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Abba SI, Yassin MA, Shah SMH, Egbueri JC, Elzain HE, Agbasi JC, Saini G, Usaman J, Khan NA, Aljundi IH. Trace element pollution tracking in the complex multi-aquifer groundwater system of Al-Hassa oasis (Saudi Arabia) using spatial, chemometric and index-based techniques. Environ Res 2024; 249:118320. [PMID: 38331148 DOI: 10.1016/j.envres.2024.118320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Revised: 01/15/2024] [Accepted: 01/25/2024] [Indexed: 02/10/2024]
Abstract
In a global context, trace element pollution assessment in complex multi-aquifer groundwater systems is important, considering the growing concerns about water resource quality and sustainability worldwide. This research addresses multiple objectives by integrating spatial, chemometric, and indexical study approaches, for assessing trace element pollution in the multi-aquifer groundwater system of the Al-Hassa Oasis, Saudi Arabia. Groundwater sampling and analysis followed standard methods. For this purpose, the research employed internationally recognized protocols for groundwater sampling and analysis, including standardized techniques outlined by regulatory bodies such as the United States Environmental Protection Agency (USEPA) and the World Health Organization (WHO). Average values revealed that Cr (0.041) and Fe (2.312) concentrations surpassed the recommended limits for drinking water quality, posing serious threats to groundwater usability by humans. The trace elemental concentrations were ranked as: Li < Mn < Co < As < Mo < Zn < Al < Ba < Se < V < Ni < Cr < Cu < B < Fe < Sr. Various metal(loid) pollution indices, including degree of contamination, heavy metal evaluation index, heavy metal pollution index, and modified heavy metal index, indicated low levels of groundwater pollution. Similarly, low values of water pollution index and weighted arithmetic water quality index were observed for all groundwater points, signifying excellent groundwater quality for drinking and domestic purposes. Spatial distribution analysis showed diverse groundwater quality across the study area, with the eastern and western parts displaying a less desirable quality, while the northern has the best, making water users in the former more vulnerable to potential pollution effects. Thus, the zonation maps hinted the necessity for groundwater quality enhancement from the western to the northern parts. Chemometric analysis identified both human activities and geogenic factors as contributors to groundwater pollution, with human activities found to have more significant impacts. This research provides the scientific basis and insights for protecting the groundwater system and ensuring efficient water management.
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Affiliation(s)
- S I Abba
- Interdisciplinary Research Centre for Membranes and Water Security, King Fahd University of Petroleum and Minerals, Dhahran, 31261, Saudi Arabia.
| | - Mohamed A Yassin
- Interdisciplinary Research Centre for Membranes and Water Security, King Fahd University of Petroleum and Minerals, Dhahran, 31261, Saudi Arabia; College of Petroleum Engineering and Geosciences, King Fahd University of Petroleum and Minerals, Dhahran 31261, Saudi Arabia.
| | - Syed Muzzamil Hussain Shah
- Interdisciplinary Research Centre for Membranes and Water Security, King Fahd University of Petroleum and Minerals, Dhahran, 31261, Saudi Arabia
| | - Johnbosco C Egbueri
- Department of Geology, Chukwuemeka Odumegwu Ojukwu University, Uli, Nigeria.
| | - Hussam Eldin Elzain
- Water Research Center, Sultan Qaboos University, P.O. 50, AlKhoud 123, Oman.
| | - Johnson C Agbasi
- Department of Geology, Chukwuemeka Odumegwu Ojukwu University, Uli, Nigeria.
| | - Gaurav Saini
- Department of Civil Engineering, Netaji Subhas University of Technology, Delhi, India.
| | - Jamilu Usaman
- Interdisciplinary Research Centre for Membranes and Water Security, King Fahd University of Petroleum and Minerals, Dhahran, 31261, Saudi Arabia
| | - Nadeem A Khan
- Interdisciplinary Research Centre for Membranes and Water Security, King Fahd University of Petroleum and Minerals, Dhahran, 31261, Saudi Arabia
| | - Isam H Aljundi
- Interdisciplinary Research Centre for Membranes and Water Security, King Fahd University of Petroleum and Minerals, Dhahran, 31261, Saudi Arabia; Department of Chemical Engineering, King Fahd University of Petroleum and Minerals, Dhahran, 31261, Saudi Arabia.
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Abdu Y, Rahhal A, Ahmed K, Adli N, Abdou M, Ali EAH, Al-Kindi S, Al Rasheed M, Altooq J, Bougmiza I, Yassin MA. The role of preoperative transfusion in sickle cell disease, a systematic review and meta-analysis. Blood Rev 2024; 65:101183. [PMID: 38388223 DOI: 10.1016/j.blre.2024.101183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 02/15/2024] [Accepted: 02/16/2024] [Indexed: 02/24/2024]
Abstract
This systematic review and meta-analysis aimed to provide guidance on preoperative blood transfusion strategies for patients with sickle cell disease (SCD). We included all randomized controlled and observational studies exploring the clinical outcomes of preoperative blood transfusion among patients with SCD compared to the conservative transfusion strategy until 14/09/2022. Sixteen studies involving 3486 participants were analysed. The findings revealed a significantly higher bleeding rate in patients who received preoperative transfusion than those who followed a conservative strategy (RR = 4.32, 95% CI 1.75-10.68, P = 0.002, I2 = 0%). However, the two strategies had no significant differences in other clinical outcomes, such as acute chest syndrome, painful crisis, fever, neurological complications, thrombosis, ICU admission, and mortality. It is important to note that all the included studies had a moderate risk of bias. Preoperative transfusion in SCD was associated with a higher bleeding risk but a similar risk in other outcomes compared to conservative strategies. Notably, the increased bleeding risk observed seldom had clinical significance. We recommend individualizing management strategies, considering the overall positive impact of transfusions in reducing complications. Further high-quality studies are needed to refine recommendations.
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Affiliation(s)
- Yasamin Abdu
- Department of Community Medicine, Hamad Medical Corporation, Doha, Qatar.
| | - Alaa Rahhal
- Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar
| | - Khalid Ahmed
- Department of Haematology, Royal Hallamshire Hospital, Sheffield Teaching Hospitals NHS Foundation trust, Sheffield, UK
| | - Nada Adli
- Department of Community Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mariam Abdou
- Department of Community Medicine, Hamad Medical Corporation, Doha, Qatar
| | | | - Salam Al-Kindi
- Department of Haematology, Sultan Qaboos University, Muscat, Oman.
| | | | - Jaffer Altooq
- Department of Internal Medicine, Bahrain Salmania Hospital, Manama, Bahrain
| | - Iheb Bougmiza
- Department of Community Medicine, Primary Health Care Corporation, Doha, Qatar; Faculty of Medicine, Sousse University, Sousse, Tunisia.
| | - Mohamed A Yassin
- Department of Haematology, NCCCR, Hamad Medical Corporation, Doha, Qatar; College of Medicine, Qatar University, Doha, Qatar
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Chelysheva E, Apperley J, Turkina A, Yassin MA, Rea D, Nicolini FE, Barraco D, Kazakbaeva K, Saliev S, Abulafia AS, Al-Kindi S, Byrne J, Robertson HF, Cerrano M, Shmakov R, Polushkina E, de Fabritiis P, Trawinska MM, Abruzzese E. Chronic myeloid leukemia diagnosed in pregnancy: management and outcome of 87 patients reported to the European LeukemiaNet international registry. Leukemia 2024; 38:788-795. [PMID: 38388649 DOI: 10.1038/s41375-024-02183-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 02/07/2024] [Accepted: 02/13/2024] [Indexed: 02/24/2024]
Abstract
The management of chronic myeloid leukemia (CML) diagnosed during pregnancy is a rare and challenging situation. We report the treatment and outcome of 87 cases diagnosed in chronic phase from 2001-2022 derived from the largest international observational registry, supported by the European LeukemiaNet (ELN), of 400 pregnancies in 299 CML women. Normal childbirth occurred in 76% without an increased rate of birth abnormalities or life-threatening events, including in patients untreated or treated with interferon-α and/or imatinib in 2nd-3rd trimester. The low birth weight rate of 12% was comparable to that seen in the normal population. Elective and spontaneous abortions occurred in 21% and 3%, respectively. The complete hematologic response rate before labor was 95% with imatinib and 47% with interferon only. No disease progression during pregnancy was observed, 28% of the patients switched their therapy at varying times after delivery. Treatment options balance the efficacy and safety for mother and infant: interferon-α can commence in the 1st trimester and continued throughout in cases of good disease control and tolerability. Because of limited placental crossing, selected tyrosine kinase inhibitors (imatinib and nilotinib) seem to be safe and effective options in 2nd and 3rd trimester while hydroxycarbamide offers few benefits.
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Affiliation(s)
| | - Jane Apperley
- Centre for Haematology, Imperial College London, London, UK
| | - Anna Turkina
- National Medical Research Center for Hematology, Moscow, Russian Federation
| | - Mohamed A Yassin
- Department of Medical Oncology/ Hematology Section, National Centre For Cancer Care & Research, Doha, Qatar
| | - Delphine Rea
- Service d'hématologie Adulte and FiLMC Hôpital Saint-Louis, Paris, France
| | - Franck E Nicolini
- Hematology department and INSERM 1052 CRCL, Centre Léon Bérard, Lyon, France
| | - Daniela Barraco
- Division of Hematology, University Hospital "Ospedale di Circolo e Fondazione Macchi - ASST Sette Laghi", Varese, Italy
| | - Khamida Kazakbaeva
- Republician Specilized Scientific and Practical Medical Centre of Hematology, Tashkent, Uzbekistan
| | - Sukhrob Saliev
- Republician Specilized Scientific and Practical Medical Centre of Hematology, Tashkent, Uzbekistan
| | - Adi Shacham Abulafia
- Institute of Hematology, Davidoff Cancer Center, Rabin Medical Center, Beilinson Campus, Petah-Tikva, Israel
| | - Salam Al-Kindi
- Department of Haematology, Sultan Qaboos University, Muscat, Oman
| | - Jennifer Byrne
- Centre for Clinical Haematology, Nottingham University Hospitals NHS Trust, Nottingham, England, UK
| | | | - Marco Cerrano
- Division of Hematology, A.O.U. Città della Salute e della Scienza di Torino, Turin, Italy
| | - Roman Shmakov
- FSBI «National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov» Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
| | - Evgenia Polushkina
- FSBI «National Medical Research Center for Obstetrics, Gynecology and Perinatology named after Academician V.I.Kulakov» Ministry of Healthcare of the Russian Federation, Moscow, Russian Federation
| | - Paolo de Fabritiis
- Hematology, S. Eugenio Hospital, Tor Vergata University, ASL Roma2, Rome, Italy
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Abidi JH, Elzain HE, Sabarathinam C, El Fehri RM, Farhat B, Ben Mammou A, Waterloo MJ, Yassin MA, Senapathi V. Integrated approach to understand the multiple natural and anthropogenic stresses on intensively irrigated coastal aquifer in the Mediterranean region. Environ Res 2024; 252:118757. [PMID: 38537744 DOI: 10.1016/j.envres.2024.118757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Revised: 02/29/2024] [Accepted: 03/19/2024] [Indexed: 04/06/2024]
Abstract
Understanding the major factors influencing groundwater chemistry and its evolution in irrigation areas is crucial for efficient irrigation management. Major ions and isotopes (δD-H2O together with δ18O-H2O) were used to identify the natural and anthropogenic factors contributing to groundwater salinization in the shallow aquifer of the Wadi Guenniche Plain (WGP) in the Mediterranean region of Tunisia. A comprehensive geochemical investigation of groundwater was conducted during both the low irrigation season (L-IR) and the high irrigation season (H-IR). The results show that the variation range and average concentrations of almost all the ions in both the L-IR and H-IR seasons are high. The groundwater in both seasons is characterized by high electrical conductivity and CaMgCl/SO4 and NaCl types. The dissolution of halite and gypsum, the precipitation of calcite and dolomite, and Na-Ca exchange are the main chemical reactions in the geochemical evolution of groundwater in the Wadi Guenniche Shallow Aquifer (WGSA). Stable isotopes of hydrogen and oxygen (δ18O-H2O and δD-H2O) indicate that groundwater in WGSA originated from local precipitation. In the H-IR season, the δ18O-H2O and δD-H2O values indicate that the groundwater experienced noticeable evaporation. The enriched isotopic signatures reveal that the WGSA's groundwater was influenced by irrigation return flow and seawater intrusion. The proportions of mixing with seawater were found to vary between 0.12% and 5.95%, and between 0.13% and 8.42% during the L-IR and H-IR seasons, respectively. Irrigation return flow and the associated evaporation increase the dissolved solids content in groundwater during the irrigation season. The long-term human activities (fertilization, irrigation, and septic waste infiltration) are the main drives of the high nitrate-N concentrations in groundwater. In coastal irrigation areas suffering from water scarcity, these results can help planners and policy makers understand the complexities of groundwater salinization to enable more sustainable management and development.
