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Zailani MAH, Raja Sabudin RZA, Abdul Jalil D, Ithnin A, Ayub NA, Alauddin H, Jalil N, Md Fauzi A, Cheah FC, Lim LS, Safian N, Yusuf MM, Othman A. Evaluation of quantitative point-of-care test for measurement of glucose-6-phosphate dehydrogenase enzyme activity in Malaysia. Malays J Pathol 2023; 45:31-41. [PMID: 37119244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Abstract
INTRODUCTION The treatment of Plasmodium vivax malaria with 8-aminoquinolines is contraindicated in glucose-6-phosphate dehydrogenase (G6PD) deficient individuals due to the risk of acute haemolytic anaemia. Effective G6PD screening is paramount to avoid adverse drug reactions. This study aimed to evaluate the performance of novel quantitative point-of-care (POC) tests as a new screening method for G6PD deficiency in Malaysia. MATERIALS AND METHODS A total of 153 neonatal cord blood, 99 peripheral blood of older children aged between 1 month to 12-years old, and 62 peripheral adult blood were screened for G6PD deficiency using two quantitative POC tests, CareStartTM biosensor (Carestart) and CareStartTM Biosensor 1 (S1). The results were compared with OSMMR2000D kit as a reference assay. Two statistical analyses were performed in this study to evaluate the POC test performances, the Spearman's correlation test and the Cohen's kappa method. RESULTS Both Carestart and S1 tests showed significant positive correlations to OSMMRS000D with r2 = 0.7916 and r2 = 0.7467. Their measurement of agreement showed a kappa (κ) value of 0.805 (p<0.001, 95% CI), and 0.795 (p<0.001, 95% CI), respectively. Analysis of the area under the Receiver Operating Curve (ROC) at 60% cut-off illustrated that the Carestart had 90.2% sensitivity, 98.9% specificity, 98.3% positive predictive value (PPV), and 93.8% negative predictive value (NPV). The corresponding values for the S1 were 95.2%, 100%, 100%, and 96.8%, respectively. CONCLUSION This study showed that the Carestart and S1 biosensors have high-performance reliability for screening of G6PD deficiency, which can guide safe prescriptions of anti-malaria medications and hence, eradication of Plasmodium vivax malaria.
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Affiliation(s)
- M A H Zailani
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia
| | - R Z A Raja Sabudin
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia
| | - D Abdul Jalil
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia
| | - A Ithnin
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia.
| | - N A Ayub
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia
| | - H Alauddin
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia
| | - N Jalil
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia
| | - A Md Fauzi
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia
| | - F C Cheah
- Universiti Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia
| | - L S Lim
- University Science Malaysia, School of Distance Education, Pulau Pinang, Malaysia
| | - N Safian
- Universiti Kebangsaan Malaysia Medical Centre, Department of Community Health, Kuala Lumpur, Malaysia
| | - M M Yusuf
- Universiti Kebangsaan Malaysia Medical Centre, Laboratory Diagnostic Services, Kuala Lumpur, Malaysia
| | - A Othman
- Universiti Sains Islam Malaysia, Faculty of Medicine, Department of Medical Sciences II, Kuala Lumpur, Malaysia
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Halim-Fikri BH, Lederer CW, Baig AA, Mat-Ghani SNA, Syed-Hassan SNRK, Yusof W, Abdul Rashid D, Azman NF, Fucharoen S, Panigoro R, Silao CLT, Viprakasit V, Jalil N, Mohd Yasin N, Bahar R, Selvaratnam V, Mohamad N, Nik Hassan NN, Esa E, Krause A, Robinson H, Hasler J, Stephanou C, Raja-Sabudin RZA, Elion J, El-Kamah G, Coviello D, Yusoff N, Abdul Latiff Z, Arnold C, Burn J, Kountouris P, Kleanthous M, Ramesar R, Zilfalil BA. Global Globin Network Consensus Paper: Classification and Stratified Roadmaps for Improved Thalassaemia Care and Prevention in 32 Countries. J Pers Med 2022; 12:jpm12040552. [PMID: 35455667 PMCID: PMC9032232 DOI: 10.3390/jpm12040552] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 03/06/2022] [Accepted: 03/23/2022] [Indexed: 11/16/2022] Open
Abstract
The Global Globin Network (GGN) is a project-wide initiative of the Human Variome/Global Variome Project (HVP) focusing on haemoglobinopathies to build the capacity for genomic diagnosis, clinical services, and research in low- and middle-income countries. At present, there is no framework to evaluate the improvement of care, treatment, and prevention of thalassaemia and other haemoglobinopathies globally, despite thalassaemia being one of the most common monogenic diseases worldwide. Here, we propose a universally applicable system for evaluating and grouping countries based on qualitative indicators according to the quality of care, treatment, and prevention of haemoglobinopathies. We also apply this system to GGN countries as proof of principle. To this end, qualitative indicators were extracted from the IthaMaps database of the ITHANET portal, which allowed four groups of countries (A, B, C, and D) to be defined based on major qualitative indicators, supported by minor qualitative indicators for countries with limited resource settings and by the overall haemoglobinopathy carrier frequency for the target countries of immigration. The proposed rubrics and accumulative scores will help analyse the performance and improvement of care, treatment, and prevention of haemoglobinopathies in the GGN and beyond. Our proposed criteria complement future data collection from GGN countries to help monitor the quality of services for haemoglobinopathies, provide ongoing estimates for services and epidemiology in GGN countries, and note the contribution of the GGN to a local and global reduction of disease burden.
