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Eshel YD, Sharaha U, Beck G, Cohen-Logasi G, Lapidot I, Huleihel M, Mordechai S, Kapelushnik J, Salman A. Monitoring the efficacy of antibiotic therapy in febrile pediatric oncology patients with bacteremia using infrared spectroscopy of white blood cells-based machine learning. Talanta 2024; 270:125619. [PMID: 38199122 DOI: 10.1016/j.talanta.2023.125619] [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: 10/15/2023] [Revised: 12/29/2023] [Accepted: 12/30/2023] [Indexed: 01/12/2024]
Abstract
Bacteremia refers to the presence of bacteria in the bloodstream, which can lead to a serious and potentially life-threatening condition. In oncology patients, individuals undergoing cancer treatment have a higher risk of developing bacteremia due to a weakened immune system resulting from the disease itself or the treatments they receive. Prompt and accurate detection of bacterial infections and monitoring the effectiveness of antibiotic therapy are essential for enhancing patient outcomes and preventing the development and dissemination of multidrug-resistant bacteria. Traditional methods of infection monitoring, such as blood cultures and clinical observations, are time-consuming, labor-intensive, and often subject to limitations. This manuscript presents an innovative application of infrared spectroscopy of leucocytes of pediatric oncology patients with bacteremia combined with machine learning to diagnose the etiology of infection as bacterial and simultaneously monitor the efficacy of the antibiotic therapy in febrile pediatric oncology patients with bacteremia infections. Through the implementation of effective monitoring, it becomes possible to promptly identify any indications of treatment failure. This, in turn, indirectly serves to limit the progression of antibiotic resistance. The logistic regression (LR) classifier was able to differentiate the samples as bacterial or control within an hour, after receiving the blood samples with a success rate of over 95 %. Additionally, initial findings indicate that employing infrared spectroscopy of white blood cells (WBCs) along with machine learning is viable for monitoring the success of antibiotic therapy. Our follow up results demonstrate an accuracy of 87.5 % in assessing the effectiveness of the antibiotic treatment.
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Affiliation(s)
- Yotam D Eshel
- Department of Hematology and Oncology, Saban Pediatric Medical Center Soroka University Medical Center and Faculty of Health Sciences, Beer-Sheva, 84105, Israel
| | - Uraib Sharaha
- Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel; Department of Biology, Science and Technology College, Hebron University, Hebron, P760, Palestine
| | - Guy Beck
- Department of Hematology and Oncology, Saban Pediatric Medical Center Soroka University Medical Center and Faculty of Health Sciences, Beer-Sheva, 84105, Israel
| | - Gal Cohen-Logasi
- Department of Green Engineering, SCE-Sami Shamoon College of Engineering, Beer-Sheva, 84100, Israel
| | - Itshak Lapidot
- Department of Electrical and Electronics Engineering, ACLP-Afeka Center for Language Processing, Afeka Tel-Aviv Academic College of Engineering, Tel-Aviv, 69107, Israel; LIA Avignon Université, 339 Chemin des Meinajaries, Avignon, 84000, France
| | - Mahmoud Huleihel
- Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, 84105, Israel
| | - Shaul Mordechai
- Department of Physics, Ben-Gurion University, Beer-Sheva, 84105, Israel
| | - Joseph Kapelushnik
- Department of Hematology and Oncology, Saban Pediatric Medical Center Soroka University Medical Center and Faculty of Health Sciences, Beer-Sheva, 84105, Israel
| | - Ahmad Salman
- Department of Physics, SCE-Sami Shamoon College of Engineering, Beer-Sheva, 84100, Israel.
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Khaleel B, Lunenfeld E, Kapelushnik J, Huleihel M. Effect of Granulocyte Colony-Stimulating Factor on the Development of Spermatogenesis in the Adulthood of Juvenile AML Mice Model Treated with Cytarabine. Int J Mol Sci 2023; 24:12229. [PMID: 37569605 PMCID: PMC10419160 DOI: 10.3390/ijms241512229] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 07/26/2023] [Accepted: 07/28/2023] [Indexed: 08/13/2023] Open
Abstract
Pediatric acute myeloid leukemia (AML) generally occurs de novo. The treatment of AML includes cytarabine (CYT) and other medications. The granulocyte-colony stimulating factor (GCSF) is used in the clinic in cases of neutropenia after chemotherapies. We show that the administration of GCSF in combination with CYT in AML-diagnosed mice (AML+CYT+GCSF) extended the survival of mice for additional 20 days. However, including GCSF in all treatment modalities does not affect the testis' weight or the histology of the seminiferous tubules (STs). We show that GCSF does not affect normal ST histology from AML-, CYT-, or (AML+CYT)-treated groups compared to the relevant treated group without GCSF 2, 4, and 5 weeks post-injection. However, when comparing the percentages of normal STs between the AML+CYT+GCSF-treated groups and those without GCSF, we observe an increase of 17%-42% in STs at 4 weeks and 5.5 weeks post-injection. Additionally, we show that the injection of GCSF into the normal, AML-alone, or CYT-alone groups, or in combination with AML, significantly decreases the percentage of STs with apoptotic cells compared to the relevant groups without GCSF and to the CT (untreated mice) only 2 weeks post-injection. We also show that injection of GCSF into the CT group increases the examined spermatogonial marker PLZF within 2 weeks post-injection. However, GCSF does not affect the count of meiotic cells (CREM) but decreases the post-meiotic cells (ACROSIN) within 4 weeks post-injection. Furthermore, GCSF not only extends the survival of the AML+CYT-treated group, but it also leads to the generation of sperm (1.2 ± 0.04 × 106/mL) at 5.5 weeks post-injection. In addition, we demonstrate that the injection of GCSF into the CT group increases the RNA expression level of IL-10 but not IL-6 compared to CT 2 weeks post-treatment. However, the injection of GCSF into the AML-treated group reverses the expression levels of both IL-10 and IL-6 to normal levels compared to CT 2 weeks post-injection. Thus, we suggest that the addition of GCSF to the regimen of AML after CYT may assist in the development of future therapeutic strategies to preserve male fertility in AML prepubertal patients.
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Affiliation(s)
- Bara’ah Khaleel
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
| | - Eitan Lunenfeld
- Adelson School of Medicine, Ariel University, Ariel 4076414, Israel;
| | - Joseph Kapelushnik
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
- Department of Pediatric Oncology and Hematology, Soroka Medical Center, Beer-Sheva, and Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel
| | - Mahmoud Huleihel
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel;
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 8410501, Israel
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3
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Freund T, Baxter SK, Walsh T, Golan H, Kapelushnik J, Abramsohn-Goldenberg M, Benor S, Sarid N, Ram R, Alcalay Y, Segel R, Renbaum P, Stepensky P, King MC, Torgerson TR, Hagin D. Clinically Complex LRBA Deficiency Due to a Founder Allele in the Georgian Jewish Population. J Clin Immunol 2023; 43:151-164. [PMID: 36063261 DOI: 10.1007/s10875-022-01358-7] [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: 05/13/2022] [Accepted: 08/15/2022] [Indexed: 01/18/2023]
Abstract
Pathogenic variants in LRBA, encoding the LPS Responsive Beige-Like Anchor (LRBA) protein, are responsible for recessive, early-onset hypogammaglobulinemia, severe multi-organ autoimmunity, and lymphoproliferation, with increased risk for malignancy. LRBA deficiency has a wide clinical spectrum with variable age of onset and disease severity. Three apparently unrelated patients with LRBA deficiency, of Georgian Jewish descent, were homozygous for LRBA c.6640C > T, p.R2214*, leading to a stop upstream of the LRBA BEACH domain. Despite carrying the same LRBA genotype, the three patients differed in clinical course: the first patient was asymptomatic until age 25 years; the second presented with failure to thrive at age 3 months; and the third presented at age 7 years with immune cytopenias and severe infections. Two of the patients developed malignancies: the first patient was diagnosed with recurrent Hodgkin's disease at age 36 years, and the second patient developed aggressive gastric cancer at age 15 years. Among Georgian Jews, the carrier frequency of the LRBA p.R2214* allele was 1.6% (4 of 236 Georgian Jewish controls). The allele was absent from other populations. Haplotype analysis showed a shared origin of the mutation. These three patients revealed a pathogenic LRBA founder allele in the Georgian Jewish population, support the diverse and complex clinical spectrum of LRBA deficiency, and support the possibility that LRBA deficiency predisposes to malignancy.
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Affiliation(s)
- Tal Freund
- Allergy and Clinical Immunology Unit, Department of Medicine, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sarah K Baxter
- Department of Pediatrics, University of Washington and Seattle Children's Research Institute, Seattle, WA, USA.,Department of Medicine and Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Tom Walsh
- Department of Medicine and Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Hana Golan
- Pediatric Hematology Oncology Department, Safra Children's Hospital, Sheba Medical Center, Ramat-Gan, Israel.,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joseph Kapelushnik
- Department of Pediatric Oncology and Department of Hematology, Faculty of Health Sciences, Soroka Medical Center and The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev, Beer Sheva, Israel
| | | | - Shira Benor
- Allergy and Clinical Immunology Unit, Department of Medicine, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nadav Sarid
- Department of Hematology and Stem Cell Transplantation Service, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ron Ram
- Department of Hematology and Stem Cell Transplantation Service, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yifat Alcalay
- Allergy and Clinical Immunology Unit, Department of Medicine, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Reeval Segel
- Shaare Zedek Medical Center and Faculty of Medicine, Medical Genetics Institute, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Paul Renbaum
- Shaare Zedek Medical Center and Faculty of Medicine, Medical Genetics Institute, The Hebrew University of Jerusalem, Jerusalem, Israel
| | - Polina Stepensky
- Department of Bone Marrow Transplantation and Cancer Immunotherapy, Faculty of Medicine, Hadassah Medical Center, Hebrew University of Jerusalem, Jerusalem, Israel
| | - Mary-Claire King
- Department of Medicine and Department of Genome Sciences, University of Washington, Seattle, WA, USA
| | - Troy R Torgerson
- Department of Pediatrics, University of Washington and Seattle Children's Research Institute, Seattle, WA, USA.,Allen Institute for Immunology, Seattle, WA, USA
| | - David Hagin
- Allergy and Clinical Immunology Unit, Department of Medicine, Tel Aviv Sourasky Medical Center and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.
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4
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Kessous R, Sheiner E, Rosen GB, Kapelushnik J, Wainstock T. Increased incidence of childhood lymphoma in children with a history of small for gestational age at birth. Arch Gynecol Obstet 2022; 306:1485-1494. [PMID: 35133455 DOI: 10.1007/s00404-022-06410-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 06/24/2021] [Accepted: 01/10/2022] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The aim of this study was to evaluate whether children that were born small for gestational age (SGA) have an increased risk for childhood neoplasm. STUDY DESIGN A population-based cohort analysis comparing the risk for long-term childhood neoplasms (benign and malignant) in children that were born SGA vs. those that were appropriate for gestational age (AGA), between the years1991-2014. Childhood neoplasms were predefined based on ICD-9 codes, as recorded in the hospital medical files. Kaplan-Meier survival curves were constructed to compare cumulative oncological morbidity in both groups over time. Cox proportional hazards model was used to control for confounders. RESULTS During the study period 231,973 infants met the inclusion criteria; out of those 10,998 were born with a diagnosis of SGA. Children that were SGA at birth had higher incidence of lymphoma (OR 2.50, 95% CI 1.06-5.82; p value = 0.036). In addition, cumulative incidence over time of total childhood lymphoma was significantly higher in SGA children (Log Rank = 0.030). In a Cox regression model controlling for other perinatal confounders; SGA at birth remained independently associated with an increased risk for childhood lymphoma (adjusted HR 2.41, 95% CI 1.03-5.56, p value = 0.043). CONCLUSION Being delivered SGA is associated with an increased long-term risk for childhood malignancy and specifically lymphoma.
