Prostate cancer and chronic lymphocytic leukemia

The association between prostate cancer and chronic lymphocytic leukemia (CLL) is rare.We report a case of 69 year old man who presented a CLL, classified as Binet stage C, treated with FCR protocol. After six cycles of chemotherapy, itwas in complete remission. Eighteen months after the end of treatment, the patient presented with dysuria and back pain. Digital rectal examination revealed an indurated prostate. The PSA was elevated to 1103 ng/ml. Prostate biopsy with histopathologic study showed poorly differentiated prostate adenocarcinoma (Gleason score: 8). Staging workup revealed bone metastases. Adjuvant radiotherapy and pulpectomy associated with bisphosphonates and analgesics was proposed. The association between CLL and prostate cancer appears too frequent to be accidental.Keywords: Prostate cancer; Chronic lymphocytic leukaemia; TreatmentAfrican Journal of Urology (2013) 19, 35–3

Management of Pediatric Tumor Lysis Syndrome

Introduction: Tumor lysis syndrome (TLS) is a serious complication of malignancies and can result in renal failure or death. Review: In tumors with a high proliferative rate with a relatively large mass and a high sensitivity to cytotoxic agents, the initiation of therapy often results in the rapid release of intracellular anions, cations and the metabolic products of proteins and nucleic acids into the bloodstream. The increased concentrations of uric acid, phosphates, potassium and urea can overwhelm the body’s homeostatic mechanisms to process and excrete these materials and result in the clinical spectrum associated with TLS. Typical clinical sequelae include gastrointestinal disturbances, neuromuscular effects, cardiovascular complications, acute renal failure and death. Tumor lysis syndrome can also compromise the efficacy or administration of curative therapies. Available evidence suggests that the incidence of clinical TLS is approximately 3–7% for acute leukemias and 4–11% for lymphomas. Pediatric cancers are the leading cause of death by disease in children. The most common pediatric cancers include the leukemias, lymphomas, central nervous system tumors and neuroblastoma. Thus, TLS is a major concern to practitioners caring for pediatric oncology patients. Given the complexity of TLS prevention and treatment, a multidisciplinary approach involving the collaboration of medical oncologists/ hematologists and nephrologists has the greatest potential of ensuring optimal patient outcomes. Rehydration is fundamental in the management of TLS in addition to the current standard therapy for hyperuricemia which include rasburicase and allopurinol. Conclusion: The early recognition and treatment of metabolic abnormalities often prevents the severe and life-threatening complications associated with tumor lysis syndrome.Keyswords: Acute Renal Failure; Burkitt’s Lymphoma; Hematologic Malignancies; Hydration; Tumor Lysis Syndrom

Le médicament générique au Maroc: le point de vue du consommateur

Introduction: Le médicament générique est souvent une origine de préjugés négatifs et de méfiance chez les professionnels de santé et les patients. Ceci pourrait être dû à plusieurs facteurs entre autre le manque des connaissances du patient sur ces médicaments. Le but de notre étude était d'évaluer l'information du consommateur sur les médicaments génériques et apprécier leur utilisation de ces médicaments. Méthodes: Il s'agit d'une étude transversale réalisée de Janvier à Mars 2010 auprès de 251 sujets. Un questionnaire comprenant dix questions fermées a été utilisé. Les questions concernaient l'évaluation des connaissances sur les médicaments génériques, les sources d'information, le degré de confiance et d'information des patients sur ces médicaments. Une analyse descriptive simple des différentes variables a été réalisée. Résultats: Dans notre étude, 126 sujets (50,2%) ont répondu connaître les médicaments génériques. Parmi eux, 52,3% les utilisaient et 67,4% estimaient qu'ils étaient insuffisamment informés sur ces médicaments. Les cadres supérieurs et les étudiants ont représenté la catégorie qui utilisait le plus les médicaments génériques (respectivement dans 40,9% et 25,7%) et qui était la mieux informée (respectivement dans 61,9% et 23,81%). Le faible coût a été la principale motivation d'utilisation du médicament générique (93,9%). Les médias ont représenté la première source d'information (59,5%). Après sensibilisation, 88,8% des sujets qui ne connaissaient pas le médicament générique ont été favorable à son utilisation.Conclusion: Une promotion efficace par une politique d'information soutenue auprès des consommateurs et par des mesures incitatrices à la prescription et à la délivrance du générique par les médecins et les pharmaciens, pourront améliorer l'utilisation de ces médicaments dans notre pays.Key words: Médicament générique, consommateur, perception, Maro

Narrowing the gap for hematopoietic stem cell transplantation in the East-Mediterranean/African region: comparison with global HSCT indications and trends.