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Affiliation(s)
- Bin Hashim Halim-Fikri
- Malaysian Node of the Human Variome Project Secretariat, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (B.H.H.-F.); (S.-N.R.-K.S.-H.); (W.Y.)
| | - Carsten W. Lederer
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology & Genetics, 6 Iroon Avenue, Ayios Dometios, Nicosia 2371, Cyprus; (C.W.L.); (C.S.); (P.K.); (M.K.)
| | - Atif Amin Baig
- Faculty of Medicine, Universiti Sultan Zainal Abidin, Kuala Terengganu 20400, Terengganu, Malaysia;
| | - Siti Nor Assyuhada Mat-Ghani
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (S.N.A.M.-G.); (N.N.N.H.)
| | - Sharifah-Nany Rahayu-Karmilla Syed-Hassan
- Malaysian Node of the Human Variome Project Secretariat, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (B.H.H.-F.); (S.-N.R.-K.S.-H.); (W.Y.)
| | - Wardah Yusof
- Malaysian Node of the Human Variome Project Secretariat, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (B.H.H.-F.); (S.-N.R.-K.S.-H.); (W.Y.)
| | - Diana Abdul Rashid
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (D.A.R.); (N.F.A.); (N.M.)
| | - Nurul Fatihah Azman
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (D.A.R.); (N.F.A.); (N.M.)
| | - Suthat Fucharoen
- Thalassemia Research Centre, Institute of Molecular Biosciences, Mahidol University, Nakhom Pathom 73170, Thailand;
| | - Ramdan Panigoro
- Department of Biomedical Sciences, Medical Genetics Research Centre, Faculty of Medicine, Universitas Padjadjaran, Bandung 40161, Indonesia;
| | - Catherine Lynn T. Silao
- Institute of Human Genetics, National Institutes of Health, University of the Philippines, Manila 1000, Philippines;
- Department of Pediatrics, College of Medicine, University of the Philippines, Manila 1000, Philippines
| | - Vip Viprakasit
- Department of Paediatrics & Thalassaemia Centre, Siriraj Hospital, Mahidol University, Bangkok 10700, Thailand;
| | - Norunaluwar Jalil
- UKM Specialist Children’s Hospital, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia;
| | - Norafiza Mohd Yasin
- Haematology Unit, Cancer Research Centre, Institute for Medical Research, National Institutes of Health, No. 1, Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam, Shah Alam 40170, Selangor Darul Ehsan, Malaysia; (N.M.Y.); (E.E.)
| | - Rosnah Bahar
- Department of Haematology, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia;
| | - Veena Selvaratnam
- Hospital Ampang, Jalan Mewah Utara, Taman Pandan Mewah, Ampang Jaya 68000, Selangor, Malaysia;
| | - Norsarwany Mohamad
- Department of Paediatrics, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (D.A.R.); (N.F.A.); (N.M.)
| | - Nik Norliza Nik Hassan
- School of Health Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia; (S.N.A.M.-G.); (N.N.N.H.)