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Affiliation(s)
- Jamila Hammami Abidi
- Laboratory of Mineral Resources and Environment, Faculty of Sciences of Tunis, University of Tunis El Manar, 2092, Tunis, Tunisia
| | - Hussam Eldin Elzain
- Water Research Center, Sultan Qaboos University, PO Box 50, AlKhoud 123, Oman.
| | | | - Rihem Mejdoub El Fehri
- Laboratory of Geotechnical Engineering and Georisk, High National School of Engineering of Tunis, University of Tunis El Manar, 2092, Tunis, Tunisia
| | - Boutheina Farhat
- Laboratory of Mineral Resources and Environment, Faculty of Sciences of Tunis, University of Tunis El Manar, 2092, Tunis, Tunisia
| | - Abdallah Ben Mammou
- Laboratory of Mineral Resources and Environment, Faculty of Sciences of Tunis, University of Tunis El Manar, 2092, Tunis, Tunisia
| | | | - Mohamed A Yassin
- Interdisciplinary Research Center for Membranes and Water Security, KFUPM, 31261, Saudi Arabia; Department of Geosciences, College of Petroleum Engineering & Geosciences, King Fahd University of Petroleum & Minerals, Dhahran 31261, Saudi Arabia
| | - Venkatramanan Senapathi
- PG and Research Department of Geology, National College (Autonomous), Tiruchirappalli - 620001, Tamil Nadu, India
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Alkassfarity AN, Yassin MA, Abdel Rehim MH, Liu L, Jiao Z, Wang B, Wei Z. Modified cellulose nanocrystals enhanced polycaprolactone multifunctional films with barrier, UV-blocking and antimicrobial properties for food packaging. Int J Biol Macromol 2024; 261:129871. [PMID: 38309396 DOI: 10.1016/j.ijbiomac.2024.129871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/15/2024] [Accepted: 01/29/2024] [Indexed: 02/05/2024]
Abstract
The packaging industry demands improved eco-friendly materials with new and enhanced properties. In this context, bio-nanocomposite films with antimicrobial and UV-shielding properties based on modified cellulose nanocrystals/polycaprolactone (MCNC/PCL) were fabricated via solution casting method, and then food packaging simulation was carried out. CNCs were obtained by acid hydrolysis followed by successful functionalization with Quaternary ammonium surfactant, confirmed by FTIR, XPS, XRD, TEM, and DLS analyses. Furthermore, the morphological, physical, antibacterial, and food packaging properties of all prepared films were investigated. Results showed that the mechanical, UV blocking, barrier properties, and antibacterial activity of all composite films were remarkably improved. Particularly, the addition of 3 wt% MCNC increased the tensile strength and elongation at break by 27.5 % and 20.0 %, respectively. Moreover, the permeability of O2, CO2, and water vapor dramatically reduced by 97.6 %, 96.7 %, and 49.8% compared to the Neat PCL. Further, the UV-blocking properties of the composite films were significantly improved. The antimicrobial properties of MCNC/PCL films showed good antimicrobial properties against S. aureus. Finally, cherry packaged with 1 and 3 wt% MCNC films exhibited satisfactory freshness after 22 days of preservation. Overall, the fabricated PCL nanocomposite films can be utilized in the food packaging industry.
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Affiliation(s)
- Asmaa N Alkassfarity
- Department of Polymer Science and Engineering, School of Chemical Engineering, Dalian University of Technology, Dalian 116024, China; Packing and Packaging Materials Department, National Research Centre, Giza, Egypt
| | - Mohamed A Yassin
- Packing and Packaging Materials Department, National Research Centre, Giza, Egypt; Advanced Materials and Nanotechnology Lab, Center of Excellence, National Research Centre, Giza, Egypt
| | - Mona H Abdel Rehim
- Packing and Packaging Materials Department, National Research Centre, Giza, Egypt
| | - Lipeng Liu
- Department of Polymer Science and Engineering, School of Chemical Engineering, Dalian University of Technology, Dalian 116024, China
| | - Ziyue Jiao
- Department of Polymer Science and Engineering, School of Chemical Engineering, Dalian University of Technology, Dalian 116024, China
| | - Bo Wang
- Department of Polymer Science and Engineering, School of Chemical Engineering, Dalian University of Technology, Dalian 116024, China
| | - Zhiyong Wei
- Department of Polymer Science and Engineering, School of Chemical Engineering, Dalian University of Technology, Dalian 116024, China.
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Ghanem AF, Yassin MA, Cosquer R, Gouanvé F, Espuche E, Abdel Rehim MH. Polycaprolactone composite films infused with hyperbranched polyester/reduced graphene oxide: influence on biodegradability, gas/water transport and antimicrobial properties for sustainable packaging. RSC Adv 2024; 14:5740-5753. [PMID: 38362077 PMCID: PMC10864823 DOI: 10.1039/d3ra08948g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2023] [Accepted: 01/31/2024] [Indexed: 02/17/2024] Open
Abstract
Biodegradable polymers have gained great interest as ecofriendly packaging materials. However, addition of suitable fillers to the polymer matrix enhances their barrier and mechanical properties besides gaining new features such as bactericidal activity. This work deals with investigation of mechanical, gas/water transport properties and biodegradability performance of films based on polycaprolactone (PCL) reinforced by 1wt% of reduced graphene oxide (RGO) or modified graphene (mRG). To achieve this goal, nanosheets of RGO were firstly prepared then their surfaces were modified through in situ polymerization of hyperbranched polyester (PES) to obtain mRG. Then PCL was loaded with both fillers, and the nanocomposite films were prepared by a casting technique. Studying of the thermal properties of the films showed that the addition of RGO or mRG had no influence on the crystallinity of the PCL matrix. Although the mechanical characteristics of the PCL did not change when either filler was added, there was an increase in permeability and diffusivity in the presence of the fillers regardless of their composition. Nevertheless, the nanocomposites demonstrated antimicrobial properties against S. aureus and E. coli as models for Gram-positive and Gram-negative bacteria, respectively. The biodegradability test performed on the prepared film PCL, and those containing 1% of the filler, PCL/RGO, and PCL/mRG, emphasized that the film degradation became pronounced after three months for all samples.
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Affiliation(s)
- Ahmed F Ghanem
- Packing and Packaging Materials Department, National Research Centre Giza Egypt
| | - Mohamed A Yassin
- Packing and Packaging Materials Department, National Research Centre Giza Egypt
- Advanced Materials and Nanotechnology Lab., Center of Excellence, National Research Centre Giza Egypt
| | - Raphael Cosquer
- UMR CNRS 5223, Ingénierie des Matériaux Polymères, Université Claude Bernard Lyon 1 69622 Villeurbanne Cedex France
| | - Fabrice Gouanvé
- UMR CNRS 5223, Ingénierie des Matériaux Polymères, Université Claude Bernard Lyon 1 69622 Villeurbanne Cedex France
| | - Eliane Espuche
- UMR CNRS 5223, Ingénierie des Matériaux Polymères, Université Claude Bernard Lyon 1 69622 Villeurbanne Cedex France
| | - Mona H Abdel Rehim
- Packing and Packaging Materials Department, National Research Centre Giza Egypt
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Adel AA, Exarchakou A, Elshafey N, Ghazouani H, Alshurafa A, Yassin MA. Epidemiologic and Clinical Patterns of Malignant Lymphoma in Qatar 2013-2017: A population-based Cohort Study. Oncology 2024:000536567. [PMID: 38320544 DOI: 10.1159/000536567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2023] [Accepted: 01/10/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND Lymphoma, encompassing common non-Hodgkin lymphoma (NHL) and less common Hodgkin lymphoma (HL), represents significant hematological malignancies. Advancements in treatment modalities have reshaped survival rates, particularly in NHL. This complexity results in varying outcomes, some requiring extended observation periods and multiple chemotherapy treatments. OBJECTIVE The primary objective is to explore and compare the overall survival (OS) of HL and NHL at 1, 3, and 5-year follow-ups among adult lymphoma patients in Qatar during January 2013 - December 2017. Further objectives encompass comparing the most prevalent histological types, clinical and epidemiological traits of HL and NHL, as well as secondary aims of assessing clinical features, treatment, response, disease-free survival, and overall survival. METHODS A retrospective, descriptive study of consecutive cases was conducted at Qatar's NCCCR between 2013 and 2017. Inclusion criteria involved patients ≥18 years old, of any gender and clinical stage at diagnosis, who received chemotherapy and had known outcomes. Descriptive statistics were applied, and survival analysis utilized Kaplan-Meier curves. STATA version 13.0 facilitated data analysis. RESULTS Between 2013-2017, 414 individuals in Qatar were diagnosed with lymphoma. The median age at diagnosis was 49 years (IQR 36-95 years; p<0.001) across all patients. Males exhibited a higher likelihood of developing HL and NHL, comprising 74% and 70% of cases respectively, though this difference was statistically insignificant (p=0.45). Among NHL-B subtypes, mature B-cell neoplasms (60%) predominated, while Lymphocyte-rich subtype (49%) was prominent in HL cases. With a median follow-up of 17.3 months, OS rates at 1, 3, and 5 years were 99%, 82%, and 64% respectively for all lymphoma patients. Subtype stratification revealed trends in 3-year follow-up OS (94% versus 82%) for HL and NHL, with 5-year OS of 67% and 60% respectively. HL demonstrated higher OS throughout the study period compared to NHL (p<0.001), though median OS remained unreached. CONCLUSIONS Diffuse large B-cell lymphoma emerged as the most prevalent subtype among lymphomas in Qatar. Generally, HL exhibited superior survival rates, at 67% compared to 60% for NHL. Minor deflation in survival rates, particularly for HL, might be attributed to Qatar's immigration patterns.
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Elzain HE, Abdalla O, A Ahmed H, Kacimov A, Al-Maktoumi A, Al-Higgi K, Abdallah M, Yassin MA, Senapathi V. An innovative approach for predicting groundwater TDS using optimized ensemble machine learning algorithms at two levels of modeling strategy. J Environ Manage 2024; 351:119896. [PMID: 38171121 DOI: 10.1016/j.jenvman.2023.119896] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/05/2024]
Abstract
Groundwater salinization in coastal aquifers is a major socioeconomic challenge in Oman and many other regions worldwide due to several anthropogenic activities and natural drivers. Therefore, assessing the salinization of groundwater resources is crucial to ensure the protection of water resources and sustainable management. The aim of this study is to apply a novel approach using predictive optimized ensemble trees-based (ETB) machine learning models, namely Catboost regression (CBR), Extra trees regression (ETR), and Bagging regression (BA), at two levels of modeling strategy for predicting groundwater TDS as an indicator for seawater intrusion in a coastal aquifer, Oman. At level 1, ETR and CBR models were used as base models or inputs for BA in level 2. The results show that the models at level 1 (i.e., ETR and CBR) yielded satisfactory results using a limited number of inputs (Cl, K, and Sr) from a few sets of 40 groundwater wells. The BA model at level 2 improved the overall performance of the modeling by extracting more information from ETR and CBR models at level 1 models. At level 2, the BA model achieved a significant improvement in accuracy (MSE = 0.0002, RSR = 0.062, R2 = 0.995 and NSE = 0.996) compared to each individual model of ETR (MSE = 0.0007, RSR = 0.245, R2 = 0.98 and NSE = 0.94), and CBR (MSE = 0.0035, RSR = 0.258, R2 = 0.933 and NSE = 0.934) at level 1 models in the testing dataset. BA model at level 2 outperformed all models regarding predictive accuracy, best generalization of new data, and matching the locations of the polluted and unpolluted wells. Our approach predicts groundwater TDS with high accuracy and thus provides early warnings of water quality deterioration along coastal aquifers which will improve water resources sustainability.
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Affiliation(s)
- Hussam Eldin Elzain
- Water Research Center, Sultan Qaboos University, P.O. 50, Al Khoudh 123, Oman.
| | - Osman Abdalla
- Department of Earth Sciences, College of Science, Sultan Qaboos University, P.O. 36, Al Khoudh 123, Oman.
| | - Hamdi A Ahmed
- Department of Industrial and Data Engineering, Pukyong National University, Busan, 48513, South Korea.
| | - Anvar Kacimov
- Department of Soils, Water and Agricultural Engineering, Sultan Qaboos University, P.O. 34, Al Khoudh 123, Oman.
| | - Ali Al-Maktoumi
- Water Research Center, Sultan Qaboos University, P.O. 50, Al Khoudh 123, Oman; Department of Soils, Water and Agricultural Engineering, Sultan Qaboos University, P.O. 34, Al Khoudh 123, Oman.
| | - Khalifa Al-Higgi
- Department of Earth Sciences, College of Science, Sultan Qaboos University, P.O. 36, Al Khoudh 123, Oman.
| | - Mohammed Abdallah
- College of Hydrology and Water Resources, Hohai University, Nanjing, Jiangsu, 210024, China.
| | - Mohamed A Yassin
- Interdisciplinary Research Centre for Membranes and Water Security, King Fahd University of Petroleum and Minerals, Dhahran 31261, Saudi Arabia.
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Elmahdy MM, Yassin MA. Linear and nonlinear optical parameters of biodegradable chitosan/polyvinyl alcohol/sodium montmorillonite nanocomposite films for potential optoelectronic applications. Int J Biol Macromol 2024; 258:128914. [PMID: 38143059 DOI: 10.1016/j.ijbiomac.2023.128914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/08/2023] [Accepted: 12/18/2023] [Indexed: 12/26/2023]
Abstract
Innovations in sophisticated optoelectronic devices have increased interest in high-refractive index polymers. Herein, we report innovative nanocomposite films with high linear and nonlinear refractive indices prepared by casting chitosan (Cs) with polyvinyl alcohol (PVA) (50:50 wt%) along with different concentrations (10-50 wt%) of sodium montmorillonite (NaMMT) nanoclay. The refractive indices in addition to other optical parameters of homopolymers and hybrid materials were investigated by UV-Vis. spectroscopy and optical modeling to assess their potential applications in optics. Besides, the structure, morphology, and thermal stability of the prepared films were investigated by a multitude of experimental techniques including X-ray diffraction (XRD), attenuated total reflectance-Fourier transform infrared spectroscopy (ATR-FTIR), scanning electron microscopy (SEM), atomic force microscopy (AFM), and thermogravimetric analysis (TGA/DTG). The ATR-FTIR, XRD, SEM, and AFM measurements confirmed the complete exfoliation of NaMMT nanolayers in the Cs/PVA matrix. The TGA/DTG revealed an increase in the thermal stability of Cs/PVA film with increasing clay content. The UV-Vis. measurements revealed a decrease in the optical energy gap (Eg) and a substantial increase in the linear (nD) and nonlinear (n2) refractive indices as clay content increased. Additionally, the nanohybrids displayed low UV transmission and reflected about 80 % of UV rays, making them excellent candidates for UV protection. For the first time, the dissipation factor (tanδ) in the UV/Vis. region has been calculated and fitted with the Drude-Lorentz model to predict the plasma frequency (ωp), resonance frequency (ω0), and electron lifetime (τ) of pristine polymers and nanocomposites.
