Background:Chemoport is an essential part of the management of children with cancer and provides long-term venous access. There are few studies from resource poor countries reporting complications of chemoport.Aims:This study was aimed at describing the complications of chemoport in patients with cancer.Materials and Methods:This retrospective observational study analyzed 200 patients <15 years of age who underwent chemoport insertion. The medical records of these patients were reviewed for the patient characteristics, diagnosis, nature of port use, port-related complications and their management.Results:A total of 209 ports were implanted in 200 patients and 24 ports were removed due to port-related complications. There were 122 boys and 78 girls whose ages ranged from 4 months to 13 years (median age 2.5 years). About72% of patients were <2 years old. The cumulative duration of catheterization was 54,100 days. Of 209 ports, there were 36 complications that led to the removal of 21 ports. Port-related infection was the most common infection observed in our study (0.66/1000 catheter days and 11.9%). Mechanical complications were seen in 9 patients. Venous thrombosis and skin necrosis occurred in one patient each.Conclusions:Use of chemoport is safe and is a boon for children with cancer in developing countries with incidence of complications similar to Western countries. Although use of chemoport is associated with complications, they are easily managed. With stringent catheter care by trained personnel, some complications can be prevented.

Introduction. The incidence of Acute Myeloid Leukemia (AML) increases progressively with age and its treatment is challenging. This prospective case control study was undertaken to compare the safety, efficacy, and cost-effectiveness of decitabine with those of cytarabine in older patients with newly diagnosed AML who are not fit for intensive chemotherapy. Materials and Methods. 30 eligible patients above 60 years old with newly diagnosed AML were assigned to receive decitabine or cytarabine. The primary end point was overall survival (OS). The secondary objective was to compare adverse events and cost-effectiveness of therapy in the two study groups. Results. In this study, 15 patients received decitabine and 15 patients received cytarabine. The median OS was 5.5 months for each of the treatment groups. The hazard ratio between the treatment groups was 0.811 with 95% CI of 0.390 to 1.687. Toxicity profile was similar in both groups. Cost per cycle of chemotherapy in INR was 24,200 for decitabine and 1,600 for low-dose cytarabine group. Median of simplified cost-effectiveness ratio was 0.00022 for decitabine group and 0.0034 for low-dose cytarabine group. Conclusions. For elderly patients with AML, decitabine and low-dose cytarabine should be chosen based on the patient's choice and affordability. Our study has shown that both of these agents have similar OS and toxicity. Low-dose cytarabine scores over decitabine in developing countries as it is more cost-effective.

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Background: Acute myeloid leukemia (AML) is a heterogeneous disease, associated with a high diversity of phenotypes. The study was done with the aim to study about the aberrant phenotypes in acute myeloid leukemia cases and the correlation among the aberrant phenotypes and poor prognostic factors in acute myeloid leukemia.Methods: This cross sectional study was conducted on 35 cases of newly diagnosed AML according to the selection criteria at Madras Medical College and Rajiv Gandhi Government General Hospital, Chennai for a period of 6 months. Immunophenotyping analysis by flow cytometry was done on fresh bone marrow aspirate or peripheral blood sample by applying Acute Leukemia Panel. The co-expression of different antigen markers on lymphocytes was analyzed.Results: Aberrant lymphoid markers were seen in 17 (49%) cases. 5 (14%) cases had lymphoid associated antigen expression alone. 3 (8%) cases had asynchronous antigen expression alone. 9 (27%) cases had both asynchronous antigen expression and lymphoid associated antigen expression which is of cases . In total, lymphoid associated antigen expression is seen in 41% of cases and asynchronous antigen expression in 35% of cases. CD3, CD19 (lymphoid associated antigen) and CD34+ CD15+ (asynchronous aberrant phenotype) were the most common equally expressed aberrant phenotypes, each in 7 cases. CD 3 was significantly more common in males (P=0.021) but in general there were no statistically significant association between adverse prognostic factors and aberrant phenotypic AML.Conclusions: CD19 and CD3 were the most commonly expressed lymphoid associated antigen. Most common asynchronous aberrant phenotype was CD34+CD15+. None of the aberrant phenotypic expression was not associated with poor risk factors in acute myeloid leukemia except for common expression of CD3 in males.