| | - Ezalia Esa
- Haematology Unit, Cancer Research Centre, Institute for Medical Research, National Institutes of Health, No. 1, Jalan Setia Murni U13/52, Seksyen U13, Bandar Setia Alam, Shah Alam 40170, Selangor Darul Ehsan, Malaysia; (N.M.Y.); (E.E.)
| | - Amanda Krause
- Division of Human Genetics, National Health Laboratory Service (NHLS) and School of Pathology, Faculty of Health Sciences, The University of the Witwatersrand, Watkins Pitchford Building, NHLS Braamfontein, Cnr Hospital and De Korte St, Hillbrow, P.O. Box 1038, Johannesburg 2000, South Africa;
| | - Helen Robinson
- Nossal Institute for Global Health, MDDHS, University of Melbourne, Melbourne, VIC 3010, Australia;
| | - Julia Hasler
- Global Variome, Institute of Genetic Medicine, International Centre for Life, Central Parkway, Newcastle upon Tyne NE1 3BZ, UK;
| | - Coralea Stephanou
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology & Genetics, 6 Iroon Avenue, Ayios Dometios, Nicosia 2371, Cyprus; (C.W.L.); (C.S.); (P.K.); (M.K.)
| | - Raja-Zahratul-Azma Raja-Sabudin
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras 56000, Kuala Lumpur, Malaysia;
| | - Jacques Elion
- Medical School, Université Paris Diderot, 75018 Paris, France;
| | - Ghada El-Kamah
- Clinical Genetics Department, Human Genetics and Genome Research Institute, National Research Centre, Cairo 12622, Egypt;
| | - Domenico Coviello
- Laboratorio di Genetica Umana, IRCCS Istituto Giannina Gaslini, Largo Gerolamo Gaslini 5, 16147 Genova, Italy;
| | - Narazah Yusoff
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Bertam, Kepala Batas 13200, Pulau Pinang, Malaysia;
| | - Zarina Abdul Latiff
- Department of Paediatrics, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Cheras 56000, Kuala Lumpur, Malaysia;
| | - Chris Arnold
- BioGrid Australia, Hodgson Associates, 4 Hodgson St., Kew, Melbourne, VIC 3101, Australia;
| | - John Burn
- Translational and Clinical Research Institute, International Centre for Life Times Square, Newcastle upon Tyne NE1 3BZ, UK;
| | - Petros Kountouris
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology & Genetics, 6 Iroon Avenue, Ayios Dometios, Nicosia 2371, Cyprus; (C.W.L.); (C.S.); (P.K.); (M.K.)
| | - Marina Kleanthous
- Molecular Genetics Thalassaemia Department, The Cyprus Institute of Neurology & Genetics, 6 Iroon Avenue, Ayios Dometios, Nicosia 2371, Cyprus; (C.W.L.); (C.S.); (P.K.); (M.K.)
| | - Raj Ramesar
- Department of Pathology, University of Cape Town City of Cape Town, Cape Town 7925, South Africa;
| | - Bin Alwi Zilfalil
- Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian 16150, Kelantan, Malaysia
- Correspondence: or ; Tel.: +60-9767-6531
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Wong YY, Alauddin H, Raja Sabudin RZA, Ithnin A, Jalil N, Abdul Latiff Z, Loh CK, Alias H, Othman A. Siriraj I Gγ( Aγδβ) 0-thalassaemia causing severe thalassaemia intermedia in compound heterozygous state with IVS1-1(G→T) mutation. Malays J Pathol 2021; 43:95-100. [PMID: 33903312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
The Siriraj I Gγ(Aγδβ)0-thalassaemia is a novel mutation involving a 118kb deletion of the β-globin gene cluster. It was first reported in 2012 in two unrelated families from the southern part of Thailand. The carriers in the heterozygous state are clinically asymptomatic. Nonetheless, its complex interaction with other β-thalassaemia could give rise to different clinical phenotypes, ranging from mild thalassaemia intermedia to thalassaemia major. We report here a case of a six-year-old Malay boy, presented with pallor, growth failure and hepatosplenomegaly. His haemoglobin at presentation was 9.2g/dL with a mean cell haemoglobin of 22.6pg and a mean cell volume of 69.9fl. His peripheral blood smear showed features of thalassaemia intermedia. Haemoglobin (Hb) analysis revealed markedly raised Hb F (83%), normal HbA2 levels and absent HbA. Deoxyribonucleic acid (DNA) analysis showed compound heterozygous IVS1-1 (G→T) β-globin gene mutation and Siriraj I Gγ(Aγδβ)0-deletion (genotype βIVS1-1/ β Siriraj I deletion). Both his father and elder sister are carriers of Siriraj I Gγ(Aγδβ)0-thalassaemia while his mother carries IVS1-1 (G→T) gene mutation. Clinically, the patient is transfusion dependent on six weekly regime. To the best of our knowledge, this is the first reported case in Malaysia involving unique Siriraj I Gγ(Aγδβ)0-thalassaemia and IVS1-1 (G→T) in a compound heterozygous state. In summary, detection of Siriraj I Gγ(Aγδβ)0-thalassaemia is essential as this deletion can lead to severe disease upon interaction with a β-thalassemia point mutation as demonstrated in our case. The establishment of effective carrier screening and genetic counselling is important to prevent its adverse consequences.