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Affiliation(s)
- Roy Kessous
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, 84101, Beer-Sheva, Israel.
| | - Eyal Sheiner
- Department of Obstetrics and Gynecology, Soroka University Medical Center, Ben-Gurion University of the Negev, 84101, Beer-Sheva, Israel
| | - Guy Beck Rosen
- Pediatric Hemato-Oncology Department, Saban Pediatric Medical Center, Soroka University Medical Center, Beer-Sheva, Israel
| | - Joseph Kapelushnik
- Pediatric Hemato-Oncology Department, Saban Pediatric Medical Center, Soroka University Medical Center, Beer-Sheva, Israel
| | - Tamar Wainstock
- The Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
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5
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Michailov Y, AbuMadighem A, Lunenfeld E, Kapelushnik J, Huleihel M. Granulocyte Colony-Stimulating Factor Restored Impaired Spermatogenesis and Fertility in an AML-Chemotherapy Mice Model. Int J Mol Sci 2021; 22:ijms222011157. [PMID: 34681817 PMCID: PMC8538347 DOI: 10.3390/ijms222011157] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2021] [Revised: 10/12/2021] [Accepted: 10/13/2021] [Indexed: 11/24/2022] Open
Abstract
Leukemia and treatment of male patients with anticancer therapy (aggressive chemotherapy and/or radiotherapy) may lead to infertility or even permanent male sterility. Their mechanisms of spermatogenesis impairment and the decrease in male fertility are not yet clear. We showed that under acute myeloid leukemia (AML) conditions, alone and in combination with cytarabine (CYT), there was significant damage in the histology of seminiferous tubules, a significant increase in apoptotic cells of the seminiferous tubules, and a reduction in spermatogonial cells (SALL and PLZF) and in meiotic (CREM) and post-meiotic (ACROSIN) cells. In addition, we showed a significant impairment in sperm parameters and fertilization rates and offspring compared to control. Our results showed a significant decrease in the expression of glial cell line-derived neurotrophic factor (GDNF), macrophage colony-stimulating factor (MCSF) and stem cell factor (SCF) under AML conditions, but not under cytarabine treatment compared to control. In addition, our results showed a significant increase in the pro-inflammatory cytokine interleukin-1 (IL-1) alpha in whole testis homogenates in all treatment groups compared to the control. Increase in IL-1 beta level was shown under AML conditions. We identified for the first time the expression of GCSF receptor (GCSFR) in sperm cells. We showed that GCSF injection in combination with AML and cytarabine (AML + CYT + GCSF) extended the survival of mice for a week (from 6.5 weeks to 7.5 weeks) compared to (AML + CYT). Injection of GCSF to all treated groups (post hoc), showed a significant impact on mice testis weight, improved testis histology, decreased apoptosis and increased expression of pre-meiotic, meiotic and post- meiotic markers, improved sperm parameters, fertility capacity and number of offspring compared to the controls (without GCSF). GCSF significantly improved the spermatogonial niche expressed by increased the expression levels of testicular GDNF, SCF and MCSF growth factors in AML-treated mice and (AML + CYT)-treated mice compared to those groups without GCSF. Furthermore, GCSF decreased the expression levels of the pro-inflammatory cytokine IL-12, but increased the expression of IL-10 in the interstitial compartment compared to the relevant groups without GCSF. Our results show for the first time the capacity of post injection of GCSF into AML- and CYT-treated mice to improve the cellular and biomolecular mechanisms that lead to improve/restore spermatogenesis and male fertility. Thus, post injection of GCSF may assist in the development of future therapeutic strategies to preserve/restore male fertility in cancer patients, specifically in AML patients under chemotherapy treatments.
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Affiliation(s)
- Yulia Michailov
- The Center of Advanced Research and Education in Reproduction (CARER), The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel; (Y.M.); (A.A.)
- Barzilai University Medical Center, IVF Unit, Ashkelon 7830604, Israel
| | - Ali AbuMadighem
- The Center of Advanced Research and Education in Reproduction (CARER), The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel; (Y.M.); (A.A.)
| | - Eitan Lunenfeld
- The Center of Advanced Research and Education in Reproduction (CARER), Dep OB/GYN, Soroka Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel;
| | - Joseph Kapelushnik
- Soroka Medical Center, Department of Pediatric Oncology and Hematology, Beer-Sheva, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel;
| | - Mahmoud Huleihel
- The Center of Advanced Research and Education in Reproduction (CARER), The Shraga Segal Department of Microbiology, Immunology, and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel; (Y.M.); (A.A.)
- Correspondence:
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Agbaria AH, Beck G, Lapidot I, Rich DH, Kapelushnik J, Mordechai S, Salman A, Huleihel M. Correction: Diagnosis of inaccessible infections using infrared microscopy of white blood cells and machine learning algorithms. Analyst 2020; 145:7447. [PMID: 32926029 DOI: 10.1039/d0an90103b] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Correction for 'Diagnosis of inaccessible infections using infrared microscopy of white blood cells and machine learning algorithms' by Adam H. Agbaria et al., Analyst, 2020, DOI: 10.1039/D0AN00752H.
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Affiliation(s)
- Adam H Agbaria
- Department of Physics, Ben-Gurion University, Beer-Sheva 84105, Israel
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7
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Agbaria AH, Beck G, Lapidot I, Rich DH, Kapelushnik J, Mordechai S, Salman A, Huleihel M. Diagnosis of inaccessible infections using infrared microscopy of white blood cells and machine learning algorithms. Analyst 2020; 145:6955-6967. [PMID: 32852502 DOI: 10.1039/d0an00752h] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Physicians diagnose subjectively the etiology of inaccessible infections where sampling is not feasible (such as, pneumonia, sinusitis, cholecystitis, peritonitis), as bacterial or viral. The diagnosis is based on their experience with some medical markers like blood counts and medical symptoms since it is harder to obtain swabs and reliable laboratory results for most cases. In this study, infrared spectroscopy with machine learning algorithms was used for the rapid and objective diagnosis of the etiology of inaccessible infections and enables an assessment of the error for the subjective diagnosis of the etiology of these infections by physicians. Our approach allows for diagnoses of the etiology of both accessible and inaccessible infections as based on an analysis of the innate immune system response through infrared spectroscopy measurements of white blood cell (WBC) samples. In the present study, we examined 343 individuals involving 113 controls, 89 inaccessible bacterial infections, 54 accessible bacterial infections, 60 inaccessible viral infections, and 27 accessible viral infections. Using our approach, the results show that it is possible to differentiate between controls and infections (combined bacterial and viral) with 95% accuracy, and enabling the diagnosis of the etiology of accessible infections as bacterial or viral with >94% sensitivity and > 90% specificity within one hour after the collection of the blood sample with error rate <6%. Based on our approach, the error rate of the physicians' subjective diagnosis of the etiology of inaccessible infections was found to be >23%.
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Affiliation(s)
- Adam H Agbaria
- Department of Physics, Ben-Gurion University, Beer-Sheva 84105, Israel
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8
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Leibovitz E, Kapelushnik J, Alsanaa S, Tschernin D, Sergienko R, Leibovitz R, Mazar J, Fruchtman Y. Comparison of the etiologic, microbiologic, clinical and outcome characteristics of febrile vs. non-febrile neutropenia in hospitalized immunocompetent children. Eur J Clin Microbiol Infect Dis 2020; 39:2415-2426. [PMID: 32720090 PMCID: PMC7384562 DOI: 10.1007/s10096-020-03938-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/15/2020] [Accepted: 06/01/2020] [Indexed: 11/30/2022]
Abstract
We compared the etiologic, microbiologic, clinical, and outcome picture among febrile and non-febrile immunocompetent children hospitalized during 2013–2015 with acute neutropenia (absolute neutrophil count < 1.5 × 109/L). Serious bacterial infections (SBI) were defined as culture-positive blood, urine, cerebrospinal fluid, articular fluid or stool infections, pneumonia, brucellosis, and rickettsiosis. Overall, 664 children < 18 years of age were enrolled; 407 (62.2%) had fever > 38.0 °C and 247 (37.8%) were non-febrile at admission. There were 425 (64.0%), 125 (18.8%), 48 (7.2%), and 66 (9.9%) patients aged 0–24 months, 2-6, 7–12, and > 12 years, respectively. No differences were recorded in the distribution of febrile vs. non-febrile patients among the age groups nor among the 3 neutropenia severity groups (< 0.5, 0.5–1.0 and 1.0–1.5 × 109/L). SBI infections were diagnosed in 98 (14.8%) patients, with higher rates among febrile patients vs. non-febrile patients (16.8% vs. 11.5%, P = 0.06). Brucellosis and rickettsiosis were diagnosed in 15.4% and 23.1% tests performed, respectively. 295/688 (42.9%) virologic examinations returned positive. Among patients < 24 months, more febrile ones had viral infectious compared with afebrile patients (P = 0.025). Acute leukemia was diagnosed in 6 patients. Neutropenia resolved in 163/323 (50.5%) patients during a 1-month follow-up. No differences were recorded in neutropenia resolution between febrile and non-febrile children among all 3 severity groups. Severe neutropenia was rare and occurred mainly in very young patients. SBIs were more common among febrile patients compared with non-febrile patients, but there was no association between severity of neutropenia or its resolution and the presence or absence of fever at diagnosis.
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Affiliation(s)
- Eugene Leibovitz
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel. .,Soroka University Medical Center, Beer Sheva, Israel. .,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel. .,Pediatric Infectious Disease Unit, Soroka University Medical Center, P.O. Box 151, 84101, Beer Sheva, Israel.
| | - Joseph Kapelushnik
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.,Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Sabrin Alsanaa
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.,Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Dov Tschernin
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.,Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Ruslan Sergienko
- Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel.,Epidemiology Department, Soroka University Medical Center, Beer Sheva, Israel
| | - Ron Leibovitz
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
| | - Julia Mazar
- Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel.,Laboratory of Hematology, Soroka University Medical Center, Beer Sheva, Israel
| | - Yariv Fruchtman
- Division of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.,Soroka University Medical Center, Beer Sheva, Israel.,Faculty of Health Sciences, Ben-Gurion University, Beer Sheva, Israel
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9
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Agbaria AH, Rosen GB, Lapidot I, Rich DH, Mordechai S, Kapelushnik J, Huleihel M, Salman A. Rapid diagnosis of infection etiology in febrile pediatric oncology patients using infrared spectroscopy of leukocytes. J Biophotonics 2020; 13:e201900215. [PMID: 31566906 DOI: 10.1002/jbio.201900215] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 05/31/2019] [Revised: 08/27/2019] [Accepted: 09/15/2019] [Indexed: 06/10/2023]
Abstract
Rapid diagnosis of the etiology of infection is highly important for an effective treatment of the infected patients. Bacterial and viral infections are serious diseases that can cause death in many cases. The human immune system deals with many viral and bacterial infections that cause no symptoms and pass quietly without treatment. However, oncology patients undergoing chemotherapy have a very weak immune system caused by leukopenia, and even minor pathogen infection threatens their lives. For this reason, physicians tend to prescribe immediately several types of antibiotics for febrile pediatric oncology patients (FPOPs). Uncontrolled use of antibiotics is one of the major contributors to the development of resistant bacteria. Therefore, for oncology patients, a rapid and objective diagnosis of the etiology of the infection is extremely critical. Current identification methods are time-consuming (>24 h). In this study, the potential of midinfrared spectroscopy in tandem with machine learning algorithms is evaluated for rapid and objective diagnosis of the etiology of infections in FPOPs using simple peripheral blood samples. Our results show that infrared spectroscopy enables the diagnosis of the etiology of infection as bacterial or viral within 70 minutes after the collection of the blood sample with 93% sensitivity and 88% specificity.
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Affiliation(s)
- Adam H Agbaria
- Department of Physics, Ben-Gurion University, Beer-Sheva, Israel
| | - Guy Beck Rosen
- Department of Hematology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Itshak Lapidot
- Department of Electrical and Electronics Engineering, ACLP-Afeka Center for Language Processing, Afeka Tel-Aviv Academic College of Engineering, Tel-Aviv, Israel
| | - Daniel H Rich
- Department of Physics, Ben-Gurion University, Beer-Sheva, Israel
| | - Shaul Mordechai
- Department of Physics, Ben-Gurion University, Beer-Sheva, Israel
| | - Joseph Kapelushnik
- Department of Hematology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Mahmoud Huleihel
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ahmad Salman
- Department of Physics, SCE-Sami Shamoon College of Engineering, Beer-Sheva, Israel
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10
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Elhasid R, Nirel R, Avigad S, Avrahami G, Abramov A, Attias D, Arad N, Ballin A, Ben-Arush M, Bielorai B, Burstein Y, Elitzur S, Gabriel H, Hameiri-Grossman M, Kapelushnik J, Sthoeger D, Toren A, Wientraub M, Yaniv I, Izraeli S, Stark B. Poorer outcome of childhood acute lymphoblastic leukemia in the Bedouin population: A report from the Berlin-Frankfurt-Muenster-based Israeli national protocols. Pediatr Blood Cancer 2020; 67:e28024. [PMID: 31595664 DOI: 10.1002/pbc.28024] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Revised: 08/10/2019] [Accepted: 09/04/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Therapy outcomes for childhood acute lymphoblastic leukemia (ALL) had substantially improved in the last decades, but variability across racial and ethnic groups was identified in some clinical studies. In this study, we aimed to investigate whether such a difference in outcome is found in the diverse ethnicities in Israel as well. METHODS A retrospective study was conducted among 1154 patients (855 Jews, 195 Muslims, 52 Bedouins, 26 Druze, and 26 others) aged 1 to 21 years, who were diagnosed with ALL between 1989 and 2011 and were treated according to the same Berlin-Frankfurt-Muenster-based Israel National Study protocols. RESULTS Bedouins had a higher incidence of t(1;19) (16% vs 3% for non-Bedouins) and a lower incidence of high-hyperdiploidy (10% vs 25% for non-Bedouins) (P = 0.01). Five-year event-free survival (EFS) and overall survival (OS) were poorer for the Bedouins (60.3% ± 7.2% and 63.1% ± 7.2%, respectively) compared with the Jews, Muslims, and Druze (80.4% ± 1.4%, 77.3% ± 3.2%, and 84% ± 7.3%, respectively, for EFS [P = 0.02], and 86.3% ± 1.2%, 82.3% ± 2.9%, and 88.3% ± 6.4%, respectively, for OS [P = 0.002]). Adherence to intensive chemotherapy was similar between the Muslims and the Bedouins. CONCLUSIONS Our findings suggest that the Bedouins, a highly inbred ethnic Arab people, may be considered a higher risk group that may need more intensive chemotherapy and/or supportive care in order to improve their outcome.
