1
|
Mohiuddin Malla T, Amin Shah Z, Hussain Bhat A, Ahmad Malik M, Anjum Baba R, Rasool R, Rasool J, Ashaq S, Haq F. Fishing for ETV6/RUNX1 fusion and MLL gene rearrangements and their additional abnormalities in childhood acute lymphoblastic leukemia patients of Kashmir. Gene 2023; 856:147128. [PMID: 36565795 DOI: 10.1016/j.gene.2022.147128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/28/2022] [Accepted: 12/16/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Evidence suggests that ETV6/RUNX1 translocation in pediatric acute lymphocytic leukemia shows geographical variation. Therefore, the present study aimed at unveiling the incidence of ETV6/RUNX1 fusion in pediatric acute lymphocytic leukemia cases of this region using fluorescent in-situ hybridization. Besides, we aimed to determine the incidence of MLL gene rearrangement and the pattern of chromosomal abnormalities in this study group. METHODS Samples from 57 acute lymphocytic leukemia cases of pediatric age group were subjected to fluorescent in-situ hybridization and conventional cytogenetic analysis using standard methods. RESULTS Conventional cytogenetic analysis revealed chromosomal abnormalities in 19.3% cases. The other major chromosomal abnormalities reported were monosomies in 10.5%, hypodiploidy in 7%, marker chromosomes in 3.5% and deletions in 3.5% cases. We found a 44,XX,-7,-18, r(5), i(17q) complex karyotype in one of the cases. Fluorescent in-situ hybridization analysis revealed ETV6/RUNX1 translocation to be present in 28.07% cases and MLL gene rearrangement in 3.5% cases. 12.5% of ETV6/RUNX1 fusion positive cases were found to have a loss of ETV6 allele. Besides, 8.8% cases were found to exhibit a signal pattern suggestive of RUNX1 amplification. ETV6 gene deletion and MLL gene amplification was detected in 3.5% cases each, of our study. CONCLUSIONS Frequency of ETV6/RUNX1 fusion oncogene was found to be higher in pediatric ALL cases of Kashmir region as compared to that reported from other parts of India. Besides, a case was found to have a karyotype viz 44,XX,-7,-18, r(5), i(17q) that has not been reported elsewhere in the childhood ALL.
Collapse
Affiliation(s)
- Tahir Mohiuddin Malla
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Zafar Amin Shah
- Department of Immunology & Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
| | - Aashiq Hussain Bhat
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Manzoor Ahmad Malik
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Rafia Anjum Baba
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Roohi Rasool
- Department of Immunology & Molecular Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Javaid Rasool
- Department of Hematology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Sozi Ashaq
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| | - Faizanul Haq
- Cancer Diagnostic and Research Centre, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India
| |
Collapse
|
2
|
G. SD, Ahmed F, Mundada MC, Khera R, Nambaru L, Mallavarapu K, Boyella PK, Patil V, Laddha PS, Rajappa SJ. Retrospective Study of B Lymphoblastic Leukemia to Assess the Prevalence of TEL/AML1 in South India: A Study of 214 Cases and Review of Literature. Indian J Med Paediatr Oncol 2022. [DOI: 10.1055/s-0042-1742611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Abstract
Introduction Translocation t(12;21)(p13;q22), a recurrent and an invisible chromosomal abnormality, resulting in TEL/AML1 gene fusion, associated with good prognosis, has been described to be a common abnormality, in children with B-acute lymphoblastic leukemia (B-ALL).
Objectives The initial observation of very few TEL/AML1 positive patients at this center on testing by fluorescence in situ hybridization (FISH) led to study the prevalence of the abnormality, compare with the global distribution, and evaluate clinical, pathological, molecular, and cytogenetic features in TEL/AML1 positive patients.
Materials and Methods A retrospective study of all B-ALL patients tested for TEL/AML1 gene fusion during the period January 2009 to November 2020 was undertaken. Clinicopathological, molecular, cytogenetic, treatment, and follow-up details were collected. All publications dealing with TEL/AML1 gene rearrangement were reviewed post Google and PubMed search.
