Incidence of ocular manifestations in patients with graft versus host disease after allogeneic stem cell transplant in Riyadh, Saudi Arabia.

Minimal Residual Disease following Allogeneic Hematopoietic Stem Cell Transplantation

The Role of Cytotoxic Therapy with Hematopoietic Stem Cell Transplantation in the Treatment of Adult Acute Lymphoblastic Leukemia: Update of the 2006 Evidence-Based Review

EBMT Risk Score Predicts Outcome of Allogeneic Hematopoietic Stem Cell Transplantation in Patients Who Have Failed a Previous Transplantation Procedure

Conditioning with Treosulfan and Fludarabine followed by Allogeneic Hematopoietic Cell Transplantation for High-Risk Hematologic Malignancies

Aim: Acute myeloid leukemia (AML) is a type of malignancy that is associated with a malignant alteration of normal hematopoietic stem cells in the bone marrow. The aim of this study was to study the demographics and pathological subtypes of AML, evaluate the response and outcome to different treatment modalities. Methods: This was a retrospective study of adult patients diagnosed with AML at King Abdulaziz Medical City - Riyadh, between 2006 and 2013. Data were retrieved from patients′ files, electronic medical files and laboratory information system. Results: 91 patients were included in the study with a male dominance. M1 was the most common French-American-British subtype with 23 (32%) cases. Patients with intermediate-risk AML were the most common subgroup with 41 (48%) cases followed by high and low-risk subgroups, 29 (33%) and 16 (19%), respectively. 74 patients were treated with intensive chemotherapy, and 17 were on palliative chemotherapy or best supportive treatment. Remission rate was found to be 84% in patients who received induction chemotherapy while 41% of them relapsed. 93% of low-risk patients underwent complete remission (CR) compared to intermediate and high-risk patients (79% and 87% respectively), but it was not statistically significant (P = 0.4). The median follow-up was 19 months, with overall survival (OS) of 46% for all groups. The low-risk patients had the highest OS 57% compared to intermediate and high risk (52% and 36%, respectively), but it was not statistically significant (P = 0.3). 18 patients had been treated with allogeneic stem cell transplant and at a median follow-up of 17 months posttransplant the OS was 72%. Conclusion: This study shows M1 subtype to be the most common of AML in this population. In addition, the CR was better with similar survival rate as compared to other local and internationally published experiences. These results, albeit with its limitations, need to be confirmed in a prospective clinical trial or national disease registry.

Pediatric Blood & CancerVolume 60, Issue 9 p. 1559-1560 Letter To The Editor Novel frameshift mutations in ADAMTS13 in two families with hereditary thrombotic thrombocytopenic purpura Abdulrahman Alsultan, Corresponding Author Abdulrahman Alsultan Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia Correspondence to: Abdulrahman Alsultan, MD, Department of Pediatrics, College of Medicine, King Saud University, PO Box 261691, Riyadh 11342, Saudi Arabia. E-mail: aalsultan1@ksu.edu.saSearch for more papers by this authorMohammed Jarrar, Mohammed Jarrar Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi ArabiaSearch for more papers by this authorTalal Al-Harbi, Talal Al-Harbi Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi ArabiaSearch for more papers by this authorMohammed AL Balwi, Mohammed AL Balwi Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center, Riyadh, Saudi Arabia College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaSearch for more papers by this author Abdulrahman Alsultan, Corresponding Author Abdulrahman Alsultan Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia Department of Pediatrics, College of Medicine, King Saud University, Riyadh, Saudi Arabia Correspondence to: Abdulrahman Alsultan, MD, Department of Pediatrics, College of Medicine, King Saud University, PO Box 261691, Riyadh 11342, Saudi Arabia. E-mail: aalsultan1@ksu.edu.saSearch for more papers by this authorMohammed Jarrar, Mohammed Jarrar Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi ArabiaSearch for more papers by this authorTalal Al-Harbi, Talal Al-Harbi Department of Oncology, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi ArabiaSearch for more papers by this authorMohammed AL Balwi, Mohammed AL Balwi Department of Pathology and Laboratory Medicine, King Abdulaziz Medical City, National Guard Health Affairs, Riyadh, Saudi Arabia King Abdullah International Medical Research Center, Riyadh, Saudi Arabia College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi ArabiaSearch for more papers by this author First published: 16 May 2013 https://doi.org/10.1002/pbc.24594Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume60, Issue9September 2013Pages 1559-1560 RelatedInformation

