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Ammad Ud Din M, Shahzad M, Ashraf A, Liaqat H, Jaan A, Anwer F. Clinical Research in Chronic Lymphocytic Leukemia in Pakistan; A Systematic Review. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1483. [PMID: 37629773 PMCID: PMC10456454 DOI: 10.3390/medicina59081483] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 08/12/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
Background: Significant advances have been made in the treatment of chronic lymphocytic leukemia (CLL) since the turn of the new millennium. However, most clinical trials were done in developed countries where minority ethnicities were underrepresented. Materials and Methods: To gauge the quality of research in CLL being done in Pakistan, we conducted a comprehensive literature search using PubMed, Clinicaltrials.gov, and Google Scholar on 14 January 2022 following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Results: A total of 16 studies met the inclusion criteria. The most common study design was cross-sectional. Eight studies evaluated the clinicohematological profile of CLL patients and the effect of various cytogenic abnormalities through fluorescence in situ hybridization (FISH) technique on disease progression and prognosis. Five studies discussed the prevalence of abnormalities such as autoimmune cytopenias and other serum chemistry derangements. Only two studies evaluated treatment outcomes, among which one study reported a 2-year overall survival of 65% among patients with 17p deletion. None of the studies had patients on novel targeted agents. No pharmaceutical sponsored or funded clinical trials were found. Conclusions: Our review suggests that although small clinical studies continue to be performed across the country, multiple financial and logistical barriers need to be addressed for larger, more impactful clinical trials to be conducted that will help answer demographic-specific questions and decrease reliance on foreign studies.
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Affiliation(s)
- Mohammad Ammad Ud Din
- Hematology/ Oncology, Moffitt Cancer Center, University of South Florida, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Hematology/ Oncology, University of South Florida, Tampa, FL 33612, USA
| | - Moazzam Shahzad
- Hematology/ Oncology, Moffitt Cancer Center, University of South Florida, 12902 USF Magnolia Drive, Tampa, FL 33612, USA
- Hematology/ Oncology, University of South Florida, Tampa, FL 33612, USA
| | - Aqsa Ashraf
- Internal Medicine, Northwell Health Mather Hospital, Port Jefferson, New York, NY 11777, USA
| | - Hania Liaqat
- Internal Medicine, Rochester General Hospital, Rochester, New York, NY 14621, USA
| | - Ali Jaan
- Internal Medicine, Rochester General Hospital, Rochester, New York, NY 14621, USA
| | - Faiz Anwer
- Hematology/ Oncology, Cleveland Clinic, Cleveland, OH 44195, USA
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Ou Y, Long Y, Ji L, Zhan Y, Qiao T, Wang X, Chen H, Cheng Y. Trends in Disease Burden of Chronic Lymphocytic Leukemia at the Global, Regional, and National Levels From 1990 to 2019, and Projections Until 2030: A Population-Based Epidemiologic Study. Front Oncol 2022; 12:840616. [PMID: 35359356 PMCID: PMC8961301 DOI: 10.3389/fonc.2022.840616] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/07/2022] [Indexed: 12/12/2022] Open
Abstract
Background The prognosis of chronic lymphocytic leukemia (CLL) has been improved dramatically, but there are limited studies focusing on CLL disease burden on a global scale. We aimed to evaluate the accurate assessment of the disease burden of CLL that may provide more detailed epidemiological information for rational policies. Methods The main source of the data was the Global Burden of Disease (GBD) study 2019. Incident cases, death cases, disability-adjusted life years (DALYs), and their corresponding age-standardized rates (ASRs) from 1990 to 2019 were used to describe the burden of CLL. Data about attributable risk factors were also extracted and analyzed. Bayesian age-period-cohort (BAPC) models were used to assess and project the incidence and mortality rates till 2030. Results Globally, the incidence of CLL had been increasing. Deaths and DALYs decreased slightly. The burden of death and DALY is affected by socio-demographic index (SDI). The incidence rate, death rate, and DALY rate of CLL increased significantly with age. Male-to-female ratios of incidence rates varied in different SDI quintiles. Smoking, high body mass index, and occupational exposure to benzene or formaldehyde were the potential risk factors related to CLL. Global ASIRs might tend to increase until 2030, while ASDR would decrease until 2030. Conclusion The disease burden of CLL decreased in higher SDI countries but increased in lower ones. Strategies for early detection of asymptomatic CLL, development of novel drugs, and measures against attributable factors should be implemented to combat CLL burden.
