Evaluation of growth factor independence 1 expression in patients with de novo acute myeloid leukemia

Objective

Growth factor independence 1 (GFI1), a transcriptional repressor, is required for hematopoietic stem cell maintenance and self-renewal in addition to controlling differentiation and proliferation of myeloid cells. As murine studies have demonstrated that this transcription factor has a notable role in the initiation and progression of acute myeloid leukemia (AML) disease, the aim of the current study was to investigate and review the influence of GFI1 in human AML cells.

Methods

GFI1 expression levels were measured by means of real-time polymerase chain reaction in 96 primary AML samples which were then compared to gene expression levels observed in 18 healthy subjects. Moreover, GFI1 expression patterns were analyzed based on specific AML subtypes including acute promyelocytic leukemia (APL). Finally, leukemic cells were stained to measure levels of myeloperoxidase (MPO) activity.

Results

This study reports that AML patients have significantly higher GFI1 mRNA levels in comparison to healthy subjects and that, when considering AML subtypes, patients with APL have higher GFI1 expression than non-APL patients.

Conclusion

It is also concluded that GFI1 overexpression in patients with high MPO levels, such as those of the APL subtype, is correlated with favorable disease prognosis as supported by other studies which demonstrate that increased peroxide activity and GFI1 are independently correlated with a favorable prognosis.

Study on the significance correlation between CEBPA and Calreticulin at mRNA level diagnosed in de nevo AML patients

Objectives: Calreticulin (CALR) and CCAAT/enhancer binding protein (C/EBP) alpha (CEBPA) are two important multifunctional proteins which play different roles in regulation of hematopoiesis. Expressional changes of these genes were related to the malignancy. Methods: The present study aimed to investigate the expression levels of CALR and CEBPA genes in 96 de novo AML patients compared to 18 normal people as the control group through the Real-Time-PCR. Results: Results of the present study revealed that the expression of these genes was significantly higher in patients with AML than the normal group (P <0.0001). Furthermore, there was a significant and positive correlation between CALR and CEBPA (P= 0.001 and r= 0.348). Discussion: Higher level of CALR expression was expected, but the overexpression of CEBPA was on the contrary to its well-known role in the myeloid maturation. Based on the studies, CALR probably played roles in the expression of oncogenic CEBPA and it repressed the CEBPA translation in tumor suppressor gene (TSG). Conclusion: The present study first indicated the over-expression of CALR in AML patients and compared it with the healthy normal control group and also found a positive relationship between CALR and CEBPA expression in the AML patients. Bangladesh Journal of Medical Science Vol.19(4) 2020 p.730-736

Ewing Sarcoma/Peripheral Primitive Neuroectodermal Tumor in the Adrenal Gland of a Child

Ewing sarcoma/peripheral primitive neuroectodermal tumor (ES/PNET) typically occurs in long or flat bones, soft tissues, or less often, solid organs. Ewing sarcoma/peripheral primitive neuroectodermal tumor arising from the adrenal gland is extremely rare, especially in children, and only limited cases are reported previously. Herein, we review a case of a 22-month-old girl who presented to our department with abdominal pain, bulging of the left flank, and a nonfunctioning adrenal lesion which was found to be an adrenal ES/PNET. The patient was successfully treated with surgery and adjuvant chemotherapy. Since delayed diagnosis may result in metastatic lesions, this case underscores the importance of considering ES/PNET in the differential diagnosis of large adrenal masses.

Imerslund-Grasbeck syndrome in a 5-year-old Iranian boy

Imerslund-Grasbeck syndrome (IGS) is a rare syndrome characterized by clinical symptoms and signs of Vitamin B₁₂ deficiency and proteinuria. Our patient was a 5-year-old boy with pallor, lack of appetite, and low weight gain. Laboratory studies showed severe macrocytic anemia, normal reticulocyte count, negative direct coombs test, normal osmotic fragility, and autohemolysis test. He has had intermittent proteinuria since 3 years ago despite normal creatinine level and absence of hematuria or hypertension. Finally, based on low level of serum B₁₂ vitamin and normal folate level accompanied by asymptomatic proteinuria, the diagnosis of IGS was made. Furthermore, his sister has had laboratory abnormalities without any symptoms. IGS responded to B₁₂ replacement therapy dramatically but intermittent proteinuria persisted even after appropriate therapy.

Primary Ewing's Sarcoma of the temporal bone in an infant

Introduction : Ewing's sarcoma is the second most common primary malignant tumor of bone found in children after Osteosarcoma. It accounts for 4-9% of primary malignant bone tumors and it affects bones of the skull or face in only 1-4% of cases. Hence it rarely affects the head and neck. Subject and Method : In this case report, we describe a case of primary Ewing's sarcoma occurring in the temporal bone. The tumor was surgically excised, and the patient underwent chemotherapy for ten months. Results : Neither recurrence nor distant metastasis was noted in these 10 months after surgery but about 18 months after surgery our patient was expired. Conclusion : Although the prognosis of Ewing's sarcoma is generally poor because of early metastasis to the lungs and to other bones, a review of the article suggested that Ewing's sarcoma occurring in the skull can often be successfully managed by intensive therapy with radical excision and chemotherapy. This result was supported by the case reported here.

Warfarin-induced Eosinophilia in a Child with urkitt Lymphoma: A Case Report

An important complication of chemotherapy is thromboembolic events that can occur during treatment course. In this way, Warfarin can be used as an efficient prophylactic agent to prevent these complications. Although bleeding is a common adverse effect of Warfarin, eosinophilia is a rare side effect of this drug. We have reported a 5-year-old boy with Burkitt lymphoma who underwent chemotherapy. In the course of chemotherapy, because of thrombosis of the left jugular vein, we initiated Warfarin as a prophylactic drug for TEE secondary to chemotherapy. Following Warfarin initiation, eosinophilia appeared and subsequent to cessation of drug, eosinophilia disappeared. This case is presented to point out physicians to consider eosinophilia as a rare adverse-effect of Warfarin and monitor blood cell differentiation regularly during the course of treatment with this drug.

Development of secondary T-cell acute lymphoblastic leukemia in a child with hemophagocytic lymphohistiocytosis

Hemophagocytic lymphohistiocytosis (HLH) is a severe life-threatening disorder, characterized by hyperactivation of macrophages. A 12-year-old female was referred to our center; the diagnosis of HLH was made for the patient and immunosuppressive regimen was started. After a 2-year follow-up, the patient developed secondary T-cell acute lymphoblastic leukemia (T-ALL), confirmed by flow cytometric studies. Treatment was started based on T-ALL protocol, but the patient died because of relapse and sepsis. This case highlights the issue of secondary malignancy following HLH and demonstrates the need for continued follow-up in such patients.