Results TEL/AML1gene rearrangement was assessed by FISH in 178 patients and by reverse transcription polymerase chain reaction in 36 patients and detected as the sole abnormality in 8.4% patients with additional genetic abnormalities noted on FISH evaluation. Normal karyotype was noted in 14/18 (77.7%) of these patients and 2 had complex karyotype. Complete blood count revealed hemoglobin to range from 35 to 116 g/L (median: 74 g/L), white blood count: 1.01–110×109/L (median: 7.8×109/L), platelet counts: 10–115×109/L (median: 42×109/L), blast count in peripheral smear: 0–98% (median: 41%). Immunophenotyping demonstrated 94.4% were CD34 positive, common acute lymphoblastic leukemia associated antigen (CALLA) positive with aberrant expression of CD13, CD33, CD56, singly or in combination in 58.8%.
Conclusion TEL/AML1 fusion is rare in Indian patients with B-ALL and appears to be much rarer in our region. The detection of relevant specific abnormalities is of fundamental importance in B-ALL patients and these geographic variations can be used in defining management policies.
Collapse
Affiliation(s)
- Sandhya Devi G.
- Department of Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Faiq Ahmed
- Department of Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Manasi C. Mundada
- Department of Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Rachna Khera
- Department of Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Lavanya Nambaru
- Department of Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Krishnamohan Mallavarapu
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Pavan Kumar Boyella
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Veerandra Patil
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Pallavi Suresh Laddha
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Senthil J. Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| |
Collapse
|
3
|
Jamal S, Meraj F, Mansoor N, Parveen S, Shaikh A, Jabbar N. Distribution of subtypes and immunophenotypic characterization of 1379 cases of paediatric acute leukaemia. Pak J Med Sci 2021; 37:805-811. [PMID: 34104169 PMCID: PMC8155440 DOI: 10.12669/pjms.37.3.3552] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objectives: Acute leukaemia is the most common and highly curable childhood malignancy; subtyping and identification of antigens via immunophenotyping helps in treatment plan as well as minimal residual disease monitoring. Methods: This retrospective study was conducted at the Haematology section of the clinical laboratories of Ziauddin University Hospital and The Indus Hospital, Karachi conducted at January 1st, 2012 to December 31st, 2017. The study included 1379 cases of de novo acute leukemia from 2012 to 2017. Among these, 80% were diagnosed by using four color flowcytometry (FACS Calibur), 9% and 11% via immunohistochemistry on bone marrow trephine biopsy samples and morphological examination respectively. Results: The mean age of patients was 7.4 ± 4.3 years while male to female ratio was 1.75:1. Lymphoblastic leukaemia accounted for 77.2% and myeloid leukaemia 21.2%. Amongst lymphoblastic lineage, B-ALL was 80.4% while T-ALL was 19.6%. Among the phenotypic expression of B-ALL, CD79a (99.8%) had the highest positivity. In B-ALL, CD13 (29.8%) was the most common aberrant myeloid marker. Aberrant expression of CD79a observed in 11.1% of T-ALL cases. In non APL AML, aberrant expression of CD79a and CD19 was observed in 6.6% and 5.5% of cases respectively. Conclusion: Overall immunophenotypic profile, expression of aberrant phenotypes and subtype distribution in our patients was similar to international literature except for a relatively high frequency of T-ALL which was discordant from the western data.
