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
Leukemia is the most common cancer in children which causes death despite the high survival rate. Therefore, new methods are required to find a suitable therapy. A small RNA called microRNAs (miRNAs) is used as a biomarker for cancer diagnosis and early prognostic evaluation. Expression levels of three miRNAs from the 3' arm (miR-142-3p, miR-223-3p and miR-146-3p) were detected in serum samples from 30 acute leukemic children and from 30 healthy individuals by using qPCR. The miR-142-3p and miR-146-3p profiles were significantly downregulated (P=0.0010 and 0.0012, respectively), while miR-223 was found to be significantly upregulated (P= 0.0044) in the pateints. Serum level of C/EBP-β
... Show MoreAcute lymphoblastic leukemia (ALL) is one of the most common diseases , so in this study the serum level of malondialdehyde and its relationship with metanephrine was investigated in acute lymphoblastic leukemia patients over one month of treatment. Some biochemical parameters (serum glucose , total serum protein , malondialdehyde ,vitamin C, and metanephrine) changed as well as white blood cell count and blood hemoglobinlevelswere analyzed in sixty patients diagnosed with acute lymphoblastic leukemia over one month of treatment compared to healthy control group.Statistically significant increases (p<0.01) in white blood cell (WBC) count, mean concentrations of malondialdehyde (MDA) (p< 0.05) and metanephrine (p< 0.001) were observed in
... Show MoreBackground: Maxillary sinusitis is one of the most common infections of humans. Sinusitis can be defined as an inflammation of the membrane lining of any sinus, especially one of the
paranasal sinuses.
Objective: To determine the causative microorganisms of acute maxillary sinusitis.
Patients: Forty five acute sinusitis patients were involved in the present study.
Methods: Sampling methods were per-oral nasopharyngeal swabs.
Results: Haemophilus species, Streptococcus pneumoniae (S.pneumoniae) and Moraxella catarrhalis (M.catarrhalis) were the most frequent isolates.
Conclusion: The most causative agents of acute maxillary sinusitis were bacterial isolates, which were Haemophilus species followed by S.pne
Acute lymphoblastic leukemia which developed after first primary solid organ malignancy (1M) considered as secondary acute lymphoblastic leukemia (sALL) and it is rare. The observational study that researches for(sALL) in worldwide and even in Iraq is limited. This study investigated (sALL) among 50 (ALL) Iraqi patients (30 children; 20 adults). Five (4 female;1 male) out of 50 (ALL) patients (10%) were with(sALL) .They asked through questionnaire form about their age , 1M , latency period and immunophenotype .They were in 14-40 years age group and with previous malignancies breast , ovary, lung and thyroid cancers. The median latency period (from 1M to sALL) was 30 months. Four of (sALL) were with B cell immunophenotype , while on
... Show MoreBackground: the exposure of chronic lymphocytic leukemia (CLL) cells to fludarabine and cyclophosphamide resulted in an increased, synergistic cytotoxicity . DNA repair mechanisms in CLL cells, which are initiated in response to cyclophosphamide exposition, are inhibited by fludarabine. This observation was later translated into clinical trials evaluating the combination of fludarabine plus cyclophosphamide (FC) showed promising efficacy with response rates exceeding 90% in previously untreated and pretreated patient
Aim of this study: To assess the efficacy and safety of combination therapy of fludarabine plus cyclophosphamide in Iraqi adults patients with advance stage of chro
... Show MoreLeukemia or cancer of the blood is the most common childhood cancer, Acute lymphoblastic leukemia (ALL), is the most common form of leukemia that occurs in children. It is characterized by the presence of too many immature white blood cells in the child’s blood and bone marrow, Acute lymphoblastic leukemia can occur in adults too, treatment is different for children. Children with ALL develop symptoms related to infiltration of blasts in the bone marrow, lymphoid system, and extramedullary sites, such as the central nervous system (CNS). Common constitutional indications consist of fatigue (50%), pallor (25%), fever (60%), and weight loss (26%). Infiltration of blast cells in the marrow cavity and periosteum often lead to bone
... Show MoreABSTRACTBackground: dyslipidemia plays a crucial rule in the development of cardiovascular disease, which has become the leading cause of death in most developed countries as well as in developing countries (1). The effects of reducing low density lipoprotein – C (LDL-C) concentrations on the prevention of cardiovascular events and stroke have been well reported in many clinical trials.Objectives: Evidence supports the use of statins for lipid modifications in the primary prevention of coronary artery disease, morbidity and mortality. This study aims to determine the effectiveness of atorvastatin in treating dyslipidemia in Iraqi obese patients.Methods: 200 overweight and obese patients with hypercholesterolemia, according to NCEP ATP
... Show MoreBackground: 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 me