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Affiliation(s)
- Mahdy M Elmahdy
- Department of Physics, College of Science and Humanities, Prince Sattam bin Abdulaziz University, 11942 Al-Kharj, Saudi Arabia; Department of Physics, Faculty of Science, Mansoura University, 35516 Mansoura, Egypt.
| | - Mohamed A Yassin
- Advanced Materials and Nanotechnology Lab., Center of Excellence, National Research Centre, Cairo 12622, Egypt; Packaging Materials Department, National Research Centre, Cairo 12622, Egypt
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10
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Ali EA, Al-Sadi A, Al-maharmeh Q, Subahi EA, Bellamkonda A, Kalavar M, Panigrahi K, Alshurafa A, Yassin MA. SARS-CoV-2 and chronic myeloid leukemia: a systematic review. Front Med (Lausanne) 2024; 10:1280271. [PMID: 38327268 PMCID: PMC10847560 DOI: 10.3389/fmed.2023.1280271] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/21/2023] [Indexed: 02/09/2024] Open
Abstract
Introduction Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the virus causing the coronavirus disease of 2019. The disease has caused millions of deaths since the first pandemic at the end of 2019. Immunocompromised individuals are more likely to develop severe infections. Numerous mutations had developed in SARS-CoV-2, resulting in strains (Alfa Beta Delta Omicron) with varying degrees of virulence disease severity. In CML (chronic myeloid leukemia) patients, there is a lot of controversy regarding the effect of the treatment on the patient outcome. Some reports suggested potential better outcomes among patients with CML, likely due to the use of TKI; other reports showed no significant effects. Additionally, it is unknown how much protection immunization provides for cancer patients. Method In accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) standards, we conducted a systematic review. Retrospective, prospective studies, reviews, case series, and case reports of chronic myeloid leukemia patients aged above 18 years who had SARS-CoV-2 infection were included. English literature was screened using PubMed, SCOPUS, and Google Scholar. Search terms include chronic myeloid leukemia, chronic myelogenous leukemia, and SARS-CoV-2 and Coronavirus disease 2019 (COVID-19). We searched the reference lists of the included studies for any new articles. The search included all articles published up to April 20, 2023. The review is registered in PROSPERO (registration number CRD42022326674). Results We reviewed 33 articles of available published literature up to April 2023 and collected data from a total of 682 CML patients with COVID-19. Most patients were in the chronic phase, seven were in the accelerated phase, and eight were in the blast phase. Disease severity was classified according to WHO criteria. Mortality was seen in 45 patients, and there were no reports of thrombotic events. Two hundred seventy-seven patients were in the era before vaccination; among them, eight were in the intensive care unit (ICU), and mortality was 30 (11%). There were 405 patients after the era of vaccination; among them, death was reported in 15 (4%) patients and ICU in 13 patients. Limitations and conclusion The major limitation of this review is the lack of details about the use or hold of TKIs during SARS-CoV-2 infection. Additionally, after the appearance of the different variants of the SARS-CoV-2 virus, few studies mentioned the variant of the virus, which makes it difficult to compare the outcome of the other variants of the SARS-CoV-2 virus in patients with CML. Despite the limitations of the study, CML patients with COVID-19 have no significant increase in mortality compared to other hematological malignancy. Hematological cancers are associated with an increased risk of thrombosis, which is expected to increase in patients with COVID-19. However, patient with CML has not been reported to have a significant increase in thrombosis risk. The available data indicates that COVID-19's effect on patients with chronic myeloid leukemia (CML) still needs to be better understood due to the limited data. Systematic review registration https://www.crd.york.ac.uk/PROSPERO/display_record.php? RecordID:326674.
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Affiliation(s)
- Elrazi A. Ali
- Internal Medicine Department, Interfaith Medical Center/One Brooklyn Health, Brooklyn, NY, United States
| | - Anas Al-Sadi
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Qusai Al-maharmeh
- Internal Medicine Department, Saint Michael's Medical Center, Newark, CA, United States
| | - Eihab A. Subahi
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Amulya Bellamkonda
- Internal Medicine Department, Interfaith Medical Center/One Brooklyn Health, Brooklyn, NY, United States
| | - Madhumati Kalavar
- Internal Medicine Department, Interfaith Medical Center/One Brooklyn Health, Brooklyn, NY, United States
| | - Kalpana Panigrahi
- Internal Medicine Department, Interfaith Medical Center/One Brooklyn Health, Brooklyn, NY, United States
| | - Awni Alshurafa
- Department of Oncology-Hematology, National Center for Cancer Care and Research – Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A. Yassin
- Department of Oncology-Hematology, National Center for Cancer Care and Research – Hamad Medical Corporation, Doha, Qatar
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11
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Alshurafa A, Afshan Adil, Yassin MA. Safety and Efficacy of Asciminib in Chronic Myeloid Leukemia Patient with Chronic Kidney Diseases: A Case Report. Case Rep Oncol 2024; 17:96-100. [PMID: 38229976 PMCID: PMC10791132 DOI: 10.1159/000535958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Accepted: 12/18/2023] [Indexed: 01/18/2024] Open
Abstract
Introduction Chronic myeloid leukemia (CML) is characterized by the presence of the BCR::ABL1 fusion gene, and the advent of tyrosine kinase inhibitors (TKIs) has revolutionized its therapeutic landscape. Asciminib, a STAMP inhibitor, emerges as a promising option for patients unresponsive or intolerant to multiple conventional TKIs. However, the safety and efficacy of asciminib in individuals with chronic kidney disease remain understudied. Case Presentation In this report, we detail the case of a 62-year-old patient with CML and stage 3 chronic kidney disease, who faced intolerance to traditional TKIs primarily due to fluid retention. The transition to asciminib therapy resulted in a profound molecular response and did not exacerbate renal function, effectively addressing the fluid retention issue. Conclusion This case highlights the potential of asciminib as a viable therapeutic alternative for CML patients with chronic kidney disease, particularly those intolerant to standard TKIs. Further research is warranted to establish the broader safety and efficacy profile of asciminib in this patient population.
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Affiliation(s)
- Awni Alshurafa
- Hematology Department, Hamad Medical Corporation, Doha, Qatar
| | - Afshan Adil
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
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12
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El-Beshlawy A, Dewedar H, Hindawi S, Alkindi S, Tantawy AA, Yassin MA, Taher AT. Management of transfusion-dependent β-thalassemia (TDT): Expert insights and practical overview from the Middle East. Blood Rev 2024; 63:101138. [PMID: 37867006 DOI: 10.1016/j.blre.2023.101138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 10/04/2023] [Accepted: 10/05/2023] [Indexed: 10/24/2023]
Abstract
β-Thalassemia is one of the most common monogenetic diseases worldwide, with a particularly high prevalence in the Middle East region. As such, we have developed long-standing experience with disease management and devising solutions to address challenges attributed to resource limitations. The region has also participated in the majority of clinical trials and development programs of iron chelators and more novel ineffective erythropoiesis-targeted therapy. In this review, we provide a practical overview of management for patients with transfusion-dependent β-thalassemia, primarily driven by such experiences, with the aim of transferring knowledge to colleagues in other regions facing similar challenges.
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Affiliation(s)
- Amal El-Beshlawy
- Department of Pediatric Hematology, Faculty of Medicine, Cairo University, Cairo, Egypt
| | - Hany Dewedar
- Thalassemia Center, Latifa Hospital, Dubai, United Arab Emirates
| | - Salwa Hindawi
- Department of Hematology, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Salam Alkindi
- Department of Hematology, Sultan Qaboos University Hospital, Muscat, Oman
| | - Azza A Tantawy
- Department of Pediatrics, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | - Mohamed A Yassin
- Department of Hematology and Oncology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Ali T Taher
- Department of Internal Medicine, American University of Beirut Medical Center, Beirut, Lebanon.
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13
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Afana MS, Abu-Tineh M, Alshurafa A, Ahmed K, Abdulgayoom M, Yassin MA. Obstructive Sleep Apnea Does Not Exclude Polycythemia Vera: A Case Report. Case Rep Oncol 2024; 17:91-95. [PMID: 38213957 PMCID: PMC10783889 DOI: 10.1159/000535742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2023] [Accepted: 12/06/2023] [Indexed: 01/13/2024] Open
Abstract
Introduction Polycythemia vera (PV) is one of the myeloproliferative neoplasms (MPN) diagnosed by World Health Organization (WHO) criteria 2016, which requires the presence of 3 major criteria: high hemoglobin/hematocrit, bone marrow findings, and Janus Kinase 2 (JAK2) mutation or two major and one minor criteria, including erythropoietin (EPO) level. However, in clinical practice, difficulties in diagnosis can arise as it may be masked by secondary causes for erythrocytosis such as smoking or obstructive sleep apnea (OSA). Case Presentation Here, we report a 55-year-old gentleman, morbidly obese with OSA on home continuous positive airway pressure (CPAP) machine, who was incidentally found to have polycythemia. Further evaluation confirmed the diagnosis of PV. Conclusion PV can be masked by the assumption of secondary polycythemia based on history. This underscores the importance of screening such cohort through JAK2 and EPO testing to avoid missing PV.
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Affiliation(s)
- Mohammad S Afana
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Abu-Tineh
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Awni Alshurafa
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Khalid Ahmed
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Abdulgayoom
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A Yassin
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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14
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Ata F, Benkhadra M, Ghasoub R, Fernyhough LJ, Omar NE, Nashwan AJ, Aldapt MB, Mushtaq K, Kassem NA, Yassin MA. Tyrosine Kinase Inhibitors in pediatric chronic myeloid leukemia: a focused review of clinical trials. Front Oncol 2023; 13:1285346. [PMID: 38188307 PMCID: PMC10769570 DOI: 10.3389/fonc.2023.1285346] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 11/29/2023] [Indexed: 01/09/2024] Open
Abstract
Tyrosine Kinase Inhibitors (TKIs) is revolutionizing the management of pediatric Chronic Myeloid Leukemia (CML), offering alternatives to Allogeneic Hematopoietic Stem Cell Transplantation (AHSCT). We conducted a comprehensive review of 16 Randomized Controlled Trials (RCTs) encompassing 887 pediatric CML patients treated with TKIs including Imatinib, Dasatinib, and Nilotinib. The median patient age ranged from 6.5 to 14 years, with a median white blood cell count of 234 x 10^9/uL, median hemoglobin level of 9.05 g/dL, and median platelet count of 431.5 x 10^9/µL. Imatinib seems to be predominant first line TKI, with the most extensive safety and efficacy data. BCR::ABL response rates below 10% ranged from 60% to 78%, CCyR at 24 months ranged from 62% to 94%, and PFS showed variability from 56.8% to 100%, albeit with differing analysis timepoints. The Safety profile of TKIs was consistent with the known safety profile in adults. With the availability of three TKIs as first line options, multiple factors should be considered when selecting first line TKI, including drug formulation, administration, comorbidities, and financial issues. Careful monitoring of adverse events, especially in growing children, should be considered in long term follow-up clinical trials.
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Affiliation(s)
- Fateen Ata
- Department of Endocrinology and Metabolism, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Maria Benkhadra
- Pharmacy Department, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Rola Ghasoub
- Pharmacy Department, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Liam J. Fernyhough
- Department of Medical Education, Weill Cornell Medicine Qatar, Doha, Qatar
| | - Nabil E. Omar
- Pharmacy Department, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
- Health Sciences Program, Clinical and Population Health Research, College of Pharmacy, Qatar University, Doha, Qatar
| | | | - Mahmood B. Aldapt
- Department of Medicine, Unity Hospital/Rochester Regional Health, Rochester, NY, United States
| | - Kamran Mushtaq
- Department of Gastroenterology, University Hospital Southampton, Southampton, United Kingdom
| | - Nancy A. Kassem
- Pharmacy Department, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A. Yassin
- Department of Medical Oncology/Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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15
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Yassin MA, Al-Rasheed M, Al-Khaboori M, Marashi M, Osman H, Wali Y, Al Kindi S, Alsayegh F, Provan D. Thrombopoietin-receptor agonists for adult patients with immune thrombocytopenia: a narrative review and an approach for managing patients fasting intermittently. Front Cardiovasc Med 2023; 10:1260487. [PMID: 38162126 PMCID: PMC10755910 DOI: 10.3389/fcvm.2023.1260487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2023] [Accepted: 11/17/2023] [Indexed: 01/03/2024] Open
Abstract
Introduction Thrombopoietin-receptor agonist (TPO-RAs) currently represent the state of art for treating immune thrombocytopenia. Their different molecular structures contribute to the difference in their pharmacodynamics and pharmacokinetics. This narrative review aims to provide an overview of the current TPO-RAs approved for primary immune thrombocytopenia (romiplostim, eltrombopag, avatrombopag) and the effect of intermittent fasting in adult patients receiving TPO-RAs. Areas covered Literature was searched with no limits on date or language, using various combinations of keywords. Data on the pharmacokinetics, pharmacodynamics, efficacy, and safety of TPO-RAs and the effect of intermittent fasting were summarized. Expert opinion Switching between TPO-RAs is a useful strategy to tackle some associated limitations. Romiplostim and avatrombopag have an advantage over eltrombopag as they do not require any dietary restrictions. In cases where romiplostim and avatrombopag are unavailable, patients should be educated on the appropriate administration, possible interactions, and dietary restrictions before initiating eltrombopag.
