In this study, we provide a molecular signature of highly enriched CD34 þ cells from bone marrow of untreated patients with chronic myelogenous leukemia (CML) in chronic phase in comparison with normal CD34 þ cells using microarrays covering 8746 genes. Expression data reflected several BCR-ABL-induced effects in primary CML progenitors, such as transcriptional activation of the classical mitogen-activated protein kinase pathway and the phosphoinositide-3 kinase/AKT pathway as well as downregulation of the proapoptotic gene IRF8. Moreover, novel transcriptional changes in comparison with normal CD34 þ cells were identified. These include upregulation of genes involved in the transforming growth factorb pathway, fetal hemoglobin genes, leptin receptor, sorcin, tissue inhibitor of metalloproteinase 1, the neuroepithelial cell transforming gene 1 and downregulation of selenoprotein P. Additionally, genes associated with early hematopoietic stem cells (HSC) and leukemogenesis such as HoxA9 and MEIS1 were transcriptionally activated. Differential expression of differentiation-associated genes suggested an altered composition of the CD34 þ cell population in CML. This was confirmed by subset analyses of chronic phase CML CD34 þ cells showing an increase of the proportion of megakaryocyteerythroid progenitors, whereas the proportion of HSC and granulocyte-macrophage progenitors was decreased in CML. In conclusion, our results give novel insights into the biology of CML and could provide the basis for identification of new therapeutic targets.
Coronary artery lesions are frequently detected on the initial echocardiogram of children with Kawasaki syndrome. If future studies show ectasia to have a relatively high degree of specificity for Kawasaki syndrome, the initial echocardiography may be a useful adjunctive diagnostic test.
Although adults with coronavirus disease 2019 (COVID-19) who require admission to the hospital have often required critical care, infants and children with COVID-19 have generally demonstrated milder disease severity, fewer complications, and overall a much lower case fatality rate (1-2). Neurologic manifestations have been reported with COVID-19 in adult patients including acute cerebrovascular disease, ischemic and hemorrhagic strokes, skeletal muscle injury and rare cases of encephalopathy (3-5). We report here an adolescent patient with acute encephalitis associated with COVID-19.
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