• Investigative Magnetic Resonance Imaging
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• v.13 no.1
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• pp.88-92
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• 2009

Granulocytic sarcoma is a rare extramedullary tumor composed of immature granulocytic precursors. Usually, granulocytic sarcoma is seen in association with acute myeloid leukemia, or other myeloproliferative disorders. Rarely, it may manifest as a primary presentation before the onset of systemic disease in acute myeloid leukemia. The clinical suspicion of granulocytic sarcoma based on imaging findings is important for the management of the patient especially when systemic disease of acute myeloid leukemia is not confirmed as in our case. We report the MR findings of a granulocytic sarcoma in the left leg mimicking hemorrhagic abscess in a patient with acute myeloid leukemia. We believe that MRI can be a helpful diagnostic method of making a differential diagnosis of granulocytic sarcoma in a patient with leukemia, and this can be done by analyzing the signal intensity and the enhancement pattern.

• Journal of Periodontal and Implant Science
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• v.44 no.6
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• pp.293-299
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• 2014

Purpose: Systemic disease can manifest oral signs at an early phase, which may be crucial for the diagnosis and timing of treatment. This report describes two patients who presented with gingival enlargement as an early sign of acute leukemia. Methods: Two patients presented with oral symptoms including severe gingival enlargement. The progress of their symptoms was associated with underlying systemic disease. Results: The patients were transferred to the Department of Hematology and diagnosed with acute myelomonocytic leukemia. They received appropriate treatment and survived. Conclusions: Gingival enlargement can be caused by underlying systemic diseases. Accurate diagnosis and timely referral are important for preventing a fatal situation. It must be emphasized that some oral signs and symptoms may be closely correlated with systemic diseases.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.15
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• pp.6127-6130
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• 2014

Objective: Explore the feasibility of allo-hemopietic stem cell transplants in treating patients with B cell acute lymphocytic leukemia. Methods: Between september 2006 and February 2011, fifteen patients with B cell acute lymphocytic leukemia (ALL) were treated by allo-hemopietic stem cell transplants (HSCT). Stem cell sources were peripheral blood. Six patients were conditioned by busulfan (BU) and cyclophosphamide (CY) and nine patients were conditioned with TBI and cyclophosphamide (CY). Graft versus host disease (GVHD) prophylaxis regimen consisted of cyclosporine A (CSA), methotrex ate (MTX) and mycophenolatemofetil (MMF). Results: Patients received a median of $7.98{\times}10^8{\cdot}kg^{-1}$ ($5.36-12.30{\times}10^8{\cdot}kg^{-1}$) mononuclear cells (MNC). The median time of ANC> $0.5{\times}10^9/L$ was day 12 (10-15), and PLT> $20.0{\times}10^9/L$ was day 13 (11-16). Extensive acute GVHD occurred in 6 (40.0%) patients, and extensive chronic GVHD was recorded in 6 (40.0%) patients. Nine patients were alive after 2.5-65 months follow-up. Conclusion: Allogeneic stem cell transplant could be effective in treating patients with B cell acute lymphocytic leukemia.

• Clinical and Experimental Pediatrics
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• v.56 no.6
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• pp.247-253
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• 2013

Purpose: In children with acute leukemia, bone marrow genetic abnormalities (GA) have prognostic significance, and may be the basis for minimal residual disease monitoring. Since April 2007, we have used a multiplex reverse transcriptase-polymerase chain reaction tool (HemaVision) to detect of GA. Methods: In this study, we reviewed the results of HemaVision screening in 270 children with acute leukemia, newly diagnosed at The Catholic University of Korea from April 2007 to December 2011, and compared the results with those of fluorescence in situ hybridization (FISH), and G-band karyotyping. Results: Among the 270 children (153 males, 117 females), 187 acute lymphoblastic leukemia and 74 acute myeloid leukemia patients were identified. Overall, GA was detected in 230 patients (85.2%). HemaVision, FISH, and G-band karyotyping identified GA in 125 (46.3%), 126 (46.7%), and 215 patients (79.6%), respectively. TEL-AML1 (20.9%, 39/187) and AML1-ETO (27%, 20/74) were the most common GA in ALL and AML, respectively. Overall sensitivity of HemaVision was 98.4%, with false-negative results in 2 instances: 1 each for TEL-AML1 and MLL-AF4. An aggregate of diseases-specific FISH showed 100% sensitivity in detection of GA covered by HemaVision for actual probes utilized. G-band karyotype revealed GA other than those covered by HemaVison screening in 133 patients (49.3%). Except for hyperdiplody and hypodiploidy, recurrent GA as defined by the World Health Organizationthat were not screened by HemaVision, were absent in the karyotype. Conclusion: HemaVision, supported by an aggregate of FISH tests for important translocations, may allow for accurate diagnosis of GA in Korean children with acute leukemia.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.1
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• pp.369-372
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• 2016

Background: Acute myeloid leukemia is an acquired clonal heterogeneous stem cell disorder. Hence, various parameters are sought out to categorize this disease into subtypes, so that as a consequence specific treatment modalities can be offered. Conventionally, the practically used method for classification utilizes French American British (FAB) criteria based on morphology and cytochemistry. The aim of present study was to determine the current spectrum of AML sub types in patients in Karachi. Materials and Methods: This single centre cross sectional study was conducted at Liaquat National Hospital, Karachi, extending from January 2010 to December 2014. Data were retrieved from archives were analyzed with SPSS version 22. Results: A total of 125 patients were diagnosed at our institution with de novo AML during five years period, 76 males and 49 females. Median age was 34.5 years. AML-M1 was the predominant FAB subtype (23.2%) followed by M2 (18.4%), M3 and M4 (16% each), M0 (14.4%), M5 (7.2%), M6 (3.2%) and M7 (1.6%). Conclusions: AML in Pakistani patients is seen in a relatively young population. The most common FAB subtype observed in our study was acute myeloblastic leukemia, without maturation (M1).