Collapse
Affiliation(s)
- Saba Jamal
- Dr. Saba Jamal (MBBS) Diplomate American Board of Anatomic and Clinical Pathology, Diplomate American Board of Hematology), Haematology Clinical Laboratory, The Indus Hospital, Karachi, Pakistan
| | - Fatima Meraj
- Dr. Fatima Meraj (MBBS, MCPS, FCPS), Haematology Clinical Laboratory, The Indus Hospital, Karachi, Pakistan
| | - Neelum Mansoor
- Dr. Neelum Mansoor (MBBS, FCPS), Haematology Clinical Laboratory, The Indus Hospital, Karachi, Pakistan
| | - Sadia Parveen
- Ms. Sadia Parveen (M.Phil.), Indus Hospital Research Center, The Indus Hospital, Karachi, Pakistan
| | - Ameerah Shaikh
- Ameerah Shaikh, Medical Student, Ziauddin Medical College, Karachi, Pakistan
| | - Naeem Jabbar
- Dr. Naeem Jabbar (MBBS, FCPS). Paediatric Haematology Oncology, The Indus Hospital, Karachi, Pakistan
| |
Collapse
|
4
|
ARID5B gene polymorphisms and the risk of childhood acute lymphoblastic leukemia: a meta-analysis. Int J Hematol 2019; 110:272-284. [PMID: 31111395 DOI: 10.1007/s12185-019-02658-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Revised: 05/08/2019] [Accepted: 05/08/2019] [Indexed: 12/11/2022]
Abstract
Genome-wide association studies have implicated several single-nucleotide polymorphisms (SNPs) in the AT-rich interactive domain 5B (ARID5B) gene in children with ALL; however, whether ARID5B variants (rs10821936, rs10994982, rs7089424) are associated with childhood ALL remains controversial. We performed this study to obtain more conclusive results. Eligible studies were searched in PubMed, Web of Science, and EMBASE. Odds ratios and 95% confidence intervals were calculated. A total of 26 studies were included. Analyses stratified by ethnicity revealed that three polymorphisms are significantly associated with the odds of childhood ALL in Caucasians, and rs10994982 and rs7089424 with the odds of childhood ALL in Asian populations. Furthermore, subtype analyses provided strong evidence that the three polymorphisms are highly associated with the risk of B-cell ALL. Our findings indicate that the ARID5B variants (rs10821936, rs10994982, rs7089424) are significantly associated with the risk of childhood ALL.
Collapse
|
5
|
Yu W, Chen G, Sun Y, Gao S, Li W, Cui J, Sun J. Gastric carcinoma subsequent to myelodysplastic syndrome with t (1; 19) chromosome translocation: A rare case report and its potential mechanisms. Medicine (Baltimore) 2018; 97:e11535. [PMID: 30045276 PMCID: PMC6078750 DOI: 10.1097/md.0000000000011535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Accepted: 06/21/2018] [Indexed: 11/28/2022] Open
Abstract
RATIONALE Myelodysplastic syndrome (MDS) is a heterogeneous malignant hematologic disease with median overall survival ranging from six months to more than ten years. Solid tumor rarely occurs in combination with MDS and the underlying pathogenesis and prognostic significance still remain controversial. PATIENT CONCERNS Here we report a relative low risk myelodysplastic syndrome-refractory cytopenia with multilineage dysplasia (MDS-RCMD) patient, with a rare t(1; 19)chromosome translocation. This patient also suffered from gastric carcinoma. DIAGNOSES Gastric carcinoma, Myelodysplastic syndrome with t (1; 19) chromosome translocation. INTERVENTIONS This patient received radical operation for gastric carcinoma and erythropoietin infusion. OUTCOMES The patient took follow up visits every 2 to 3 months in past years and now he is in stable disease without further treatment. LESSONS We reviewed the mechanism of MDS complicated by solid tumor and concluded the potential mechanisms of this patient. The interactions between potential factors may play a role in oncogenesis which, however, need an in-depth study of its operating mechanism.
