Acute Nonlymphocytic Leukemia Research Articles

The risk of developing acute non-lymphocytic leukemia in women with breast cancer.

BackgroundThis study had the purpose of examining the incidences, risk factors, and survival outcome of developing subsequent acute non-lymphocytic leukemia (ANLL) among a large group of breast cancer survivors.MethodsWe analyzed data from the Surveillance, Epidemiology, and End Results (SEER) program for standardized incidence ratio (SIR), risk factors, and survival of subsequent ANLL, focusing on the period between 2000 and 2014.ResultsThere was an increased SIR among breast cancer patients for subsequent ANLL (SIR: 2.41; 95% CI: 2.26–2.58). Risk factors of subsequent ANLL were age at first cancer diagnosis (40+ vs. 15–39 years, aHR =1.572, P=0.003), tumor size (21–50 vs. ≤20 mm, aHR =1.332, P=0.003; 50+ vs. ≤20 mm, aHR =1.735, P<0.001), chemotherapy exposure (yes vs. no, aHR =1.692, P<0.001), and radiation exposure (yes vs. no, aHR =1.232, P=0.002). Meanwhile, following subsequent ANLL, survivors had an adverse overall survival (OS) compared with patients who did not develop ANLL (aHR =3.359, P<0.001).ConclusionsBreast cancer survivors have a higher risk of developing subsequent ANLL compared to the general population. Increased vigilance should be shown towards the potential development of ANLL due to older age, larger tumor size, chemotherapy, and radiation exposure in survivors.

Strategic plan for management of COVID-19 in paediatric haematology and oncology departments

Strategic plan for management of COVID-19 in paediatric haematology and oncology departments

The physiological and pathological roles and applications of sialyl Lewis x, a common carbohydrate ligand of the three selectins

In the past decades, the roles of carbohydrates in living organisms and their potential use in many fields have been extensively investigated. Sialyl Lewis x (sLex), a member of body carbohydrate, is an inherent blood-type tetrasaccharide on the surface of different cells, the lymphocyte, neutrophil, some T cells, multiple tumor cells and so on. SLex is a common ligand of the three selectins, L-selectin, E-selectin and P-selectin, and plays important roles in multiple physiological phenomenas by interacting with selectins. Under normal physiological conditions, sLex can affect the immune process and fertilization process. Lower expression of sLex could cause leukocyte adhesion defects (LAD) II. Overexpression of sLex on the other hand has been linked to several cancers including melanoma, breast, pancreatic, liver, lung, head and neck, ovarian, bladder carcinomas and some blood disease including Hodgkin disease, some B cell chronic lymphocytic leukemias, acute lymphoblastic leukemias, and most acute nonlymphocytic leukemias. This paper mainly reviews the physiological functions and pathological effects of sLex and its applications in disease diagnosis, drug delivery, gene transfer and medical molecular imaging. We aim to help researchers and other readers quickly grasp the physiological and pathological roles and its medical applications of sLex, and give some suggestions for research directions.

Increased incidence of second primary malignancy in patients with malignant astrocytoma: a population-based study.

We identified patients diagnosed with malignant astrocytoma (MA) as the first of two or more primary malignancies between 1973 and 2015 from Surveillance, Epidemiology and End Results (SEER) database. Multiple primaries-standardized incidence ratio (MP-SIR) was calculated to quantitate the risk of second primary malignancy (SPM). We further identified the risk factors of developing SPM and factors affecting overall survival (OS) in MA patients with SPM. Our results revealed that overall risk of SPM among MA patients was significantly higher than that in general population (SIR: 1.09, 95% confidence interval (CI): 1–1.18, P<0.05). Specific sites where the risk of SPM increased included salivary gland, bone and joints, soft tissue including heart, brain, cranial nerves other nervous system, thyroid, acute non-lymphocytic leukemia and acute myeloid leukemia. Overall risk of SPM in patients aged ≤29 and 30–59 years significantly increased (4.34- and 1.41-fold respectively). Whereas patients aged ≥60 years had a significantly decreased risk of SPM. Patients in the group of latency at 36–59, 60–119 and ≥120 months carried significantly increased overall risk of SPM. Multivariate analysis revealed that age, race, marital status, WHO grade, differentiated grade of cancer tissues, latency was independent predictor of OS in MA patients with SPM, which were all selected into the nomogram. The calibration curve for probability of survival showed good agreement between prediction by nomogram and actual observation. In conclusion, MA survivors should be advised of their increased risk for developing certain cancers in their lifetime. Our study had clinical implications for the surveillance of MA survivors at risk of developing SPM.