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Affiliation(s)
- Yang Ou
- Center for Tumor Diagnosis & Therapy, Jinshan Hospital, Fudan University, Shanghai, China
| | - Yichen Long
- School of Life Science, University of Chinese Academy of Sciences, Beijing, China
| | - Lili Ji
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yanxia Zhan
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Tiankui Qiao
- Center for Tumor Diagnosis & Therapy, Jinshan Hospital, Fudan University, Shanghai, China
| | - Xiangdong Wang
- Center for Tumor Diagnosis & Therapy, Jinshan Hospital, Fudan University, Shanghai, China
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Hao Chen
- Department of Thoracic Surgery, Zhongshan Hospital Xuhui Branch, Fudan University, Shanghai, China
| | - Yunfeng Cheng
- Center for Tumor Diagnosis & Therapy, Jinshan Hospital, Fudan University, Shanghai, China
- Department of Hematology, Zhongshan Hospital, Fudan University, Shanghai, China
- Institute of Clinical Science, Zhongshan Hospital, Fudan University, Shanghai, China
- Department of Hematology, Zhongshan Hospital Qingpu Branch, Fudan University, Shanghai, China
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Ebrahim H, Fisha T, Debash H, Bisetegn H. Patterns of Bone Marrow Confirmed Malignant and Non-Malignant Hematological Disorders in Patients with Abnormal Hematological Parameters in Northeast Ethiopia. J Blood Med 2022; 13:51-60. [PMID: 35210892 PMCID: PMC8857978 DOI: 10.2147/jbm.s346091] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Accepted: 01/24/2022] [Indexed: 12/24/2022] Open
Affiliation(s)
- Hussen Ebrahim
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
- Correspondence: Hussen Ebrahim, Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, 1145, Ethiopia, Tel +251 921332772, Email
| | - Temesgen Fisha
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Habtu Debash
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
| | - Habtye Bisetegn
- Department of Medical Laboratory Sciences, College of Medicine and Health Sciences, Wollo University, Dessie, Ethiopia
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Rashid B, Jalal S, Yassin A, Hassan K, Mohamed Z, Ahmed Z, Mahmood T, Shamoon R, Mustafa S, Karam M, Abdullah D, Mohammad S, Abdulrahman L, Yousif RH, Abdulla B, Mohammed N, Getta H, Polus R, Numan G. Impact of clinical staging and demographic data (age and sex) on response to treatment and survival of chronic lymphocytic leukemia patients in Kurdistan Region of Iraq. IRAQI JOURNAL OF HEMATOLOGY 2021. [DOI: 10.4103/ijh.ijh_11_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Korubo KI, Okite UP, Ezeugwu SI. Chronic Lymphocytic Leukemia: Prognostic Factors at Presentation in a Resource-Limited Center. JCO Glob Oncol 2021; 7:56-62. [PMID: 33434067 PMCID: PMC8081540 DOI: 10.1200/go.20.00276] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 10/11/2020] [Accepted: 11/17/2020] [Indexed: 01/31/2023] Open
Abstract
PURPOSE Determining chronic lymphocytic leukemia (CLL) prognosis using the International Prognostic Index markers such as TP53 and immunoglobulin heavy-chain variable region gene mutation in a resource-limited setting is difficult to achieve because of cost and equipment unavailability. The aim of this study is to determine prognostic factors easily available to hematologists in low- or medium-income countries. MATERIALS AND METHODS This was a retrospective study conducted at the University of Port Harcourt Teaching Hospital, Nigeria. Data were retrieved