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Affiliation(s)
- Mohamed A. Yassin
- National Center for Cancer Care and Research, Hematology Section, Hamad Medical Corporation, Doha, Qatar
| | - Mona Al-Rasheed
- Hematology Unit, Department of Medicine, Al-Adan Hospital, Hadiya, Kuwait
| | | | - Mahmoud Marashi
- Dubai Academic Health Corporation, Dubai, United Arab Emirates
| | - Hani Osman
- Hematology-Oncology Department, Tawam Hospital, Abu Dhabi, United Arab Emirates
| | - Yasser Wali
- Department of Child Health, Sultan Qaboos University, Muscat, Oman
| | - Salam Al Kindi
- Department of Hematology, Sultan Qaboos University, Muscat, Oman
| | - Faisal Alsayegh
- Faculty of Medicine, Department of Medicine, Health Sciences Center, Kuwait University, Kuwait City, Kuwait
| | - Drew Provan
- Academic Haematology Unit, Blizard Institute, Barts and The London School of Medicine and Dentistry, London, United Kingdom
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16
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Elenga N, Yassin MA. Real-world observational study on the long-term effect of L-glutamine treatment on renal parameters of adult and pediatric patients with sickle cell disease. Front Med (Lausanne) 2023; 10:1243870. [PMID: 38131044 PMCID: PMC10735270 DOI: 10.3389/fmed.2023.1243870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Background Sickle cell disease (SCD) is a rare genetic blood condition affecting millions worldwide. Oxidative stress is a key player in the pathogenesis of SCD and its comorbid consequences. Renal function impairment is a common complication of SCD in both pediatric and adult patients with serious consequences leading to increased risk of mortality. In this observational real-world study, we are reporting the long-term (120 weeks) renal function in 10 patients treated with L-glutamine. Methods Ten patients (4 pediatric and 6 adults), with confirmed diagnoses of SCD (HbSS genotype), were enrolled, these included four patients from Qatar with Arab Indian haplotype and six patients from French Guiana with African haplotype. All patients were treated with L-glutamine oral powder (~0.3 g/kg body weight, Endari®) twice daily for 120 weeks. Clinical events and laboratory parameters (renal function, hemoglobin, reticulocytes, and lactate dehydrogenase [LDH]) were measured at baseline, 48, and 120 weeks. Results The study showed that with L-glutamine treatment there were improvements in renal and hematological parameters with no vaso-occlusive crisis at both 48-and 120-week follow-up time points in all 10 patients. Improvements were seen in the albumin creatinine ratio (ACR) from baseline to 48 weeks (mean [Standard deviation SD] ACR: -4.19 [9.81] mg/g) and 120 weeks (mean [SD] ACR: -12.31 [21.09] mg/g). Mean (SD) increase in hemoglobin concentrations from baseline to 48 weeks and 120 weeks was 0.72 (1) g/dL and 1.41 (0.79) g/dL, respectively. Mean (SD) reticulocyte counts and LDH levels decreased from baseline to 48 weeks (mean [SD] change from baseline to 48 weeks, reticulocyte counts: -40.30 [101.58] × 109 cells/L; LDH levels: -259 [154.93] U/L) and 120 weeks (mean [SD] change from baseline to 120 weeks, reticulocyte counts: -58.30 [128.38] × 109 cells/L; LDH levels: -344.80 [274.63] U/L). Conclusion This is one of the first studies that assessed the long-term renal outcomes in SCD using L-glutamine. L-glutamine improved the renal function in patients with SCD along with improvements in clinical outcomes and hemolysis, from 48 weeks and sustained through 120 weeks of treatment.
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Affiliation(s)
- Narcisse Elenga
- Paediatric Department, Centre Hospitalier de Cayenne, Cayenne, France
| | - Mohamed A. Yassin
- Hematology Section, Medical Oncology Department, Hamad Medical Corporation, Doha, Qatar
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17
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Afana MS, Abu-Tineh M, Alshurafa A, Yasin AK, Ahmed K, Abdulgayoom M, Yassin MA. Recurrence of acute chest syndrome post stopping Crizanlizumab, the dilemma of stopping vs continuation in patient with sickle cell disease: case report. Hematology 2023; 28:2229115. [PMID: 37519115 DOI: 10.1080/16078454.2023.2229115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Sickle cell disease (SCD) is one of the most common hematological diseases, which results in variable complications. The treatment of SCD is evolving but limited options are available for now. Acute chest syndrome (ACS) is one of the serious complications observed in SCD and a challenging one in prevention. Crizanlizumab is a monoclonal antibody that binds to P-selectin and improves blood flow by preventing sickle cell adhesion to endothelium, resulting in improvement of vaso-oclusive crises (VOC). It is not well evaluated in terms of ACS prevention. Here we report a 23-year-old patient with SCD and recurrent ACS; she was started on Crizanlizumab and she had no more ACS, but once she was off Crizanlizumab she developed ACS again, later Crizanlizumab was re-started, and the patient has improved significantly.
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Affiliation(s)
- Mohammad S Afana
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Abu-Tineh
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Awni Alshurafa
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed K Yasin
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Khalid Ahmed
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Abdulgayoom
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A Yassin
- Hematology Section, Department of Medical Oncology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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18
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Al-Mashdali AF, Gulied A, Bakr MM, Yassin MA. Romiplostim use for thrombocytopenia following allogeneic hematopoietic stem cell transplantation: a case series from a single center in Qatar. Hematology 2023; 28:2280872. [PMID: 37961987 DOI: 10.1080/16078454.2023.2280872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Thrombocytopenia is a common and serious complication that can occur following hematopoietic stem cell transplantation (HSCT), and it contributes to increased morbidity and mortality. The mechanisms of post-HSCT thrombocytopenia are multifactorial and complex. There are no clear consensus and guidelines for managing thrombocytopenia post-HSCT. Recently, there has been promising use of thrombopoietin receptor agonists (TPO-RAs), particularly eltrombopag and romiplostim, as treatments for post-HSCT thrombocytopenia. Notably, that this indication is considered off-label, and data in this use are limited. Based on the existing body of evidence, romiplostim emerges as a safe and effective option for individuals with transfusion-dependent thrombocytopenia after HSCT. In this context, we present a summary of our experience at a single center, where romiplostim was used in the management of post-HSCT thrombocytopenia due to poor graft function. Notably, all four cases responded positively to romiplostim treatment, and no significant adverse events were observed.
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Affiliation(s)
- Abdulrahman F Al-Mashdali
- National Center for Cancer Care and Research, Department of Oncology, Hematology and BMT Section, Hamad Medical Corporation, Doha, Qatar
| | - Amaal Gulied
- National Center for Cancer Care and Research, Department of Oncology, Hematology and BMT Section, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed M Bakr
- National Center for Cancer Care and Research, Department of Oncology, Hematology and BMT Section, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A Yassin
- National Center for Cancer Care and Research, Department of Oncology, Hematology and BMT Section, Hamad Medical Corporation, Doha, Qatar
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19
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Ismail A, Abdalla E, Aqel A, Fadul A, Ahmed A, Alsayed A, Musa M, Yassin MA. The utility of testing erythropoietin level in polycythemia diagnosis. Hematology 2023; 28:2269510. [PMID: 37843428 DOI: 10.1080/16078454.2023.2269510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 10/07/2023] [Indexed: 10/17/2023] Open
Abstract
OBJECTIVES Polycythemia vera (PV) is classically thought to be associated with low erythropoietin (EPO) levels. Here, we present a review of the utility of using EPO levels in diagnosing polycythemia. METHODS We conducted a systematic literature review of the Medline data through Pubmed and Google Scholar. We included the articles which described confirmed PV associated with elevated EPO level. Our search strategy included the following terms in Pubmed (((polycythemia vera[MeSH Terms]) OR (jak2 protein tyrosine kinase[MeSH Terms])) OR (Myeloproliferative Disorders[MeSH Terms])) AND (Erythropoietin[MeSH Terms]), and 'polycythemia vera with erythropoietin' in Google Scholar. RESULTS Our research yielded four cases of PV with elevated EPO levels. The most common symptom was a headache. Thrombotic phenomena happened in a single case in the form of Budd-Chiari syndrome. The mean Hb level was 20.2 gm/dl, and the EPO level was 213 mlU/mL. DISCUSSION Although PV is usually associated with low EPO levels, high levels do not exclude this diagnosis. Workup should include testing for JAK2 mutation and bone marrow biopsy in the presence of suggestive signs and symptoms. Novel biomarkers are also being proposed to aid in the diagnosis. CONCLUSION Although elevated EPO levels suggest secondary causes of polycythemia, cases where elevated EPO levels were associated with an underlying PV are reported in the literature, and we have summarized a review of them. Workup for polycythemia should include JAK2 mutation testing if signs and symptoms suggest PV even if EPO is elevated.
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Affiliation(s)
- Abdellatif Ismail
- Department of Internal Medicine, University of Maryland Medical Center Midtown Campus, Baltimore, MD, USA
| | | | - Ali Aqel
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Abdalla Fadul
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Ashraf Ahmed
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Alsayed
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Muzamil Musa
- Department of Medicine, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A Yassin
- Department of Medical Oncology /Hematology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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20
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Nashwan AJ, Yassin MA. Deferasirox in Patients with Chronic Kidney Disease: Assessing the Potential Benefits and Challenges. J Blood Med 2023; 14:589-594. [PMID: 38047247 PMCID: PMC10693276 DOI: 10.2147/jbm.s415604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 06/07/2023] [Indexed: 12/05/2023] Open
Abstract
Chronic kidney disease (CKD) is a major global health concern, affecting millions of people worldwide. The progressive decline in kidney function often necessitates renal replacement therapy, such as hemodialysis (HD) or peritoneal dialysis (PD), to maintain a patient's health. Iron overload, which is common in CKD patients on dialysis, can lead to severe complications, including cardiovascular disease and infections where most of the existing iron chelators are deemed unsuitable due to their suboptimal clearance in patients with compromised renal function, it becomes a significant challenge to effectively manage iron overload. Deferasirox (DFX), an oral iron chelator, has emerged as a promising treatment option for managing iron overload in these patients. However, the use of DFX comes with its unique set of challenges, such as its cost, potential side effects, and the need for close monitoring of patients, as well as the noticeable scarcity of comprehensive and rigorous clinical studies confirming its efficacy and safety of DFX. In this review, we delve into both the promising prospects and the emerging challenges associated with DFX use in managing CKD patients on HD or PD, striving for a comprehensive understanding that informs better clinical practice and patient care.
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Affiliation(s)
| | - Mohamed A Yassin
- Department of Medical Oncology/Hematology, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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21
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Alawad MJ, Abu-Tineh M, Alshurafa A, Al-Taie A, Yousaf A, Yassin MA. Glanzmann Thrombasthenia Associated with Siderotic Synovitis and Arthropathy: A Case Report. J Blood Med 2023; 14:563-567. [PMID: 37941894 PMCID: PMC10629506 DOI: 10.2147/jbm.s418937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 09/20/2023] [Indexed: 11/10/2023] Open
Abstract
Glanzmann thrombasthenia is a bleeding disorder with a low incidence. It typically manifests as superficial bleeding episodes, which tend to be mild. Deep organ involvement is not uncommon but remains rare due to the rarity of the disease itself and the unusual association between platelet disorders and deep organ implications. A 17-year-old boy with Glanzmann thrombasthenia since infancy developed ankle pain after a minor trauma. His initial workup was negative, but he continued to experience ankle pain. A magnetic resonance imaging (MRI) done after four weeks suggested siderotic synovitis. The patient was lost to follow-up after that and returned after two years with recurrent left ankle pain. Imaging and studies have shown evidence of chronic arthropathy. A specialized orthopedic team assessed the patient. The patient underwent intra-articular steroid injection for pain relief and was referred to continue physical therapy. In conclusion, hemarthrosis is more common in hemophilia than in platelet disorders and has potential morbidity and quality-of-life implications.
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Affiliation(s)
- Mouhammad J Alawad
- Department of Medical Education, Internal Medicine Residency Program, Hamad Medical Corporation, Doha, Qatar
| | - Mohammad Abu-Tineh
- Department of Medical Oncology, Hematology and BMT Section, National Center for Hamad Medical Corporation, Doha, Qatar
| | - Awni Alshurafa
- Department of Medical Oncology, Hematology and BMT Section, National Center for Hamad Medical Corporation, Doha, Qatar
| | - Alaa Al-Taie
- Clinical Imaging Department, Hamad Medical Corporation, Doha, Qatar
| | - Anil Yousaf
- Department of Medical Oncology, Hematology and BMT Section, National Center for Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A Yassin
- Department of Medical Oncology, Hematology and BMT Section, National Center for Hamad Medical Corporation, Doha, Qatar
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22
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Nashwan AJ, Alkhawaldeh IM, Shaheen N, Albalkhi I, Serag I, Sarhan K, Abujaber AA, Abd-Alrazaq A, Yassin MA. Using artificial intelligence to improve body iron quantification: A scoping review. Blood Rev 2023; 62:101133. [PMID: 37748945 DOI: 10.1016/j.blre.2023.101133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 09/13/2023] [Accepted: 09/14/2023] [Indexed: 09/27/2023]
Abstract
This scoping review explores the potential of artificial intelligence (AI) in enhancing the screening, diagnosis, and monitoring of disorders related to body iron levels. A systematic search was performed to identify studies that utilize machine learning in iron-related disorders. The search revealed a wide range of machine learning algorithms used by different studies. Notably, most studies used a single data type. The studies varied in terms of sample sizes, participant ages, and geographical locations. AI's role in quantifying iron concentration is still in its early stages, yet its potential is significant. The question is whether AI-based diagnostic biomarkers can offer innovative approaches for screening, diagnosing, and monitoring of iron overload and anemia.
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Affiliation(s)
- Abdulqadir J Nashwan
- Department of Nursing, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar; Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar.
| | | | - Nour Shaheen
- Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ibrahem Albalkhi
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia; Department of Neuroradiology, Great Ormond Street Hospital NHS Foundation Trust, Great Ormond St, London WC1N 3JH, United Kingdom.
| | - Ibrahim Serag
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Khalid Sarhan
- Faculty of Medicine, Mansoura University, Mansoura, Egypt
| | - Ahmad A Abujaber
- Department of Nursing, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar.
| | - Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar.
| | - Mohamed A Yassin
- Hematology and Oncology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.