PB1765 CHARACTERISTICS OF ERYTHROLEUKEMIA ABOUT 10 CASES WITH REVIEW OF THE LITERATURE

Background:Acute erythroblastic leukemia (AML‐M6) is a rare entity, accounting for 3‐4% of all LAs. There are two types: erythroleukemia and pure erythroid leukemia. It is most often manifested by signs of cytopenia and infiltration of extrahematopoietic tissues, and is more common in adults than in children with a poor prognosis.Aims:The objective of this study is to describe the clinical, biological and evolutionary aspects of erytholeukemia in a monocentric retrospective study.Methods:the diagnosis is based on a cytological examination of the blood smear (FS) and medullary (PMO) as well as the immunophenotypic examination. We calculated overall survival by Kaplan Meier methodResults:n = 181 (evaluable), n = 10 patients with AML6 according to the FAB classification (5%). • The cytological study of FS and PMO + CMF results led to the diagnosis of erythroleukemia in 08 of our patients and pure erythroid leukemia in 2 patients. Mean age = 47 ± 21.77 years [0‐64]. Sex ratio = 1.5 (6H / 4F). Duration: 40 ± 35 days [01‐90]. Symptoms of bone marrow failure: PCM (100%), hemorrhagic syndrome: 3 cases (30%), infection: 04 cases (40%), splenomegaly: 04 cases (30%), mean WB = 84,300 ± 11.260 giga / l [125.000‐83.400], peripheral blast level (avg = 26 ± 23% [1‐65]), medullary blasts = average 49.5 ± 19% (08‐93) • mean hemoglobin level = 8.06 ± 1.09 g / dl [5‐10], platelets: 21‐151giga / l (avg: 65,900 ± 47,450 / mm3) n = 03 patients had severe thrombocytopenia at 13‐21‐39 giga / respectively (30%), pancytopenia found in n = 05 cases (50%), LDH level (mean) = 905 ± 896 IU / L [12‐2,900], n = 02 patients had 1 metabolic complication at diagnosis (hyperkalemia, hyponatremia). n = 8 patients received induction CT (3 + 7), n = 01 patient received only 2 aracytin‐associated antracycline injections. Newborn LAM, the newborn clinically presents: cutaneous and mucosal paleness and hepatosplenomegaly, on the biological plane: GB: 125giga / l, (EB = 64%, blast = 3%), HB = 10 g / dl, PLQ = 13gigal / l, PMO: infiltration by 68% of dystrophic EB, 08% of MB, the newborn t under aseptic vacuum The specific treatment has not yet been started. The complete remission is obtained (n = 04 cases (40%)) and n = 03 failures (30%), n = 01patient came out against medical advice; one induction death is listed (acute cardiac toxicity) • Overall survival = 27% (fig1)Summary/Conclusion:our data are similar to those of the literature: rare pathologic LAM6 (3‐5 / series, 05% in ours), exceptional in children. The signs of bone marrow failure are almost constant, 1 pancytopenia in 50%. Splenomegaly is found in 1/3 of the cases. The prognosis is reserved (overall survival = 25% at 05 years) from wherethe value of rapid diagnosis and adequate managementimage