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Affiliation(s)
- Ronit Elhasid
- Department of Pediatric Hemato-Oncology, Tel Aviv Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Nirel
- Department of Statistics, Hebrew University, Jerusalem, Israel
| | - Smadar Avigad
- Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Gali Avrahami
- Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Aya Abramov
- Department of Pediatric Hematology/Oncology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Dina Attias
- Department of Pediatric Hematology/Oncology, Bnei-Zion Medical Center and Faculty of Medicine, Technion, Haifa, Israel
| | - Nira Arad
- Department of Pediatric Hematology/Oncology, Rambam Medical Center, and The Bruce Rappaport Faculty of Medicine, Technion-Israel, Institute of Technology, Haifa, Israel
| | - Ami Ballin
- Department of Pediatric Hematology/Oncology, Edith Wolfson Medical Center, Holon, Israel
| | - Myriam Ben-Arush
- Department of Pediatric Hematology/Oncology, Rambam Medical Center, and The Bruce Rappaport Faculty of Medicine, Technion-Israel, Institute of Technology, Haifa, Israel
| | - Bella Bielorai
- Department of Pediatric Hematology/Oncology Chaim Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yoav Burstein
- Department of Pediatric Hemato-Oncology, Tel Aviv Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Sarah Elitzur
- Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Herzel Gabriel
- Department of Pediatric Hematology/Oncology, Ha-Emek Medical Center, Afula, Israel
| | - Michal Hameiri-Grossman
- Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joseph Kapelushnik
- Department of Pediatric Hematology/Oncology, Soroka Medical Center, Beer Sheva, Israel
| | - Dalia Sthoeger
- Department of Pediatric Hematology/Oncology, Kaplan Medical Center, Rehovot, Israel
| | - Amos Toren
- Department of Pediatric Hematology/Oncology Chaim Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Michael Wientraub
- Department of Pediatric Hematology/Oncology, Hadassah University Hospital, Hebrew University Hadassah Medical School, Jerusalem, Israel
| | - Isaac Yaniv
- Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shai Izraeli
- Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Batia Stark
- Division of Pediatric Hematology/Oncology, Schneider Children's Medical Center of Israel, Petah Tiqwa, and the Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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11
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Elitzur S, Arad-Cohen N, Barg A, Litichever N, Bielorai B, Elhasid R, Fischer S, Fruchtman Y, Gilad G, Kapelushnik J, Kharit M, Konen O, Laor R, Levy I, Raviv D, Shachor-Meyouhas Y, Shvartser-Beryozkin Y, Toren A, Yaniv I, Nirel R, Izraeli S, Barzilai-Birenboim S. Mucormycosis in children with haematological malignancies is a salvageable disease: a report from the Israeli Study Group of Childhood Leukemia. Br J Haematol 2019; 189:339-350. [PMID: 31885080 DOI: 10.1111/bjh.16329] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 06/17/2019] [Accepted: 09/04/2019] [Indexed: 12/12/2022]
Abstract
Mucormycosis has emerged as an increasingly important cause of morbidity and mortality in immunocompromised patients, but contemporary data in children are lacking. We conducted a nationwide multicentre study to investigate the characteristics of mucormycosis in children with haematological malignancies. The cohort included 39 children with mucormycosis: 25 of 1136 children (incidence 2·2%) with acute leukaemias prospectively enrolled in a centralized clinical registry in 2004-2017, and an additional 14 children with haematological malignancies identified by retrospective search of the databases of seven paediatric haematology centres. Ninety-two percent of mucormycosis cases occurred in patients with acute leukaemias. Mucormycosis was significantly associated with high-risk acute lymphoblastic leukaemia (OR 3·75; 95% CI 1·51-9·37; P = 0·004) and with increasing age (OR 3·58; 95% CI 1·24-9·77; P = 0·01). Fifteen patients (38%) died of mucormycosis. Rhinocerebral pattern was independently associated with improved 12-week survival (OR 9·43; 95% CI 1·47-60·66; P = 0·02) and relapsed underlying malignancy was associated with increased 12-week mortality (OR 6·42; 95% CI, 1·01-40·94; P = 0·05). In patients receiving frontline therapy for their malignancy (n = 24), one-year cumulative mucormycosis-related mortality was 21 ± 8% and five-year overall survival was 70 ± 8%. This largest paediatric population-based study of mucormycosis demonstrates that children receiving frontline therapy for their haematological malignancy are often salvageable.
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Affiliation(s)
- Sarah Elitzur
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nira Arad-Cohen
- Pediatric Hematology-Oncology Department, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel.,Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Assaf Barg
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Pediatric Hematology, Oncology and BMT, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Naomi Litichever
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Bella Bielorai
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Pediatric Hematology, Oncology and BMT, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Ronit Elhasid
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pediatric Hemato-Oncology, Sourasky Medical Center, Tel Aviv, Israel
| | - Salvador Fischer
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yariv Fruchtman
- Department of Pediatric Hematology-Oncology, Soroka Medical Center, Ben Gurion University, Beer Sheva, Israel
| | - Gil Gilad
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Joseph Kapelushnik
- Department of Pediatric Hematology-Oncology, Soroka Medical Center, Ben Gurion University, Beer Sheva, Israel
| | - Mira Kharit
- Department of Hematology, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Osnat Konen
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Department of Pediatric Radiology, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Ruth Laor
- Pediatric Hematology-Oncology, Bnai Zion Medical Center, Haifa, Israel
| | - Itzhak Levy
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Pediatric Infectious Disease Unit, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Dror Raviv
- Pediatric Hematology-Oncology, Hadassah Hebrew University Medical Center, Jerusalem, Israel
| | - Yael Shachor-Meyouhas
- Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.,Pediatric Infectious Disease Unit, Ruth Rappaport Children's Hospital, Rambam Health Care Campus, Haifa, Israel
| | - Yulia Shvartser-Beryozkin
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Institute of Pathology, Beilinson Hospital, Petah Tikva, Israel
| | - Amos Toren
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel.,Division of Pediatric Hematology, Oncology and BMT, The Edmond and Lily Safra Children's Hospital, Sheba Medical Center, Ramat Gan, Israel
| | - Isaac Yaniv
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Ronit Nirel
- Department of Statistics, Hebrew University, Jerusalem, Israel
| | - Shai Izraeli
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Shlomit Barzilai-Birenboim
- The Rina Zaizov Division of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, Israel.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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12
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Steinberg-Shemer O, Goldberg TA, Yacobovich J, Levin C, Koren A, Revel-Vilk S, Ben-Ami T, Kuperman AA, Zemer VS, Toren A, Kapelushnik J, Ben-Barak A, Miskin H, Krasnov T, Noy-Lotan S, Dgany O, Tamary H. Characterization and genotype-phenotype correlation of patients with Fanconi anemia in a multi-ethnic population. Haematologica 2019; 105:1825-1834. [PMID: 31558676 PMCID: PMC7327661 DOI: 10.3324/haematol.2019.222877] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Accepted: 09/25/2019] [Indexed: 12/16/2022] Open
Abstract
Fanconi anemia (FA), an inherited bone marrow failure (BMF) syndrome, caused by mutations in DNA repair genes, is characterized by congenital anomalies, aplastic anemia, high risk of malignancies and extreme sensitivity to alkylating agents. We aimed to study the clinical presentation, molecular diagnosis and genotype-phenotype correlation among patients with FA from the Israeli inherited BMF registry. Overall, 111 patients of Arab (57%) and Jewish (43%) descent were followed for a median of 15 years (range: 0.1-49); 63% were offspring of consanguineous parents. One-hundred patients (90%) had at least one congenital anomaly; over 80% of the patients developed bone marrow failure; 53% underwent hematopoietic stem-cell transplantation; 33% of the patients developed cancer; no significant association was found between hematopoietic stem-cell transplant and solid tumor development. Nearly 95% of the patients tested had confirmed mutations in the Fanconi genes FANCA (67%), FANCC (13%), FANCG (14%), FANCJ (3%) and FANCD1 (2%), including twenty novel mutations. Patients with FANCA mutations developed cancer at a significantly older age compared to patients with mutations in other Fanconi genes (mean 18.5 and 5.2 years, respectively, P=0.001); however, the overall survival did not depend on the causative gene. We hereby describe a large national cohort of patients with FA, the vast majority genetically diagnosed. Our results suggest an older age for cancer development in patients with FANCA mutations and no increased incidence of solid tumors following hematopoietic stem-cell transplant. Further studies are needed to guide individual treatment and follow-up programs.
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Affiliation(s)
- Orna Steinberg-Shemer
- Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.,Pediatric Hematology Laboratory, Felsenstein Medical Research Center, Petach Tikva
| | - Tracie A Goldberg
- Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva
| | - Joanne Yacobovich
- Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | - Carina Levin
- Pediatric Hematology Unit, Emek Medical Center, Afula.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa
| | - Ariel Koren
- Pediatric Hematology Unit, Emek Medical Center, Afula.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa
| | - Shoshana Revel-Vilk
- Pediatric Hematology/Oncology Unit, Shaare Zedek Medical Center, Jerusalem, affiliated with Hadassah- Hebrew University Medical School, Jerusalem
| | - Tal Ben-Ami
- Pediatric Hematology Unit, Kaplan Medical Center, Rehovot
| | - Amir A Kuperman
- Blood Coagulation Service and Pediatric Hematology Clinic, Galilee Medical Center, Nahariya.,Azrieli Faculty of Medicine, Bar-Ilan University, Safed
| | - Vered Shkalim Zemer
- Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva.,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv
| | - Amos Toren
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.,Department of Pediatric Hemato-Oncology, Children's Hospital (Edmond and Lily), Sheba Medical Center, Tel-Hashomer
| | - Joseph Kapelushnik
- Pediatric Hematology, Soroka University Medical Center, Ben-Gurion University, Beer Sheva
| | - Ayelet Ben-Barak
- Pediatric Hematology-Oncology Department, Rambam Medical Center, Haifa, Israel
| | - Hagit Miskin
- Pediatric Hematology/Oncology Unit, Shaare Zedek Medical Center, Jerusalem, affiliated with Hadassah- Hebrew University Medical School, Jerusalem
| | - Tanya Krasnov
- Pediatric Hematology Laboratory, Felsenstein Medical Research Center, Petach Tikva
| | - Sharon Noy-Lotan
- Pediatric Hematology Laboratory, Felsenstein Medical Research Center, Petach Tikva
| | - Orly Dgany
- Pediatric Hematology Laboratory, Felsenstein Medical Research Center, Petach Tikva
| | - Hannah Tamary
- Department of Hematology-Oncology, Schneider Children's Medical Center of Israel, Petach Tikva .,Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv.,Pediatric Hematology Laboratory, Felsenstein Medical Research Center, Petach Tikva
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13
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Abstract
Spermatogenesis is the process of the proliferation and differentiation of spermatogonial stem cells (SSCs) to generate sperm. Leukemia patients show impairment in some of the endocrine hormones that are involved in spermatogenesis. They also show a decrease in semen parameters before and after thawing of cryopreserved samples compared to a control. The mechanisms behind these effects have not yet been described. This review summarizes the effect of leukemia on semen parameters from adult patients and highlights feasible suggested mechanisms that may affect impairment of spermatogenesis in these patients. We suggest the possible involvement of leukemia in disturbing hormones involved in spermatogenesis, and the imbalance in testicular paracrine/autocrine factors involved in the formation of SSC niches that control their proliferation and differentiation. Understanding the mechanisms of leukemia in the impairment of spermatogenesis may lead to the development of novel therapeutic strategies mainly for prepubertal boys who do not yet produce sperm.
