Background: Chronic lymphocytic leukemia (CLL) is a heterogeneous disease with an extremely variable course. Survival after diagnosis can range from months to decades and wide variability exists in the rate of disease progression and the incidence of disease-related complications among patients with CLL. Staging helps to define prognosis and to decide when to initiate therapy.
Objective: To asses response to oral alkylating therapy and to evaluate the adverse events that can complicate the disease itself or the treatment, including infections, autoimmune and other complications. The survival events are also been assessed.
Patients and methods: Forty nine Iraqi CLL patients, their age ranged between 40-90 years were followed with median duration of 28 months. During the follow up period of these patients, the events that complicated the disease or therapy were recorded. The primary endpoints were response rates, quality of response, Secondary endpoints of the study were overall survival , progression-free survival and event free survival. Response rates were calculated for 40 patients who were treated for at least 6 months. All patients were treated with intermittent pulse therapy of oral single alkylating agent.
Results: The majority of patients recruited either had intermediate or advanced stage disease in 45(91%) patients .Autoimmune phenomena, were documented in 5(10.2%)patients. There was increased incidence of infections with either viral or bacterial pathogen, complicating the course of disease in 20 (40.8%). Remission state was mainly with partial response in 26/40(65%).In12(24.4%) patients the disease progressed and death occurred in 6(12.2% ) patients ,4(8.1% )of them were CLL(related) and 2(4.08%)of them unrelated(stroke, ischemic heart disease) to CLL with median progression free survival(PFS)and overall survival(OS) for these patients were not reached, with 2 years PFS and OS were70%.
Conclusion: Although CLL is an indolent disease still the course is complicated by many events like autoimmune problem and infections whether related to CLL or to treatments. Alkylating agent were effective therapy in the treatment of CLL and the majority of patients in this study partially responded
Environmental Tax is deemed as one of the most important tools that can be used to eliminate the problem of oil –based environment pollution resulted out of oil products processes and this has been significantly approved by the experience in those leading countries in the field of protecting the environment against pollution whereas oil-producing countries which are rather awkward in maintaining the environment such as Iraq , suffer from notorious environmental effects pertaining to oil product processes.
The problem of the research is represented the increased and constant rise in the volume of the environmental pollutants resulted from the processes managed by the intern
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As one year elapsed since COVID-19 outbreak, venous and arterial thromboses are increasingly reported in different vascular territories. Once accessed by the virus, the endothelial cells, abundant in angiotensin converting enzyme-2 (ACE-2) protein, will be activated by the inflammatory process leading to coagulopathy and vascular lesions. Herein, we describe a case of extensive thrombosis of the infra-renal inferior vena cava and iliac femoral vein in a man of 62 and a case of acute superficial femoral artery thrombosis in a lady of 55. Both were COVID-19 confirmed cases with severe pneumonia, high D-Dimer levels and risk factors for severe disease or death. Despite presentation 1-2 weeks after the onse
... Show MoreThe paper tackles two topics. The first is about the term "Ремейк" which is very common in contemporary Russian literature; it has counterparts such as " Обработка" and " Переделка", where these two may indicate any of the following meanings (remake, reformulate, rewrite, treatment, modification, change). It has been shown that this term does not have a stable definition. Also, the role of this term in literary studies has been mentioned along with how it has come to its peak of use in post-modern literature.
The second is that I have taken a sample of well-known works in Russian literature " On the Eve, On the Eve " by the contemporary Russian writer YevgueniBobov, and shown the effort of the writer
... Show MoreThe research aims to identify the importance of using the style of the cost on the basis of activity -oriented in time TDABC and its role in determining the cost of products more equitably and thus its impact on the policy of allocation of resources through the reverse of the changes that occur on an ongoing basis in the specification of the products and thus the change in the nature and type of operations . The research was conducted at the General Company for Textile Industries Wasit / knitting socks factory was based on research into the hypothesis main of that ( possible to calculate the cost of activities that cause the production through the time it takes to run these activities can then be re- distributed product cost
... Show MoreBackground: This study compared in vitro the marginal adaptation of three different, low shrink, direct posterior composites Filtekâ„¢ P60 (packable composite), Filtekâ„¢ P90 (Silorane-based composite) and Sonic fillâ„¢ (nanohybrid composite) at three different composite/enamel interface regions (occlusal, proximal and gingival regions) of a standardized Class II MO cavity after thermal changes and mechanical load cycling by scanning electron microscopy. Materials and methods:Thirty six sound human maxillary first premolars of approximately comparable sizes were divided into three main groups of (12 teeth) in each according to the type of restorative material that was used: group (A) the teeth were restored with Filtekâ„¢ P6
... Show MoreThe aim of the research is to assess the practice of tax administration to diminish the strategic direction of (proactive, analytical, defensive, response) and the nature of its relationship to organizational excellence represented by (leadership, strategic planning, focus on taxpayers, information and analysis and knowledge management, focus on operations, focus on forces. The questionnaire was adopted as a main tool in collecting data and information from the sample members of the General Authority for Taxes (110) who are in the site (m. Second Division Manager, Ms The statistical program (SPSS) was used to calculate (mean, standard deviation, difference coefficient, correlation coefficient, t-test). The research reached a number
... Show MoreProfit is a goal sought by all banks because it brings them income and guarantees them survival and continuity, and on the other hand, facing commitments without financial crisis. Hence the idea of research in his quest to build scientific tools and means that can help bank management in particular, investors, lenders and others to predict financial failure and to detect early financial failures. The research has produced a number of conclusions, the most important of which is that all Islamic banks sample a safe case of financial failure under the Altman model, while according to the Springate model all Islamic banks sample a search for a financial failure except the Islamic Bank of Noor Iraq for Investment and Finance )BINI(. A
... Show MoreThe present study aimed to investigate the effects of cages of fish farming of Mussayyib district,The fish farming have been selected at Euphrates river with in Mussayyib districtBabylon province the area of study extend 3 Km at the river and includes 541 cages in water with in 46 fish farming . Water samples were taken from 3 stations three times within one month for each two of them were taken from two water purification stations in mussayyib ,physical and chemical examination of water quality were taken ,The results for samples from the fish farming indicated that PH and salinity of water within acceptable levels, high proporation of dissolved oxygen and vital oxygen required were very high while the turbidity was more t
... Show MoreThe syntheses, characterizations and structures of three novel dichloro(bis{2-[1-(4-methoxyphenyl)-1H-1,2,3-triazol-4-yl-κN3]pyridine-κN})metal(II), [M(L)2Cl2], complexes (metal = Mn, Co and Ni) are presented. In the solid state the molecules are arranged in infinite hydrogen-bonded 3D supramolecular structures, further stabilized by weak intermolecular π…π interactions. The DFT results for all the different spin states and isomers of dichloro(bis{2-[1-phenyl-1H-1,2,3-triazol-4-yl-κN3]pyridine-κN})metal(II) complexes, [M(L1)2Cl2], support experimental measurements, namely that (i) d5 [Mn(L1)2Cl2] is high spin with S = 5/2; (ii) d7 [Co(L1)2Cl2] has a spin state of S = 3/2, (iii) d8 [Ni(L1)2Cl2] has a spin state of S =
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