Secondary Malignant Neoplasms in Patients with Medulloblastoma

To analyze the incidence and types of second malignant neoplasms (SMN) in patients treated for medulloblastoma. Using the multiple primary-standardized incidence ratio (MP-SIR) session from SEER 9 registry data (1973-2014), we compared the incidence of SMN in patients with medulloblastoma treated with radiotherapy (RT) to the general population. Observed-to-expected incidence ratios (O/E ratios) and 95% confidence intervals (CI) were reported for the overall cohort and classified by disease sites according to age, era treated and use of chemotherapy (CT). We report organ systems or disease sites with statistically significant elevated O/E ratios of p <0.05. Of 1294 patients with medulloblastoma who received RT, 68 developed a SMN. A total of 75 SMN was reported, with 4 patients having 2 SMN and 1 having 4 SMN. The O/E ratio for SMN was 4.49 (CI 3.53-5.62) for all patients diagnosed with medulloblastoma (p<0.05). The highest risk for developing a SMN was in the central nervous system (CNS; O/E 40.62; CI 25.46 –61.51), followed by endocrine (O/E 15.95; CI 9.12-25.91), bone (O/E 14.45; CI 1.75-52.21), soft tissues (O/E 9.01; 95% 1.09-32.56), digestive (O/E 5.03; CI 2.51-9.00) and lymphatic/hematopoietic (O/E 3.37; CI 1.35-6.94) systems. Patients receiving chemotherapy had a higher O/E compared to RT alone (O/E 5.52, CI 3.75-7.83 vs. 3.96, CI 2.88-5.32); chemotherapy patients also had a higher O/E for SMN in the CNS, salivary gland, and acute non-lymphocytic leukemia compared to RT alone patients. After accounting for differences in length of follow-up with standardized incidence ratios, patients treated before 1995 and younger age at diagnosis were associated with a higher O/E for SMN. The O/E for ages 0-10 years, 11 to 20 years and > 20 years at time of RT were 11.48 (CI 7.85-16.21), 8.85 (CI 5.55-13.4) and 1.84 (CI 1.14-2.81) (p < 0.05 individual O/E ratios). The CNS, thyroid and salivary gland had higher O/E in the younger age groups compared to those > 20 years. Medulloblastoma patients have an elevated risk for SMN compared to the general population. Variations by organ systems most at risk were observed based on treatment modality, age at diagnosis and time period. The CNS is the most common site of SMN and is seen more frequently in younger patients and those receiving chemotherapy.

Allograft and patient survival after sequential HSCT and kidney transplantation from the same donor-A multicenter analysis.

Tolerance induction through simultaneous hematopoietic stem cell and renal transplantation has shown promising results, but it is hampered by the toxicity of preconditioning therapies and graft‐versus‐host disease (GVHD). Moreover, renal function has never been compared to conventionally transplanted patients, thus, whether donor‐specific tolerance results in improved outcomes remains unanswered. We collected follow‐up data of published cases of renal transplantations after hematopoietic stem cell transplantation from the same donor and compared patient and transplant kidney survival as well as function with caliper‐matched living‐donor renal transplantations from the Austrian dialysis and transplant registry. Overall, 22 tolerant and 20 control patients were included (median observation period 10 years [range 11 months to 26 years]). In the tolerant group, no renal allograft loss was reported, whereas 3 were lost in the control group. Median creatinine levels were 85 μmol/l (interquartile range [IQR] 72‐99) in the tolerant cohort and 118 μmol/l (IQR 99‐143) in the control group. Mixed linear‐model showed around 29% lower average creatinine levels throughout follow‐up in the tolerant group (P < .01). Our data clearly show stable renal graft function without long‐term immunosuppression for many years, suggesting permanent donor‐specific tolerance. Thus sequential transplantation might be an alternative approach for future studies targeting tolerance induction in renal allograft recipients.

Application of suction assisted closure to repair refractory ulcers of leukemia in children