20020 Background: The outcome of children with acute myeloid leukemia (AML) has improved over last two decades. The main factors behind this are increasing intensity of chemotherapy and improved measures of supportive care. While white blood cell count and age are major factors for risk classification in childhood acute lymphoblastic leukemia (ALL), therapy remains the single most prognostic factor. Objectives: To assess survival with each regimen of chemotherapy and causes of treatment failure. Methods: we retrospectively reviewed the details of treatment and outcome of all children with AML from 1986- 2005 (20 yr.) and ALL from 1989–2003 (15yr.) at King Abdulaziz Medical City, Jeddah, Saudi Arabia. Results: AML 54 patients, 23 boys with median age 5 yr. (range 0.5–14 yr.). Five (9%) had CNS leukemia. Between 1986–1995, 22 pts were treated with BFM based chemotherapy, remaining 32 received UK-AML 10 between 1996–2005. 8/22 (36%) & 5/32 (16%) died of toxicity and 12 (54%) and 8 (25%) died of AML during 1st & 2nd era respectively. With a median follow up of 3 year (.5–10 yr.). The overall survival is 9% in 1st era and 59% in 2nd era. ALL 297 patients were registered. Male 165 pts., median age 5 yr. (range 1–14), WBCs >50,000x109, 55 pts. (19%). T-cell 36 (12%), pre-B 222 (75%) and 29 (10%) unknown. NCI risk classification according to age & WBCs count at presentation as HR 84 (28%), SR 204 (69%). Causes of death; 50/297 (17%) disease recurrence which failed 2nd line chemotherapy, 12/297 (4%) induction death and 11/297 (4%) died of toxicity. Survival by different regimens of chemotherapy were showing UKALL-X 1989–1993, 67 pts.as 55%; UKALL-XI/BFM (1994–1998) 98 pts. As 72%; MRC-97/CCG1991 (1999–2003) 132 pts.87% as overall 5 yr survival. Conclusions: This single center study confirmed that the outcome of children with AML/ALL has improved over last decade. Increasing local experience, advances in supportive care and chemotherapy have contributed to this improvement. No significant financial relationships to disclose.

BACKGROUND AND OBJECTIVES:Patients in the ICU have encountered an increasing emergence and spread of antibiotic-resistant pathogens. We examined patterns of antimicrobial susceptibility in gram-negative isolates to commonly used drugs in an adult ICU at a tertiary care hospital in Riyadh, Saudi Arabia.METHODS:A retrospective study was carried out of gram-negative isolates from the adult ICU of King Fahad National Guard Hospital (KFNGH) between 2004 and 2009. Organisms were identified and tested by an automated identification and susceptibility system, and the antibiotic susceptibility testing was confirmed by the disk diffusion method.RESULTS:The most frequently isolated organism was Acinetobacter baumannii, followed by Pseudomonas aeruginosa, Escherichia coli, Klebsiella pnemoniae, Stenotrophomonas maltophilia, and Enterobacter. Antibiotic susceptibility patterns significantly declined in many organisms, especially A baumannii, E coli, S marcescens, and Enterobacter. A baumannii susceptibility was significantly decreased to imipenem (55% to 10%), meropenem (33% to 10%), ciprofloxacin (22% to 10%), and amikacin (12% to 6%). E coli susceptibility was markedly decreased (from 75% to 50% or less) to cefuroxime, ceftazidime, cefotaxime, and cefepime. S marcescens susceptibility was markedly decreased to cefotaxime (100% to 32%), ceftazidime (100% to 35%), and cefepime (100% to 66%). Enterobacter susceptibility was markedly decreased to ceftazidime (34% to 5%), cefotaxime (34% to 6%), and pipracillin-tazobactam (51% to 35%). Respiratory samples were the most frequently indicative of multidrug-resistant pathogens (63%), followed by urinary samples (57%).CONCLUSION:Antimicrobial resistance is an emerging problem in the KFNGH ICU, justifying new more stringent antibiotic prescription guidelines. Continuous monitoring of antimicrobial susceptibility and strict adherence to infection prevention guidelines are essential to eliminate major outbreaks in the future.

Leukemia Lineage-Specific Chimerism Analysis and Molecular Monitoring Improve Outcome of Donor Lymphocyte Infusions

A pilot study of tacrolimus and mycophenolate mofetil graft-versus-host disease prophylaxis in childhood and adolescent allogeneic stem cell transplant recipients.