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23
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Alshurafa A, Soliman AT, De Sanctis V, Ismail O, Abu-Tineh M, Hemadneh MKE, Rashid FR, Yassin K, Qasim H, Nashwan AJ, Yassin MA. Clinical and epidemiological features and therapeutic options of avascular necrosis in patients with sickle cell disease (SCD): a cross-sectional study. Acta Biomed 2023; 94:e2023198. [PMID: 37850770 PMCID: PMC10644931 DOI: 10.23750/abm.v94i5.14603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 06/07/2023] [Indexed: 10/19/2023]
Abstract
BACKGROUND Avascular necrosis (AVN) is a debilitating complication in sickle cell disease (SCD) patients, and its management is usually challenging. This study aims to evaluate the clinical and epidemiological features and therapeutic options of AVN in sickle cell patients in Qatar. PATIENTS AND METHODS A cross-sectional study was conducted on a 49 SCD patients who were diagnosed with AVN and attended the hematology clinic at the National Center for Cancer care & research, Hamad Medical Corporation, Qatar between Jan-2011 to Jan2021. Results: Forty-nine adult patients with SCD who were diagnosed with AVN were studied. The median age of the study population is 32 years, and the median age at the first AVN diagnosis was 26 years (range: 11-44 yr.). 37 (75.5%) patients suffered from multiple joints AVN while 12(24.5%) had single joint involvement. 31 (63.3%) patients had bilateral hip AVN and 18 (36.7%) had shoulder involvement. 30 patients (61%) were on Hydroxyurea treatment. Based on FICAT and Alert classification of AVN, 57 % of patients had stage III and above at first diagnosis. 20 (40.8%) were managed with a conservative approach, 11 (22.4%) received hyperbaric oxygen with good response, 6(12.2%) underwent hip core decompression and 12(24.5%) underwent hip replacement surgery. CONCLUSION In SCD patients, AVN occurred more during the 3rd and 4th decades of life. The majority of AVN represented with advanced stage and had multiple joint involvements. We recommend adopting a low threshold of joint imaging for early detection and prevention of further complications.
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24
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Wong RSM, Yavaşoğlu İ, Yassin MA, Tarkun P, Yoon SS, Wei X, Elghandour A, Angchaisuksiri P, Ozcan M, Yang R, Mattar M, Rahman M, Ingles S, Goldbrunner M, Frueh JA, Jang JH. Eltrombopag in patients with chronic immune thrombocytopenia in Asia-Pacific, the Middle East, and Turkey: final analysis of CITE. Blood Adv 2023; 7:4773-4781. [PMID: 36103340 PMCID: PMC10469381 DOI: 10.1182/bloodadvances.2022008287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/23/2022] [Accepted: 08/23/2022] [Indexed: 11/20/2022] Open
Abstract
CITE was a prospective, noninterventional study in adult patients with chronic immune thrombocytopenia treated with eltrombopag under routine clinical care in Asia-Pacific, the Middle East, and Turkey. Data to assess eltrombopag usage, compliance, and outcomes were collected from May 2017 to December 2020. Platelet response was defined as platelet count ≥50 × 103/μL in the absence of rescue medications and splenectomy. Quality of life was evaluated using the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire. Noncompliance was defined as the number of missed doses and number of days where the patient did not follow food instructions. A total of 231 patients were enrolled; the median (range) duration of eltrombopag treatment was 484.5 (1-642) days. Compliance to prescribed eltrombopag dose since the previous routine visit was high at ≥96.0%. Baseline median platelet count was 19.0 × 103/μL, which increased to ≥50 × 103/μL at month 2 and mostly fluctuated between 70 × 103/μL and 100 × 103/μL thereafter. The median time to first platelet response was 1.05 (95% confidence interval: 0.92-1.28) months, and the median (interquartile range) maximum duration of platelet response was 193 (57-456) days. FACIT-F scores improved from a mean (standard deviation) 34.4 (12.1) at baseline to 38.5 (9.1) at month 18. Adverse events occurred in 50.9% of patients (n = 116), the most common being upper respiratory tract infection (8.3%) and headache (6.6%). These findings confirmed the effectiveness of eltrombopag treatment in routine practice and reassured that real-world compliance to eltrombopag-prescribed doses and dietary instructions in Asia-Pacific, the Middle East, and Turkey were in line with current recommendations.
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Affiliation(s)
- Raymond Siu Ming Wong
- Sir Y.K. Pao Centre for Cancer and Department of Medicine & Therapeutics, The Chinese University of Hong Kong, Hong Kong
| | - İrfan Yavaşoğlu
- Department of Hematology, Faculty of Medicine, Adnan Menderes University, Aydın, Turkey
| | - Mohamed A. Yassin
- National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
| | - Pınar Tarkun
- Department of Hematology, Medical Faculty, Kocaeli University, Kocaeli, Turkey
| | - Sung-Soo Yoon
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul National University Hospital, Seoul, South Korea
| | - Xie Wei
- The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | | | | | - Mehmet Ozcan
- Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Renchi Yang
- Institute of Haematology and Hospital of Blood Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Mervat Mattar
- Clinical Hematology Unit, Department of Internal Medicine, Faculty of Medicine, Cairo University, Cairo, Egypt
| | | | | | | | | | - Jun Ho Jang
- Department of Hematology-Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
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25
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Al-Mashdali AF, Al-Dubai HN, Yassin MA. Osteolytic bone lesions as an initial presenting manifestation of adult acute lymphoblastic leukemia: a mini review. Ann Med Surg (Lond) 2023; 85:4404-4409. [PMID: 37663744 PMCID: PMC10473363 DOI: 10.1097/ms9.0000000000001065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2022] [Accepted: 07/02/2023] [Indexed: 09/05/2023] Open
Abstract
Hematological malignancies can lead to bone lesions, and the most common example is the osteolytic lesions found in multiple myeloma. Cases of osteolytic lesions have been rarely reported in acute lymphoblastic leukemia (ALL), non-Hodgkin lymphoma, Waldenström macroglobulinemia, chronic lymphocytic leukemia, acute myeloid leukemia, and myeloproliferative neoplasms. This review sheds light on the association between ALL and osteolytic bone lesions. To our knowledge, we found 15 cases of patients with ALL who developed osteolytic lesions. Most patients were males with a median age of 29 years. B-cell ALL was the most common type of ALL associated with osteolytic lesions. All patients presented with bone pain, and hypercalcemia was found in 80% of the reported cases. Osteolytic lesions were detected by plain radiography (X-ray) in approximately half of the patients; computed tomography, MRI, or PET scans confirmed the osteolytic lesions in the remaining patients. The axial skeleton was mainly affected. Based on our review, there was no association between osteolytic bone lesions and the Philadelphia chromosome. There are no case of spinal cord compression in adults ALL patients attributed to osteolytic lesions of the vertebra. The majority of patients received chemotherapy, and the outcomes among these patients were variable. Almost all of them achieved complete remission. However, two patients developed a disease relapse. Given that our review is solely based on case reports, we could not conclude if the presence of osteolytic bone lesions is a prognostic factor for adverse outcomes or indicates an 'aggressive' form of ALL.
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Affiliation(s)
- Abdulrahman F. Al-Mashdali
- Department of Oncology, Hematology and BMT Section, National Center for Cancer Care and Research, Hamad Medical Corporation
| | - Hussam N. Al-Dubai
- Department of Oncology, Hematology and BMT Section, National Center for Cancer Care and Research, Hamad Medical Corporation
| | - Mohamed A. Yassin
- Department of Internal Medicine, Hamad Medical Corporation, Doha, Qatar
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26
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Ibraheem A, Nashwan AJ, Yassin MA. Elderly Patient With Hematological and Neurological Manifestations of Undetermined Origin: A Diagnostic Dilemma of Pernicious Anemia. Cureus 2023; 15:e43045. [PMID: 37680425 PMCID: PMC10480558 DOI: 10.7759/cureus.43045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/06/2023] [Indexed: 09/09/2023] Open
Abstract
Pernicious anemia (PA) is a chronic inflammatory destructive disease of parietal cells of predominantly the gastric fundus. It leads to vitamin B12 (cobalamin) deficiency secondary to a deficiency of intrinsic factors. Despite the medical advances nowadays, diagnosing PA can be challenging. This report highlights a neglected case of PA with ongoing subacute combined degeneration of the cord (SCDS) in an elderly patient. An 86-year-old lady with multiple comorbidities was referred to the hematology outpatient clinic for refractory anemia for the last two months. At first, her general practitioner (GP) treated her as a case of anemia of chronic disease but without improvement. Her initial clinical assessment revealed hematological and neurological manifestations of undetermined origin, including global weakness, hypertonia, and hyperreflexia with sensory deficits, especially in the lower limbs. On investigation, the hemoglobin level was 9 g/dL with high indirect bilirubinemia and lactate dehydrogenase (LDH). Despite the normal mean corpuscular volume (MCV) and peripheral blood smear, positive anti-intrinsic factor and parietal cell antibodies tests were subsequently reported, suggesting the diagnosis of PA. As a result, she was commenced on lifelong parenteral cobalamin replacement therapy. On follow-up visits of three months, she illustrated a clinical recovery in fatigability and paranesthesia. As expected, the laboratory parameters revealed a rise in hemoglobin level (11 g/dL) and serum vitamin B12 (418 pg/mL). However, she remained bedridden with spastic limbs. Clinicians should have a high index of suspicion since PA is a rare disease with variable clinical presentations. The optimal management approach is by a multidisciplinary care team of internists, neurologists, gastroenterologists, and hematologists.
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Affiliation(s)
- Anas Ibraheem
- Internal Medicine, Imamein Kadhimein Medical City, Baghdad, IRQ
- Internal Medicine, Clinical Hematology, Al Karama Teaching Hospital, Baghdad, IRQ
| | | | - Mohamed A Yassin
- Hematology, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT
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27
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Altayyan MM, Abu-Tineh M, Alshurafa A, Abdulgayoom M, Afana M, Ahmed K, Toba HA, Yassin MA. Toe Gangrene as the First Presenting Symptom of Essential Thrombocythemia: A Case Report. Cureus 2023; 15:e42388. [PMID: 37621813 PMCID: PMC10446243 DOI: 10.7759/cureus.42388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 08/26/2023] Open
Abstract
Essential thrombocythemia is a myeloproliferative neoplasm. Thrombosis and bleeding complications are common with myeloproliferative neoplasms, particularly essential thrombocythemia and polycythemia vera. Here, we report the case of a 52-year-old female who presented initially with painful toe swelling and discoloration. Initial imaging showed a small abscess. An incision and drainage, and debridement of toe dry gangrene were performed twice in two months with no improvement in her complaint and worsening discoloration, ending in a toe amputation. Two years later, the patient was referred to a hematology clinic for a high platelet count. On review of her medical records, the patient had the same numbers during the initial presentation. The patient's condition was diagnosed retrogradely by a hematologist as essential thrombocythemia. This case sheds light on myeloproliferative neoplasm as a differential diagnosis in patients with atypical thrombosis. Thinking in such a way could have diagnosed our patient two years earlier.
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Affiliation(s)
| | - Mohammad Abu-Tineh
- Department of Medical Oncology, Hematology, and Bone Marrow Transplant, National Center for Cancer Care and Research, Doha, QAT
| | - Awni Alshurafa
- Department of Medical Oncology, Hematology, and Bone Marrow Transplant, National Center for Cancer Care and Research, Doha, QAT
| | - Mohammed Abdulgayoom
- Department of Medical Oncology, Hematology, and Bone Marrow Transplant, National Center for Cancer Care and Research, Doha, QAT
| | - Mohammad Afana
- Department of Medical Oncology, Hematology, and Bone Marrow Transplant, National Center for Cancer Care and Research, Doha, QAT
| | - Khalid Ahmed
- Department of Medical Oncology, Hematology, and Bone Marrow Transplant, National Center for Cancer Care and Research, Doha, QAT
| | - Haneen A Toba
- Department of Medical Education, Hamad Medical Corporation, Doha, QAT
| | - Mohamed A Yassin
- Department of Medical Oncology, Hematology, and Bone Marrow Transplant, National Center for Cancer Care and Research, Doha, QAT
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28
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Alshurafa A, Alkhatib M, Abu-Tineh M, Yassin MA. Sickle cell leg ulcer successfully managed by hyperbaric oxygen: a case report. Front Med (Lausanne) 2023; 10:1171971. [PMID: 37396892 PMCID: PMC10310543 DOI: 10.3389/fmed.2023.1171971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 05/18/2023] [Indexed: 07/04/2023] Open
Abstract
Sickle cell leg ulcers (SCLUs) are usually chronic, painful, and devastating complications of sickle cell disease. Skin vaso-occlusion with compromised blood flow, chronic inflammation, and endothelial dysfunction is thought to be the underlying mechanism. It is usually slow to heal, and it may become chronic and superinfected. The management of SCLUs is usually challenging and requires a multidisciplinary team. Multiple systemic and local therapies have been tried in SCLU treatment. However, the outcome is variable: currently, there are no official recommendations for the best effective treatment. Herein, we report a 34-year-old male patient with non-transfusion-dependent sickle cell disease who was suffering from a chronic left ankle ulcer and was successfully managed with hyperbaric oxygen therapy, resulting in a complete resolution of this devastating complication.