• BLOOD RESEARCH
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• v.53 no.4
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• pp.294-298
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• 2018

Background Production of immunosuppressive enzymes such as indoleamine 2,3-dioxygenase (IDO) is one of the strategies employed by hematologic malignancies, including acute myeloid leukemia (AML), to circumvent immune surveillance. Moreover, IDO has the ability to convert $CD4^+CD25^-$ conventional T cells into regulatory T cells (Tregs). In this study, we evaluated the expression of IDO in cytogenetically normal acute myeloid leukemia (CN-AML) patients and its correlation with the Treg marker, FOXP3, as well as clinical and laboratory parameters. Methods Thirty-seven newly diagnosed CN-AML patients were enrolled in our study along with 22 healthy individuals. The expression of the IDO and FOXP3 genes was analyzed by SYBR Green real-time PCR. Results Both IDO and FOXP3 were highly upregulated in CN-AML patients compared to control groups (P=0.004 and P=0.031, respectively). A positive correlation was observed between IDO and FOXP3 expression among AML patients (r=0.512, P=0.001). Expression of IDO and FOXP3 showed no significant correlation with laboratory parameters such as white blood cell and platelet counts, hemoglobin levels, bone marrow blast percentage, gender, and FLT3 mutation status (P>0.05). Conclusion Higher IDO expression in CN-AML patients may be associated with an increased Treg phenotype which may promote disease progression and lead to poor prognosis of CN-AML patients.

• The Korean Journal of Nuclear Medicine
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• v.32 no.5
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• pp.436-442
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• 1998

Radioactive iodine treatment has been widely used for nearly 50 years in the treatment of thyroid cancer to ablate residual thyroid tissue after thyroidectomy and to treat metastatic disease. Leukemia is a rare complication associated with the radioactive iodine therapy. The occurrence of leukemia is known to be related to the cumulative dosage of I-131 more than 37 GBq (1 Ci) and also associated with the intervals of less than 12 months between the repeated doses. We report a case of a 52 year-old female patient with papillary cancer of thyroid who developed acute myelogenous leukemia after the total 20.4 GBq (550 mCi) of I-131 therapy over 3.2 years and palliative radiation therapy (3000 cGy) due to multiple bone metastasis of papillary cancer.

• Journal of Korean Dental Science
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• v.15 no.2
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• pp.141-146
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• 2022

Leukemia is a neoplastic disease with an excessive proliferation of immature white blood cells and their precursors. Common oral manifestations of acute myeloid leukemia (AML) include ulceration, petechiae, spontaneous bleeding, and gingival hyperplasia. The estimated prevalence of AML is 19 per 100,000 populations, the median age of diagnosis is over 65 years, and of all the subtypes of leukemia, AML accounts for the highest percentage of leukemic deaths. The purpose of this study is to report the case of a 77-year-old female patient, who visited our outpatient clinic due to consistent inflammatory findings. Though she received surgical treatment, she was diagnosed with AML by chance after a preoperative blood test. We also discuss the necessity of performing a preoperative blood test prior to invasive dental procedures such as tooth extraction or biopsy.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.17
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• pp.7893-7895
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• 2015

Background: Acute promyelocytic leukemia (APL) is a distinctive clinical, biological and molecular subtype of acute myeloid leukemia. However, data from Pakistan are scarce. Therefore we reviewed the demographic and clinical profile along with risk stratification of APL patients at our center. Materials and Methods: In this descriptive cross sectional study, 26 patients with acute promyelocytic leukemia were enrolled from January 2011 to June 2015. Data were analyzed with SPSS version 22. Results: The mean age was $31.8{\pm}1.68years$ with a median of 32 years. The female to male ratio was 2:1.2. The majority of our patients had hypergranular variant (65.4%) rather than the microgranular type. The major complaints were bleeding (80.7%), fever (76.9%), generalized weakness (30.7%) and dyspnea (15.38%). Physical examination revealed petechial rashes as a predominant finding detected in 61.5% followed by pallor in 30.8%. The mean hemoglobin was $8.04{\pm}2.29g/dl$ with the mean MCV of $84.7{\pm}7.72fl$. The mean total leukocyte count of $5.44{\pm}7.62{\times}10^9/l$; ANC of $1.08{\pm}2.98{\times}10^9/l$ and mean platelets count were $38.84{\pm}5.38{\times}10^9/l$. According to risk stratification, 15.3% were in high, 65.4% in intermediate and 19.2% in low risk groups. Conclusions: Clinico-epidemiological features of APL in Pakistani patients appear comparable to published data. Haemorrhagic diathesis is the commonest presentation. Risk stratification revealed predominance of intermediate risk disease.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.5
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• pp.2075-2081
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• 2014

The association between glutathione-S-transferase polymorphisms (GSTM1, GSTT1 and GSTP1) and risk of acute leukemia in Asians remains controversial. This study was therefore designed to evaluate the precise association in 23 studies identified by a search of PubMed and several other databases, up to December 2013. Using random or fixed effects models odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated. Heterogeneity across studies was assessed, and funnel plots were constructed to test for publication bias. The meta-analysis showed positive associations between GST polymorphisms (GSTM1 and GSTT1 but not GSTP1) and acute leukemia risk [(OR=1.47, 95% CI 1.18-1.83); (OR=1.32, 95% CI 1.07-1.62); (OR=1.01, 95% CI 0.84-1.23), respectively] and heterogeneity between the studies. The results suggested that the GSTM1 null genotype and GSTT1null genotype, but not the GSTP1 polymorphism, might be a potential risk factors for acute leukemia. Further well-designed studies are needed to confirm our findings.