Objective To investigate the effect of suction assisted closure (SAC) in treatment of children′s leukemia with refractory ulcers. Methods The clinical data of 15 children who had leukemia associated with refractory ulcers from January 2013 to April 2017 in Department of Orthopedics, Wuhan Children′s Hospital, Tongji Medical College of Huazhong University of Science & Technology were retrospectively analyzed.There were 8 males and 7 females, among whom 9 cases were acute non-lymphocytic leukemia and 6 cases were acute lymphoblastic leukemia.Patient′s ages ranged from 2 to 9 years old with the mean age of 6.2 years.There were 5 cases of refractory ulcers located in the medial side of thigh and 4 cases in the perineum and around anus, 3 cases in the ankle, 2 cases in the crus and 1 case in the lateral side of thigh.The refractory ulceration area varied from 2 cm×3 cm-7 cm×5 cm, and the depth varied from 0.6-1.8 cm.All the 15 cases were cultured with secretions, including 7 cases of Staphylococcus aureus, 4 cases of Escherichia coli, 2 cases of Klebsiella pneumoniae, 1 case of Pseudomonas aeruginosa, and 1 case with no bacteria detected.These children were transferred from Department of Hematology to Department of Orthopedics when there was no improvement in conventional therapy with the average treatment of 26 d (11-36 d). All of these children underwent SAC after thorough debridement.Secondary suturing of ulcers closure was performed or skin transplantation according to the recovery condition of ulcers. Results All the 15 patients of refractory ulcers achieved fresh granulation tissue after SAC treatment.Ten of them who had refractory ulcers could be sutured directly after once SAC treatment, and 5 cases who had refractory ulcers underwent SAC treatment again, in which 3 cases could be sutured directly, and the other 2 cases needed to reduce the wound area and autologous skin graft.All of these patients had refractory ulcers healed after SAC treatment, without any local or systemic complications. Conclusions SAC can bring the deep refractory ulcers into full drainage, protect the refractory ulcers against contamination, stimulate the growth of granulation tissue.SAC is a simple and effective method in treatment of children′s leukemia with refractory ulcers. Key words: Child; Leukemia; Suction assisted closure; Debridement

Acute Erythroblastic Leukemia Revealed by Dermatological Manifestations

Acute Erythroblastic Leukemia Revealed by Dermatological Manifestations

R-CHOP, radioimmunotherapy, and maintenance rituximab in untreated follicular lymphoma (SWOG S0801): a single-arm, phase 2, multicentre study

Despite an abundance of therapeutic options, advanced-stage follicular lymphoma remains incurable. Furthermore, the ideal sequence and absolute benefit of post-induction therapy is unclear. We designed SWOG S0801 to assess the efficacy and safety of consolidative radioimmunotherapy and sequential maintenance rituximab following chemoimmunotherapy. For this single-arm, phase 2, multicentre study, we enrolled patients aged 18 years and older with a diagnosis of stage III, IV, or bulky stage II follicular lymphoma, grades 1, 2, or 3a, who had not received previous therapy, from from 20 institutions within the United States National Cancer Institute Clinical Trials Network. Patients were assigned to a 5-year treatment plan consisting of R-CHOP (rituximab plus cyclophosphamide [750 mg/m2], doxorubicin [50 mg/m2], vincristine [1·4 mg/m2], and prednisone or prednisolone [100 mg]) every 21 days for up to six cycles, with rituximab 375 mg/m2 given on day 1 of cycles 1-4, followed by 131iodine tositumomab radioimmunotherapy and subsequent maintenance rituximab 375 mg/m2 within 12 weeks after the sixth cycle of R-CHOP, every 3 months for up to 4 years. The primary endpoint was 3-year progression-free survival in the intention-to-treat population. Efficacy and safety analyses were done in the intention-to-treat population and the per-protocol population. This trial was registered with ClinicalTrials.gov, number NCT00770224. Between April 1, 2009, and Dec 15, 2010, we enrolled 84 evaluable patients, of whom 73 completed R-CHOP and radioimmunotherapy. Of 69 patients who registered to maintenance therapy, only 41 completed the 4-year rituximab maintenance treatment. Progression-free survival at 3 years was 90% (95% CI 82-95). The most common grade 3 or worse adverse events included neutropenia in 48 (57%) patients, leucopenia in 34 (40%) patients, thrombocytopenia in 17 (20%) patients, and febrile neutropenia in 14 (17%) patients. Nine patients had possible treatment-related deaths during the study from secondary or unknown causes (n=3), cirrhosis (n=1), cardiac arrest (n=1), and secondary malignancies (n=4). Secondary malignancies occurred in seven patients, including two sarcomas, two colorectal carcinomas, two acute myelogenous leukaemias, and one case of renal-cell carcinoma. SWOG S0801 showed near universal responses following chemoimmunotherapy and radioimmunotherapy. However, most discontinuations occurred during maintenance therapy, suggesting that rituximab over a 4-year span is not feasible for many patients. Nonetheless, this sequential therapeutic strategy resulted in good overall outcomes for patients, including a low incidence of early disease progression. The National Cancer Institute and GlaxoSmithKline.