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Affiliation(s)
- Yulia Michailov
- a The Shraga Segal Dept. of Microbiology, Immunology, and Genetics , Ben-Gurion University of the Negev , Beer-Sheva , Israel.,b The Center of Advanced Research and Education in Reproduction (CARER) , Ben-Gurion University of the Negev , Beer-Sheva , Israel.,c Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer-Sheva , Israel.,d IVF Unit , Barzilai Medical Center , Ashkelon , Israel
| | - Eitan Lunenfeld
- b The Center of Advanced Research and Education in Reproduction (CARER) , Ben-Gurion University of the Negev , Beer-Sheva , Israel.,c Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer-Sheva , Israel.,e Department of Obstetrics and Gynaecology , Soroka Medical Center , Beer-Sheva , Israel
| | - Joseph Kapelushnik
- b The Center of Advanced Research and Education in Reproduction (CARER) , Ben-Gurion University of the Negev , Beer-Sheva , Israel.,c Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer-Sheva , Israel.,f Department of Pediatric Oncology and Department of Hematology , Soroka Medical Center , Beer-Sheva , Israel
| | - Mahmoud Huleihel
- a The Shraga Segal Dept. of Microbiology, Immunology, and Genetics , Ben-Gurion University of the Negev , Beer-Sheva , Israel.,b The Center of Advanced Research and Education in Reproduction (CARER) , Ben-Gurion University of the Negev , Beer-Sheva , Israel.,c Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer-Sheva , Israel.,g The National Institute for Biotechnology in the Negev , Beer-Sheva , Israel
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14
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AbuMadighem A, Solomon R, Stepanovsky A, Kapelushnik J, Shi Q, Meese E, Lunenfeld E, Huleihel M. Development of Spermatogenesis In Vitro in Three-Dimensional Culture from Spermatogonial Cells of Busulfan-Treated Immature Mice. Int J Mol Sci 2018; 19:ijms19123804. [PMID: 30501072 PMCID: PMC6321353 DOI: 10.3390/ijms19123804] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 11/20/2018] [Accepted: 11/24/2018] [Indexed: 01/22/2023] Open
Abstract
Aggressive chemotherapy may lead to permanent male infertility. Prepubertal males do not generate sperm, but their testes do contain spermatogonial cells (SPGCs) that could be used for fertility preservation. In the present study, we examined the effect of busulfan (BU) on the SPGCs of immature mice, and the possible induction of the survivor SPGCs to develop spermatogenesis in 3D in-vitro culture. Immature mice were injected with BU, and after 0.5⁻12 weeks, their testes were weighed and evaluated histologically compared to the control mice. The spermatogonial cells [Sal-like protein 4 (SALL4) and VASA (a member of the DEAD box protein family) in the testicular tissue were counted/seminiferous tubule (ST). The cells from the STs were enzymatically isolated and cultured in vitro. Our results showed a significant decrease in the testicular weight of the BU-treated mice compared to the control. This was in parallel to a significant increase in the number of severely damaged STs, and a decrease in the number of SALL4 and VASA/STs compared to the control. The cultures of the isolated cells from the STs of the BU-treated mice showed a development of colonies and meiotic and post-meiotic cells after four weeks of culture. The addition of homogenates from adult GFP mice to those cultures induced the development of sperm-like cells after four weeks of culture. This is the first study demonstrating the presence of biologically active spermatogonial cells in the testicular tissue of BU-treated immature mice, and their capacity to develop sperm-like cells in vitro.
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Affiliation(s)
- Ali AbuMadighem
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Beer-Sheva 84105, Israel.
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Beer-Sheva 8410501, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
| | - Ronnie Solomon
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Beer-Sheva 84105, Israel.
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Beer-Sheva 8410501, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
| | - Alina Stepanovsky
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Beer-Sheva 84105, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
| | - Joseph Kapelushnik
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Beer-Sheva 8410501, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
- Department of Pediatric Oncology and Department of Hematology, Soroka University Medical Center, Beer-Sheva 8410501, Israel.
| | - QingHua Shi
- Molecular and Cell Genetics Laboratory, The CAS Key Laboratory of Innate Immunity and Chronic Disease, Hefei National Laboratory for Physical Sciences at Microscale and School of Life Sciences, University of Science and Technology of China, Hefei 230000, China.
| | - Eckart Meese
- Institute of Human Genetics, Saarland University, Homburg/Saar, 66421 Homburg, Germany.
| | - Eitan Lunenfeld
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Beer-Sheva 8410501, Israel.
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer-Sheva 8410501, Israel.
- Fertility and IVF Unit and Department of Obstetrics and Gynecology, Soroka University Medical Center, Beer-Sheva 8410501, Israel.
| | - Mahmoud Huleihel
- The Shraga Segal Department of Microbiology, Immunology, and Genetics, Beer-Sheva 84105, Israel.
- The Center of Advanced Research and Education in Reproduction (CARER), Faculty of Health Sciences, Beer-Sheva 8410501, Israel.
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15
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Abofoul-Azab M, AbuMadighem A, Lunenfeld E, Kapelushnik J, Shi Q, Pinkas H, Huleihel M. Development of Postmeiotic Cells In Vitro from Spermatogonial Cells of Prepubertal Cancer Patients. Stem Cells Dev 2018; 27:1007-1020. [PMID: 29779447 DOI: 10.1089/scd.2017.0301] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Aggressive chemotherapy in childhood often results in testicular damage and consequently jeopardizes future fertility. The presence of spermatogonial cells (SPGCs) in the testes of prepubertal cancer patient boys (PCPBs) can be used to develop future strategies for male fertility preservation. In the present study, we examined the presence of SPGCs in testes of chemotherapy-treated PCPBs and their ability to develop spermatogenesis in vitro using a three-dimensional culture system. Seven testicular biopsies were obtained from chemotherapy-treated PCPBs and one from a patient with β-thalassemia major. Isolated testicular cells were cultured in a methylcellulose culture system (MCS)-containing StemPro enriched with growth factors for 5-15 weeks. The presence of premeiotic, meiotic, and postmeiotic cells was examined by immunofluorescence staining and/or reverse transcription-polymerase chain reaction (RT-PCR) analysis. We observed SPGCs in the examined testicular biopsies. Isolated testicular cells cultured in MCS developed into colonies and contained premeiotic, meiotic, and postmeiotic cells. Furthermore, we identified sperm-like cells that had developed from testicular cells of a PCPB. Our results demonstrate, for the first time, the presence of biologically active SPGCs in testicular biopsies of chemotherapy-treated PCPBs and their capacity to develop in vitro to different stages of spermatogenesis, including the generation of sperm-like cells. This study may open the way for new therapeutic strategies for fertility preservation of PCPBs and for azoospermic patients.
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Affiliation(s)
- Maram Abofoul-Azab
- 1 The Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev , Beer-Sheva, Israel .,2 The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev , Beer-Sheva, Israel .,3 Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel
| | - Ali AbuMadighem
- 1 The Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev , Beer-Sheva, Israel .,2 The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev , Beer-Sheva, Israel .,3 Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel
| | - Eitan Lunenfeld
- 2 The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev , Beer-Sheva, Israel .,3 Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel .,4 Fertility and IVF Unit, Department of Obstetrics and Gynecology, Soroka University Medical Center , Beer-Sheva, Israel
| | - Joseph Kapelushnik
- 2 The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev , Beer-Sheva, Israel .,3 Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel .,5 Department of Pediatric Oncology, Soroka University Medical Center , Beer-Sheva, Israel .,6 Department of Hematology, Soroka University Medical Center , Beer-Sheva, Israel
| | - QingHua Shi
- 7 Molecular and Cell Genetics Laboratory, The CAS Key Laboratory of Innate Immunity and Chronic Disease, Hefei National Laboratory for Physical Sciences at Microscale and School of Life Sciences, University of Science and Technology of China , Hefei, China
| | - Haim Pinkas
- 8 Male Infertility and Sperm Bank, Helen Schneider Hospital for Women, Rabin Medical Center , Beilinson Hospital, Petach Tikva, Israel
| | - Mahmoud Huleihel
- 1 The Shraga Segal Department of Microbiology, Immunology and Genetics, Ben-Gurion University of the Negev , Beer-Sheva, Israel .,2 The Center of Advanced Research and Education in Reproduction (CARER), Ben-Gurion University of the Negev , Beer-Sheva, Israel .,3 Faculty of Health Sciences, Ben-Gurion University of the Negev , Beer-Sheva, Israel
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16
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Agbaria AH, Beck Rosen G, Lapidot I, Rich DH, Huleihel M, Mordechai S, Salman A, Kapelushnik J. Differential Diagnosis of the Etiologies of Bacterial and Viral Infections Using Infrared Microscopy of Peripheral Human Blood Samples and Multivariate Analysis. Anal Chem 2018; 90:7888-7895. [PMID: 29869874 DOI: 10.1021/acs.analchem.8b00017] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Human viral and bacterial infections are responsible for a variety of diseases that are still the main causes of death and economic burden for society across the globe. Despite the different responses of the immune system to these infections, some of them have similar symptoms, such as fever, sneezing, inflammation, vomiting, diarrhea, and fatigue. Thus, physicians usually encounter difficulties in distinguishing between viral and bacterial infections on the basis of these symptoms. Rapid identification of the etiology of infection is highly important for effective treatment and can save lives in some cases. The current methods used for the identification of the nature of the infection are mainly based on growing the infective agent in culture, which is a time-consuming (over 24 h) and usually expensive process. The main objective of this study was to evaluate the potential of the mid-infrared spectroscopic method for rapid and reliable identification of bacterial and viral infections based on simple peripheral blood samples. For this purpose, white blood cells (WBCs) and plasma were isolated from the peripheral blood samples of patients with confirmed viral or bacterial infections. The obtained spectra were analyzed by multivariate analysis: principle component analysis (PCA) followed by linear discriminant analysis (LDA), to identify the infectious agent type as bacterial or viral in a time span of about 1 h after the collection of the blood sample. Our preliminary results showed that it is possible to determine the infectious agent with high success rates of 82% for sensitivity and 80% for specificity, based on the WBC data.
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Affiliation(s)
- Adam H Agbaria
- Department of Physics , Ben-Gurion University , Beer-Sheva 84105 , Israel
| | - Guy Beck Rosen
- Department of Pediatric Hematology/Oncology , Soroka University Medical Center , Beer-Sheva 84105 , Israel
| | - Itshak Lapidot
- Department of Electrical and Electronics Engineering, ACLP-Afeka Center for Language Processing , Afeka Tel-Aviv Academic College of Engineering , Tel-Aviv 69107 , Israel
| | - Daniel H Rich
- Department of Physics , Ben-Gurion University , Beer-Sheva 84105 , Israel
| | - Mahmoud Huleihel
- Department of Microbiology, Immunology and Genetics, Faculty of Health Sciences , Ben-Gurion University of the Negev , Beer-Sheva 84105 , Israel
| | - Shaul Mordechai
- Department of Physics , Ben-Gurion University , Beer-Sheva 84105 , Israel
| | - Ahmad Salman
- Department of Physics , SCE-Sami Shamoon College of Engineering , Beer-Sheva 84100 , Israel
| | - Joseph Kapelushnik
- Department of Pediatric Hematology/Oncology , Soroka University Medical Center , Beer-Sheva 84105 , Israel
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David O, Fruchtman Y, Sergienko R, Kapelushnik J, Leibovitz E. The Infectious and Noninfectious Etiology, Clinical Picture and Outcome of Neutropenia in Immunocompetent Hospitalized Children. Pediatr Infect Dis J 2018; 37:570-575. [PMID: 29319583 DOI: 10.1097/inf.0000000000001893] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND Acquired neutropenia in immunocompetent children is common, and its differential diagnosis ranges from benign causes to life-threatening diseases. We described the etiology, clinical picture and outcome of new-onset neutropenia in immunocompetent children assessed in the emergency department and hospitalized at our medical center. METHODS Previously healthy children admitted with neutropenia (absolute neutrophil count <1.5 × 10(9)/L) were included. Serious bacterial infections were defined as culture-positive blood, urine, cerebrospinal fluid, articular fluid or stool infections, pneumonia, Brucellosis and Rickettsiosis. RESULTS A total of 601 patients (5 days-202 months old) were enrolled; 3 (0.5%), 48 (8%), 165 (27.5%) and 385 (64%) had absolute neutrophil counts <0.2, 0.2-0.5, 0.5-1.0 and 1.0-1.5 × 10(9)/L, respectively. Associated leukopenia and thrombocytopenia were diagnosed in 186 (39%) and 71 (11.8%) patients. Three hundred sixteen of 601 (52.6%) and 519 of 601 (86.4%) were <2 or 36 months of age, respectively. Fever at admission was present in 27.6% patients. Serious bacterial infections were diagnosed in 106 (17.6%) patients. Brucellosis and rickettsiosis were diagnosed in 8 of 52 (15.4%) and 9 of 39 (23.1%) tests obtained. Respiratory syncytial virus was diagnosed in 17 of 33 (51.5%) nasal washes. An infectious etiology was determined in 171 (28.5%) patients. Acute leukemia was diagnosed in 6 patients. A significant correlation was found between resolution of neutropenia and patient age, infectious etiology and severity of neutropenia. CONCLUSIONS (1) Severe neutropenia was rare; (2) More than half of patients were <2 months of age; (3) An infectious etiology was diagnosed in a high number of patients, and serious bacterial infections were frequent and (4) Brucella spp. and rickettsial infections were frequent etiologies associated with neutropenia in our setting.