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Affiliation(s)
- Y Y Wong
- University Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia
| | - H Alauddin
- University Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia.
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Jamali NS, Raja Sabudin RZA, Alauddin H, Ithnin A, Tumian NR, Jalil N, Awai R, Abu Amis SH, Shuib S. H396P mutation in chronic myeloid leukaemia patient on nilotinib - A case report. Malays J Pathol 2021; 43:63-68. [PMID: 33903307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION The advent of BCR-ABL1-targeted therapy with the tyrosine kinase inhibitor (TKI), for example, imatinib and nilotinib, marked a turning point in the therapy of chronic myeloid leukaemia (CML). However, a substantial proportion of patients experience primary or secondary disease resistance to TKI. There are multifactorial causes contributing to the treatment failure of which BCR-ABL1 kinase domain mutation being the most common. Here, we describe a case of a CML patient with H396P mutation following treatment with nilotinib. CASE A 60-year-old woman presented with abdominal discomfort and hyperleukocytosis. She was diagnosed as CML in the chronic phase with positive BCR-ABL1 transcripts. Due to the failure to obtain an optimal response with imatinib treatment, it was switched to nilotinib. She responded well to nilotinib initially and achieved complete haematological and cytogenetic responses, with undetectable BCR-ABL1 transcripts. However, in 4 years she developed molecular relapse. Mutation analysis which was done 70 months after commencement of nilotinib showed the presence of BCRABL1 kinase domain mutation with nucleotide substitution at position 1187 from Histidine(H) to Proline(P) (H396P). Currently, she is on nilotinib 400mg twice daily. Her latest molecular analysis showed the presence of residual BCR-ABL1 transcripts at 0.22%. DISCUSSION/CONCLUSION This case illustrates the importance of BCR-ABL1 mutation analysis in CML patients with persistent BCR-ABL1 positivity in spite of treatment. Early detection and identification of the type of BCRABL1 mutation are important to guide appropriate treatment options as different mutation will have different sensitivity to TKI.
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Affiliation(s)
- N S Jamali
- University Kebangsaan Malaysia Medical Centre, Department of Pathology, Kuala Lumpur, Malaysia
| | - R Z A Raja Sabudin
- University Kebangsaan Malaysia Medical Centre, Department of Medicine, Kuala Lumpur, Malaysia.
