7 research outputs found
Expression of EBV Encoded viral RNA 1, 2 and anti-inflammatory Cytokine (interleukin-10) in FFPE lymphoma specimens: a preliminary study for diagnostic implication in Pakistan
<p>Abstract</p> <p>Background</p> <p>Epstein Barr Virus (EBV) plays a significant role as a cofactor in the process of tumorigenesis and has consistently been associated with a variety of malignancies. EBV encoded RNAs (EBER1 and EBER2) are the most abundant viral transcripts in latently EBV-infected cells and their role in viral infection is still unclear. Formalin Fixed Paraffin Embedded (FFPE) tissues of surgically removed carcinoma biopsies are widely available form but have never been exploited for expressional studies previously in Pakistan. Immunohistochemistry (IHC) and <it>in situ </it>hybridization (ISH) in FFPE biopsy tissues remains the gold standard for proving EBV relationship in a histopathological lesion but their reagents associated limitations confines their reliability in some applications. Recently introduced targeted drug delivery systems induce viral lytic gene expression and therefore require more sensitive method to quantify viral as well as cellular gene expression.</p> <p>Methods</p> <p>Eight (8) lymphoma samples were screened to detect the EBV genome. Qualitative and quantitative expression of EBV Encoded RNAs (EBER1, EBER2) and anti-inflammatory cytokine (interleukin-10) in FFPE EBV positive lymphoma tissue samples were then analysed by using Reverse transcriptase Polymerase Chain Reaction (RT-PCR) and Real Time Polymerase Chain Reaction (qRT-PCR), respectively.</p> <p>Results</p> <p>In this study we have successfully quantified elevated expressional levels of both cellular and viral transcripts, namely EBER1, EBER2 and anti-inflammatory cytokine (IL-10) in the FFPE Burkitt's lymphoma (BL) specimens of Pakistani origin.</p> <p>Conclusions</p> <p>These results indicate that FFPE samples may retain viral as well as cellular RNA expression information at detectable level. To our knowledge, this is first study which represents elevated expressional levels of EBER1, EBER2 and IL-10 in FFPE tissue samples of Burkitt's lymphoma in Pakistan. These observations will potentially improve current lacunas in clinical as well as diagnostic practices in Pakistan and can be further exploited to develop new strategies for studying cellular and/or viral gene expression.</p
Immunophenotyping of mature T/NK cell neoplasm presenting as leukemia
Introduction : Mature T/NK cell lymphomas (MTNKL) presenting as
leukemia are rare and show considerable overlapping of clinical,
morphological and immunophenotypic features. AIM: Critical analysis of
the morphology and immunophenotypic profile of MTNKL. Materials and
Methods : We reviewed 380 consecutive cases of mature lymphoid neoplasm
that presented as leukemia and were diagnosed on morphology and
immunophenotyping of bone marrow and/or peripheral blood samples.
Results : Peripheral blood and bone marrow involvement was seen in all
cases. MTNKL constituted 4% (nine cases) of all mature lymphoid
neoplasms presenting as leukemia. It included four cases of T-large
granular leukemia (T-LGL), two of T-cell prolymphocytic leukemia small
cell variant (T-PLL), two of adult T-cell leukemia/lymphoma (ATLL) and
one of primary cutaneous gamma delta T-cell lymphoma (PCGDTCL). T-LGL
revealed CD4-/CD8+ phenotype in three, and CD4+/CD8+ phenotype in one
case. CD56 was absent in all the cases of T-LGL. One case of T- PLL
small cell variant showed CD4+/CD8- phenotype, while the other revealed
CD4-/CD8+ phenotype. Both cases of ATLL showed CD4+/CD8+/CD25+
phenotype. The single case of PCGDTCL showed CD4-/CD8- phenotype
pattern. CD3 and CD5 were expressed in all MTNKL. CD7 was absent in
three cases of T-LGL. TCR\u3b1/\u3b2 was performed in three cases of
T-LGL and was positive in all. TCR\u3b1/\u3b2 was also seen in both
the cases of T-PLL small variant. However, TCR\u3b1/\u3b2 was seen in
the single case of PCGDTCL. Conclusion : Mature nodal T/NK cell
neoplasms are rare and MTNKL presenting as leukemia are even rarer.