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Affiliation(s)
- Odeya David
- From the Pediatric Hematology/Oncology Department.,Soroka University Medical Center, Beer-Sheva, Israel.,Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Yariv Fruchtman
- From the Pediatric Hematology/Oncology Department.,Soroka University Medical Center, Beer-Sheva, Israel.,Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ruslan Sergienko
- Public Health Department.,Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Joseph Kapelushnik
- From the Pediatric Hematology/Oncology Department.,Soroka University Medical Center, Beer-Sheva, Israel.,Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Eugene Leibovitz
- Pediatric Infectious Disease Unit, Soroka University Medical Center, Beer-Sheva, Israel.,Soroka University Medical Center, Beer-Sheva, Israel.,Ben-Gurion University of the Negev, Beer-Sheva, Israel
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18
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Schneider S, Kapelushnik J, Kraus M, El Saied S, Levi I, Kaplan DM. The association between otogenic lateral sinus thrombosis and thrombophilia - A long-term follow-up. Am J Otolaryngol 2018. [PMID: 29530427 DOI: 10.1016/j.amjoto.2018.03.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
PURPOSE Otogenic lateral sinus thrombosis (OLST) is an intracranial, potentially life-threatening complication of acute and chronic otitis media. Since congenital thrombophilic disorders are risk factors for cerebral venous thrombosis, OLST may be related to thrombophilia. The aim of our study was twofold: to evaluate whether patients who suffered from OLST in childhood also have thrombophilia, and whether these patients experienced thromboembolic episodes in future years. STUDY DESIGN Retrospective case series. METHODS The medical charts of all children hospitalized for OLST at Soroka University Medical Center of Israel, a tertiary referral hospital, from January 1983 to September 2014 were reviewed. The patients were invited for a follow-up visit and comprehensive medical history was taken along with a physical examination and laboratory work-up for thrombophilia. MAIN FINDINGS Seven patients were included in the study. Of these, 3 (43%) had results suggesting thrombophilic disorders manifested by elevated levels of factor IX and decreased levels of protein S activity (n = 1), decreased levels of proteins C and S activity (n = 1), and elevated levels of antibodies to cardiolipin (n = 1). No patients experienced clear thrombophilic events; however, 2 patients (29%) with later proven thrombophilia suffered neurologic sequelae, possibly suggesting thrombophilic events. CONCLUSIONS Pediatric OLST secondary to acute otitis media and mastoiditis may reflect an underlying thrombophilia. Laboratory work-up for thrombophilia should be performed, and anticoagulant treatment may be warranted in managing these patients.
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Imterat M, Wainstock T, Sheiner E, Kapelushnik J, Walfisch A. 146: Advanced maternal age and the risk for long-term malignant morbidity in the offspring. Am J Obstet Gynecol 2018. [DOI: 10.1016/j.ajog.2017.10.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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20
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Kenet G, Waldman D, Lubetsky A, Kornbrut N, Khalil A, Koren A, Wolach B, Fattal A, Kapelushnik J, Tamary H, Yacobovitch J, Raveh E, Revel-Vilk S, Toren A, Brenner B. Paediatric cerebral sinus vein thrombosis. Thromb Haemost 2017; 92:713-8. [PMID: 15467900 DOI: 10.1160/th04-03-0182] [Citation(s) in RCA: 55] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
SummaryThe etiology and pathophysiology of cerebral sinus venous thrombosis (CSVT) in the paediatric population is still poorly understood, and the role of thrombophilic risk factors remains to be elucidated. In our multi-center case-controlled study we studied 46 patients with CSVT diagnosed from April 1996 to December 2003, consecutively referred for thrombophilia work-up. The results of thrombophilia screen were compared to 112 healthy paediatric controls. Anticoagulant therapy was applied according to treating physicians’ decisions, and all cases were prospectively followed for a median of 4.1 years. Of 46 children, 8 had CSVT diagnosed in the neonatal period and therefore were analyzed separately. The prevalence of single thrombophilia markers and combinations of thrombophilic risk factors were similar among cases and controls. Among children with CSVT co-morbid systemic illness was present in most patients at diagnosis. Seven out of 8 children with idiopathic CSVT had thrombophilic risk factors as compared to 31/38 patients with co-morbid conditions. Anticoagulation was initiated in most patients, 11/46 patients continued therapy for a total of one year or more post event. Neither clinical presentation nor initial treatment decisions were affected by presence of thrombophilic risk factors in our study group. Thrombophilia prevalence was not increased in children with CSVT as compared to controls, however thrombophilia was more frequent among children with idiopathic CSVT. Thus, those selected patients would benefit most from thrombophilia work-up, required for long-term therapy considerations.
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Affiliation(s)
- Gili Kenet
- The Israeli National Hemophilia Center, Sheba Medical Center, Tel-Hashomer, 52621, Israel.
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Resnitzky P, Shaft D, Shalev H, Kapelushnik J, Dgany O, Krasnov T, Tamary H. Morphological features of congenital dyserythropoietic anemia type I: The role of electron microscopy in diagnosis. Eur J Haematol 2017; 99:366-371. [DOI: 10.1111/ejh.12931] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/21/2017] [Indexed: 10/19/2022]
Affiliation(s)
- Peretz Resnitzky
- Efrati Research Laboratory for Blood Cells and Cytology; Kaplan Medical Center; Rehovot Israel
- Hebrew University School of Medicine; Jerusalem Israel
| | - Dina Shaft
- Efrati Research Laboratory for Blood Cells and Cytology; Kaplan Medical Center; Rehovot Israel
| | - Hanna Shalev
- Pediatric Division; Soroka Medical Center; Beer Sheva Israel
- Faculty of Medicine; Ben-Gurion University; Beer Sheva Israel
| | - Joseph Kapelushnik
- Faculty of Medicine; Ben-Gurion University; Beer Sheva Israel
- Department of Pediatric Hematology-Oncology; Soroka Medical Center; Beer Sheva Israel
| | - Orly Dgany
- Pediatric Hematology Laboratory; Felsenstein Medical Research Center; Beilinson Hospital; Petach Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
| | - Tanya Krasnov
- Pediatric Hematology Laboratory; Felsenstein Medical Research Center; Beilinson Hospital; Petach Tikva Israel
| | - Hannah Tamary
- Pediatric Hematology Laboratory; Felsenstein Medical Research Center; Beilinson Hospital; Petach Tikva Israel
- Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv Israel
- Hematology Unit; Schneider Children's Medical Center of Israel; Petach Tikva Israel
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22
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Kapelushnik J, Weiss L, Pappo O, Okon E, Or R. Thalidomide does not interfere with graft-versus-leukemia reactivity in mice. J Oncol Pharm Pract 2016. [DOI: 10.1177/107815529900500403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Objective. To determine whether thalidomide is an effective prophylactic agent against acute graft-versus-host disease (GVHD) and whether it exerts an effect on graft-versus-leukemia (GVL) reactivity, the drug was administered to leukemic mice that were exposed to allogeneic bone marrow transplantation. Methods. Mice (BALB/c 3 C57BL/6) F1 were inoculated with 107 B cell leukemia cells (BCL1) and conditioned with total body irradiation followed by reconstitution with bone marrow plus splenic cells harvested from C57BL/6 mice. After transplant, mice were treated with oral thalidomide (20 mg/kg/day) for a period of 10 days. Results. Stable chimerism was documented in all recipients with $73% (mean) donor-type C57 cells. In this semi-allogeneic murine model, thalidomide failed to prevent or alleviate the acute GVHD symptoms; however, the drug did not impair GVL reactivity. The antileukemia allogeneic effect was similar in the thalidomide and non-thalidomide-treated animals. Comparison of the GVL reactivity occurring in the allogeneically transplanted groups with that in the syngeneic recipients revealed a significant difference ( P 5 0.001). Conclusions. Although thalidomide did not exert any effect against acute GVHD, the fact that the GVL reactivity was spared holds promise for its use as a treatment modality in chronic GVHD.
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Affiliation(s)
- Joseph Kapelushnik
- Department of Bone Marrow Transplantation and Cancer Immunobiology Research Laboratory, Hadassah University Hospital, Jerusalem, Israel
| | - Lola Weiss
- Department of Bone Marrow Transplantation and Cancer Immunobiology Research Laboratory, Hadassah University Hospital, Jerusalem, Israel
| | - Orit Pappo
- Department of Pathology, Hebrew University-Hadassah Medical School and Hadassah University Hospital, Jerusalem, Israel
| | - Eliezer Okon
- Department of Pathology, Hebrew University-Hadassah Medical School and Hadassah University Hospital, Jerusalem, Israel
| | - Reuven Or
- Department of Bone Marrow Transplantation and Cancer Immunobiology Research Laboratory, Hadassah University Hospital, Jerusalem, Israel
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23
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Barlev E, Zelig U, Bar O, Segev C, Mordechai S, Kapelushnik J, Nathan I, Flomen F, Kashtan H, Dickman R, Madhala-Givon O, Wasserberg N. A novel method for screening colorectal cancer by infrared spectroscopy of peripheral blood mononuclear cells and plasma. J Gastroenterol 2016; 51:214-21. [PMID: 26112122 DOI: 10.1007/s00535-015-1095-7] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2015] [Accepted: 06/04/2015] [Indexed: 02/04/2023]
Abstract
BACKGROUND Early detection of colorectal cancer (CRC) can reduce mortality and morbidity. Current screening methods include colonoscopy and stool tests, but a simple low-cost blood test would increase compliance. This preliminary study assessed the utility of analyzing the entire bio-molecular profile of peripheral blood mononuclear cells (PBMCs) and plasma using Fourier transform infrared (FTIR) spectroscopy for early detection of CRC. METHODS Blood samples were prospectively collected from 62 candidates for CRC screening/diagnostic colonoscopy or surgery for colonic neoplasia. PBMCs and plasma were separated by Ficoll gradient, dried on zinc selenide slides, and placed under a FTIR microscope. FTIR spectra were analyzed for biomarkers and classified by principal component and discriminant analyses. Findings were compared among diagnostic groups. RESULTS Significant changes in multiple bands that can serve as CRC biomarkers were observed in PBMCs (p = ~0.01) and plasma (p = ~0.0001) spectra. There were minor but statistically significant differences in both blood components between healthy individuals and patients with benign polyps. Following multivariate analysis, the healthy individuals could be well distinguished from patients with CRC, and the patients with benign polyps were mostly distributed as a distinct subgroup within the overlap region. Leave-one-out cross-validation for evaluating method performance yielded an area under the receiver operating characteristics curve of 0.77, with sensitivity 81.5% and specificity 71.4%. CONCLUSIONS Joint analysis of the biochemical profile of two blood components rather than a single biomarker is a promising strategy for early detection of CRC. Additional studies are required to validate our preliminary clinical results.
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Affiliation(s)
- Eyal Barlev
- Department of Surgery B, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Udi Zelig
- Todos Medical Ltd, 1 HaMada St, 76703, Rehovot, Israel.
| | - Omri Bar
- Todos Medical Ltd, 1 HaMada St, 76703, Rehovot, Israel
| | - Cheli Segev
- Todos Medical Ltd, 1 HaMada St, 76703, Rehovot, Israel
| | - Shaul Mordechai
- Department of Physics, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Joseph Kapelushnik
- Pediatric Hemato-Oncology Unit, Soroka University Medical Center, Beer-Sheva, Israel
- Faculty of Medicine, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Ilana Nathan
- Department of Clinical Biochemistry, Ben-Gurion University of the Negev, Beer-Sheva, Israel
- Institute of Hematology, Soroka University Medical Center, Beer-Sheva, Israel
| | - Felix Flomen
- Todos Medical Ltd, 1 HaMada St, 76703, Rehovot, Israel
| | - Hanoch Kashtan
- Division of General Surgery, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
| | - Ram Dickman
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Gastroenterology, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
| | - Osnat Madhala-Givon
- Department of Surgery B, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Nir Wasserberg
- Department of Surgery B, Rabin Medical Center, Beilinson Campus, Petach Tikva, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
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24
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Huleihel M, Azab M, Kapelushnik J, Lunenfeld E. Fertility preservation of pre-pubertal cancer patient boys before aggressive chemotherapy. peliminary results from in vitro cultue of fresh testicular tissue from three pre-pubertal patients. Fertil Steril 2013. [DOI: 10.1016/j.fertnstert.2013.07.1876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kapelushnik J, Zelig A, Geffen DB, Gusakova I, Mordichai S. Detection of solid tumors by infrared biochemical analysis of peripheral blood mononuclear cells. J Clin Oncol 2013. [DOI: 10.1200/jco.2013.31.15_suppl.e22069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22069 Background: Detection of malignancies such as breast, colorectal and lung at early stages can improve survival rates from 20% up to 80%. Over the past few years, great efforts have been taken to develop novel, non invasive and effective methods for early diagnosis of cancer; however, a low sensitivity and/or specificity, has prevented their introduction as methods for early detection of cancer in populations at risk Methods: The clinical study was conducted at Todos Medical Ltd., Ben-Gurion University of the Negev and Soroka University Medical Center. 2 ml of peripheral blood was collected from each of 67 cancer patients (breast 26; gastrointestinal 27; lung 13; other 11) and 46 healthy controls. Peripheral blood mononuclear cells (PBMC) were extracted from whole blood and measured under Fourier transformed infrared microscope spectroscopy(FTIR-MSP). The differences between spectra of cancer and controls subjects' PBMCs were analyzed. Results: Significant differences were observed between healthy subjects and cancer patients at multiple bands along the infrared spectra of the PBMCs. Furthermore, we observed a distinct spectral pattern for each type of cancer which may indicate a difference in composition and activity of PBMC population. Several absorption bands may indicate for the stage of the disease.with sensitivity of 84% and specificity 94%. Conclusions: This study suggests the potential of FTIR spectroscopy analysis as a simple, low cost and minimally invasive method for cancer detection. The present research is preliminary and additional clinical trials are required for further validation and verification.