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Hazir QA, Jalil N, Sabudin RZAR, Alauddin H, Yusof N, Tumian NR. A Fast-Moving Hemoglobin, Hb J-Bangkok: A Case Study from a Single Referral Center in Malaysia. Hemoglobin 2020. [DOI: 10.1080/03630269.2020.1717743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Qhasmira Abu Hazir
- Department of Pathology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Norunaluwar Jalil
- Haematology Unit, Department of Diagnostic Medical Laboratory Services, National University of Malaysia, Kuala Lumpur, Malaysia
| | | | - Hafiza Alauddin
- Department of Pathology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nurasyikin Yusof
- Department of Pathology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - Nor Rafeah Tumian
- Haematology Unit, Department of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
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Pauzy LHM, Jalil N, Sabudin RZAR, Alauddin H. Case Series of IVS-II-666 (C>T) (HBB: c.316-185C>T) Polymorphism: Experience from a Single Referral Center in Malaysia. Hemoglobin 2020. [DOI: 10.1080/03630269.2020.1717735] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Norunaluwar Jalil
- Haematology Unit, Department of Diagnostic Medical Laboratory Services, National University of Malaysia, Kuala Lumpur, Malaysia
| | | | - Hafiza Alauddin
- Department of Pathology, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
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Mohamad NZ, Jalil N, C-Khai L, Latiff ZA, Alauddin H, Azma RZ. A Rare IVS-I-2 (T>C) HBB Gene Mutation Diagnosed in a Child with Anemia. Hemoglobin 2020. [DOI: 10.1080/03630269.2020.1717737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
| | - Norunaluwar Jalil
- Department of Diagnostic Medical Laboratory Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Loh C-Khai
- Department of Paediatrics, UKM Medical Centre, Kuala Lumpur, Malaysia
| | | | - Hafiza Alauddin
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
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Razak SAA, Murad NAA, Masra F, Chong DLS, Abdullah N, Jalil N, Alauddin H, Sabudin RZAR, Ithnin A, Khai LC, Aziz NA, Muda Z, Ibrahim H, Latiff ZA. Genetic Modifiers of Fetal Haemoglobin (HbF) and Phenotypic Severity in β-Thalassemia Patients. Curr Mol Med 2019; 18:295-305. [PMID: 30289070 DOI: 10.2174/1566524018666181004121604] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/19/2018] [Accepted: 09/28/2018] [Indexed: 11/22/2022]
Abstract
BACKGROUND The phenotypic severity of β-thalassemia is highly modulated by three genetic modifiers: β-globin (HBB) mutations, co-inheritance of α-thalassemia and polymorphisms in the genes associated with fetal haemoglobin (HbF) production. This study was aimed to evaluate the effect of HbF related polymorphisms mainly in the HBB cluster, BCL11A (B-cell CLL/lymphoma 11A) and HBS1L-MYB (HBS1-like translational GTPase-MYB protooncogene, transcription factor) with regards to clinical severity. METHODS A total of 149 patients were included in the study. HBA and HBB mutations were characterised using multiplex PCR, Sanger sequencing and multiplex ligationdependent probe amplification. In addition, 35 HbF polymorphisms were genotyped using mass spectrometry and PCR-restriction fragment length polymorphism (PCRRFLP). The genotype-phenotype association was analysed using SPSS version 22. RESULTS Twenty-one HBB mutations were identified in the study population. Patients with HBB mutations had heterogeneous phenotypic severity due to the presence of other secondary modifiers. Co-inheritance of α-thalassemia (n = 12) alleviated disease severity of β-thalassemia. In addition, three polymorphisms (HBS1LMYB, rs4895441 [P = 0.008, odds ratio (OR) = 0.38 (0.18, 0.78)], rs9376092 [P = 0.030, OR = 0.36 (0.14, 0.90)]; and olfactory receptor [OR51B2] rs6578605 [P = 0.018, OR = 0.52 (0.31, 0.89)]) were associated with phenotypic severity. Secondary analysis of the association between single-nucleotide polymorphisms with HbF levels revealed three nominally significant SNPs: rs6934903, rs9376095 and rs9494149 in HBS1L-MYB. CONCLUSION This study revealed 3 types of HbF polymorphisms that play an important role in ameliorating disease severity of β-thalassemia patients which may be useful as a predictive marker in clinical management.