from CLL patient records from January 2004 to December 2019 (15 years). Data collected were analyzed using SPSS software version 25. RESULTS A total of 46 records were reviewed, with a median age of 55 years and a male:female ratio of 1:1.2. All patients were symptomatic at presentation, with splenomegaly (91.3%), anemia (82.6%), and lymphadenopathy (76.1%) predominating. About 89.1% of the patients presented at Binet stage C and/or high-risk Rai (Rai stages III and IV) with 10.9% presenting at Binet stage B and/or intermediate-risk Rai (Rai stage II). Only 13% of the patients had immunophenotyping done with 6.5% being done for the Matutes CLL score. The 5-year overall survival (OS) was 15.7% with a median survival of 26 months. WBC count and absolute lymphocyte count (ALC) > 100 × 109/L were significant poor prognostic markers (P = .013 and .021, respectively). Thirty-five (76.1%) received chemotherapy, and they had a better median survival than those who did not (26 v 17.5 months). The most common regimen used was cyclophosphamide, vincristine, and prednisolone for 15 (42.9%) patients. CONCLUSION WBC count and ALC > 100 × 109/L were poor prognostic markers. Patients who received chemotherapy had a better OS.
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Affiliation(s)
- Kaladada Ibitrokoemi Korubo
- Department of Haematology & Blood Transfusion, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Uchechukwu Prince Okite
- Department of Haematology & Blood Transfusion, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
| | - Sampson Ibekwe Ezeugwu
- Department of Haematology & Blood Transfusion, University of Port Harcourt Teaching Hospital, Port Harcourt, Nigeria
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Bagheri M, Vosoughi T, Hosseinzadeh M, Saki N. Evaluation of immunophenotypic markers and clinico-hematological profile in chronic lymphocytic leukemia: implications for prognosis. BMC Res Notes 2020; 13:412. [PMID: 32883360 PMCID: PMC7469386 DOI: 10.1186/s13104-020-05243-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Accepted: 08/19/2020] [Indexed: 11/10/2022] Open
Abstract
Objective Chronic lymphocytic leukemia (CLL) is an adult leukemia presented with clonal accumulation of lymphocytes. Immunophenotypic changes can be effective in predicting clinical course, the survival of patients, and determining first-line treatment. This is a study of the association between immunophenotypic markers with complete blood cell count (CBC) values and clinical parameters. Results Peripheral blood samples were collected from 35 newly diagnosed CLL patients. The expression of immunophenotypic markers and CBC were evaluated. Platelet counts and hemoglobin concentration had a significant, inverse association with Rai staging, modified Rai staging, Binet staging systems (all p < 0.001 in both parameters), and splenomegaly (p = 0.001 and 0.007, respectively). The platelet/lymphocyte ratio (PLR) had a significant, inverse association with Rai staging (p = 0.014), modified Rai staging (p = 0.024), Binet staging systems (p = 0.027), and splenomegaly (p = 0.033). However, CD38, CD25, and double-positive CD56/CD117 expression, group 3 of innate lymphocyte cells (ILC3s), had no significant association with clinical parameters. In regression analysis, that ILC3s has an inverse correlation with neutrophil/lymphocyte ratio (r = −0.340, p = 0.046). Given that there is an inverse association between PLR and advanced clinical stages, it seems that PLR may have prognostic value in CLL.