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Affiliation(s)
- Joseph Kapelushnik
- Soroka Medical Center and Ben-Gurion University of the Negev, Beersheba, Israel
| | | | - David Barry Geffen
- Soroka Medical Center and Ben-Gurion University of the Negev, Beersheba, Israel
| | - Irena Gusakova
- Soroka Medical Center and Ben-Gurion University of the Negev, Beersheba, Israel
| | - S. Mordichai
- Ben-Gurion University of the Negev, Beer- Sheva, Israel
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Shalev H, Landau D, Pissard S, Krasnov T, Kapelushnik J, Gilad O, Broides A, Dgany O, Tamary H. A novel epsilon gamma delta beta thalassemia presenting with pregnancy complications and severe neonatal anemia. Eur J Haematol 2013. [DOI: 10.1111/ejh.12047] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Hanna Shalev
- Pediatric Division; Soroka University Medical Center; Beer Sheva; Israel
| | - Daniela Landau
- Pediatric Division; Soroka University Medical Center; Beer Sheva; Israel
| | - Serge Pissard
- Laboratory of Biochemistry and Genetics, Henri Mondor and UPEC; Creteil; France
| | - Tanya Krasnov
- Pediatric Hematology Laboratory, Felsenstein Medical Research Center, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University; Tel Aviv; Israel
| | - Joseph Kapelushnik
- Pediatric Division; Soroka University Medical Center; Beer Sheva; Israel
| | - Oded Gilad
- Department of Pediatrics B; Schneider Children's Medical Center of Israel, Petach Tikva and Sackler Faculty of Medicine, Tel Aviv University; Tel Aviv; Israel
| | - Arnon Broides
- Pediatric Division; Soroka University Medical Center; Beer Sheva; Israel
| | - Orly Dgany
- Laboratory of Biochemistry and Genetics, Henri Mondor and UPEC; Creteil; France
| | - Hannah Tamary
- Department of Hematology-Oncology; Schneider Children's Medical Center of Israel; Petach Tikva and Sackler Faculty of Medicine; Tel Aviv University; Tel Aviv; Israel
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27
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Shalev H, Perez-Avraham G, Kapelushnik J, Levi I, Rabinovich A, Swinkels DW, Brasse-Lagnel C, Tamary H. High levels of soluble serum hemojuvelin in patients with congenital dyserythropoietic anemia type I. Eur J Haematol 2012; 90:31-6. [PMID: 23095116 DOI: 10.1111/ejh.12027] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/11/2012] [Indexed: 12/13/2022]
Abstract
OBJECTIVE Congenital dyserythropoietic anemia (CDA) is a rare group of red blood cell disorders with ineffective erythropoiesis and secondary hemochromatosis. Inappropriate suppression of hepcidin and high levels of growth differentiation factor 15 (GDF15) have been described in CDA I and II patients, probably contributing to secondary hemochromatosis. Hemojuvelin (HJV) is an important regulator of serum hepcidin, while soluble form of HJV (s-HJV) competitively down-regulates hepcidin. METHODS We determined the soluble hemojuvelin (s-HJV) levels in 17 patients with CDA I and in 17 healthy volunteers (HV) and looked for correlations with other parameters of iron overload and erythropoiesis. RESULTS Significantly higher levels of s-HJV were found in patients (2.32 ± 1.40 mg/L) compared with healthy volunteers (0. 69 ± 0.44 mg/L) (P = 0.001). Western blot analysis confirmed the presence of high levels of s-HJV in CDA I patients. s-HJV positively correlated with serum ferritin, erythropoietin, soluble transferrin receptor, and GDF15 and negatively correlated with hepcidin to ferritin ratios. CONCLUSIONS We for the first time documented high levels of serum s-HJV in CDA I patients, suggesting that it may contribute to iron loading pathology in CDA I and eventually in other anemias with ineffective erythropoiesis.
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Affiliation(s)
- Hanna Shalev
- Hematology Department, Soroka Medical Center, Faculty of Medicine, Ben-Gurion University, Beer Sheva, Israel
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Leibson T, Ben-Shimol S, Hazan G, Fruchtman Y, Kapelushnik J, Greenberg D. [Microbiological characteristics of pathogens causing bacteremia among hospitalized pediatric oncology patients with fever and neutropenia]. Harefuah 2012; 151:592-604. [PMID: 23316669] [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] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Bacterial infections are a major threat to pediatric oncology patients with fever and neutropenia. Current management consists of empiric broad-spectrum antibiotics and prompt medical evaluation. Local bacterial susceptibility rates were published in 2005, and the local protocol (piperacillin and amikacin) was established as an adequate empiric treatment with -100% efficiency against the common pathogens in our pediatric hemato-oncology ward. AIM To characterize the spectrum of bacteria isolated from blood cultures at the pediatric hemato-oncology ward between 2008- 2010, and to evaluate the current protocol. METHODS A prospective study, conducted in the pediatric hemato-oncologic ward among hospitalized children (2 months - 18 years) with fever and neutropenia. Blood cultures from peripheral blood and central lines were obtained from all patients at admission. Bacterial resistance to various antimicrobial agents was determined. RESULTS During 2008-2010, 195 admissions (105 children) due to fever and neutropenia were recorded. Approximately 30% of all blood cultures were positive for a pathogen with -50% Gram positive bacteria mostly CONS. The most prevalent Gram negative bacteria were acinetobacter and klebsiella spp. Candida species were isolated from 7% of positive cultures. Susceptibility rates for the current empiric antimicrobial regimen were about 90%. CONS bacteremia rate increased from 4% in 2000-2002 to 29% in 2008-2010 (p < 0.01). CONCLUSIONS The currently applied empiric antimicrobial protocol is an optimal first line regimen, considering the susceptibility of the most common pathogens. Judicious use of carbapenems for gram negative bacteria and glycopeptides or other novel antimicrobial agents in cases of CONS bacteremia is required.
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Affiliation(s)
- Tom Leibson
- Pediatric Infectious Diseases Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev
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Manor E, Kapelushnik J, Brennan PA, Bodner L. Chromosomal aberrations in primary Ewing sarcoma of the mandible. Br J Oral Maxillofac Surg 2012; 50:574-6. [DOI: 10.1016/j.bjoms.2011.09.016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2011] [Accepted: 09/21/2011] [Indexed: 11/30/2022]
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Newman N, Issa A, Greenberg D, Kapelushnik J, Cohen Z, Leibovitz E. Central venous catheter-associated bloodstream infections. Pediatr Blood Cancer 2012; 59:410-4. [PMID: 22535579 DOI: 10.1002/pbc.24135] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2012] [Accepted: 02/21/2012] [Indexed: 01/12/2023]
Abstract
BACKGROUND To investigate the epidemiologic and microbiological aspects of long-term central vein catheter (CVC)-associated bloodstream infections (CABSI) in children <18 years old treated at the hemato-oncology unit during 1998-2008. PATIENTS AND METHODS The two long-term access devices used were Hickman and Port-A-Cath catheters. Information retrieved included demographic data, baseline pathologies, methods of insertion, anatomical insertion sites, duration of use, microbiological, and antibiotic susceptibility data and outcome. RESULTS There were 178 CABSI episodes; average number of episodes/1,000 catheter days was 4.7. More CABSI episodes were recorded among patients with Hickman catheter than in patients with Port-A-Cath catheter (5.05 vs. 3.57/1,000 catheter days, P = 0.059). The CVC was removed due to BSI in 52/178 (29.2%) episodes. Overall, 243 pathogens were isolated (144 Gram-negative, 92 Gram-positive, and 7 Candida spp). More Enterobacteriaceae spp. were isolated in CABSI in patients with Hickman catheters than in patients with Port-A-Cath catheters (35/103, 34%, vs. 10/65, 15%, P = 0.008); more coagulase-negative staphylococci were isolated in patients with Port-A-Cath catheters than in patients with Hickman catheters (25/65, 38.5%, vs. 23/103, 22.3%, P = 0.02). No differences in pathogen distribution were found between CABSI recorded for jugular versus subclavian veins, open versus close inserted-CVC or for CVC requiring removal versus those treated conservatively. No fatalities directly related to CABSI were recorded. CONCLUSIONS CABSI rates were higher in patients with Hickman catheters compared with those with Port-A-Cath catheters; Gram-negative organisms were the dominant etiologic agents of CABSI; CABSI in patients with Hickman catheters had different etiologies compared with patients with Port-A-Cath catheters.
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Affiliation(s)
- Nitza Newman
- Pediatric Surgery Department, Faculty of Health Sciences, Soroka University Medical Center, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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Manor E, Kapelushnik J, Joshua BZ, Bodner L. Metastatic neuroblastoma of the mandible: a cytogenetic and molecular genetic study. Eur Arch Otorhinolaryngol 2011; 269:1967-71. [DOI: 10.1007/s00405-011-1863-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2011] [Accepted: 11/22/2011] [Indexed: 12/18/2022]
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van den Akker M, Zudekov V, Moser A, Kapelushnik J. An osseous lesion in a 10-year-old boy with Hodgkin's lymphoma: a case report. J Med Case Rep 2011; 5:511. [PMID: 21982527 PMCID: PMC3206865 DOI: 10.1186/1752-1947-5-511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2011] [Accepted: 10/08/2011] [Indexed: 11/10/2022] Open
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33
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Zelig U, Mordechai S, Shubinsky G, Sahu RK, Huleihel M, Leibovitz E, Nathan I, Kapelushnik J. Pre-screening and follow-up of childhood acute leukemia using biochemical infrared analysis of peripheral blood mononuclear cells. Biochim Biophys Acta Gen Subj 2011; 1810:827-35. [DOI: 10.1016/j.bbagen.2011.06.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2011] [Revised: 06/13/2011] [Accepted: 06/15/2011] [Indexed: 01/17/2023]
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Katz OB, Ben Barak A, Abrahami G, Arad N, Burstein Y, Dvir R, Fischer S, Kapelushnik J, Kaplinsky H, Toren A, Vilk-Revel S, Weintraub M, Yaniv I, Linn S, Futerman B, Ben-Arush MW. Treatment of T cell lymphoblastic lymphoma in children and adolescents: Israel Society of Pediatric Hematology Oncology retrospective study. Isr Med Assoc J 2011; 13:161-165. [PMID: 21608337] [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] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Survival in T cell lymphoblastic lymphoma has improved over the past 30 years, largely due to treatment protocols derived from regimens designed for children with acute lymphoblastic leukemia. OBJECTIVES To assess the outcome of the NHL-BFM-95 protocol in children and adolescents hospitalized during the period 1999-2006. METHODS We conducted a retrospective multi-institutional, non-randomized study of children and adolescents up to age 21 with T cell lymphoma admitted to pediatric departments in six hospitals in Israel, with regard to prevalence, clinical characteristics, pathological characteristics, prognostic factors, overall survival (OS) and event-free survival (EFS). All patients had a minimal follow-up of one year after diagnosis. The study was based on the NHL-BFM-95 protocol. RESULTS At a median follow-up of 4 years (range 1-9 years), OS and EFS for all patients was 86.5% and 83.8%, respectively. OS was 86.7% and 83.3% for patients with stage III and stage IV, respectively, and EFS was 83.3% and 83.3%, respectively. EFS was 62.5% for Arab patients and 89.7% for Jewish patients (P = 0.014). Patients who did not express CD45 antigen showed superior survival (P = 0.028). Five patients (13.5%) relapsed, four of whom died of their disease. Death as a consequence of therapy toxicity was documented in one patient while on the re-induction protocol (protocol IIA). CONCLUSIONS Our study shows that OS and EFS for all patients was 86.5% and 83.8%, respectively.