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Affiliation(s)
- S A A Razak
- UKM Medical Molecular Biology Institute, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - N A A Murad
- UKM Medical Molecular Biology Institute, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - F Masra
- Department of Paediatrics, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - D L S Chong
- Department of Paediatrics, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - N Abdullah
- UKM Medical Molecular Biology Institute, Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - N Jalil
- Department of Pathology, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - H Alauddin
- Department of Pathology, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - R Z A R Sabudin
- Department of Pathology, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - A Ithnin
- Department of Pathology, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - L C Khai
- Department of Paediatrics, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
| | - N A Aziz
- Institute for Medical Research (IMR), Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Z Muda
- Institute of Paediatrics, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - H Ibrahim
- Institute of Paediatrics, Hospital Kuala Lumpur, Jalan Pahang, 50586 Kuala Lumpur, Malaysia
| | - Z A Latiff
- Department of Paediatrics, Faculty of Medicine, University Kebangsaan Malaysia (UKM), Jalan Yaacob Latif, 56000 Cheras, Kuala Lumpur, Malaysia
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Alauddin H, Kamarudin K, Loong TY, Azma RZ, Ithnin A, Jalil N, Razak NF, Koh-Xuan-Rong D, Ismail E, C-Khai L, Abdul Latiff Z, Alias H, Othman A. A Unique Interaction of IVS-I-1 (G>A) (HBA2: c.95+1G>A) with Hb Adana (HBA2: c.179G>A) Presenting as Transfusion-Dependent α-Thalassemia. Hemoglobin 2019; 42:247-251. [PMID: 30623696 DOI: 10.1080/03630269.2018.1528985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Nondeletional α-globin mutations are known to cause more serious clinical effects than deletional ones. A rare IVS-I-1 (G>A) (HBA2: c.95+1G>A) donor splice site mutation interferes with normal splicing of pre mRNA and results in activation of a cryptic splice site as well as a frameshift mutation. Hb Adana [HBA2: c.179G>A (or HBA1)] is a highly unstable variant hemoglobin (Hb) resulting from a mutation at codon 59 on the HBA2 or HBA1 gene, recognized to cause severe α-thalassemia (α-thal) syndromes. We report a unique case of compound heterozygosity for these two mutations in a 9-year-old boy who presented with a Hb level of 5.3 g/dL and hepatomegaly at the age of 15 months. He required regular blood transfusions in view of a Hb level of <7.0 g/dL and failure to thrive. He had thalassemic red cell indices and peripheral blood film. The Hb electrophoresis only showed a raised Hb F level (3.3%) and a pre run peak but the Hb H inclusion test was negative. His father had thalassemic red cell indices but a normal Hb level. His mother had almost normal Hb levels and red cell indices. Hb Adana involving the HBA2 gene was detected by mutiplex amplification refractory mutation system-polymerase chain reaction (ARMS-PCR) in the proband and his father. DNA sequencing of the HBA2 gene confirmed the IVS-I-1 mutation in the proband and his mother. This case highlighted the unique interaction of the IVS-I-1 mutation with Hb Adana in a young Malay boy presenting with transfusion-dependent α-thal.
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Affiliation(s)
- Hafiza Alauddin
- a Department of Pathology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
| | - Khairina Kamarudin
- a Department of Pathology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
| | - Tang Yee Loong
- a Department of Pathology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
| | - Raja Zahratul Azma
- a Department of Pathology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
| | - Azlin Ithnin
- a Department of Pathology , Universiti Kebangsaan Malaysia Medical Centre , Kuala Lumpur , Malaysia
| | - Norunaluwar Jalil
- b Department of Laboratory Diagnostic Services , Universiti Kebangsaan Malaysia Medical Centre , Kuala , Lumpur , Malaysia
| | - Noor-Farisah Razak
- b Department of Laboratory Diagnostic Services , Universiti Kebangsaan Malaysia Medical Centre , Kuala , Lumpur , Malaysia
| | - Danny Koh-Xuan-Rong
- c School of Bioscience and Biotechnology , Universiti Kebangsaan Malaysia , Selangor , Malaysia
| | - Endom Ismail
- c School of Bioscience and Biotechnology , Universiti Kebangsaan Malaysia , Selangor , Malaysia
| | - Loh C-Khai
- d Department of Paediatrics , Universiti Kebangsaan Malaysia Medical Centre , Kuala , Lumpur , Malaysia
| | - Zarina Abdul Latiff
- d Department of Paediatrics , Universiti Kebangsaan Malaysia Medical Centre , Kuala , Lumpur , Malaysia
| | - Hamidah Alias
- d Department of Paediatrics , Universiti Kebangsaan Malaysia Medical Centre , Kuala , Lumpur , Malaysia
| | - Ainoon Othman
- e Department of Medical Science II , Faculty of Medicine and Health Science, Universiti Sains Islam Malaysia , Nilai , Malaysia
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Jalil N, Azma RZ, Mohamed E, Ithnin A, Alauddin H, Baya SN, Othman A. Evaluation of Glucose-6-Phosphate Dehydrogenase stability in stored blood samples. EXCLI J 2016; 15:155-62. [PMID: 27103895 PMCID: PMC4834747 DOI: 10.17179/excli2015-604] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/30/2015] [Accepted: 02/02/2016] [Indexed: 12/05/2022]
