). The associated factors identified as statistically associated were medical and surgical history (P = 0.02) and ear and nose piercing (P = 0.01). 51% of the infected persons were females. The mean age for viral hepatitis C carriage was 46.13 ± 14.3 years and 10.40% of viral hepatitis C carriers were over 50 years old. We found a high viral hepatitis C prevalence in married (9.55%) and divorced (9.38%) participants. The majority of our participants were farmers (60.25%) with a prevalence of viral hepatitis C (7.92%) while 11.54% of the infected participants were not educated. In conclusion, the current study shows a high prevalence of Viral Hepatitis C infection in Burundi. Infection was more likely to occur in older, married, farmer, and illiterates. Unsafe medical and surgical interventions with traditional practitioners were significant risk factors for contracting VHC infection.

Epidemiological and Prognostic Aspects of Anemia during Heart Failure in Brazzaville (The Republic of the Congo)

To improve the management of patients with heart failure and anemia at the University Hospital of Brazzaville, a cross-sectional study of patients diagnosed with heart failure condition (left or global heart failure) was conducted over a period of nine months from January 1 to September 30, 2017. A total of 171 patients were included during the study period. Study participants were divided into two groups: Group A included patients with an additional anemic condition (n = 57) and Group NA patients without anemia (n = 114). Anemia was defined as a hemoglobin rate of < 12 g/dL for men and <11 g/dL for women. All eligible patients admitted to the Department of Cardiology were included in the study. The frequency of anemia was 33.3%, with a mean hemoglobin level of 9.4 ± 1.5 g/dL. Men accounted for 46.9% of cases (n = 79) and women 53.8% (n = 92). The mean age of eligible patients was 57.5 ± 16.5 years. Of these, 46.2% (n = 75) had a secondary educational level and 53.8% (n = 92) had a low socioeconomic status. Heart failure was global in 153 cases (89.5%). Patients were on NYHA III-IV functional class in 112 cases (65.5%), with a statistically significant difference between anemic and non-anemic patients (p = 0.0001). The main underlying heart diseases were dilated cardiomyopathy (75.1%), hypertensive heart disease (10.5%), ischemic heart disease (6.5%), and valvular disease (4.7%). The comparison between the two groups (A and NA) showed a longer hospital length of stay (18.4 ± 8.9 versus 12.9 ± 7.6 days;p = 0.00001) and a higher mortality rate (4 versus 2 deaths). The re-hospitalization rate was more important in group A (n = 4) than in group NA (n = 1). Anemia is a common condition in patients with heart failure. It worsens the clinical features and prognosis.

Aetiologic Factors of Anemia During Heart Failure in Brazzaville (The Republic of the Congo)

To contribute to improving the management of patients with heart failure and anemia in Brazzaville, a prospective and descriptive study was conducted in the University Hospital of Brazzaville for nine months (January 1st to September 30, 2017). Included 57 patients hospitalized for left or global heart failure and presenting anemia. Anemia was defined by an haemoglobin level < 12 g/dL in men and <11 g/dL in women. Proportionings of the reticulocytes rate, serum iron, ferritin, erythrocyte sedimentation rate (ESR) and/or C-reactive protein (CRP), electrophoresis of proteins, and evaluation of renal function by glomerular filtration rate (GFR), as well as the treatments of heart failure, and the auxiliary therapeutic ones, in particular the antithrombotic drugs, allowed aetiologic research. They were 20 men (35%) and 37 women (65%), old on average of 59 ± 17 years. The average rate of haemoglobin was 11.4 ± 1.4 g/dL. Heart failure was de novo in 24 cases (42.1%), old in 33 cases (57.9%);it was global in 54 cases (94.7%).The maintenance treatment associated diuretics in 32 cases (97%), angiotensin-converting enzyme inhibitor (ACEI) or angiotensin II receptor blocker (ARB) in 31 cases (94%), beta-blockers in two cases (6.1%), digoxin in four cases (12.1%), aspirin in five cases (15.1%) and anti-vitamin K in four cases (12.1%). Anemia was microcytic hypochromic in 30 cases (52.6%), normocytic normochromic in 20 cases (35.1%), and macrocytic normochromic in one case (1.7%). The main aetiologic factors were hemodilution in 46 cases (80.7%), renal insufficiency in 30 cases (52.3%), inflammation in 29 cases (50.8%), and iron deficiency in one case (1.7%). The HIV serology, carried out in 11 cases, was negative. Anemia is a frequent comorbidity among heart failure patients. Aetiologic research remains difficult in our context, and its often multifactorial origin.