Collapse
Affiliation(s)
- Wenqing Yu
- Cancer Center, the First Hospital of Jilin Unversity, Jilin
- Department of Hematology, Yantai Affiliated Hospital of Binzhou Medical University, Yantai
| | - Gaoyang Chen
- Research Center ,the Second Hospital of Jilin UniversityJilin
| | - Yunpeng Sun
- Cardiovascular Surgery Department, the First Hospital of Jilin Unversity, Jilin, People's Republic of China
| | - Sujun Gao
- Cancer Center, the First Hospital of Jilin Unversity, Jilin
| | - Wei Li
- Cancer Center, the First Hospital of Jilin Unversity, Jilin
| | - Jiuwei Cui
- Cancer Center, the First Hospital of Jilin Unversity, Jilin
| | - Jingnan Sun
- Cancer Center, the First Hospital of Jilin Unversity, Jilin
| |
Collapse
|
6
|
Zeng H, Wang XB, Cui NH, Nam S, Zeng T, Long X. Associations between AT-rich interactive domain 5B gene polymorphisms and risk of childhood acute lymphoblastic leukemia: a meta-analysis. Asian Pac J Cancer Prev 2017; 15:6211-7. [PMID: 25124600 DOI: 10.7314/apjcp.2014.15.15.6211] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Previous genome-wide association studies (GWAS) have implicated several single nucleotide polymorphisms (SNPs) in the AT-rich interactive domain 5B (ARID5B) gene with childhood acute lymphoblastic leukemia (ALL). However, replicated studies reported some inconsistent results in different populations. Using meta-analysis, we here aimed to clarify the nature of the genetic risks contributed by the two polymorphisms (rs10994982, rs7089424) for developing childhood ALL. Through searches of PubMed, EMBASE, and manually searching relevant references, a total of 14 articles with 16 independent studies were included. Odds ratios (ORs) with 95% confidence intervals (95%CI) were calculated to assess the associations. Both SNPs rs10994982 and rs7089424 showed significant associations with childhood ALL risk in all genetic models after Bonferroni correction. Furthermore, subtype analyses of B-lineage ALL provided strong evidence that SNP rs10994982 is highly associated with the risk of developing B-hyperdiploid ALL. These results indicate that SNPs rs10994982 and rs7089424 are indeed significantly associated with increased risk of childhood ALL.
Collapse
Affiliation(s)
- Hui Zeng
- Center for Gene Diagnosis, Zhongnan Hospital of Wuhan University, Wuhan, China E-mail :
| | | | | | | | | | | |
Collapse
|
7
|
|
8
|
Limsuwanachot N, Siriboonpiputtana T, Karntisawiwat K, Chareonsirisuthigul T, Chuncharunee S, Rerkamnuaychoke B. Multiplex RT-PCR Assay for Detection of Common Fusion Transcripts in Acute Lymphoblastic Leukemia and Chronic Myeloid Leukemia Cases. Asian Pac J Cancer Prev 2016; 17:677-84. [PMID: 26925663 DOI: 10.7314/apjcp.2016.17.2.677] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Acute lymphoblastic leukemia (ALL) is a heterogeneous disease which requires a risk-stratified approach for appropriate treatment. Specific chromosomal translocations within leukemic blasts are important prognostic factors that allow identification of relevant subgroups. In this study, we developed a multiplex RT-PCR assay for detection of the 4 most frequent translocations in ALL (BCR-ABL, TEL-AML1, MLL-AF4, and E2A- PBX1). MATERIALS AND METHODS A total of 214 diagnosed ALL samples from both adult and pediatric ALL and 14 cases of CML patients (154 bone marrow and 74 peripheral blood samples) were assessed for specific chromosomal translocations by cytogenetic and multiplex RT-PCR assays. RESULTS The results showed that 46 cases of ALL and CML (20.2%) contained the fusion transcripts. Within the positive ALL patients, the most prevalent cryptic translocation observed was mBCR-ABL (p190) at 8.41%. In addition, other genetic rearrangements detected by the multiplex PCR were 4.21% TEL-AML1 and 2.34% E2A-PBX1, whereas MLL-AF4 exhibited negative results in all tested samples. Moreover, MBCR-ABL was detected in all 14 CML samples. In 16 samples of normal karyotype ALL (n=9), ALL with no cytogentic result (n=4) and CML with no Philadelphia chromosome (n=3), fusion transcripts were detected. CONCLUSIONS Multiplex RT-PCR provides a rapid, simple and highly sensitive method to detect fusion transcripts for prognostic and risk stratification of ALL and CML patients.