Abstract
Glucose-6-Phosphate Dehydrogenase (G6PD) deficiency is the commonest cause of neonatal jaundice in Malaysia. Recently, OSMMR2000-D G6PD Assay Kit has been introduced to quantitate the level of G6PD activity in newborns delivered in Universiti Kebangsaan Malaysia Medical Centre (UKMMC). As duration of sample storage prior to analysis is one of the matters of concern, this study was conducted to identify the stability of G6PD enzyme during storage. A total of 188 cord blood samples from normal term newborns delivered at UKMMC were selected for this study. The cord bloods samples were collected in ethylene-diamine-tetra-acetic acid (EDTA) tubes and refrigerated at 2-8 °C. In addition, 32 out of 188 cord blood samples were spotted on chromatography paper, air-dried and stored at room temperature. G6PD enzyme activities were measured daily for 7 days using the OSMMR2000-D G6PD Assay Kit on both the EDTA blood and dried blood samples. The mean value for G6PD activity was compared between days of analysis using Student Paired T-Test. In this study, 172 out of 188 cord blood samples showed normal enzyme levels while 16 had levels corresponding to severe enzyme deficiency. The daily mean G6PD activity for EDTA blood samples of newborns with normal G6PD activity showed a significant drop on the fourth day of storage (p < 0.005) while for samples with severely deficient G6PD activity, significant drop was seen on third day of storage (p = 0.002). Analysis of dried cord blood showed a significant reduction in enzyme activity as early as the second day of storage (p = 0.001). It was also noted that mean G6PD activity for spotted blood samples were lower compared to those in EDTA tubes for all days (p = 0.001). Thus, EDTA blood samples stored at 2-8 °C appeared to have better stability in terms of their G6PD enzyme level as compared to dried blood samples on filter paper, giving a storage time of up to 3 days.
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Affiliation(s)
- Norunaluwar Jalil
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur; Department of Medical Laboratory Technology, Universiti Teknologi MARA, Puncak Alam, Selangor
| | - Raja Zahratul Azma
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Emida Mohamed
- Department of Medical Laboratory Technology, Universiti Teknologi MARA, Puncak Alam, Selangor
| | - Azlin Ithnin
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Hafiza Alauddin
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Siti Noor Baya
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur
| | - Ainoon Othman
- Department of Medical Sciences II, Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur
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Ghani W, Zain R, Jalil N, Razak I, Raja-Latifah R, Samsuddin A. O30. Sociodemographic characteristics, clinicopathological parameters and survival among Malaysians with oral squamous cell carcinoma (OSCC). Oral Oncol 2011. [DOI: 10.1016/j.oraloncology.2011.06.141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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12
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Wong G, Ha K, Himratul-Aznita W, Cheong S, Saini R, Mustaffa WW, Jalil N, Karen-Ng L, Zain R. P131. Development of an ELISA method for the detection of HPV 16 in oral cancer patients. Oral Oncol 2011. [DOI: 10.1016/j.oraloncology.2011.06.374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Abstract
On 15 September 1995 a Malaysian Airlines (MAS) Fokker 50 plane plunged while descending and crashed, killing thirty-four passengers aboard. The dental disaster victim identification team comprising dental surgeons from the Dental faculty, University of Malaya; Ministry of Health, Sabah; and the Malaysian Defence Forces played an active role in the identification process. Most of the bodies were badly mutilated, disfigured and severely incinerated. Problems were encountered due to inadequate facilities and space at the mortuary. Difficulties were also encountered during the procurement and deciphering of information from dental records. This disaster has however created greater awareness amongst Malaysians of the important role of forensic odontology in mass disasters.
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Affiliation(s)
- P Nambiar
- Dept. of Oral Biology, Faculty of Dentistry University of Malaya, Kuala Lumpur, Malaysia
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Ley BE, Jalil N, McIntosh J, Smart A, Wilson M, Foot AB, Millar MR. Bolus or infusion teicoplanin for intravascular catheter associated infections in immunocompromised patients? J Antimicrob Chemother 1996; 38:1091-5. [PMID: 9023659 DOI: 10.1093/jac/38.6.1091] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
An unexpected low efficacy of teicoplanin in the treatment of coagulase negative staphylococcal (CNS) infections on a regional Bone Marrow Transplant (BMT) Unit led to a retrospective study. CNS infections treated with gylcopeptides in BMT patients with in-dwelling central venous lines between May 1990 and May 1995 were reviewed. Efficacy rates of 50% for teicoplanin compared with 80% for vancomycin despite comparable antibiotic susceptibility. Glycopeptides have bactericidal action which is time dependent. Teicoplanin was administered by bolus injection during the study period and it is suggested that this observed difference in efficacy is caused by the short duration of exposure of luminal bacteria.