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Affiliation(s)
- Ofrat Beyar Katz
- Department of Pediatric Hematology-OncologyMeyer Children's Hospital, Rambam Health Care Campus affiliated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Ben Arush MW, Beyar Katz O, Ben Barak A, Avrahami G, Dvir R, Kapelushnik J, Kaplinsky H, Vilk Revel S, Yaniv I, Linn S. T-cell lymphoblastic lymphoma in children and adolescents: The experience of the Israel Society of Pediatric Hematology Oncology. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.9574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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36
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Zelig U, Dror Z, Iskovich S, Zwielly A, Ben-Harush M, Nathan I, Mordechai S, Kapelushnik J. Biochemical analysis and quantification of hematopoietic stem cells by infrared spectroscopy. J Biomed Opt 2010; 15:037008. [PMID: 20615037 DOI: 10.1117/1.3442728] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Identification of hematopoietic stem cells (HSCs) in different stages of maturation is one of the major issues in stem cell research and bone marrow (BM) transplantation. Each stage of maturation of HSCs is characterized by a series of distinct glycoproteins present on the cell plasma membrane surface, named a cluster of differentiation (CD). Currently, complicated and expensive procedures based on CD expression are needed for identification and isolation of HSCs. This method is under dispute, since the correct markers' composition is not strictly clear, thus there is need for a better method for stem cell characterization. In the present study, Fourier transform infrared (FTIR) spectroscopy is employed as a novel optical method for identification and characterization of HSCs based on their entire biochemical features. FTIR spectral analysis of isolated mice HSCs reveals several spectral markers related to lipids, nucleic acids, and carbohydrates, which distinguish HSCs from BM cells. The unique "open" conformation of HSC DNA as identified by FTIR is exploited for HSCs quantification in the BM. The proposed method of FTIR spectroscopy for HSC identification and quantification can contribute to stem cell research and BM transplantation.
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Affiliation(s)
- Udi Zelig
- Ben-Gurion University of the Negev, Department of Biomedical Engineering, Beer-Sheva 84105 Israel
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Jeison M, Ash S, Halevy-Berko G, Mardoukh J, Luria D, Avigad S, Feinberg-Gorenshtein G, Goshen Y, Hertzel G, Kapelushnik J, Ben Barak A, Attias D, Steinberg R, Stein J, Stark B, Yaniv I. 2p24 Gain region harboring MYCN gene compared with MYCN amplified and nonamplified neuroblastoma: biological and clinical characteristics. Am J Pathol 2010; 176:2616-25. [PMID: 20395439 DOI: 10.2353/ajpath.2010.090624] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Although the role of MYCN amplification in neuroblastoma is well established, the biological and clinical characteristics of the 2p gain region harboring the MYCN gene remain unclear. The aim of this study was to compare the biological and clinical characteristics of these tumors with MYCN amplified and nonamplified neuroblastoma and to determine their impact on disease outcome. Samples from 177 patients were analyzed by fluorescence in situ hybridization, including MYCN, 1p, 17q, and 11q regions; 2p gain was identified in 25 patients, MYCN amplification in 31, and no amplification in 121 patients. Patients with 2p gain had a significantly worse 5-year event-free survival rate than patients with no MYCN amplified (P < 0.001), and an intermediate 5-year overall survival rate difference existed between the MYCN amplified tumors (P = 0.025) and nonamplified (P = 0.003) groups. All of the 2p gain samples were associated with segmental and/or numerical alterations in the other tested regions. The presence of segmental alterations with or without MYCN amplification was recently found to be the strongest predictor of relapse in a multivariate analysis. The results of the present study suggest that the determination of MYCN gene copy number relative to chromosome 2, when evaluating MYCN status at diagnosis, may help to reveal the underlying genetic pattern of these tumors and better understand their clinical behavior.
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Affiliation(s)
- Marta Jeison
- Ca-Cytogenetic Lab, Schneider Children's Medical Center of Israel, Kaplan St. 14, 49202 Petah Tikva, Israel.
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38
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Landau D, Rosenberg N, Zivelin A, Staretz-Chacham O, Kapelushnik J. Familial factor VII deficiency with foetal and neonatal fatal cerebral haemorrhage associated with homozygosis to Gly180Arg mutation. Haemophilia 2010; 15:774-8. [PMID: 19432927 DOI: 10.1111/j.1365-2516.2009.02004.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Inherited factor VII (FVII) deficiency is a rare autosomal recessive disorder with a wide heterogeneous clinical pattern. Intracranial haemorrhage in infants has been previously reported in the severe form of the FVII deficiency and it has a high fatality rate. We report a family with high consanguineous relations, who experienced death of two baby girls, the first with prenatal manifestation of foetal hydrocephalus secondary to intracranial bleeding and the second with postnatal intracranial bleeding, both with less than 1% activity of FVII. Genetic analysis revealed that both parents are heterozygous and both daughters homozygous for a point mutation gG9639A in exon 7, predicting Gly180Arg substitution. This mutation was described previously in a compound heterozygous patient with mild bleeding manifestation. It seems that in this family, the mutation in its homozygous state is fatal and the lethal clinical expression can appear in utero at an early stage of gestation.
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Affiliation(s)
- D Landau
- Neonatal Department, Sheba Medical Center, Tel-Hashomer, Israel.
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Stark B, Nirel R, Avrahami G, Abramov A, Attias D, Ballin A, Bielorai B, Burstein Y, Gavriel H, Elhasid R, Kapelushnik J, Sthoeger D, Toren A, Wientraub M, Yaniv I, Izraeli S. Long-term results of the Israeli National Studies in childhood acute lymphoblastic leukemia: INS 84, 89 and 98. Leukemia 2009; 24:419-24. [PMID: 20016534 DOI: 10.1038/leu.2009.254] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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40
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Zelig U, Kapelushnik J, Moreh R, Mordechai S, Nathan I. Diagnosis of cell death by means of infrared spectroscopy. Biophys J 2009; 97:2107-14. [PMID: 19804743 DOI: 10.1016/j.bpj.2009.07.026] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2009] [Revised: 07/16/2009] [Accepted: 07/17/2009] [Indexed: 02/07/2023] Open
Abstract
Fourier transform infrared (FTIR) spectroscopy has been established as a fast spectroscopic method for biochemical analysis of cells and tissues. In this research we aimed to investigate FTIR's utility for identifying and characterizing different modes of cell death, using leukemic cell lines as a model system. CCRF-CEM and U937 leukemia cells were treated with arabinoside and doxorubicin apoptosis inducers, as well as with potassium cyanide, saponin, freezing-thawing, and H(2)O(2) necrosis inducers. Cell death mode was determined by various gold standard biochemical methods in parallel with FTIR-microscope measurements. Both cell death modes exhibit large spectral changes in lipid absorbance during apoptosis and necrosis; however, these changes are similar and thus cannot be used to distinguish apoptosis from necrosis. In contrast to the above confounding factor, our results reveal that apoptosis and necrosis can still be distinguished by the degree of DNA opaqueness to infrared light. Moreover, these two cell death modes also can be differentiated by their infrared absorbance, which relates to the secondary structure of total cellular protein. In light of these findings, we conclude that, because of its capacity to monitor multiple biomolecular parameters, FTIR spectroscopy enables unambiguous and easy analysis of cell death modes and may be useful for biochemical and medical applications.
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Affiliation(s)
- Udi Zelig
- Department of Biomedical Engineering, Ben Gurion University, Beer Sheva, Israel
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41
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Stark B, Avrahami G, Nirel R, Abramov A, Attias D, Ballin A, Bielorai B, Burstein Y, Gavriel H, Elhasid R, Kapelushnik J, Sthoeger D, Toren A, Wientraub M, Yaniv I, Izraeli S. Extended triple intrathecal therapy in children with T-cell acute lymphoblastic leukaemia: a report from the Israeli National ALL-Studies. Br J Haematol 2009; 147:113-24. [DOI: 10.1111/j.1365-2141.2009.07853.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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42
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Weyl Ben Arush M, Hersalis Eldar A, Abrahami G, Attias D, Ben Barak A, Dvir R, Gabriel H, Kapelushnik J, Kaplinsky H, Vilk-Revel S. Burkitt lymphoma in children: The Israel Society of Pediatric Hematology Oncology retrospective study. J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.10051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10051 Background: From 2000 to 2005, the Israel Society of Pediatric Hematology Oncology studied the results of the FAB-LMB 96 protocol in children with B cell lymphoma. Methods: Eighty eight patients (pts) were eligible, 63 boys, 25 girls, median age was 8.9 years. Fifty patients (57%) were classified as burkitt lymphoma, 5 (5.7%) as burkitt-like lymphoma, 22 (25%) as diffuse large B cell (DLBC), 9 (10.2%) as burkitt leukemia. Initial disease sites included the abdomen in 43%, head and neck in 45%, mediastinum in 7%. Stage I: 9.1%, Stage II in 28.4%, stage III in 45.5%, stage IV in 17%. Five pts had bone marrow involvement (BM) alone, 5 pts CNS alone and 4 both CNS and BM. Five children were treated according to group A, 69 pts group B and 14 pts group C. Results: At a median follow up of 3 years, Kaplan Meier for EFS and OS for all pts was respectively 88.6%, 90.9%, group A, 100%,100%, group B: 90%, 93%, group C 79%, 79%. In group A: there were neither events nor deaths in this group, 6 patients relapsed in group B, among them 4 patients had died, tumor lysis syndrome in 3 patients, death of toxicity in 1 patient. In group C, 3 patients had relapsed and died, no death of toxicity. EFS for LDH less then twice was 96.4%, EFS for LDH more than twice was 73.3% (p = 0.002). OS according to primary site: bone and ovary (100%), head and neck (95%), abdomen (92%) and mediastinum (50%) (p = 0.003). All of the mediastinal tumors were of DLBC origin, but when comparing the DLBC to other histologies, no significant difference in outcome were found.(DLBC: 81.8%, other B line: 90.9%). The OS for Arab ethnic origin is 79.2%, OS for Jewish is 95.3% (p = 0.02). Conclusions: In nonresected mature B cell lymphoma of childhood and adolescence with no BM or CNS involvement, a 93% cure rate was achieved. Patients with primary DLBC mediastinal mass had a significantly reduced overall survival, indicating the need for a different therapeutic approach. No significant financial relationships to disclose.
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Affiliation(s)
- M. Weyl Ben Arush
- Rambam Medical Center, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel; Shneider Children's Hospital, Tel Aviv, Israel; Bnai Zion Medical Center, Haifa, Israel; Dana Children's Hospital, Tel Aviv, Israel; Haemek Medical Center, Afula, Israel; Soroka Medical Center, Beer Sheva, Israel; Sheba Medical Center, Tel Aviv, Israel; Hadassah Medical Center, Jerusalem, Israel
| | - A. Hersalis Eldar
- Rambam Medical Center, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel; Shneider Children's Hospital, Tel Aviv, Israel; Bnai Zion Medical Center, Haifa, Israel; Dana Children's Hospital, Tel Aviv, Israel; Haemek Medical Center, Afula, Israel; Soroka Medical Center, Beer Sheva, Israel; Sheba Medical Center, Tel Aviv, Israel; Hadassah Medical Center, Jerusalem, Israel
| | - G. Abrahami
- Rambam Medical Center, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel; Shneider Children's Hospital, Tel Aviv, Israel; Bnai Zion Medical Center, Haifa, Israel; Dana Children's Hospital, Tel Aviv, Israel; Haemek Medical Center, Afula, Israel; Soroka Medical Center, Beer Sheva, Israel; Sheba Medical Center, Tel Aviv, Israel; Hadassah Medical Center, Jerusalem, Israel
| | - D. Attias
- Rambam Medical Center, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel; Shneider Children's Hospital, Tel Aviv, Israel; Bnai Zion Medical Center, Haifa, Israel; Dana Children's Hospital, Tel Aviv, Israel; Haemek Medical Center, Afula, Israel; Soroka Medical Center, Beer Sheva, Israel; Sheba Medical Center, Tel Aviv, Israel; Hadassah Medical Center, Jerusalem, Israel
| | - A. Ben Barak
- Rambam Medical Center, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel; Shneider Children's Hospital, Tel Aviv, Israel; Bnai Zion Medical Center, Haifa, Israel; Dana Children's Hospital, Tel Aviv, Israel; Haemek Medical Center, Afula, Israel; Soroka Medical Center, Beer Sheva, Israel; Sheba Medical Center, Tel Aviv, Israel; Hadassah Medical Center, Jerusalem, Israel
| | - R. Dvir
- Rambam Medical Center, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel; Shneider Children's Hospital, Tel Aviv, Israel; Bnai Zion Medical Center, Haifa, Israel; Dana Children's Hospital, Tel Aviv, Israel; Haemek Medical Center, Afula, Israel; Soroka Medical Center, Beer Sheva, Israel; Sheba Medical Center, Tel Aviv, Israel; Hadassah Medical Center, Jerusalem, Israel
| | - H. Gabriel
- Rambam Medical Center, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel; Shneider Children's Hospital, Tel Aviv, Israel; Bnai Zion Medical Center, Haifa, Israel; Dana Children's Hospital, Tel Aviv, Israel; Haemek Medical Center, Afula, Israel; Soroka Medical Center, Beer Sheva, Israel; Sheba Medical Center, Tel Aviv, Israel; Hadassah Medical Center, Jerusalem, Israel
| | - J. Kapelushnik
- Rambam Medical Center, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel; Shneider Children's Hospital, Tel Aviv, Israel; Bnai Zion Medical Center, Haifa, Israel; Dana Children's Hospital, Tel Aviv, Israel; Haemek Medical Center, Afula, Israel; Soroka Medical Center, Beer Sheva, Israel; Sheba Medical Center, Tel Aviv, Israel; Hadassah Medical Center, Jerusalem, Israel
| | - H. Kaplinsky
- Rambam Medical Center, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel; Shneider Children's Hospital, Tel Aviv, Israel; Bnai Zion Medical Center, Haifa, Israel; Dana Children's Hospital, Tel Aviv, Israel; Haemek Medical Center, Afula, Israel; Soroka Medical Center, Beer Sheva, Israel; Sheba Medical Center, Tel Aviv, Israel; Hadassah Medical Center, Jerusalem, Israel
| | - S. Vilk-Revel
- Rambam Medical Center, Haifa, Israel; Technion Faculty of Medicine, Haifa, Israel; Shneider Children's Hospital, Tel Aviv, Israel; Bnai Zion Medical Center, Haifa, Israel; Dana Children's Hospital, Tel Aviv, Israel; Haemek Medical Center, Afula, Israel; Soroka Medical Center, Beer Sheva, Israel; Sheba Medical Center, Tel Aviv, Israel; Hadassah Medical Center, Jerusalem, Israel
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Shabbat S, Aharoni J, Sarid L, Ben-Harush M, Kapelushnik J. Rituximab as monotherapy and in addition to reduced CHOP in children with primary immunodeficiency and non-Hodgkin lymphoma. Pediatr Blood Cancer 2009; 52:664-6. [PMID: 19142990 DOI: 10.1002/pbc.21808] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Children with primary immunodeficiency or chromosomal breakage syndromes are at increased risk of developing non-Hodgkin lymphomas; they cannot tolerate standard chemotherapy regimens. We report two children with diffuse, large, B-cell lymphoma; one had ataxia telangiectasia and one had common variable immunodeficiency. Both were given rituximab, 1 as monotherapy and 1 in combination with a reduced CHOP regimen. Complete remission was obtained in each patient. Use of rituximab as a first-line monotherapy or in conjunction with reduced chemotherapy should be considered to reduce cytotoxic effects.
