Background: Chronic myeloid leukaemia (CML) is a clonal disease of a hematopoietic stem cell. The incidence of this disease is about 15% of leukemias and may be present at any age. The presence of the Philadelphia (Ph) chromosome confirms the diagnosis of CML. The expression of the Patched homolog 1 gene (PTCH1) has been proposed as a prognostic marker of imatinib response in chronic phase chronic myeloid leukaemia (CP-CML) patients. Aim: This study aimed to measure the level of PTCH1 protein in newly diagnosed CP-CML and to find correlation between its level in those patients and response to first line of treatment, imatinib and other prognostic factors.Patients and Methods: Our study enrolled 50 patients of newly diagnosed CP-CML. We have measured the level of PTCH1 protein initially once the patient diagnosed and after 6 months of treatment with imatinib by ELISA test. Results: There was highly significant difference between initial PTCH1 level and its level after 6 months of imatinib treatment (P=0.000). The level of PTCH 1 was correlated significantly with the molecular response both at the beginning of treatment with imatinib and six months later. (P=0.002), (p=0.001) respectively.
Conclusion:To the best of our knowledge that we are the first to report on PTCH1 protein as a new diagnostic and prognostic marker in CP-CML patients.
Introduction: Bloodstream Infections (BSIs) are a main cause of life-threatening complications among patients with cancer.
Methodology: This study aimed to identify microbial pathogens causing BSI in febrile neutropenic patients with hematologic malignancy and compare the results of conventional blood culture with a nested multiplex real time PCR assay done directly on whole blood samples. The nested multiplex PCR was based on 16S rDNA and 18S rDNA sequence-specific primers; hence, it allowed the identification of most species of bacteria and fungi.
Results: Forty adult patients with febrile neutropenia, admitted at Hematology ward of Ain Shams University Hospitals, were included in this study. Each patient was subjected to conventional blood culture and nested multiplex PCR. Blood culture was positive in 19 patients (47.5%). About 68.4% of the positive cultures were monomicrobial, while 31.6% were polymicrobial. A total number of 26 isolates were grown from positive cultures; Staphylococcus aureus was the most common (30.8%), followed by Klebsiella pneumoniae (19.2%). Regarding nested PCR, positive results were detected in 37/40 patients (92.5%) which was statistically significantly higher than that of blood culture. Eighteen samples that tested negative by culture were positive using the molecular approach. The agreement between the two approaches was 55%.
Conclusion: nested multiplex real time PCR can be a promising tool in order to achieve rapid diagnosis in cancer patients clinically suspected of BSIs. Its utilization could affect the choice of antimicrobial treatment whether bacterial or fungal and, therefore avoid unnecessary use of antimicrobials.
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