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Affiliation(s)
- B E Ley
- Department of Paediatric Oncology, Bristol Royal Hospital for Sick Children, UK
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Souadka A, Zouhal A, Souadka F, Jalil N, Benjelloun S, Benjaafar B, Mansouri M, el Gueddari B. [Breast cancers and pregnancy. 43 cases reported in the National Oncology Institute between 1985 and 1988]. Rev Fr Gynecol Obstet 1994; 89:67-72. [PMID: 8184247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
We report a 4-year retrospective study of 43 cases of breast cancer related to pregnancy and the post-natal period, corresponding to a 4.6% incidence in the breast cancers recorded during the same period. The mean age of our patients was 33 years. The most common reason for the consultation was the tumour. Inflammatory signs were present in 25% of cases and 80% of our patients had palpable under-arm adenopathies. 27% of cases were metastatic from the outset. The timing of treatment was the only parameter to be changed on the basis of age or the continuation of pregnancy or stage of the illness. Termination of pregnancy was carried out in only 2 cases. Recurrences occurred in 70% of cases and the survival median was 18 months. We noted that breast cancer during the perinatal period constitutes a poor prognosis, hence the importance of early diagnosis and care.
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Affiliation(s)
- A Souadka
- Service de Chirurgie, Institut national d'Oncologie, Rabat Institut, Maroc
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Jalil N, Gilchrist C, Taylor-Robinson D. Factors influencing the in-vitro sensitivity of Ureaplasma urealyticum to tetracyclines. J Antimicrob Chemother 1989; 23:341-5. [PMID: 2732118 DOI: 10.1093/jac/23.3.341] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
The sensitivity of 23 strains of Ureaplasma urealyticum to doxycycline was measured by a metabolism-inhibition technique. The minimal inhibitory concentrations were not influenced by using, as inocula in the tests, organisms either directly from the patient or after culture, providing that the numbers of organisms in the inocula were about the same in both. All the strains were sensitive to doxycycline but an apparent increase in the resistance of the cultured organisms occurred when the number, expressed as colour-changing units (ccu), in the inoculum was 10(5) or more/ml. Tests may be undertaken on cultured organisms of U. urealyticum but it is recommended that a standard inoculum of 10(3)-10(4) ccu/ml should be used.
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Affiliation(s)
- N Jalil
- Division of Sexually Transmitted Diseases, Clinical Research Centre, Harrow, Middlesex, UK
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Abstract
In a prospective study of 24 men (mean age 28.3 years) with acute epididymitis who underwent epididymal aspiration, micro-organisms were detected in 15 (62.5%). Chlamydia trachomatis accounted for 10 (42%) of the cases, being located in both the urethra and epididymis in 5 individuals. Chlamydial serology supported the diagnosis of chlamydial infection, there being a strong correlation between the detection of C. trachomatis and elevated titres of both chlamydial IgG and IgM antibodies. In 4 patients (mean age 55.5 years), Escherichia coli was cultured from both mid-stream urine and epididymal aspirate. Transrectal ultrasound revealed abnormal prostatic scans in 19 patients (79%). These data confirm the aetiological role of C. trachomatis, support the notion that micro-organisms spread intra-canalicularly and suggest that the prostate is also involved in the inflammatory process in acute epididymitis.
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Affiliation(s)
- A Doble
- Department of Urology, St Mary's Hospital, London
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Abstract
Ureaplasma urealyticum organisms (ureaplasmas) were isolated from the urethra and epididymal aspirate of a man aged 24 who had acute right sided epididymitis. No other microorganisms were detected, and he had no chlamydial antibody response. A fourfold antibody response to the epididymal ureaplasma isolate was detected by two methods, however, and the patient responded clinically to doxycycline, to which the ureaplasmal isolates were susceptible in vitro. These findings suggest that U urealyticum had a causative role.
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Affiliation(s)
- N Jalil
- Jefferiss Research Wing of the Praed Street Clinic, St. Mary's Hospital, Paddington, London
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