Application of GATA-3 gene marker in the detection of hematologic disorders in children.

The aim of the present study was to investigate the use of GATA-3 markers in the detection of hematologic disorders in children. In total, 35 pediatric patients diagnosed with blood disease and treated in Henan Red Cross Blood Center from January 2014 to June 2015 were selected for the observation group. Another 32 healthy children were selected for the control group. The differences in the GATA-3 mRNA expression levels between the control and observation groups were detected via reverse transcription-quantitative polymerase chain reaction (RT-qPCR). The differences in the GATA-3 protein expression levels were detected via enzyme-linked immunosorbent assay (ELISA) and western blot analysis. Compared with those in the healthy children, the mRNA expression levels of GATA-3 in patients with hematologic malignancies, acute lymphoblastic leukemia, myeloproliferative disorder, acute non-lymphocytic leukemia or thrombocytopenic purpura were significantly higher, and there were statistically significant differences between the groups (P<0.05). The results of ELISA showed that the GATA-3 protein expression levels in patients with hematologic malignancies (241.3±42.6 µg/l), acute lymphoblastic leukemia (196.3±21.6 µg/l), myeloproliferative disorder (284.2±45.1 µg/l), acute non-lymphocytic leukemia (269.3±31.4 µg/l) or thrombocytopenic purpura (272.1±39.1 µg/l) were significantly higher than those in healthy subjects (69.3±15.2 µg/l). The results of western blot analysis were consistent with those of ELISA. Based on our results, the expression levels of GATA-3 in healthy children and pediatric patients with blood diseases exhibit significant differences, and can be used as important markers for the clinical diagnosis of blood diseases in children.

Health Care Quality - An Urgent Issue for Bangladesh

Thirty-four patients undergoing bone marrow transplantation or remission induction for acute non-lymphocytic leukemia were the subjects of a study to determine whether outcome of infection (survival, death) could be related to total complement (TC), complement components, or C-reactive protein (CRP). Serum samples were obtained when the neutropenic patients became febrile, and at intervals thereafter. Significant differences were found between final total serum complement levels, the C3 component of complement, and the C-reactive protein. Multivariate logistic regression demonstrated a significant relationship between the final C3 complement and C-reactive protein levels and the outcome of infection. Changes between initial and final values were also predictive of outcome, suggesting that the magnitude and direction of changes in these measurements may assist the clinician in assessing the success of his prescribed antibiotic therapy. Our data suggest that a test battery comprising serial TC, C3, and CRP measurements may have more predictive potential than each test performed independently.

Asociere miastenia gravis – leucemie eritroblastică acută

Myasthenia Gravis is a chronic autoimmune neuromuscular disorder that is characterized by fluctuating weakness of the voluntary muscle groups. It occurs in all races, at any age (especially under 40 or over 60), both genders, with a prevalence of 20/100,000 population in the United States. About 15 percent of patients with myasthenia gravis have thymomas, much rarely another solid tumor, thyroid dysfunction and more often another autoimmune condition, such as rheumatoid arthritis, lupus, Biermer anaemia. We present a 72 year-old male patient with ocular myasthenia gravis treated with cholinesterase inhibitors, that, after many laboratory exams, was diagnosed with acute erythroblastic leukemia, a very rare clinical association.

Correlation between Dynamic Change of IL-32 Level and Disease Development in Acute Leukemia Patients

To investigate the correlation between dynamic change of IL-32 level and disease development in the patients with acute leukemia(AL) and to explore its clinical significance. The serum IL-32 levels and IL-32 mRNA expression in 82 cases of AL and 30 healthy persons were measured by ELISA and real-time PCR. Compared with healthy persons, the serum IL-32 protein level and IL-32 mRNA expression in AL, acute lymphoblastic leukemia(ALL) and acute non-lymphocytic leukemia(ANLL) groups all were significantly higher(P<0.05). The serum level of IL-32 protein and mRNA expression in newly diagnosed, PR and relapsed ALL and ANLL groups were all higher than those in the control group(P<0.05), and the serum protein level of IL-32 in relapsed ALL and ANLL groups were higher than that in other stage group(P<0.05). The serum levels of IL-32 protein and mRNA were not significantly different between CR and control group(P>0.05). The IL-32 in the peripheral blood of patients with AL has been found to be closely related with the occurrence and development of disease, therefore, monitoring the dynamic changes of serum IL-32 level would contribute to the clinical judgment of the severity, the IL-32 levels can be used as indicators for the therapeutic efficacy for AL.