Epidemiology, Diagnosis and Survival of Breast Cancer: Data from the Population-Based Cancer Registry of the City of Parakou from 2017 to 2021

Background: Breast cancer mortality remains high in the majority of developing countries. The Ministry of Health has established two population-based cancer registries in Benin: the first one in Cotonou in 2014 and the second one in Parakou in 2017. However, there is a scarcity of data on breast cancer survival and prognosis in Benin Republic. Objective: This study sought to investigate epidemiological, diagnostic, and survival aspects of breast cancer in Parakou, based on data from its population-based cancer registry from 2017 to 2021. Method: For descriptive and analytical purposes, we used a retrospective cohort design. From January 24, 2022 to August 31, 2022, data were collected in all health facilities covered by the Parakou population-based cancer registry using an individual questionnaire. Survival and prognosis analysis were performed using KAPLAN MEIER method and David COX proportional hazard model respectively. Result: A total of 81 patients have been included in this study. The incidence rate of breast cancer in Parakou was 17.5 per 100,000 person-years with a mortality rate of 2.76 per 100,000 person-years. The median age at diagnosis was 44.50 years with extremes ranging from 19 to 76 years and a predominance of 40 - 50 years age group. The median survival time was estimated at 30 months with an overall 5-year survival of 47%. Young age at diagnosis (p-value = 0.002) and advanced stage at diagnosis (p-value = 0.000) had a negative impact on survival in women. The combination of surgery and chemotherapy improved survival (p-value = 0.018). Conclusion: Breast cancer is still a public health issue in Parakou. It comes out mandatory that resources be made available to make screening, early diagnosis and appropriate treatment of breast cancer affordable.

Prognostic Value of Neutrophil to Lymphocyte Ratio in Acute Myeloid Leukemia

Objective: Acute myeloid leukemia (AML) is a heterogeneous, hematologic malignancy at which short survival may be seen. Our study aims to evaluate the effect of the neutrophil-to-lymphocyte ratio (NLR) on the course of the disease, response to therapy, and overall survival (OS). Materials and Methods: A total of 124 patients followed-up with the diagnosis of AML from 2016 to 2019 were retrospectively examined. Results: 69 of the cases (55.6%) were men and 55 (44.3%) were women. The average age at the time of diagnosis was 53.44 ± 30.3 years old. We determined the NLR as median 0.46 (0.16 - 1.1). In AML, 69 patients were responsive to the induction regimen (57.9%) while 46 patients were unresponsive (37.8%). 5 patients died before completing the regimen. D-dimer was found to be higher and fibrinogen was found to be lower in the responsive group. Lower OS was observed in cases of >60 years of age, male gender, non-APL AML, high NLR, and recurrence at diagnosis. Recurrences were detected in 23 patients (18.5%) and the median time to the recurrence was 416 (236 - 639) days. Fibrinogen level and the bone marrow blast ratio at the time of application were determined to be associated with recurrence. The median follow-up time was 856 (143 - 1276) days. Final condition analysis reveals that 74 patients (59.6%) are alive. Conclusion: We determined in our study that the NLR is effective on survival. Medical literature on this subject is scanty and prospective studies with large patient groups are needed.