There is an overlap between the immunophenotypic profiles of different
MTNKL subtypes and elaborate T/NK cell panels are required for their
evaluation
Role of RT-PCR and FISH in diagnosis and monitoring of acute promyelocytic leukemia
Background: Patients with a presence of Promyelocytic Leukemia-Retinoic
Acid Receptor Alpha (PML-RARA) genes rearrangement predict a favorable
response to all-trans retinoic acid (ATRA), and a significant
improvement in survival. Therefore, establishing the presence of
PML-RARA rearrangement is important for optimal patient management.
Aim: The objective of this study is to compare and assess the role of
fluorescent in situ hybridization (FISH) and reverse transcriptase
polymerase chain reaction (RT-PCR) in the diagnosis and long-term
monitoring of Acute Promyelocytic Leukemia (APL). Materials and
Methods: We compared 145 samples received at different interval of
times to analyze the sensitivity of RT-PCR and FISH. Results: The
failure rate for RT-PCR was 4% at baseline, 13% at induction, and 0% at
the end of consolidation. And for FISH it was 8% at baseline, 38% at
induction, and 66% at the end of consolidation. The predictive values
of relapse in the patients who were positive and negative by RT-PCR, at
the end of induction, were 60 % and 3%, respectively, and at end of
consolidation it was 67 % and 4%, respectively. On the other hand the
predictive values of relapse in patients who were positive and negative
by FISH at end of induction were 57 % and 6%, respectively; while at
end of consolidation it was 14% who were negative by FISH. Conclusion:
Both RT-PCR and FISH are important for the diagnosis of APL cases, as
both techniques complement each other in the absence or failure of any
one of them. However, RT-PCR is more sensitive than FISH for the
detection of minimal residual disease in the long-term monitoring of
these patients. The present study shows that the predictive value of
relapse is more associated with minimal residual disease (MRD) results
by RT-PCR than that by FISH
Clinico-Hematological Profile in Biphenotypic Acute Leukemia
Background : We present a clinico-hematological profile and treatment
outcome of Biphenotypic Acute Leukemia (BAL). Aim : Study incidence
and subtypes of BAL, correlate with age, morphology, and cytogenetic
findings and correlate the clinico-hematological data with the
treatment response. St Jude\u2032s and the EGIL\u2032s criteria have
been compared for their diagnostic and clinical relevance. Material
and Methods : Diagnosis was based on WHO classification, including
clinical details, morphology, cytochemistry, immunophenotyping, and
molecular genetics. We included those cases, which fulfilled the
European Group for the Immunological Characterization of Acute
Leukemia\u2032s (EGIL\u2032s) scoring system criteria for the
diagnosis of BAL, as per recommendation of the WHO classification.
Results : There were 32 patients diagnosed with BAL, based on
EGIL\u2032s criteria. Incidence of BAL was 1.2%. B-Myeloid (14 cases)
followed by T-Myeloid BAL (13 cases) were the commonest subtypes.
Polymorphous population of blasts (16 cases) was commonly associated
with T-Myeloid BAL (10 cases). BCR ABL fusion positivity was a common
cytogenetic abnormality (seven cases). Fifteen patients received
chemotherapy; eight achieved complete remission (CR) at the end of the
induction period. Conclusions : Pediatric BAL and T-B lymphoid BAL
have a better prognosis. A comprehensive panel of reagents is required,
including cytoplasmic markers; to diagnose BAL. St Jude\u2032s
criteria is a simple, easy, and cost-effective method to diagnose BAL.