Oral squamous cell carcinoma positive for p16/human papilloma virus in post allogeneic stem cell transplantation: 2 cases and review of the literature

Introduction: Acute lymphoblastic leukemia (ALL) is the most common childhood cancer. It is associated with many environmental factors. The correlation between month of birth, seasonality, genetic abnormalities and ALL has been studied with conflicting results and this issue remains controversial. The principal aim of this study was to assess the association of ALL and month/season of birth and its association. with cytogenetic abnormalities. Methods This was a retrospective cohort study that took place at Department of pediatric hematology, King Abdulaziz Medical City, Riyadh, Saudi Arabia. Inclusion criteria was any patient diagnosed with ALL until the age of 14 years. Patients with a family history of ALL were excluded. Data was retrived from electronic medical records and analyzed using SPSS version 27. Results: A total of 192 patients were analyzed. More than half (60.9%) of the patients were male. With regard to ALL’s subtype, B-cell was found in 84.9% of the patients. In addition, B-ALL was the highest incidence in both genders accounting for 82.05% and 89.3% in males and females, respectively. January was the month with the highest incidence of ALL (12%), while February and September were the lowest (6.3%). Season-wise, spring season had the highest number of ALL patients (26.6%), and Summer had the lowest incidence (24%). We found trisomy of chromosome 12 in patients with ALL is significantly higher in 1-3 years age group (P-value= 0.039). Patients who had trisomy of chromosome 12 accounted for 13.7% in 1-3 age group compared to 3.8% in 7-14, 1.5% in 3-7, and none in up to 1 year of age. Moreover, AML gene abnormality in ALL patients was also found to be significantly associated with age group, where it was found that majority of patients were aged from 3-7 years (27.7%) (P-value= 0.014). the lowest was in 1-3 age group accounting for 7.8%. TCRgamma mutation was also found to be significantly increased (14.3%) in ALL patients aged up to 1 year (P-value= 0.025), and only 2% in 1-3 age group. Furthermore, we divided them into seasons (summer, winter, autumn, and spring) and their chromosomal abnormalities. Autumn was found to have a significant increase (31.9%) in trisomy 17 (P-value= 0.004). Furthermore, in winter, spring, and summer, it accounted for 8.30%, 9.80%, and 13.00%, respectively. We also noted an increase in trisomy 21 in Spring season in 23.5% of the patients (P-value= 0.039). in winter, summer, and autumn, it was 4.20%, 23.50%, 10.90%, 14.90%, respectively. Lastly, tetrasomy of chromosome 21 had a significant increase in Autumn season (23.4%) (P-value= 0.032) compared to 10.40% in winter, 9.80% in spring, and 4.30% in autumn. Conclusion: We found that age at the time of diagnosis was significantly associated with the season of birth. We conclude that prognostically important genetic abnormalities have a significant association with seasonality and age groups in pediatric ALL patients. Further studies in this regard can help understand important bearing of seasonality on biology and genetics of pediatric ALL. Citation Format: Khalid Aljamaan, Sarah AlMukhaylid, Zafar Iqbal. Investigations on association of month of birth and seasonality with chromosomal abnormalities of prognostic significance and disease incidences in pediatric acute lymphoblastic leukemia in Saudi Arabia [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pediatric Cancer Research; 2024 Sep 5-8; Toronto, Ontario, Canada. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl):Abstract nr A027.

The impact of second allogeneic hematopoietic stem cell transplantation as salvage therapy for hematologic diseases after a first allogeneic transplantation.

Genome-wide Profiling in AML Patients Relapsing after Allogeneic Hematopoietic Cell Transplantation

This study aimed to compare the effect of disease status at the time of allogeneic hematopoietic cell transplantation (HCT) on post-transplant outcomes between acute myeloid leukemia (AML) and acute lymphoblastic leukemia (ALL). Japanese nationwide registry data for 6901 patients with AML and 2469 patients with ALL were analyzed. In this study, 2850 (41%), 937 (14%), 62 (1%), and 3052 (44%) AML patients and 1751 (71%), 265 (11%), 23 (1%), and 430 (17%) ALL patients underwent transplantation in first complete remission (CR1), second CR (CR2), third or subsequent CR (CR3 +), and non-CR, respectively. The probabilities of overall survival at 5years for patients transplanted in CR1, CR2, CR3 + , and non-CR were 58%, 61%, 41%, and 26% for AML patients and 67%, 45%, 20%, and 21% for ALL patients, respectively. Multivariate analyses revealed that the risks of relapse and overall mortality were similar for AML patients transplanted in CR1 and CR2 (P = 0.672 and P = 0.703), whereas they were higher for ALL patients transplanted in CR2 than for those transplanted in CR1 (P < 0.001 for both). The risks of relapse and overall mortality for those transplanted in CR3 + and non-CR increased in a stepwise manner for both diseases, with the relevance being stronger for ALL than for AML patients. These results suggest a significant difference in the effect of disease status at HCT on post-transplant outcomes in AML and ALL. Further investigation to incorporate measurable residual disease data is warranted.