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Affiliation(s)
- Shimrit Shabbat
- Department of Pediatrics, Soroka University Medical Center, Beer Sheva, Israel.
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44
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Mazor D, Abucoider A, Meyerstein N, Kapelushnik J. Antioxidant status in pediatric acute lymphocytic leukemia (ALL) and solid tumors: the impact of oxidative stress. Pediatr Blood Cancer 2008; 51:613-5. [PMID: 18623225 DOI: 10.1002/pbc.21665] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Pediatric ALL patients are subjected to an aggressive and continuous chemotherapy protocol, while solid tumor patients have a less intensive treatment. We studied the antioxidant status of children from the two groups and hypothesized that the antioxidant status will differ in concert with their treatment. PROCEDURE The antioxidant status in plasma of seven ALL children and that of six children treated for different solid tumors, in regard to the different treatment regimen, was compared with healthy controls. These samples were taken during therapy, just before the next cyclophosphamide treatment, to determine the accumulative oxidative stress. RESULTS Children from the ALL group (n = 7) had significantly lower thiol plasma levels than controls (P < 0.01) and their antioxidant capacity as measured by the ferric reducing ability of plasma (FRAP) was significantly lower (P < 0.01). These parameters were normal in the solid tumors group (n = 6) but plasma antioxidant capacity as measured by the 2,2-diphenyl-1-picrylhydrazyl (DPPH) assay was significantly lower (P < 0.01). CONCLUSIONS Both groups had impaired plasma antioxidant status. The higher oxidative stress of children with ALL is associated with the protocol for treating ALL which is much more aggressive and frequent than that of the solid tumors. The lower antioxidant status in plasma with ALL children is probably associated with increased reactive oxygen species (ROS) as indicated by the decrease of the antioxidant activity. This oxidative stress may lead to cell death or greater sensitivity of the tumor cell to therapy, with better outcome for pediatric patients with ALL.
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Affiliation(s)
- Dalia Mazor
- Faculty of Health Sciences, Experimental Hematology Laboratory, Physiology Department, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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45
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Tamary H, Bar-Yam R, Shalmon L, Rachavi G, Krostichevsky M, Elhasid R, Barak Y, Kapelushnik J, Yaniv I, Auerbach AD, Zaizov R. Fanconi anaemia group A (FANCA
) mutations in Israeli non-Ashkenazi Jewish patients. Br J Haematol 2008. [DOI: 10.1111/j.1365-2141.2000.02323.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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Pinsk V, Levy J, Moser A, Yerushalmi B, Kapelushnik J. Efficacy and safety of intravenous iron sucrose therapy in a group of children with iron deficiency anemia. Isr Med Assoc J 2008; 10:335-338. [PMID: 18605353] [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] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
BACKGROUND Iron deficiency is the most common single cause of anemia worldwide. Treatment consists of improved nutrition along with oral, intramuscular or intravenous iron administration. OBJECTIVES To describe the efficacy and adverse effects of intravenous iron sucrose therapy in a group of children with iron deficiency anemia who did not respond to oral iron therapy. METHODS We conducted a prospective investigation of 45 children, aged 11 months to 16 years, whose oral iron therapy had failed. The children attended the Pediatric Day Care Unit where they received intravenous iron sucrose infusion. RESULTS Forty-four of the 45 patients were non-compliant. Nine had Helicobacter pylori gastritis and 16 patients suffered from intestinal malabsorption from different causes. Before treatment, the blood mean hemoglobin concentration was 7.43 g/dl (range 5-10.1 g/dl). Fourteen days after treatment it increased to 9.27 g/dl (SD 1.23) and 6 months later to 12.40 g/dl (SD 1.28). One patient demonstrated a severe side effect with temporary and reversible reduced blood pressure during treatment. CONCLUSIONS These preliminary data suggest that administration of intravenous iron in pediatric patients is well tolerated and has a good clinical result, with minimal adverse reactions.
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Affiliation(s)
- Vered Pinsk
- Pediatric Day Care Unit, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel
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Abstract
AIMS To estimate the prevalence of iron deficiency and iron deficiency anaemia using haematological indices. METHODS Prospective interventional study. Healthy toddlers from Bedouin and Jewish towns in southern Israel. Capillary blood was sampled to assess iron status and nutritional history recorded. Parents were given specific nutritional instructions. Anaemia was defined as haemoglobin level < or = 11 gr/dL. Iron deficiency without anaemia was defined as mean corpuscular volume (MCV) < 70 fL and/or red blood cell width (RDW) > or = 16, with haemoglobin level > 11 gr/dL. Toddlers with iron deficiency were treated with 5 mg/kg/day of elemental iron. Follow-up iron and nutritional status was performed 1 and 2 months after enrolment. RESULTS At the time of enrolment 42% of the 107 Jewish and 93% of the 43 Bedouin toddlers were iron deficient (p < 0.001). Significantly higher proportions of Bedouin toddlers were breastfed, drank tea, did not eat meat, did not take supplementary iron in their first year of life and were previously diagnosed with anaemia. Rate of follow-up was 55% among Bedouins and 33% among Jews. The mean haemoglobin rise over two months was 0.91 gr/dL (95% CI: 0.63-1.18 gr/dL; p < 0.001) in Bedouins and 0.58 gr/dL (95% CI: 0.14-1.02 gr/dL; p = 0.014) in Jews. CONCLUSIONS Higher rates of anaemia and iron deficiency, as well as most of the risk factors, found among the Bedouin toddlers, call for the design and implementation of innovative, culturally appropriate interventions in the Bedouin population.
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Affiliation(s)
- J Urkin
- Primary Pediatric Care Unit, Ben-Gurion University of the Negev, Beer-Sheva, Israel.
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48
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Abstract
Hypocholesterolemia of unknown etiology has been previously described in various chronic anemias. Few small studies also suggested that those patients have a lower incidence of atherosclerotic events. The aim of our study was to determine the extent of hypocholesterolemia in various types of anemias. We studied 59 patients with chronic anemias associated with high-erythropoietic activity (thalassemia intermedia, congenital dyserythropoietic anemia type I, congenital spherocytosis), 8 patients with low-erythropoietic activity anemias (acquired aplastic anemia, Fanconi anemia, and Diamond Blackfan anemia), and 20 healthy controls. Mean serum cholesterol, high-density lipoprotein (HDL) cholesterol, low-density lipoprotein (LDL) cholesterol, triglycerides, hemoglobin, serum ferritin, soluble transferrin receptor (STR), and serum erythropoietin levels were determined in each patient. All patients with chronic anemia and increased erythropoietic activity had hypocholesterolemia, whereas none of those with low erythropoietic activity was hypocholesterolemic. Mean serum cholesterol, HDL cholesterol, and LDL cholesterol levels were found to be significantly lower in the high-erythropoietic activity group (80+/-19 mg/dl; 31+/-10 mg/dl; 35+/-14 mg/dl, respectively) compared with the control group (P<0.001; 0.001; 0.001, respectively) and the low-erythropoietic activity group (P<0.001; 0.001; 0.01, respectively). Significant inverse correlation (R2=0.507) was observed between serum cholesterol and STR levels, which in the absence of iron deficiency reflect bone marrow activity. Taken together, our results imply that hypocholesterolemia accompanies anemias with high-erythropoietic activity. We suggest that the high-erythropoitic activity-associated hypocholesterolemia is due to increased cholesterol requirements by the proliferating erythoid cells. Further studies are needed to elucidate the exact mechanism and the possible clinical consequences of this phenomenon.
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Affiliation(s)
- Hanna Shalev
- Pediatric Clinic Center, General Health Services (Kupat-Holim Clalit), Rahat and Faculty of Medicine, Ben Gurion University of the Negev, Beer Sheva, Israel
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49
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Beigelman A, Kapelushnik J, Shubinsky G, Haim A, Moser A. Leukemoid Reaction in Children: Lymphocytes Flow Cytometry Characterization and Clinical Etiologies. J Allergy Clin Immunol 2007. [DOI: 10.1016/j.jaci.2006.12.063] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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50
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Moser AM, Manor E, Narkis G, Kapelushnik J. Imatinib resistant chronic myelogenous leukemia, BCR-ABL positive by chromosome and FISH analyses but negative by PCR, in a child progressing to acute basophilic leukemia: cytogenetic follow-up. ACTA ACUST UNITED AC 2006; 170:54-7. [PMID: 16965955 DOI: 10.1016/j.cancergencyto.2005.08.026] [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: 06/10/2005] [Revised: 08/02/2005] [Accepted: 08/03/2005] [Indexed: 11/22/2022]
Abstract
The case of an 11-year-old child with adult-type chronic myeloid leukemia, Philadelphia (BCR-ABL) positive, reverse transcription-polymerase chain reaction negative for the major, minor, and micro breakpoints is presented. In the course of 3 years, the child failed to respond to treatment with hydroxyurea, refused all therapy for 6 months, was intolerant to alpha-interferon and progressed, while on imatinib, to acute basophilic leukemia. Subsequently he underwent successful bone marrow transplantation. A secondary cytogenetic clonal evolution, i(17q), developed during hydroxyurea treatment and a tertiary clonal evolution, +8, was detected during imatinib treatment. It is not clear to what extent the several factors (undefined BCR-ABL breakpoint, treatment avoidance, and initial treatment choices, alone or in combination) played a role in the imatinib relapse and resistance and in the disease progression. We conclude that close follow-up with frequent bone marrow sampling is crucial in order to monitor such patients for early relapse and prompt referral for bone marrow transplant.
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MESH Headings
- Antineoplastic Agents/therapeutic use
- Benzamides
- Bone Marrow Transplantation
- Child
- Disease Progression
- Drug Resistance, Neoplasm
- Genes, abl
- Humans
- Imatinib Mesylate
- Immunophenotyping
- In Situ Hybridization, Fluorescence
- Leukemia, Basophilic, Acute/immunology
- Leukemia, Basophilic, Acute/pathology
- Leukemia, Basophilic, Acute/surgery
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/drug therapy
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/genetics
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/immunology
- Leukemia, Myelogenous, Chronic, BCR-ABL Positive/pathology
- Male
- Piperazines/therapeutic use
- Pyrimidines/therapeutic use
- Reverse Transcriptase Polymerase Chain Reaction
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Affiliation(s)
- Asher M Moser
- Pediatric Hematology-Oncology Unit, Soroka University Medical Center, Ben Gurion University of the Negev, P.O. Box 151, Be'er Sheva, 84501 Israel
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