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Affiliation(s)
- Marziye Bagheri
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.,Department of Laboratory Sciences, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Tina Vosoughi
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehran Hosseinzadeh
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Najmaldin Saki
- Thalassemia and Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Basabaeen AA, Abdelgader EA, BaHashwan OS, Babekir EA, Abdelateif NM, Bamusa SA, Abdelrahim SO, Altayeb OA, Fadul EA, Ibrahim IK. Combined analysis of ZAP-70 and CD38 expression in sudanese patients with B-cell chronic lymphocytic leukemia. BMC Res Notes 2019; 12:282. [PMID: 31122288 PMCID: PMC6533771 DOI: 10.1186/s13104-019-4319-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Accepted: 05/18/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVE To investigate the ZAP-70 and CD38 expressions and their combined expressions in Sudanese B-CLL patients and their relationships with clinical and hematological characteristics as well as the disease staging at presentation. RESULTS In the present cross-sectional descriptive study, analysis of ZAP-70 expression showed that 36/110 (32.7%) patients positively expressed ZAP-70 and insignificant higher presentation in intermediate and at advanced stages as well as no correlation was seen with hematological parameters and clinical features compared with negatively ZAP-70, on the other hand, 41/110 (37.3%) were CD38+ and no significant correlation was shown with the stage at presentation, clinical characteristics (except Splenomegaly, P = 0.02) and hematological parameters. However, in combined expressions of both ZAP-70 and CD38 together, 20/110 (18.2%) were concordantly ZAP-70+/CD38+, 53/110 (48.2%) concordantly ZAP-70-/CD38- and 37/110 (33.6%) either ZAP-70+ or CD38+, and these three groups showed insignificant correlation with clinical (except Splenomegaly, P = 0.03) and hematological parameters, and the stage at presentation. Our data showed the combined analysis of these two markers, lead to classify our patients into three subgroups (either concordant positive, negative or discordant expressions) with statistically insignificant correlation with clinical presentation (except Splenomegaly), hematological parameters and stage at presentation of B-CLL patients.
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MESH Headings
- ADP-ribosyl Cyclase 1/blood
- ADP-ribosyl Cyclase 1/genetics
- ADP-ribosyl Cyclase 1/immunology
- Adult
- Aged
- B-Lymphocytes/immunology
- B-Lymphocytes/pathology
- Biomarkers, Tumor/blood
- Biomarkers, Tumor/genetics
- Biomarkers, Tumor/immunology
- Cross-Sectional Studies
- Female
- Gene Expression
- Humans
- Immunophenotyping
- Leukemia, Lymphocytic, Chronic, B-Cell/diagnosis
- Leukemia, Lymphocytic, Chronic, B-Cell/genetics
- Leukemia, Lymphocytic, Chronic, B-Cell/immunology
- Leukemia, Lymphocytic, Chronic, B-Cell/pathology
- Male
- Membrane Glycoproteins/blood
- Membrane Glycoproteins/genetics
- Membrane Glycoproteins/immunology
- Middle Aged
- Neoplasm Staging
- Prospective Studies
- Splenomegaly/diagnosis
- Splenomegaly/genetics
- Splenomegaly/immunology
- Splenomegaly/pathology
- Sudan
- ZAP-70 Protein-Tyrosine Kinase/blood
- ZAP-70 Protein-Tyrosine Kinase/genetics
- ZAP-70 Protein-Tyrosine Kinase/immunology
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Affiliation(s)
- Ameen Abdulaziz Basabaeen
- Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
- Ministry of Health & Population, Hadhramout, Yemen
| | | | - Othman Saeed BaHashwan
- Department of Family Medicine, Faculty of Medicine, University of Gezira, Wad Medani, Sudan
| | - Ebtihal Ahmed Babekir
- Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
| | - Nour Mahmoud Abdelateif
- Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
| | | | - Saadia Osman Abdelrahim
- Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
| | - Osama Ali Altayeb
- Flow Cytometry Laboratory for Leukemia & Lymphoma Diagnosis, Khartoum, Sudan
| | - Eman Abbass Fadul
- Flow Cytometry Laboratory for Leukemia & Lymphoma Diagnosis, Khartoum, Sudan
| | - Ibrahim Khider Ibrahim
- Department of Hematology, Faculty of Medical Laboratory Sciences, Al Neelain University, Khartoum, Sudan
- Department of Hematology, School of Medical Sciences, University Sains Malaysia, Health Campus, 16150 Kubang Kerian, Kelantan Malaysia
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