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Affiliation(s)
- Awni Alshurafa
- Hematology Department, Hamad Medical Corporation, Doha, Qatar
| | - Mohammed Alkhatib
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
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29
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Elenga N, Loko G, Etienne-Julan M, Al-Okka R, Adel AM, Yassin MA. "Long-term efficacy and safety of L-glutamine in preventing sickle cell disease-related acute complications and hemolysis in pediatric and adult patients-Real-world, observational study". Eur J Haematol 2023; 110:772-773. [PMID: 36732400 DOI: 10.1111/ejh.13939] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Revised: 01/31/2023] [Accepted: 01/31/2023] [Indexed: 02/04/2023]
Affiliation(s)
| | - Gylna Loko
- Centre de reference de la drepanocytose, CHU de la Guadeloupe, Pointe-à Pitre, Guadeloupe, France
| | - Maryse Etienne-Julan
- Centre de reference de la drepanocytose, CH de Fort de France, Fort-de-France, France
| | - Randa Al-Okka
- Department of Pharmacy, NCCCR Pharmacy, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | - Ahmad M Adel
- Department of Pharmacy, NCCCR Pharmacy, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
| | - Mohamed A Yassin
- Medical Oncology Department-Hematology Section, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha, Ad Dawhah, Qatar
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30
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Ali Hailan YM, Al-Dubai HN, Yassin MA. Chronic Myeloid Leukemia following Exposure to Radioactive Iodine (I131): A Systematic Review. Oncology 2023:1. [PMID: 37231874 DOI: 10.1159/000530463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 03/14/2023] [Indexed: 05/27/2023]
Abstract
BACKGROUND Therapy-related leukemia is a term that describes the occurrence of leukemia following exposure to hematotoxins and radiation to emphasize the difference from leukemia that arises de novo. Many agents and host factors contribute to this entity of leukemias. Therapy-related acute myeloid leukemia has an extensive literature review in contrast to therapy-related chronic myeloid leukemia (t-CML). Radioactive iodine (RAI), an established agent in the management of differentiated thyroid carcinomas, has raised concern due to its possible carcinogenic effects. SUMMARY In this article, we reviewed all the reports from the 1960s to date related to t-CML following RAI on Google Scholar and PubMed. We have identified 14 reports and found that most reports were for men under the age of 60 years with primary papillary thyroid carcinoma and mixed follicular-papillary thyroid carcinoma who developed t-CML mainly between 4 and 7 years after exposure to varying doses of I131. However, the mean dose was 287.78 millicuries (mCi). It was reported that a statistically significant increase in leukemia following RAI therapy (relative risk of 2.5 for I131 vs. no I131). Also, there was a linear relationship between the cumulative dose of I131 and the risk of leukemia. Doses higher than 100 mCi were associated with a greater risk of developing secondary leukemia, and most of the leukemias developed within the initial 10 years of exposure. The precise mechanism through which RAI provokes leukemia is largely unclear. A few mechanisms have been proposed. KEY MESSAGES Although the risk for t-CML appears to be low based on current reports and does not represent a contraindication to RAI therapy, it should not be disregarded. We suggest including it in the risk-benefit discussion before initiating this therapy. Long-term follow-up for patients is advisable for those who received doses over 100 mCi with a complete blood count, possibly yearly, for the first 10 years. The new onset of significant leukocytosis post RAI exposure should raise the suspicion for t-CML. Further studies are needed to establish or refute a causal relationship.
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Affiliation(s)
| | - Husam Nabil Al-Dubai
- Internal Medicine Department, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Mohamed A Yassin
- National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, Qatar
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31
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Kaddoura R, Dabdoob WA, Ahmed K, Yassin MA. A practical guide to managing cardiopulmonary toxicities of tyrosine kinase inhibitors in chronic myeloid leukemia. Front Med (Lausanne) 2023; 10:1163137. [PMID: 37358999 PMCID: PMC10286131 DOI: 10.3389/fmed.2023.1163137] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 04/03/2023] [Indexed: 06/28/2023] Open
Abstract
Tyrosine kinase inhibitors (TKIs) have revolutionized the treatment of chronic myeloid leukemia (CML) but their use was associated with a range of serious cardiopulmonary toxicities including vascular adverse events, QT prolongation, heart failure, pleural effusion, and pulmonary arterial hypertension. Dedicated clinical management guidelines for TKI-induced toxicities are not available. This review aims to discuss TKI-associated cardiopulmonary toxicities and proposes a practical guide for their management.
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32
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Toba HA, Abu-Tineh M, Alshurafa A, Ahmed K, Mohammed B, Altayyan MM, Abdulgayoom M, Yassin MA. Omicron-Induced Immune Thrombocytopenia: A Case Report. Cureus 2023; 15:e39648. [PMID: 37388604 PMCID: PMC10306311 DOI: 10.7759/cureus.39648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/29/2023] [Indexed: 07/01/2023] Open
Abstract
Coronavirus disease 2019 is a systemic infection that significantly impacts the hematopoietic system and hemostasis. Among the hematological manifestations described, severe and symptomatic thrombocytopenia is rare. Immune thrombocytopenia (ITP), also known as idiopathic thrombocytopenic purpura or immune thrombocytopenic purpura, is an acquired thrombocytopenia caused by autoantibodies against platelet antigens. It is one of the more common causes of thrombocytopenia in otherwise asymptomatic adults. Here, we report the case of a patient who developed ITP after a severe acute respiratory syndrome coronavirus 2 infection to highlight the rarer hematological manifestations of the disease and the changes in treatment.
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Affiliation(s)
- Haneen A Toba
- Department of Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | - Mohammad Abu-Tineh
- Department of Medical Oncology, Hematology and Bone Marrow Transplant Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT
| | - Awni Alshurafa
- Department of Medical Oncology, Hematology and Bone Marrow Transplant Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT
| | - Khalid Ahmed
- Department of Medical Oncology, Hematology and Bone Marrow Transplant Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT
| | - Baian Mohammed
- Department of Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | | | | | - Mohamed A Yassin
- Department of Hematology and Oncology, Hamad General Hospital, Doha, QAT
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33
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Al-Haidose A, Yassin MA, Ahmed MN, Kunhipurayil HH, Al-Harbi AA, Aljaberi MA, Abbasi SA, Kordasti S, Abdallah AM. Distinct Clinical and Prognostic Features of Myelodysplastic Syndrome in Patients from the Middle East, North Africa, and Beyond: A Systemic Review. J Clin Med 2023; 12:jcm12082832. [PMID: 37109168 PMCID: PMC10143809 DOI: 10.3390/jcm12082832] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 04/05/2023] [Accepted: 04/10/2023] [Indexed: 04/29/2023] Open
Abstract
Myelodysplastic syndrome (MDS) describes a group of bone marrow malignancies with variable morphologies and heterogeneous clinical features. The aim of this study was to systematically appraise the published clinical, laboratory, and pathologic characteristics and identify distinct clinical features of MDS in the Middle East and North Africa (MENA) region. We conducted a comprehensive search of the PubMed, Web of Science, EMBASE, and Cochrane Library databases from 2000 to 2021 to identify population-based studies of MDS epidemiology in MENA countries. Of 1935 studies, 13 independent studies published between 2000 and 2021 representing 1306 patients with MDS in the MENA region were included. There was a median of 85 (range 20 to 243) patients per study. Seven studies were performed in Asian MENA countries (732 patients, 56%) and six in North African MENA countries (574 patients, 44%). The pooled mean age was 58.4 years (SD 13.14; 12 studies), and the male-to-female ratio was 1.4. The distribution of WHO MDS subtypes was significantly different between MENA, Western, and Far East populations (n = 978 patients, p < 0.001). More patients from MENA countries were at high/very high IPSS risk than in Western and Far East populations (730 patients, p < 0.001). There were 562 patients (62.2%) with normal karyotypes and 341 (37.8%) with abnormal karyotypes. Our findings establish that MDS is prevalent within the MENA region and is more severe than in Western populations. MDS appears to be more severe with an unfavorable prognosis in the Asian MENA population than the North African MENA population.
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Affiliation(s)
- Amal Al-Haidose
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
| | - Mohamed A Yassin
- Medical Oncology Department-Hematology Section, National Centre for Cancer Care and Research, Hamad Medical Corporation, Doha 3050, Qatar
| | - Muna N Ahmed
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
| | - Hasna H Kunhipurayil
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
| | | | - Musheer A Aljaberi
- Faculty of Medicine & Health Sciences, Taiz University, Taiz 6803, Yemen
| | - Saddam A Abbasi
- Statistics Program, Department of Mathematics, Statistics, and Physics, College of Arts and Sciences, Qatar University, Doha 2713, Qatar
- Statistical Consulting Unit, College of Arts and Science, Qatar University, Doha 2713, Qatar
| | - Shahram Kordasti
- School of Cancer and Pharmaceutical Science, King's College London, London WC2R 2LS, UK
- Haematology Department, Guy's and St. Thomas NHS Trust, London SE1 9RT, UK
| | - Atiyeh M Abdallah
- Department of Biomedical Sciences, College of Health Sciences, QU Health, Qatar University, Doha 2713, Qatar
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Yassin MA, Gad AAM. Decolorization of dye effluents via immobilized glycoprotein peroxidase on post-consumer polystyrene foam. Int J Biol Macromol 2023; 236:124019. [PMID: 36921820 DOI: 10.1016/j.ijbiomac.2023.124019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 03/02/2023] [Accepted: 03/08/2023] [Indexed: 03/14/2023]
Abstract
Development of sustainable approaches to manage industrial wastes such as plastic waste and dye effluents is a major research endeavor, owing to escalating environmental and health concerns arising from discharge of such wastes into water bodies. In this context, this study aims to convert packaging waste of expanded polystyrene foam (EPS) into effective biocatalyst for enzymatic degradation of dye effluent. Briefly, crushed EPS were decorated with amine groups via chlorosulfonation followed by conjugation of branched polyethylenimine. Carbohydrate rich turnip peroxidase (TPOD) was purified to homogeneity from Brassic rapa roots followed by periodate oxidation to introduce reactive dialdehyde groups. Such oxidized TPOD glycoprotein was covalently immobilized on aminated EPS through Schiff base formation. Immobilized TPOD exposed noticeable tolerance toward elevated temperatures (80 °C) that qualifies it as viable biocatalyst for decolorization of dye effluents that is frequently hot. Indeed, immobilized TPOD could successfully decolorize methyl orange (90 %) and crystal violet (96 %) within 2 h. Due to the floating nature of EPS, the immobilized TPOD was simply separated by skimming and reused in fifteen subsequent catalytic cycles. Ultimately, this work demonstrates the conversion of post-consumer EPS into a value-added biocatalyst for the ecofriendly enzymatic treatment of dye effluents.
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Affiliation(s)
- Mohamed A Yassin
- Packaging Materials Department, Chemical Industries Research Institute, National Research Centre, Cairo, Egypt; Advanced Materials and Nanotechnology Lab., Center of Excellence, National Research Centre, Cairo, Egypt.
| | - Abdul Aziz M Gad
- Molecular Biology Department, Biotechnology Research Institute, National Research Centre, Cairo, Egypt
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Aldeeb M, Khalil IA, Yassin MA. Congenital Methemoglobinemia in a 33-Year-Old Patient: A Case Report on a Rare Presentation and a Review of the Literature. Cureus 2023; 15:e35974. [PMID: 37041911 PMCID: PMC10082972 DOI: 10.7759/cureus.35974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2023] [Indexed: 03/12/2023] Open
Abstract
Cyanosis and dyspnea are common complaints in adults and have broad differential diagnoses, of which rare ones such as congenital methemoglobinemia should always be considered in the differential diagnosis. Methemoglobinemia might be acquired or congenital. Patients' symptoms vary from severe shortness of breath, mental status changes, and cyanosis to none. The diagnosis of congenital methemoglobinemia is challenging and requires high index of suspension, especially in older patients. In addition, when diagnosed the treatment of congenital methemoglobinemia is oral ascorbic acid which is readily available. We present a rare case of a 33-year-old lady, who had a long history of recurrent episodes of cyanosis, headache, and fatigue. After excluding cardiopulmonary causes, methemoglobin levels were measured and found to be high, and the chart review revealed high levels of methemoglobin in all her previous episodes, without exposure to any offending agent. This raised the concern of a late diagnosis of congenital methemoglobinemia. The patient was treated with a high dose of ascorbic acid resulting in resolution of the symptoms. Congenital methemoglobinemia is a rare diagnosis that needs a high index of suspicion, especially in adults. A thorough history, physical examination, and multiple laboratory tests are needed to confirm the diagnosis and rule out other causes.
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Al-Abdulmalek A, Al-Suliman R, Abu-Tineh M, Ali M, Yassin MA. The effectiveness of tyrosine kinase inhibitor for chronic myeloid leukemia in tuberous sclerosis. A case report and review of literature. Clin Case Rep 2023; 11:e7087. [PMID: 36941833 PMCID: PMC10024035 DOI: 10.1002/ccr3.7087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 10/07/2022] [Accepted: 02/20/2023] [Indexed: 03/20/2023] Open
Abstract
The relationship between chronic myelogenous leukemia (CML) and tuberous sclerosis (TS) is unusual and uncommon. Here, we report a 24-year-old woman diagnosed with TS and later identified with CML, as the second case reported with such coexistence, treated with Nilotinib. This article proposes a hypothesis to explain the association. Therefore, we propose Nilotinib for the treatment of patients with such coexisting diseases. Further studies are warranted to reveal the dynamics between these conditions.
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Affiliation(s)
| | - Reem Al-Suliman
- Department of Medical Oncology National Center for Cancer Care and Research Doha Qatar
| | - Mohammad Abu-Tineh
- Department of Medical Oncology National Center for Cancer Care and Research Doha Qatar
| | - Mostafa Ali
- Department of Radiology Hamad Medical Corporation Doha Qatar
| | - Mohamed A Yassin
- Department of Medical Oncology National Center for Cancer Care and Research Doha Qatar
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Al-Abdulmalek A, Al-Sulaiman R, Abu-Tineh M, Yassin MA. Congenital Methemoglobinemia: First Confirmed Case in the Arab Population with a Novel Variant in the CYB5R Gene in the State of Qatar: A Case Report. J Blood Med 2023; 14:247-251. [PMID: 37025988 PMCID: PMC10072335 DOI: 10.2147/jbm.s395865] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Accepted: 03/21/2023] [Indexed: 04/01/2023] Open
Abstract
Methemoglobinemia (MetHb) is a rare hematological condition characterized by high methemoglobin levels in the blood. It happens when hemoglobin is oxidized, resulting in hypoxia and cyanosis, which may occur in inherited or acquired forms. Inherited or congenital methemoglobinemia is a rare autosomal recessive condition and has never been reported in the Arab population. Here we report a case of a 22-year-old Arab man with a positive family history who presented with bluish discoloration of the fingers and lips and was found to have methemoglobinemia. Genetic study on the patient and his family revealed compound heterozygous variants in the CYB5R3 Exon 5 c.431G>A p.Gly144Asp likely pathogenic variant and CYB5R3 Exon 9 c.871G>A p.Val291Met variant of unknown significance. We suggest that the novel c.871G>A p.Val291Met variant could be causative for methemoglobinemia.