The outcome-related prognostic factors include age, HLA-DR, CD34
negativity, and subtype of BAL. BCR-ABL expression is an important
prognostic factor, as these cases will be labeled as Chronic myeloid
leukemia (CML) in blast crisis with biphenotypic expression and treated
accordingly
Clinico-Hematological Profile in Biphenotypic Acute Leukemia
Background : We present a clinico-hematological profile and treatment
outcome of Biphenotypic Acute Leukemia (BAL). Aim : Study incidence
and subtypes of BAL, correlate with age, morphology, and cytogenetic
findings and correlate the clinico-hematological data with the
treatment response. St Jude′s and the EGIL′s criteria have
been compared for their diagnostic and clinical relevance. Material
and Methods : Diagnosis was based on WHO classification, including
clinical details, morphology, cytochemistry, immunophenotyping, and
molecular genetics. We included those cases, which fulfilled the
European Group for the Immunological Characterization of Acute
Leukemia′s (EGIL′s) scoring system criteria for the
diagnosis of BAL, as per recommendation of the WHO classification.
Results : There were 32 patients diagnosed with BAL, based on
EGIL′s criteria. Incidence of BAL was 1.2%. B-Myeloid (14 cases)
followed by T-Myeloid BAL (13 cases) were the commonest subtypes.
Polymorphous population of blasts (16 cases) was commonly associated
with T-Myeloid BAL (10 cases). BCR ABL fusion positivity was a common
cytogenetic abnormality (seven cases). Fifteen patients received
chemotherapy; eight achieved complete remission (CR) at the end of the
induction period. Conclusions : Pediatric BAL and T-B lymphoid BAL
have a better prognosis. A comprehensive panel of reagents is required,
including cytoplasmic markers; to diagnose BAL. St Jude′s
criteria is a simple, easy, and cost-effective method to diagnose BAL.
The outcome-related prognostic factors include age, HLA-DR, CD34
negativity, and subtype of BAL. BCR-ABL expression is an important
prognostic factor, as these cases will be labeled as Chronic myeloid
leukemia (CML) in blast crisis with biphenotypic expression and treated
accordingly
Immunophenotyping of mature T/NK cell neoplasm presenting as leukemia
Introduction : Mature T/NK cell lymphomas (MTNKL) presenting as
leukemia are rare and show considerable overlapping of clinical,
morphological and immunophenotypic features. AIM: Critical analysis of
the morphology and immunophenotypic profile of MTNKL. Materials and
Methods : We reviewed 380 consecutive cases of mature lymphoid neoplasm
that presented as leukemia and were diagnosed on morphology and
immunophenotyping of bone marrow and/or peripheral blood samples.
Results : Peripheral blood and bone marrow involvement was seen in all
cases. MTNKL constituted 4% (nine cases) of all mature lymphoid
neoplasms presenting as leukemia. It included four cases of T-large
granular leukemia (T-LGL), two of T-cell prolymphocytic leukemia small
cell variant (T-PLL), two of adult T-cell leukemia/lymphoma (ATLL) and
one of primary cutaneous gamma delta T-cell lymphoma (PCGDTCL). T-LGL
revealed CD4-/CD8+ phenotype in three, and CD4+/CD8+ phenotype in one
case. CD56 was absent in all the cases of T-LGL. One case of T- PLL
small cell variant showed CD4+/CD8- phenotype, while the other revealed
CD4-/CD8+ phenotype. Both cases of ATLL showed CD4+/CD8+/CD25+
phenotype. The single case of PCGDTCL showed CD4-/CD8- phenotype
pattern. CD3 and CD5 were expressed in all MTNKL. CD7 was absent in
three cases of T-LGL. TCRα/β was performed in three cases of
T-LGL and was positive in all. TCRα/β was also seen in both
the cases of T-PLL small variant. However, TCRα/β was seen in
the single case of PCGDTCL. Conclusion : Mature nodal T/NK cell
neoplasms are rare and MTNKL presenting as leukemia are even rarer.
There is an overlap between the immunophenotypic profiles of different
MTNKL subtypes and elaborate T/NK cell panels are required for their
evaluation