Acute myocardial infarction in myeloproliferative neoplasms

Myeloproliferative neoplasms(MPNs)are a heterogeneous group of hematologic malignancies characterized by an abnormal proliferation of cells of the myeloid lineage.Affected individuals are at increased risk for cardiovascular and thrombotic events.Myocardial infarction(MI)may be one of the earliest clinical manifestations of MPNs or may be a thrombotic complication that develops during the natural course of the disease.In the present review,we examine the epidemiology,pathogenesis,clinical presentation,and management of MI in MPNs based on the available literature.Moreover,we review potential biomarkers that could mediate the MI-MPNs crosstalk,from classical biochemical tests,e.g.,lactate dehydrogenase,creatine kinase and troponins,to pro-inflammatory cytokines,oxidative stress markers,and clonal hematopoiesis.

Role of Helicobacter pylori in gastric mucosa-associated lymphoid tissue lymphomas

Mucosa-associated lymphoid tissue(MALT)lymphoma is an indolent extranodal marginal zone B-cell lymphoma,originating in acquired MALT that is induced in mucosal barriers as part of a normal adaptive immune response to a chronic immunoinflammatory stimulus,most notably chronic infection by Helicobacter pylori(H.pylori).This antigenic stimulation initially leads to lymphoid hyperplasia;the acquisition of additional genetic aberrations culminates in the activation of intracellular survival pathways,with disease progression due to proliferation and resistance to apoptosis,and the emergence of a malignant clone.There are descriptions of MALT lymphomas affecting practically every organ and system,with a marked geographic variability partially attributable to the epidemiology of the underlying risk factors;nevertheless,the digestive system(and predominantly the stomach)is the most frequently involved location,reflecting the gastrointestinal tract’s unique characteristics of contact with foreign antigens,high mucosal permeability,large extension and intrinsic lymphoid system.While early-stage gastric MALT lymphoma can frequently regress after the therapeutic reversal of the chronic immune stimulus through antibiotic eradication of H.pylori infection,the presence of immortalizing genetic abnormalities,of advanced disease or of eradication-refractoriness requires a more aggressive approach which is,presently,not consensual.The fact that MALT lymphomas are rare neoplasms,with a worldwide incidence of 1-1.5 cases per105population,per year,limits the ease of accrual of representative series of patients for robust clinical trials that could sustain informed evidence-based therapeutic decisions to optimize the quality of patient care.

Targeted therapy of gastrointestinal stromal tumours

Gastrointestinal stromal tumours(GISTs) are mesen-chymal neoplasms originating in the gastrointestinal tract, usually in the stomach or the small intestine, and rarely elsewhere in the abdomen. The malignant potential of GISTs is variable ranging from small lesions with a benign behaviour to fatal sarcomas. The majo-rity of the tumours stain positively for the CD-117(KIT) and discovered on GIST-1(DOG-1 or anoctamin 1) expression, and they are characterized by the presence of a driver kinase-activating mutation in either KIT or platelet-derived growth factor receptor α. Although surgery is the primary modality of treatment, almost half of the patients have disease recurrence following surgery, which highlights the need for an effective adjuvant therapy. Traditionally, GISTs are considered chemotherapy and radiotherapy resistant. With the advent of targeted therapy(tyrosine kinase inhibitors), there has been a paradigm shift in the management of GISTs in the last decade. We present a comprehensive review of targeted therapy in the management of GISTs.

Preparation of monoclonal antibody against human KIAA0100 protein and Northern blot analysis of human KIAA0100 gene

Monoclonal antibodies(MAbs) are important tools for the study of proteins′ function and structure. But there has been no report on the preparation of MAbs against human KIAA0100 protein up to date. Here, first, we generated the mouse MAb against human KIAA0100 protein using purified recombinant 6×Histidinc(6×His)-tagged human KIAA0100 protein segment(1557–2234) as an antigen; then, the m RNA expression of human KIAA0100 gene was detected in U937 cells using Northern blot analysis. The results showed that the mouse MAb against human KIAA0100 protein could sensitively recognize the human KIAA0100 protein using Western blot analysis and immunocytochemistry analysis. Besides, Western blot analysis revealed that human KIAA0100 gene possibly encoded two different protein products(254 k Da and < 250 k Da) in U937 cells. Moreover,Northern blot analysis confirmed that human KIAA0100 gene might produced two different m RNA products(6000–10000 bp and 5000–6000 bp) in U937 cells. The results provide a basis for large-scale production of the MAb against human KIAA0100 protein, which will be useful for the study of human KIAA0100 protein′s function/structure and MAb-targeted drugs in the future.