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Affiliation(s)
| | - Reem Al-Sulaiman
- Department of Medical Oncology/Hematology, National Center for Cancer Care and Research, Doha, Qatar
| | - Mohammad Abu-Tineh
- Department of Medical Oncology/Hematology, National Center for Cancer Care and Research, Doha, Qatar
- Correspondence: Mohammad Abu-Tineh, Department of Oncology/Hematology and BMT, National Center for Cancer Care and Research, Hamad Medical Corporation, Alrayan Road, Doha, Qatar, Tel +97455003969, Email
| | - Mohamed A Yassin
- Department of Medical Oncology/Hematology, National Center for Cancer Care and Research, Doha, Qatar
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Yasin AK, Abu-Tineh M, Alshurafa A, Ahmed K, Abdulgayoom M, Afana M, Gameil A, Yassin MA. Radioactive Iodine-Induced Chronic Myeloid Leukemia in a Patient With Graves' Disease: A Case Report. Cureus 2023; 15:e35295. [PMID: 36994284 PMCID: PMC10042516 DOI: 10.7759/cureus.35295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/22/2023] [Indexed: 02/25/2023] Open
Abstract
Therapy-related leukemia is an increasing concern in hematology. One of these substances that showed to increase the incidence of leukemia is radioactive iodine (RAI). We report here a case of radioactive iodine-induced chronic myeloid leukemia (CML) in a patient with Graves' disease, although most cases in the literature were for thyroid cancer. Also, our patient received a very low dose, which is unique compared to previous case reports in the literature.
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Del Giudice I, Cappelli LV, Delgado J, Niemann CU, Andersen MA, Rotbain EHC, Aarup K, Walewska R, Visentin A, Deodato M, Frustaci AM, Cavalloni C, Gentile M, Yassin MA, Lad D, Scarfò L, Flogegard M, Mattsson M, Raponi S, Ilari C, Starza ID, Orlandi EM, Tedeschi A, Trentin L, Semenzato G, Guarini A, Ghia P, Montserrat E, Foà R. Spontaneous regression in chronic lymphocytic leukaemia. Clinical features of 50 cases from the ERIC registry and review of the literature. Br J Haematol 2023; 201:353-356. [PMID: 36793194 DOI: 10.1111/bjh.18696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 01/26/2023] [Accepted: 02/01/2023] [Indexed: 02/17/2023]
Affiliation(s)
- Ilaria Del Giudice
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Luca Vincenzo Cappelli
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Julio Delgado
- Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Carsten Utoft Niemann
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Michael Asger Andersen
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Emelie Hamotal Curovic Rotbain
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark.,Danish Cancer Society Research Center, Copenhagen, Denmark
| | - Kathrine Aarup
- Department of Hematology, Rigshospitalet, Copenhagen University Hospital, Copenhagen, Denmark
| | - Renata Walewska
- Department of Haematology, University Hospitals Dorset, Bournemouth, UK
| | - Andrea Visentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Marina Deodato
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Anna Maria Frustaci
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | | | - Massimo Gentile
- Hematology Unit AO of Cosenza, Cosenza, Italy.,Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | | | - Deepesh Lad
- Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - Lydia Scarfò
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Max Flogegard
- Hematology, Medicine Clinic, Falun Hospital, Falun, Sweden
| | - Mattias Mattsson
- Department of Hematology, Uppsala University Hospital, Uppsala, Sweden
| | - Sara Raponi
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Caterina Ilari
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | - Irene Della Starza
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
| | | | - Alessandra Tedeschi
- Department of Hematology, Niguarda Cancer Center, ASST Grande Ospedale Metropolitano Niguarda, Milan, Italy
| | - Livio Trentin
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Gianpietro Semenzato
- Hematology and Clinical Immunology Unit, Department of Medicine, University of Padua, Padua, Italy
| | - Anna Guarini
- Department of Molecular Medicine, Sapienza University, Rome, Italy
| | - Paolo Ghia
- Università Vita-Salute San Raffaele and IRCCS Ospedale San Raffaele, Milan, Italy
| | - Emili Montserrat
- Department of Hematology, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Robin Foà
- Hematology, Department of Translational and Precision Medicine, Sapienza University, Rome, Italy
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Elzain HE, Chung SY, Venkatramanan S, Selvam S, Ahemd HA, Seo YK, Bhuyan MS, Yassin MA. Novel machine learning algorithms to predict the groundwater vulnerability index to nitrate pollution at two levels of modeling. Chemosphere 2023; 314:137671. [PMID: 36586442 DOI: 10.1016/j.chemosphere.2022.137671] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 12/12/2022] [Accepted: 12/24/2022] [Indexed: 06/17/2023]
Abstract
The accurate mapping and assessment of groundwater vulnerability index are crucial for the preservation of groundwater resources from the possible contamination. In this research, novel intelligent predictive Machine Learning (ML) regression models of k-Neighborhood (KNN), ensemble Extremely Randomized Trees (ERT), and ensemble Bagging regression (BA) at two levels of modeling were utilized to improve DRASTIC-LU model in the Miryang aquifer located in South Korea. The predicted outputs from level 1 (KNN and ERT models) were used as inputs for ensemble bagging (BA) in level 2. The predictive groundwater pollution vulnerability index (GPVI), derived from DRASTIC-LU model was adjusted by NO3-N data and was utilized as the target data of the ML models. Hyperparameters for all models were tuned using a Grid Searching approach to determine the best effective model structures. Various statistical metrics and graphical representations were used to evaluate the superior predictive performance among ML models. Ensemble BA model in level 2 was more precise than standalone KNN and ensemble ERT models in level 1 for predicting GPVI values. Furthermore, the ensemble BA model offered suitable outcomes for the unseen data that could subsequently prevent the overfitting issue in the testing phase. Therefore, ML modeling at two levels could be an excellent approach for the proactive management of groundwater resources against contamination.
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Affiliation(s)
- Hussam Eldin Elzain
- Department. of Environmental & Earth Sciences, Pukyong National University, Busan, 48513, South Korea; Water Research Center, Sultan Qaboos University, Muscat, Oman.
| | - Sang Yong Chung
- Department. of Environmental & Earth Sciences, Pukyong National University, Busan, 48513, South Korea.
| | - Senapathi Venkatramanan
- Department of Disaster Management, Alagappa University, Karaikudi, Tamil Nadu, 630003, India.
| | - Sekar Selvam
- Department of Geology, V. O. Chidambaram College, Tuticorin, Tamil Nadu, 628008, India.
| | - Hamdi Abdurhman Ahemd
- Department of Industrial and Data Engineering, Pukyong National University, Busan, 48513, South Korea.
| | - Young Kyo Seo
- Geo-Marine Technology (GEMATEK), Busan, 48071, South Korea.
| | - Md Simul Bhuyan
- Bangladesh Oceanographic Research Institute, Cox's Bazar -4730, Bangladesh.
| | - Mohamed A Yassin
- Interdisciplinary Research Center for Membranes and Water Security, KFUPM, 31261, Saudi Arabia.
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Yasin AK, Abu-Tineh M, Alshurafa A, Ahmed K, Abdulgayoom M, Afana M, Yassin MA. A Challenging Case of a Patient With Immune Thrombocytopenic Purpura on Eltrombopag Who Developed Atrial Fibrillation: An Anticoagulation Dilemma. Cureus 2023; 15:e35001. [PMID: 36938285 PMCID: PMC10020874 DOI: 10.7759/cureus.35001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/14/2023] [Indexed: 02/17/2023] Open
Abstract
A 61-year-old female, who was a known case of immune thrombocytopenic purpura (ITP) on eltrombopag, was admitted for atrial fibrillation (AF). Labs showed a platelet count of 116 × 103/µL. AF reverted to sinus rhythm by cardioversion. Therapeutic enoxaparin was started for two days. She was discharged on dabigatran for four weeks. The choice of anticoagulation in these cases (ITP and AF) is not straightforward and needs further research.
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Affiliation(s)
- Ahmed K Yasin
- Department of Internal Medicine, Hamad Medical Corporation, Doha, QAT
| | - Mohammad Abu-Tineh
- Department of Medical Oncology, Hematology and Bone Marrow Transplant Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT
| | - Awni Alshurafa
- Department of Medical Oncology, Hematology and Bone Marrow Transplant Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT
| | - Khalid Ahmed
- Department of Medical Oncology, Hematology and Bone Marrow Transplant Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT
| | - Mohammed Abdulgayoom
- Department of Medical Oncology, Hematology and Bone Marrow Transplant Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT
| | - Mohammad Afana
- Department of Medical Oncology, Hematology and Bone Marrow Transplant Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT
| | - Mohamed A Yassin
- Department of Medical Oncology, Hematology and Bone Marrow Transplant Section, National Center for Cancer Care and Research, Hamad Medical Corporation, Doha, QAT
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Elamin NH, Rashid F, Afana MS, Cherif H, Yassin MA. Differentiation syndrome in patients with acute promyelocytic leukemia. Clin Case Rep 2023; 11:e6697. [PMID: 36721680 PMCID: PMC9880381 DOI: 10.1002/ccr3.6697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 10/31/2022] [Accepted: 11/13/2022] [Indexed: 01/28/2023] Open
Abstract
A 48-year-old male diagnosed with acute promyelocytic leukemia (APL) started on all-trans-retinoic acid and arsenic trioxide, developed typical symptoms of differentiation syndrome, and improved dramatically on steroids. Hence, any APL patient started on chemotherapy, needs to be monitored closely for developing differentiation syndrome and to start steroid upon suspicion.
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Affiliation(s)
- Nusiba H. Elamin
- Department of Internal MedicineHamad General Hospital, Hamad Medical CorporationDohaQatar
| | - Farah Rashid
- Department of Internal MedicineHamad General Hospital, Hamad Medical CorporationDohaQatar
| | - Muhammad S. Afana
- Department of Medical Oncology, Hematology Section, National Center for Cancer Care and ResearchHamad Medical CorporationDohaQatar
| | - Honar Cherif
- Department of Medical Oncology, Hematology Section, National Center for Cancer Care and ResearchHamad Medical CorporationDohaQatar
| | - Mohamed A. Yassin
- Department of Medical Oncology, Hematology Section, National Center for Cancer Care and ResearchHamad Medical CorporationDohaQatar
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Yassin MA, Elsabagh A. Editorial: Uncovering the relationship between myelodysplastic syndromes and acute myeloid leukemia. Front Oncol 2023; 13:1131785. [PMID: 36741007 PMCID: PMC9895938 DOI: 10.3389/fonc.2023.1131785] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2022] [Accepted: 01/05/2023] [Indexed: 01/22/2023] Open
Affiliation(s)
- Mohamed A. Yassin
- Hematology Section, Medical Oncology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar,College of Medicine, Qatar University (QU), Doha, Qatar,*Correspondence: Mohamed A. Yassin,
| | - Ahmed Elsabagh
- College of Medicine, Qatar University (QU) Health, Qatar University, Doha, Qatar
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Al-Mashdali AF, Aldapt MB, Rahhal A, Hailan YM, Elhakeem I, Ali EA, Rozi W, Yassin MA. Pediatric Philadelphia-Negative Myeloproliferative Neoplasms in the Era of WHO Classification: A Systematic Review. Diagnostics (Basel) 2023; 13:diagnostics13030377. [PMID: 36766480 PMCID: PMC9914355 DOI: 10.3390/diagnostics13030377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Revised: 01/13/2023] [Accepted: 01/17/2023] [Indexed: 01/21/2023] Open
Abstract
BACKGROUND Philadelphia-negative myeloproliferative neoplasms (MPN) are most prevalent in the older population (median age at the diagnosis is above 60 years) and rarely diagnosed in pediatrics. Thus, our knowledge about the clinical presentation, mutational status, and complications of MPNs in pediatrics is limited. METHODS The literature in English (PubMed, SCOPUS, and Google Scholar) was searched for studies, reviews, case series, and case reports of patients with Philadelphia-negative MPNs (including essential thrombocythemia, polycythemia vera, primary myelofibrosis, and profibrotic myelofibrosis) in the pediatrics age group (less than 18 years). Only studies that fulfilled WHO 2008 or 2016 criteria for MPNs were included. We aimed to describe the clinical characteristics, vascular and long-term complications, types of driver mutations, and treatment approaches in pediatric patients with MPNs. RESULTS We reviewed 33 articles of available published literature from 2008 to 2022 and collected data from a total of 196 patients of the pediatric population. Among the cohort of patients, 139 had essential thrombocythemia (ET), 20 had polycythemia vera (PV), and 37 had primary myelofibrosis (PMF). The median age at the time of diagnosis for each disease varied, with 8.8 years for ET, 10 years for PV, and 3.6 years for MF. There was a slight difference in gender prevalence between both gender groups and all three diseases. The presenting symptoms were not mentioned in more than 50% of studies. We found that JAK2 was the most prevalent among all mutations. Both bleeding and thrombosis were present equally in ET, with 9% of cases complicated by bleeding and 9% complicated by thrombosis. Hemorrhagic events did not occur in patients with PV; thrombosis in children with MF was also not found. The progression into AML occurred in two patients with PV and one with ET. CONCLUSION Given the rarity of MPNs in pediatrics and their different characteristics compared with adults, we believe there is a need for unique diagnostic criteria to match the different molecular statuses in pediatrics. Based on our review, the incidence of MPN complications in pediatrics, including thrombotic events, hemorrhage, and leukemic transformation, differs from that in adults.
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Affiliation(s)
- Abdulrahman F. Al-Mashdali
- Department of Internal Medicine, Hamad Medical Corporation, Doha 3050, Qatar
- Correspondence: or (A.F.A.-M.); (M.A.Y.)
| | - Mahmood B. Aldapt
- Department of Medicine, Unity Hospital, Rochester Regional Health, Rochester, NY 14626, USA
| | - Alaa Rahhal
- Pharmacy Department, Hamad Medical Corporation, Doha 3050, Qatar
| | - Yousef M. Hailan
- Department of Internal Medicine, Hamad Medical Corporation, Doha 3050, Qatar
| | - Israa Elhakeem
- Clinical Oncology, Hamad Medical Corporation, Doha 3050, Qatar
| | - Elrazi A. Ali
- One Brooklyn Health, Interfaith Medical Center, Internal Medicine Department, Brooklyn, NY 11213, USA
| | - Waail Rozi
- Department of Internal Medicine, Hamad Medical Corporation, Doha 3050, Qatar
| | - Mohamed A. Yassin
- National Center for Cancer Care and Research, Department of Oncology, Hematology and BMT Section, Hamad Medical Corporation, Doha 3050, Qatar
- Correspondence: or (A.F.A.-M.); (M.A.Y.)