Epidemiology of Second Primary Tumors in Women With Ovarian Cancer.

The last large study of second primary tumors (SPTs) in women with ovarian cancer was published in 1996, prior to major changes in the differential diagnosis and treatment. The present study reports on the incidence of SPTs in a contemporary cohort of patients with a diagnosis of ovarian cancer. Ovarian cancer patients with a diagnosis of an ovarian malignancy between 1992 and 2012 were identified and characterized from 13 registries of the Surveillance, Epidemiology, and End Results database. Of 41,073 women with a diagnosis of an ovarian malignancy between 1992 and 2012, 1831 (4.5%) developed a microscopically confirmed SPT. There was no significant difference in the risk of developing an SPT at all sites between women with an ovarian cancer and the general population. There was an elevated risk of site-specific SPTs of the small intestine, vagina, thyroid gland, and acute nonlymphocytic leukemia in ovarian cancer patients compared with the general Surveillance, Epidemiology, and End Results population. Conversely, the risk of lung and non-Hodgkin lymphoma was significantly decreased in women with ovarian cancer. An elevated risk of SPTs was observed in women with mucinous, endometrioid, and germ cell tumors. White women had an overall decreased risk of developing a second primary solid tumor, whereas American Indian and Asian/Pacific Islander women had an overall increased risk of an SPT at any site. The incidence of SPTs in women with ovarian cancer was not significantly different as compared with the general population. However, divergent rates of SPTs in relation to histology, latency, age, and race were observed.

GATA1 Activity Governed by Configurations of cis-Acting Elements

The transcription factor GATA1 regulates the expression of essential erythroid and megakaryocytic differentiation genes through binding to the DNA consensus sequence WGATAR. The GATA1 protein has four functional domains, including two centrally located zinc-finger domains and two transactivation domains at the N- and C-termini. These functional domains play characteristic roles in the elaborate regulation of diversified GATA1 target genes, each of which exhibits a unique expression profile. Three types of GATA1-related hematological malignancies have been reported. One is a structural mutation in the GATA1 gene, resulting in the production of a short form of GATA1 that lacks the N-terminal transactivation domain and is found in Down syndrome-related acute megakaryocytic leukemia. The other two are cis-acting regulatory mutations affecting expression of the Gata1 gene, which have been shown to cause acute erythroblastic leukemia and myelofibrosis in mice. Therefore, imbalanced gene regulation caused by qualitative and quantitative changes in GATA1 is thought to be involved in specific hematological disease pathogenesis. In the present review, we discuss recent advances in understanding the mechanisms of differential transcriptional regulation by GATA1 during erythroid differentiation, with special reference to the binding kinetics of GATA1 at conformation-specific binding sites.

Possible Evolution of Paroxysmal Nocturnal Hemoglobinuria into Chronic Myeloid Leukemia: A Rare Transformation

PNH is a rare acquired clonal hematopoietic stem cell disorder characterized by abnormal sensitivity of red blood cells to lysis by complement. It is caused by genetic mutation resulting in deficiency of glycosyl phosphatidylinositol anchor (GPA) for cell membrane proteins including complement regulating proteins CD55 and CD59. PNH tends to be associated with Aplastic Anemia (anemia due to failure of the bone marrow to produce red and white blood cells as well as platelets), Myelodysplastic Syndrome (a group of cancers in which immature blood cells in the bone marrow do not mature or become healthy blood cells) or rarely Acute Myeloid Leukemia (AML) (also known as acute nonlymphocytic leukemia, representing a group of clonal hematopoietic stem cell disorders in which both a block in differentiation and unchecked proliferation result in the accumulation of myeloblasts at the expense of normal hematopoietic precursors). Here we report a case and assume possible evolution of PNH into CML (a myeloproliferative malignant clonal disease characterized by presence of fusion BCR/ABL fusion oncogene).

