Background: Refractory/relapsed acute leukemia has always been a challenging problem for hematologist. Over the past decade emphasis has been made in the development of regimens containing fludarabine, combined with cytosine arabinoside for the treatment of refractory/relapsed acute leukemias. The aim of this study is to evaluate the efficacy and toxicity of the combination of fludarabine, high dose cytarabine, and granulocyte colony stimulating factor in refractory relapsed cases of acute leukaemia,
Methods: a prospective study is being conducted at the national center of hematology and hematology unit /Baghdad teaching hospital from July 2008 to July 2010.Twenty Patients with refractory/relapsed acute leukemia were treated with fludarabine 30mg/m2 and cytosine arabinoside (AraC) 2 g/m2 for 5 days, and granulocyte colony stimulating factor G-CSF 300 microgram/day from day 0 till neutrophil recovery (ANC >1.0 x 109/l).Response was evaluated by bone marrow examination on day 30-post chemotherapy.
Results: Patients included were refractory acute lymphoblastic leukemia (ALL) (n=5), relapsed ALL (n=4), refractory acute myeloid leukemia (AML) (n=8), relapsed AML (n=3). Complete remission (CR) was achieved in 9(45%) patients, 3 (15%) patients got partial remission. Three (15%) patients died of post chemotherapy complications and 5(25%) patient failed to achieve remission. Major complications encountered were: anemia, fever, bleeding, mucositis and bacterial infections.
Conclusion: FLAG protocol is well tolerated and effective regimen in relapsed / refractory acute leukemias. The toxicity is acceptable, enabling most patients to receive further treatment, including transplantation procedures
The research aims to identify the degree of the availability of knowledge, skill and ability as components of human capital, in addition to stand at the level of strategic agility upon tourism and travel agencies company of Jordan, the impact of human capital on strategic agility has been tested through distribution of a questionnaire on a Randomly Sample from Workers in Jordan tourist Companies of (349),a number of statistics techinces have been used simple liner Regrision and Multiplayer regession, it has shown that the degree of knowledge, ability and skill availability was high, and the same applies on strategic agility components, and shown out that there is a statistically significant impact between human capital and strate
... Show MoreThe research shows the importance of orientation towards the formulation of the green strategy and its effect in determining the behavior of the green municipal institution in Babel governorate. The research highlighted the formulation of the green strategy as an important variable, especially today, the trend towards protecting the environment and minimizing the damage resulting from the delivery of services, and through it also the type of green behavior or performance adopted by the municipal institution and the emergence of the need for a strategy that is not harmful to the environment. The research took the sample intentionally comprehensive size of 222 personnel of municipal institutions and some formations concerned with t
... Show MoreWastewater treatment plants operators prefer to make adjustments because they are more cost effective, to use the existing tank instead of building new ones. In this case an imported materials would be used as bio-loads to increase biomass and thus maintain efficiency as the next organic loading increases.In the present study, a local substance "pumice stone" was used as a biological carrier in the aeration tank, and the experiments were carried out in five stages: without biological carriers, filling ratio of 4%,10%,20%, and25% with pumice stone, the maximum organic loading at each stage (1.1884, 1.2144, 1.9432, 2.7768, 3.3141)g BOD /l.d respectively.Other experiments were carried out to determine the best filling ratio, the SS remova
... Show MoreThe present study tackles the complex issue of the urgent need for Environmental Auditing (EA) in Iraq in the absence of laws that support environmental management and in the light of the high rates of cancerous diseases in Iraq, which coincided significantly with the increase in oil production, according to the numbers indicated in the Iraqi Ministry of Health. The study aimed to investigate the mediating role of Management Systems (MS) related to the role of EA supporting sustainability reports concerning the reduction of the negative effects of gas emissions from oil companies. We adopted the descriptive approach which relies on studying relationships through a questionnaire that was distributed to a group of workers at Doura Refinery in
... Show MoreThe current study was conducted in the environment of the Martyr Monument Lake in the city center of Baghdad during 2019 to monitor the impact of climatic conditions such as drought, water shortage, high temperatures in the environment of the city and the lack of water flow during the years 2015 to 2018 and their effects on some of the physical and chemical factors of water and the dynamics of the phytoplankton community in the lake environment. Heterogeneity of some studied environmental factors, including air and water temperature, permeability, water depth, pH, DO, BOD5, nutrients, nitrate, NO3, and phosphates were found. The results showed the effect of climate change and the pres
International relations scholars have increasingly debated the evolving landscape of actors that challenge the traditional state-centric world order. A key element of this transformation is the rise of sub-state actors, which engages in alternative diplomacy parallel to the state, transcending traditional state-centric frameworks. This paper explores the significant shifts in international actorness over the late 20th century, focusing on the emergence and implications of sub-state diplomacy, or "paradiplomacy." First, the study introduces sub-state actors and their role in challenging the dominant state-centric discourse. It then examines the dynamic evolution of paradiplomacy, highlighting how sub-states have expanded their global
... Show MoreIn this work, we construct projectively distinct (k,3)-arcs in the projective plane PG(2,9) by applying a geometrical method. The cubic curves have been been constructed by using the general equation of the cubic. We found that there are complete (13,3)-arcs, complete (15,3)-arcs and we found that the only (16,3)-arcs lead to maximum completeness