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Nashwan AJ, Yassin MA, Abd-Alrazaq A, Shuweihdi F, Othman M, Abdul Rahim HF, Shraim M. Hepatic and cardiac iron overload quantified by magnetic resonance imaging in patients on hemodialysis: A systematic review and meta-analysis. Hemodial Int 2023; 27:3-11. [PMID: 36397717 DOI: 10.1111/hdi.13054] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 10/19/2022] [Accepted: 10/26/2022] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Few studies have reported hepatic and cardiac iron overload in patients with end-stage renal disease (ESRD), and the current evidence regarding the prevalence is still scarce. AIM This review aims to estimate the prevalence of hepatic and/or cardiac iron overload quantified by magnetic resonance imaging (MRI) in patients with ESRD who receive hemodialysis (HD), peritoneal dialysis (PD), or have undergone a kidney transplant. METHODS A systematic review with meta-analysis was conducted and reported in line with PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis) guidelines. MEDLINE and Embase bibliographic databases were searched using a comprehensive list of controlled vocabulary and keywords to identify relevant studies. All studies reporting the prevalence of hepatic and/or cardiac iron overload quantified by MRI in ESRD patients were considered. The Newcastle-Ottawa scale was used to assess the methodological quality of included studies. To investigate the heterogeneity between studies, random-effect meta-analyses for proportions were used. RESULTS The review comprised seven studies that included 339 patients. Using meta-analysis, the pooled prevalence of severe and mild to moderate hepatic iron overload quantified by MRI was 0.23 [95% CI: 0.08-0.43] and 0.52 [95% CI: 0.47-0.57], respectively. Only three studies included cardiac iron quantification, and none reported iron overload. CONCLUSIONS This review has revealed a high prevalence of severe hepatic iron overload in patients with ESRD treated by HD. Further studies with a larger sample size are needed to determine the impact of iron overload on vital organs in patients with ESRD and guide future research in this understudied field. Proper use of iron chelation and continuous monitoring will help in the early detection of unsolicited complications; however, the low renal clearance of most iron chelators limits the options for treating iron excess in patients with ESRD.
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Affiliation(s)
- Abdulqadir J Nashwan
- Department of Nursing, Hazm Mebaireek General Hospital, Hamad Medical Corporation, Doha, Qatar.,Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Mohamed A Yassin
- Hematology and Oncology, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar
| | - Alaa Abd-Alrazaq
- AI Center for Precision Health, Weill Cornell Medicine-Qatar, Doha, Qatar
| | - Farag Shuweihdi
- School of Medicine, Leeds Institute of Health Sciences, University of Leeds, Leeds, UK
| | - Muftah Othman
- Nephrology Section, Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | - Hanan F Abdul Rahim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
| | - Mujahed Shraim
- Department of Public Health, College of Health Sciences, QU Health, Qatar University, Doha, Qatar
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Abdulgayoom M, Mudawi D, Lengyel Z, Abo Samra H, Alshurafa A, Yassin MA. Langerhans Cell Histiocytosis with Good Response to Low-Dose Imatinib: Case Report and Literature Review. Case Rep Oncol 2023; 16:511-518. [PMID: 37476563 PMCID: PMC10355039 DOI: 10.1159/000531230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/09/2023] [Indexed: 07/22/2023] Open
Abstract
Langerhans cell histiocytosis (LCH) is a rare neoplastic disease characterized by infiltration of histiocytes and dendritic cells into body organs. While treatment is better established in pediatrics, there is still no consensus on therapy in the adult population. Imatinib has shown promising results in some case reports and a small clinical trial. We present here a fifty-nine-year-old patient with LCH in the lung, liver, and bone who responded well to an imatinib dose of 100 mg daily. Her symptoms improved within 3 months of treatment, and subsequent positron emission tomography-computed tomography (PET/CT) showed resolution of 18F-fluorodeoxyglucose (FDG)-avid lesions.
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Affiliation(s)
- Mohammed Abdulgayoom
- Department of Hematology, National Center for Cancer Care and Research, HMC, Doha, Qatar
| | - Deena Mudawi
- Department of Hematology, National Center for Cancer Care and Research, HMC, Doha, Qatar
| | - Zsolt Lengyel
- Department of PET/CT and Nuclear Medicine, HMC, Doha, Qatar
| | - Hayan Abo Samra
- Department of Laboratory Medicine and Pathology, HMC, Doha, Qatar
| | - Awni Alshurafa
- Department of Hematology, National Center for Cancer Care and Research, HMC, Doha, Qatar
| | - Mohamed A Yassin
- Department of Hematology, National Center for Cancer Care and Research, HMC, Doha, Qatar
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Qasim H, Rahhal A, Husain A, Alammora A, Alsa’ed K, Alsayed AAM, Faiyoumi B, Maen AbuAfifeh L, Abu-Tineh M, Alshurafa A, Yassin MA. Immune Thrombocytopenia Relapse in Patients Who Received mRNA COVID-19 Vaccines. J Blood Med 2023; 14:295-302. [PMID: 37082002 PMCID: PMC10112532 DOI: 10.2147/jbm.s396026] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 03/06/2023] [Indexed: 04/22/2023] Open
Abstract
Background Immune thrombocytopenia (ITP) is a blood disorder in which antibodies coating platelets cause platelet destruction in the spleen with a resultant low platelet count and an increased tendency for bleeding. Coronavirus disease 2019 (COVID-19) is an illness caused by SARS-CoV-2. Though pneumonia and respiratory failure are major causes of morbidity and mortality, multisystemic complications were identified, including hematological ones. Several ITP relapse cases post-mRNA SARS-CoV-2 vaccines have been reported, and different pathophysiological theories have been proposed. Purpose The objective of this study is to identify the causal relationship between mRNA COVID-19 vaccines and ITP relapse, to highlight the longer-term effect of these vaccines on the platelet count more than 6 months after receiving the vaccine, and to identify if there is a statistical difference between Comirnaty and Spikevax vaccines on ITP relapse rate. Patients and Methods In this retrospective study, 67 patients with known ITP were followed before and after receiving the mRNA COVID-19 vaccine. The follow-up parameters included platelet counts when available and bleeding symptoms. All patients were adults over 18 years old, with no other identified causes of thrombocytopenia. Forty-seven patients received the Comirnaty vaccine, and 20 patients received the Spikevax vaccine. Results Data analysis showed 6% ITP relapse in the first 3 months, and a 10% relapse rate 3-6 months after receiving one of the mRNA COVID-19 vaccines, with no statically significant difference between the two vaccines. Conclusion mRNA COVID-19 vaccines increase the risk of ITP relapse and can lead to a prolonged reduction in platelet count in a proportion of ITP patients, with no statistically significant difference between Comirnaty and Spikevax vaccines.
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Affiliation(s)
- Hana Qasim
- Hematology-Oncology Department, National Centre for Cancer Care & Research, Doha, Qatar
- Department of Internal Medicine, University of Missouri-Kansas City, Kansas City, MO, USA
- Correspondence: Hana Qasim; Khaled Alsa’ed, Email ;
| | - Alaa Rahhal
- MSc Pharmacy Department, Hamad Medical Corporation, Doha, Qatar
| | - Ahmed Husain
- Infectious Disease Department, Communicable Disease Center, Hamad Medical Corporation, Doha, Qatar
| | | | - Khaled Alsa’ed
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Baha Faiyoumi
- Internal Medicine Department, Hamad Medical Corporation, Doha, Qatar
| | | | - Mohammad Abu-Tineh
- Hematology-Oncology Department, National Centre for Cancer Care & Research, Doha, Qatar
| | - Awni Alshurafa
- Hematology-Oncology Department, National Centre for Cancer Care & Research, Doha, Qatar
| | - Mohamed A Yassin
- Hematology-Oncology Department, National Centre for Cancer Care & Research, Doha, Qatar
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Muacevic A, Adler JR, Ellahie A, Ismail O, Sideeg D, Albattah A, Yassin MA. Myocardial Infarction as an Initial Presentation of Essential Thrombocythemia With Calreticulin (CALR) Mutation (None Type 1, None Type 2). Cureus 2023; 15:e33612. [PMID: 36788855 PMCID: PMC9910808 DOI: 10.7759/cureus.33612] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/02/2023] [Indexed: 01/11/2023] Open
Abstract
Essential thrombocythemia (ET) is one of the classical Philadelphia-negative myeloproliferative neoplasms with different mutations that can be associated with it, like Janus kinase 2 (JAK2), myeloproliferative leukemia protein (MPL), and Calreticulin (CALR) (types 1 and 2). However, there is a lack in the literature concerning other types of CALR mutations and their clinical significance and prognosis. Here we report a 42-year-old male with type 2 diabetes who presented with an inferior ST-elevation myocardial infarction and thrombocytosis. The diagnosis of ET with CALR (neither type 1 nor type 2) was confirmed, which suggests the pathognomonic feature of this mutation.
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Muacevic A, Adler JR, Alshurafa A, Nashwan AJ, Albsheer K, Ahmed A, Hailan Y, Rozi W, Aljaloudi E, Yassin MA. The Impact of Tyrosine Kinase Inhibitors on Fatherhood in Patients With Chronic Myeloid Leukemia: A Mixed-Method Study. Cureus 2023; 15:e33407. [PMID: 36751250 PMCID: PMC9899104 DOI: 10.7759/cureus.33407] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/05/2023] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION Multiple studies have demonstrated that tyrosine kinase inhibitors (TKIs) exert a significant extent of control over chronic myeloid leukemia (CML), as evidenced by studies such as the population-based Swedish CML registry, which found that patients reaching age 70 had a relative survival rate close to one when compared to the general population. Consequently, new perspectives on the safety of treatments have emerged, particularly in the context of their impact on fatherhood in men. According to the authors, this is the first study to examine the effect of TKIs on fatherhood in CML patients. Methods: A single-center, mixed-design study (retrospective data review and phone interviews) was conducted with CML male patients in the chronic or accelerated phase, evaluating the effect of imatinib, dasatinib, and nilotinib on their fatherhood, irrespective of whether they were administered as a first, second, or third line of treatment. RESULTS The study included interviews with 150 patients. Included were 27 patients. The average age was approximately 44.5 years. One hundred percent of the patients were in the chronic phase. The median age at first conception following TKI therapy was 36, and the median duration of TKI therapy was approximately seven years. The total number of offspring was 49; 98% were born at term and had a normal birth weight. No reports of stillbirths, fetal deaths, or congenital malformations were made. All the offspring grew and developed normally. No CML-related cancers were reported in any of the newborns. CONCLUSION Around 98% of male CML patients receiving imatinib, dasatinib, or nilotinib did not experience a negative impact on their fatherhood or the health of their children. However, improved education for patients beginning treatment with TKIs addresses the potential psychological worry of having an unfavorable effect on their fertility or offspring, which may increase medication adherence.
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Ahmed K, Abdu Y, Khasawneh S, Shukri A, Adam E, Mustafa S, Affas M, Mohamed Ibrahim MI, Al Zayed A, Yassin MA. The effect of intermittent fasting on the clinical and hematological parameters of patients with sickle cell disease: A preliminary study. Front Med (Lausanne) 2023; 10:1097466. [PMID: 36895718 PMCID: PMC9989014 DOI: 10.3389/fmed.2023.1097466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Accepted: 02/01/2023] [Indexed: 02/25/2023] Open
Abstract
Introduction Sickle cell disease is a genetic disorder that frequently presents with vaso-occlusive crisis (VOC). Most patients with sickle cell disease in Qatar are Muslims; hence, they practice intermittent fasting during the holy month of Ramadan. However, there is a paucity of literature describing the effect of intermittent fasting on the occurrence of severe VOC. As a result, there is a lack of guidelines or standardized protocols that can help physicians advise patients with sickle cell disease who wish to practice intermittent fasting. Therefore, this study's aim was to investigate the effect of intermittent fasting on the clinical and hematological parameters of individuals with sickle cell disease. Methods We conducted a retrospective study for 52 Muslim patients with sickle cell disease in Qatar aged ≥18 years who were confirmed to be fasting during the holy month of Ramadan during any of the years 2019-2021. The difference in the occurrence of severe VOC, hemolytic crisis, and other clinical, hematological, and metabolic parameters were studied one month before, during, and one month after the intermittent fasting of Ramadan using the patient's medical records. Mean (sd), median (IQR), and frequency (%) described the data. One-way with repeated measures ANOVA with a Greenhouse-Geisser correction and Friedman tests (*) were used at alpha level 0.05. Results The study participants' (mean±sd) age was (31.1±9.2) years, 51.9% were males, and 48.1% were females. Roughly seventy percent of the participants were of Arab ethnicity, while the rest were either African or Asian. Most of the patients were homozygotes (SS) (90.4%). The median number of severe VOC (P = 0.7) and hemolytic crisis (P = 0.5) was not found to be significantly different before, during, or after Ramadan. Significant differences, however, were found in platelet count (P = 0.003), reticulocyte count (P < 0.001), and creatinine level (P = 0.038) with intermittent fasting. Discussion In this preliminary study, intermittent fasting does not seem to influence the rate of occurrence of severe vaso-occlusive crisis or hemolytic crisis in patients with sickle cell disease; however, it was found to be associated with differences in platelet count, reticulocytes count, and creatinine level. The statistical and clinical significance of these findings needs to be confirmed in studies with a larger sample size.
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Affiliation(s)
- Khalid Ahmed
- Department of Hematology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
| | - Yasamin Abdu
- Department of Community Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Sief Khasawneh
- Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Ahmed Shukri
- Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Ehab Adam
- Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Salma Mustafa
- Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | - Mohammad Affas
- Department of Internal Medicine, Hamad Medical Corporation (HMC), Doha, Qatar
| | | | | | - Mohamed A Yassin
- Department of Hematology, National Center for Cancer Care and Research (NCCCR), Hamad Medical Corporation (HMC), Doha, Qatar
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