Hematopoietic Stem Cell Transplantation (HSCT) activity was evaluated in the African (AFR)/EMRO region and compared to the global activity for the years 2006-2013. Data were obtained from 1570 teams in the 6 WHO continental regions. Of these, 29 (1.85%) of all teams were active in 12 of the 68 AFR/EMRO countries. They reported 2.331 (3.3%) of the worldwide 71.036 HSCT, and a transplant rate of 32.8 (TR; HSCT/10 million inhabitants; worldwide 128.5). This reflects still the lowest regional TR despite an increase of 90% since 2006. HSCT activity in AFR/EMRO countries was characterized by a higher use of allogeneic compared to autologous HSCT, an almost exclusive use of family donors, including haploidentical family donors. These findings contrast with the prevalence of autologous over allogeneic HSCT, and a higher frequency of unrelated HSCT in other parts of the world. Of note, the increase by 200% in HSCT for hemoglobinopathies from 2006 to 2013 (72 per year) in the AFR/EMRO region. This reflects the specific role of HSCT for these disease categories with high prevalence and incidence in the AFR/EMRO region. This report provides information for the competent authorities to foster adequate infrastructure. It urges transplant organization to optimize their cooperation

Monoclonal antibodies in hematological malignancies: Past, present and future

Much progress has been made during the last few decades in the treatment of hematological malignancies. Monoclonal antibodies (MoAbs) represent a major advance toward a targeted therapy that can dramatically improve the antitumor effect with a substantial reduction of toxicity derived from therapy. Unlike many small molecules, MoAbs offer unique target specificity. Several MoAbs are now in clinical use for hematologic malignancies therapy, and many others are currently undergoing clinical evaluation. This review summarizes the state-of-the-art MoAbs treatment, beginning with an overview of the scientific background to their synthesis, mechanism of action and choice of target antigen, mainly focusing on those antibodies that are currently in use in clinical practice. Despite these advances, significant challenges remain in the identification of optimal cellular targets, antibody forms and treatment schedules for therapeutic applications

Chest wall tumor at relapse of multiple myeloma

We report the case of a 70-year-old Moroccan man who was diagnosed with stage IIIA IgA kappa multiple myeloma according to Durie and Salmon classification. He was an alcohol abuser and heavy smoker (2 packs per day). He was admitted to our department for thoracic pain, persistent and increasing. He also complained of mild shortness of breath and poor appetite. Initial physical examination was normal. Laboratory investigations showed a hemoglobin of 12 g/dL, MCV of 83fL, white cell count of 3,900/ L and platelet of 174,000/L

Cancer de la prostate et leucémie lymphoïde chronique

RésuméL'association entre cancer de la prostate et leucémie lymphoïde chronique (LLC) est rare. Nous rapportons l'observation d'un patient âgé de 69ans qui a présenté une LLC, classée stade C de Binet, traité par protocole FCR. Après 6 cures de chimiothérapie, il était en rémission complète. Dix huit mois après la fin du traitement, le patient a consulté pour dysurie et douleur lombaire. Le toucher rectal retrouvait une prostate indurée. Le PSA était élevé à 1103 ng/ml. La biopsie prostatique avec étude anatomopathologique a objectivé un adénocarcinome prostatique peu différencié (score de Gleason: 8). Le bilan d'extension retrouvait des métastases osseuses. Un traitement adjuvant par pulpectomie et radiothérapie associé aux biphosphonates et antalgiques était proposé.L'association entre LLC et cancer de la prostate parait plus fréquente pour être fortuite.AbstractThe association between prostate cancer and chronic lymphocytic leukemia (CLL) is rare. We report a case of 69 year old man who presented a CLL, classified as Binet stage C, treated with FCR protocol. After six cycles of chemotherapy, it was in complete remission. Eighteen months after the end of treatment, the patient presented with dysuria and back pain. Digital rectal examination revealed an indurated prostate. The PSA was elevated to 1103 ng/ml. Prostate biopsy with histopathologic study showed poorly differentiated prostate adenocarcinoma (Gleason score: 8). Staging workup revealed bone metastases. Adjuvant radiotherapy and pulpectomy associated with bisphosphonates and analgesics was proposed.The association between CLL and prostate cancer appears too frequent to be accidental

Epigastric discomfort during pregnancy presenting as gastric Burkitt lymphoma

No Abstract