Retrospective analysis of therapeutic response obtained with enteral and parenteral iron in adults with iron deficiency anaemia

AbstractBackgroundFew studies compare the therapeutic efficacy of different iron deficiency anaemia treatments.AimEvaluate the therapeutic response of the most common iron preparations.Material and methodsRetrospective, observational-analytical study based on medical records from the Haematology Department, conducted from March to October 2014, including 121 adults with ferropenic anaemia and 3-month follow-up. Patients with comorbidities or pregnancy were excluded.Results85.8% were women (n=103) and 14% men (n=17), with a mean age of 42 (16–83) years. Seventy patients (58.3%) started with oral administration; the rest received intravenous iron. Efficacy was similar among all the iron preparations, with no significant differences (p>0.05). Iron sucrose was most effective in rapidly replenishing body iron stores.ConclusionsDespite comparable efficacy among treatments, ferrous fumarate had the lowest treatment failure and was the therapy of choice

Detection and analysis of tumour biomarkers to strengthen the diagnosis of acute and chronic leukaemias

AbstractMolecular markers in leukaemia are essential to diagnose, establish prognosis factors and determine the correct treatment of patients; therefore, it is imperative to include molecular biology studies, so that, combined with cytomorphology and immunophenotyping studies, they constitute the differential diagnosis of these neoplasias. It is extremely important to implement a panel of molecular markers that allows us to detect oncogenes derived from chromosomal translocations, genes derived from epigenetic alterations and drug-resistant genes.A panel of molecular markers that included 11 genes derived from chromosomal translocations BCR-ABL major and minor breakpoints, E2A-PBX1, MLL-AF4, TEL-AML1, PML-RARα, AML1-ETO was standardised; cancer testis antigens (CTA) derived from NY-ESO1 and MAGE-A3 epigenetic alterations and multi-drug-resistant genes ABCB1 and ABCG2. 30 patients diagnosed with leukaemia from Mexico's General Hospital (Hospital General de Mexico) were included. They suffered from acute lymphoblastic leukaemia (ALL) and acute myeloblastic leukaemia (AML); bone marrow mononuclear cells were used, from which RNA was extracted for the synthesis of cDNA and RT-PCR for each of the markers. In acute lymphoblastic leukaemia (ALL), BCR-ABL biomarkers expressed under 30% (3/10), E2A-PBX1 10% (1/10), ABC-B1 80% (8/10), and ABC-G2 60% (6/10). Patients with acute myeloblastic leukaemia (AML) expressed 30% PML-RARα (3/10), 40% ABC-B1 (4/10), and 10% ABC-G2 (1/10). Lastly, in patients with chronic myeloid leukaemia (CML), BCR-ABL was over 100% (10/10), ABC-B1 20% (2/10), and ABC-G2 50% (5/10). The presence of transcripts from chimeric genes minor BCR-ABL and E2A-PBX1 in ALL; PML-RARα in AML; and major BCR-ABL in CML, confirms the importance that the panel of molecular markers has in strengthening the diagnosis and prognosis of these conditions

Expression of cancer testis antigens in patients with Hodgkin's lymphoma and their clinical correlation

Objective: To determine the frequency of expression of cancer testis antigens and their clinical correlation in patients with Hodgkin lymphoma. Methodology of the study: In this analytical, experimental and ambispective study, the MAGE A-3 and NY-ESO-1 antigen expression was correlated with clinical prognostic variables such as clinical stage, response to treatment, and relapse, in a total of 70 patients diagnosed with Hodgkin's lymphoma at the Hodgkin's Lymphoma Clinic of the General Hospital of Mexico “Dr. Eduardo Liceaga”, from December 2000 to December 2015. Twenty-four patients were evaluated using RT-PCR, following extraction of RNA, to detect MAGE-A3 and NY-ESO1 expression. Cellular RNA was extracted from frozen tissue and controls using trizol (Life Technologies, Paisley, UK). 1 μg of RNA was used for cDNA synthesis by M-MLV reverse transcriptase (Life technologies, Paisley, UK). Results: We studied 24 patients with a median age of 28 years, a minimum age of 16 years and a maximum age of 48 years, mostly male. 50% of patients presented complete response to the first line of treatment and 27% of patients presented relapse, 37.5% in relation to the expression of MAGE-A3. Expression of the NY-ESO-1 gene was not found in the study group. Twelve percent of patients died during the study, 8.33% of whom were also positive for MAGE-A3 (p = 0.264.95% CI). No significant correlation was found between MAGE-A3 expression and major clinical prognostic variables. Conclusion: Although the expression of MAGE-A3 in the study group was 37.5% (higher than reported in international studies), we found no correlation with the main clinical prognostics variables. Considering that the expression of MAGE-A3 in the cases studied does not confer prognostic value, making it impossible to use as a prognostic tool in peripheral blood, we are leaving the doors open to continue with this line of research, possibly increasing the number of patients as well as prolonging the follow-up time

Palliative prognostic index and Charlson comorbidity index as predictors of mortality in acute lymphoblastic leukaemia patients who are candidates for palliative care

Objective: To establish whether the palliative prognostic index (PPI), the Charlson comorbidity index (CCI) or other factors are predictors of survival for patients with ALL undergoing palliative care. Materials and methods: Retrospective cohort study of patients diagnosed with ALL undergoing palliative care. We analysed variables at the time of diagnosis (age, WBC count, and risk type), chemotherapy regimens received, PPI, CCI and transfusion requirements at time palliative care was started. Results: We studied 32 patients with a mean age of 37 (18–75) years. Fourteen cases had a PPI = 0 (43.8%). 62.5% (n = 20) with a CCI > 3 had high odds of dying within 10 years. The median survival was 200 days, unaffected by any of the factors analysed. Discussion: Neither PPI, CCI, nor the other studied factors effectively predicted survival. Scales will have to be adapted or new predictive scales devised specifically for patients with ALL. Resumen: Objetivo: Establecer si el índice pronóstico paliativo (IPP), el índice de comorbilidad de Charlson (ICC) u otros factores son predictores de sobrevida en pacientes con LLA sometidos a terapia paliativa. Material y métodos: Cohorte retrospectiva de pacientes con diagnóstico de LLA sometidos a terapia paliativa. Se analizaron variables al momento del diagnóstico (edad, cifra de leucocitos, tipo de riesgo), esquemas recibidos, IPP e ICC al momento de iniciar tratamiento paliativo, así como los requerimientos transfusionales. Resultados: Se estudiaron 32 pacientes con edad promedio de 37 (18–75) años. Catorce casos obtuvieron un IPP de 0 (43.8%). El 62.5% (n = 20) con ICC >3 tenía altas probabilidades de morir en menos de 10 años. La media de supervivencia fue de 200 días, sin afectarse significativamente por ninguno de los factores analizados. Discusión: IPP, ICC, ni otros factores predijeron efectivamente la sobrevida. Será necesario adecuar estas escalas o idear nuevas específicamente para LLA. Keywords: Palliative care, Prognosis, Precursor cell lymphoblastic leukaemia-lymphoma, Survival, Palabras clave: Cuidados paliativos, Pronóstico, Leucemia-linfoma linfoblástico de células precursoras, Supervivenci