Population Level Survival for Patients with Rare Hematologic Malignancies in the United States in the Early 21st Century

Introduction: Population level survival has increased for most of the more common hematologic malignancies in the early 21st century. However, less information is available on population level changes in survival for patients with rare hematologic malignancies. Here, we examine survival for rare hematologic malignancies in Germany and the United States (US).Methods: Cases of rare hematologic malignancies were extracted from the Surveillance, Epidemiology, and End Results (SEER13) database in the US, with an underlying population of 44.1 million people, and 12 regional cancer databases in Germany, with an underlying population of 28.3 million. For the purpose of this study, rare hematologic malignancies were defined as those having an incidence of less than 1 per 10,000 population in both the relevant databases. Modeled period analysis was used to examine changes in 5-year survival between 2003-07 and 2008-12 and to derive p-values for the comparison between the two periods.Results: Ten malignancies that met the inclusion criteria and had adequate case numbers to allow a meaningful analysis were identified (see table.) A total of 13,895 cases were identified in Germany and 19,894 in the US with case numbers for individual morphologies ranging from 302 for acute erythroblastic leukemia in Germany to 4,514 for mantle cell lymphoma in the US. Overall 5-year relative survival for patients with all morphologies was estimated as 60.4% in Germany and 57.2% in the US in 2008-12. Survival for patients varied widely depending on the individual tumor type, from less than 30% for acute monoblastic leukemia and acute erythroblastic leukemia to around 90% for hairy cell leukemia and mycosis fungoides without Sezary. A statistically significant increase in survival was observed for mantle cell lymphoma, Burkitt's lymphoma, and hairy cell leukemia in Germany and for mantle cell lymphoma, anaplastic lymphoma kinase (ALK) positive anaplastic lymphoma, and acute erythroblastic leukemia in the US.Conclusions: Five year survival varied widely for rare hematologic malignancies in Germany and the US. Significant increases in survival were observed in only a minority of rare hematologic malignancies, in contrast to the consistent increases in survival seen in almost all of the more common hematologic malignancies. Survival was lower in the US for most malignancies. Research specifically focusing on rare hematologic cancer types is needed to increase survival for these conditions. [Display omitted] DisclosuresPulte:ApoPharma: Research Funding; Selexys Pharmaceuticals: Research Funding; EBSCO: Other: Review of content for Dynamed medical reference product.

Value of DAPK Gene Methylation Patterns in the Diagnosis of Leukemia

To screen the differential methylation patterns of tumor suppressor gene DAPK and evaluate its value as a biomarker for the diagnosis of leukemia. The methylation status of DAPK gene promoter's CpG island was analyzed in the genomes of normal human white blood cells and HL-60, U937 and Jurkat cell lines by bisulfite sequencing PCR (BSP). The effectiveness of differential methylation patterns of DAPK gene for diagnosis of leukemia was verified in the leukemia cell lines and peripheral blood samples by methylation specific PCR (MSP). The methylation pattern of DAPK gene in different cell genomes displayed that the degree of unmethylation in normal cell genome was higher than that of leukemia cell lines. The differential CpG sites were found and could be used to differentiate HL-60 and the other 3 cell lines by MSP. Meanwhile, the differential methylation patterns in clinical specimens could distinguish acute non-lymphocytic leukemia (ANLL) and other types of leukemia by MSP. The diagnostic sensitivity, specificity and accuracy were 59.1%, 100% and 82.7% respectively. No relationship was found between MSP diagnosis results and clinical pathological typing. The differential methylation patterns of DAPK gene as potential tumor biomarker for diagnosis of leukemia can enrich the means of diagnosis of leukemia, provide idea and basis for finding all kinds of tumor's DNA methylation biomarkers in the future.

Erratum - Evaluation of Acute Nonlymphocytic Leukemia and Its Subtypes With Updated Benzene Exposure and Mortality Estimates

Erratum - Evaluation of Acute Nonlymphocytic Leukemia and Its Subtypes With Updated Benzene Exposure and Mortality Estimates