Helicobacter pylori eradication in patients with chronic immune thrombocytopenic purpura

AIM:To assess the effect of Helicobacter pylori(H.pylori)eradication on platelet counts in patients with chronic immune thrombocytopenic purpura(cITP).METHODS:A total of 36 cITP patients were included in the study.The diagnosis of H.pylori was done by rapid urease test and Giemsa staining of the gastric biopsy specimen.All H.pylori positive patients received standard triple therapy for 14 d and were subjected for repeat endoscopy at 6 wk.Patients who continued to be positive for H.pylori on second endoscopyreceived second line salvage therapy.All the patients were assessed for platelet response at 6 wk,3rd and 6th months.RESULTS:Of the 36 patients,17 were positive for H.pylori infection and eradication was achieved in16 patients.The mean baseline platelet count in the eradicated patients was 88615.38±30117.93/mm3and platelet count after eradication at 6 wk,3 mo and6 mo was 143230.77±52437.51/mm3(P=0.003),152562.50±52892.3/mm3(P=0.0001),150187.50±41796.68/mm3(P=0.0001)respectively and in the negative patients,the mean baseline count was71000.00±33216.46/mm3 and at 6 wk,3rd and 6th month follow up was 137631.58±74364.13/mm3(P=0.001),125578.95±71472.1/mm3(P=0.005),77210.53±56892.28/mm3(P=0.684)respectively.CONCLUSION:Eradication of H.pylori leads to increase in platelet counts in patients with cITP and can be recommended as a complementary treatment with conventional therapy.

RETREATMENT WITH FLUDARABINE AND CYCLOSPORINE FOR ONE CASE OF REFRACTORY PURE RED CELL APLASIA

MANY cases of pure red cell aplasia(PRCA)were mediated by over-function of immune cells,and responded well to immunosuppressive therapy.1 Sometimes refractory cases also arose.Fludarabine is an analogue of adenosine resistant to deamination which is widely used for B-chronic lymphocytic leukemia(CLL)and other hematological malignancies.2 As a strong immunosuppressive agent,

Bioinformatic prediction and functional characterization of human KIAA0100 gene

Our previous study demonstrated that human KIAA0100 gene is a novel acute monocytic leukemia-associated antigen(MLAA) gene. But the functional characterization of human KIAA0100 gene has remained unknown to date. Here, firstly, bioinformatic prediction of human KIAA0100 gene was carried out using online software;Secondly, human KIAA0100 gene expression was downregulated by the clustered regularly interspaced short palindromic repeats(CRISPR)/CRISPR-associated(Cas) 9 system in U937 cells. Cell proliferation and apoptosis were next evaluated in KIAA0100-knockdown U937 cells. The bioinformatic prediction showed that human KIAA0100 gene was located on 17q11.2, and human KIAA0100 protein was located in the secretory pathway. Besides, human KIAA0100 protein contained a signal peptide, a transmembrane region, three types of secondary structures(alpha helix, extended strand, and random coil), and four domains from mitochondrial protein 27(FMP27). The observation on functional characterization of human KIAA0100 gene revealed that its downregulation inhibited cell proliferation, and promoted cell apoptosis in U937 cells. To summarize, these results suggest human KIAA0100 gene possibly comes within mitochondrial genome; moreover, it is a novel anti-apoptotic factor related to carcinogenesis or progression in acute monocytic leukemia, and may be a potential target for immunotherapy against acute monocytic leukemia.