Collapse
Affiliation(s)
- Nittaya Limsuwanachot
- Human Genetics Laboratory, Department of Pathology, Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand E-mail :
| | | | | | | | | | | |
Collapse
|
9
|
Aljamaan K, Aljumah TK, Aloraibi S, Absar M, Iqbal Z. Low Frequency of ETV6-RUNX1 (t 12; 21) in Saudi Arabian Pediatric Acute Lymphoblastic Leukemia Patients: Association with Clinical Parameters and Early Remission. Asian Pac J Cancer Prev 2015; 16:7523-7. [DOI: 10.7314/apjcp.2015.16.17.7523] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
|
10
|
Goud TM, Al Salmani KK, Al Harasi SM, Al Musalhi M, Wasifuddin SM, Rajab A. Importance of FISH combined with Morphology, Immunophenotype and Cytogenetic Analysis of Childhood/ Adult Acute Lymphoblastic Leukemia in Omani Patients. Asian Pac J Cancer Prev 2015; 16:7343-50. [PMID: 26514535 DOI: 10.7314/apjcp.2015.16.16.7343] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Genetic changes associated with acute lymphoblastic leukemia (ALL) provide very important diagnostic and prognostic information with a direct impact on patient management. Detection of chromosome abnormalities by conventional cytogenetics combined with fluorescence in situ hybridization (FISH) play a very significant role in assessing risk stratification. Identification of specific chromosome abnormalities has led to the recognition of genetic subgroups based on reciprocal translocations, deletions and modal number in B or T-cell ALL. In the last twelve years 102 newly diagnosed childhood/adult ALL bone marrow samples were analysed for chromosomal abnormalities with conventional G-banding, and FISH (selected cases) using specific probes in our hospital. G-banded karyotype analysis found clonal numerical and/or structural chromosomal aberrations in 74.2% of cases. Patients with pseudodiploidy represented the most frequent group (38.7%) followed by high hyperdiploidy group (12.9%), low hyperdiploidy group (9.7%), hypodiploidy (<46) group (9.7%) and high hypertriploidy group (3.2%). The highest observed numerical chromosomal alteration was high hyperdiploidy (12.9%) with abnormal karyotypes while abnormal 12p (7.5%) was the highest observed structural abnormality followed by t(12;21)(p13.3;q22) resulting in ETV6/RUNX1 fusion (5.4%) and t(9;22)(q34.1;q11.2) resulting in BCR/ABL1 fusion (4.3%). Interestingly, we identified 16 cases with rare and complex structural aberrations. Application of the FISH technique produced major improvements in the sensitivity and accuracy of cytogenetic analysis with ALL patients. In conclusion it confirmed heterogeneity of ALL by identifying various recurrent chromosomal aberrations along with non-specific rearrangements and their association with specific immunophenotypes. This study pool is representative of paediatric/adult ALL patients in Oman.
Collapse
|
11
|
Dong WM, Cao XS, Wang B, Lin Y, Hua XY, Qiu GQ, Gu WY, Xie XB. Allogeneic hemopietic stem cell transplants for the treatment of B cell acute lymphocytic leukemia. Asian Pac J Cancer Prev 2014; 15:6127-30. [PMID: 25124585 DOI: 10.7314/apjcp.2014.15.15.6127] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Explore the feasibility of allo- hemopietic stem cell transplants in treating patients with B cell acute lymphocytic leukemia. METHODS Between september 2006 and February 2011, fifteen patients with B cell acute lymphocytic leukemia (ALL) were treated by allo-hemopietic stem cell transplants (HSCT). Stem cell sources were peripheral blood. Six patients were conditioned by busulfan (BU) and cyclophosphamide (CY) and nine patients were conditioned with TBI and cyclophosphamide (CY). Graft versus host disease (GVHD) prophylaxis regimen consisted of cyclosporine A (CSA), methotrex ate (MTX) and mycophenolatemofetil (MMF). RESULTS Patients received a median of 7.98×10⁸·kg⁻¹ (5.36-12.30×10⁸·kg⁻¹) mononuclear cells (MNC). The median time of ANC>0.5×10⁹/L was day 12 (10-15), and PLT>20.0×10⁹/L was day 13 (11-16). Extensive acute GVHD occurred in 6 (40.0%) patients, and extensive chronic GVHD was recorded in 6 (40.0%) patients. Nine patients were alive after 2.5-65 months follow-up. CONCLUSION Allogeneic stem cell transplant could be effective in treating patients with B cell acute lymphocytic leukemia.
Collapse
Affiliation(s)
- Wei-Min Dong
- Department of Hematology, The First People's Hospital of Changzhou, Third Affiliated Hospital of Suzhou University, Changzhou, Jiangsu, China E-mail :
| | | | | | | | | | | | | | | |
Collapse
|