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Xuan-Rong Koh D, Zailani MAH, Raja Sabudin RZA, Muniandy S, Muhamad Hata NAA, Mohd Noor SNB, Zakaria N, Othman A, Ismail E. Prevalence and molecular heterogeneity of glucose-6-phosphate dehydrogenase (G6PD) deficiency in the Senoi Malaysian Orang Asli population. PLoS One 2023; 18:e0294891. [PMID: 38085718 PMCID: PMC10715666 DOI: 10.1371/journal.pone.0294891] [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] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 11/13/2023] [Indexed: 12/18/2023] Open
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked genetic disorder characterized by reduced G6PD enzyme levels in the blood. This condition is common in populations exposed to malaria; an acute febrile disease caused by Plasmodium parasites. G6PD-deficient individuals may suffer from acute hemolysis following the prescription of Primaquine, an antimalarial treatment. The population at risk for such a condition includes the Senoi group of Orang Asli, a remote indigenous community in Malaysia. This study aimed to elucidate the G6PD molecular heterogeneity in this subethnic group which is important for malaria elimination. A total of 662 blood samples (369 males and 293 females) from the Senoi subethnic group were screened for G6PD deficiency using a quantitative G6PD assay, OSMMR2000-D kit with Hb normalization. After excluding the family members, the overall prevalence of G6PD deficiency in the studied population was 15.2% (95% CI: 11-19%; 56 of 369), with males (30 of 172; 17.4%) outnumbering females (26 of 197; 13.2%). The adjusted male median (AMM), defined as 100% G6PD activity, was 11.8 IU/gHb. A total of 36 participants (9.6%; 26 male and 10 female) were deficient (<30% of AMM) and 20 participants (5.4%; 4 male and 16 female) were G6PD-intermediate (30-70% of AMM). A total of 87 samples were genotyped, of which 18 showed no mutation. Seven mutations were found among 69 genotyped samples; IVS11 T93C (47.1%; n = 41), rs1050757 (3'UTR +357A>G)(39.1%; n = 34), G6PD Viangchan (c.871G>A)(25.3%; n = 22), G6PD Union (c.1360C>T)(21.8%; n = 19), c.1311C>T(20.7%; n = 18), G6PD Kaiping (c.1388G>A)(8.0%; n = 7), and G6PD Coimbra (c.592C>T)(2.3%; n = 2). Our analysis revealed 27 hemizygote males, 18 heterozygote females, 7 homozygote females, and 2 compound heterozygote females. This study confirms the high prevalence of G6PD deficiency among the Senoi Malaysian Orang Asli, with a significant degree of molecular heterogeneity. More emphasis should be placed on screening for G6PD status and proper and safe use of Primaquine in the elimination of malaria among this indigenous population.
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Affiliation(s)
- Danny Xuan-Rong Koh
- Faculty of Science and Technology, Center of Frontier Sciences, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | | | | | - Sanggari Muniandy
- Faculty of Science and Technology, Center of Frontier Sciences, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | - Nur Awatif Akmal Muhamad Hata
- Faculty of Medicine, Department of Diagnostic Laboratory Services, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Siti Noor Baya Mohd Noor
- Faculty of Medicine, Department of Diagnostic Laboratory Services, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Norhazilah Zakaria
- Faculty of Medicine, Department of Diagnostic Laboratory Services, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Ainoon Othman
- Faculty of Medicine and Health Sciences, Department of Pathology, Universiti Sains Islam Malaysia, Negeri Sembilan, Malaysia
| | - Endom Ismail
- Faculty of Science and Technology, Department of Biological Sciences Dan Biotechnology, Universiti Kebangsaan Malaysia, Selangor, Malaysia
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Azman SS, Yazid MD, Abdul Ghani NA, Raja Sabudin RZA, Abdul Rahman MR, Sulaiman N. Generation of a novel ex-vivo model to study re-endothelialization. Artif Cells Nanomed Biotechnol 2023; 51:408-416. [PMID: 37584645 DOI: 10.1080/21691401.2023.2245456] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 07/31/2023] [Accepted: 08/02/2023] [Indexed: 08/17/2023]
Abstract
Endothelial dysfunction initiates the pathogenesis of a myriad of cardiovascular diseases, yet the precise underlying mechanisms remain unclear. Current model utilises mechanical denudation of arteries resulting in an arterial-injury model with onset of intimal hyperplasia (IH). Our study shows that 5 min enzymatic denudation of human umbilical artery (hUA) lumen at 37 °C efficiently denudes hUA while maintaining vessel integrity without significantly increase intima-media thickness after 7 days in culture. This ex-vivo model will be a valuable tool in understanding the mechanism of re-endothelialization prior to smooth muscle cells (SMC) activation thus placating IH at an early stage.
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Affiliation(s)
- Siti Sarah Azman
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Faculty of Applied Sciences, Universiti Teknologi MARA, Perak Branch, Tapah Campus, Perak, Malaysia
| | - Muhammad Dain Yazid
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Nur Azurah Abdul Ghani
- Department of Obstetrics and Gynaecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
- Hospital Canselor Tuanku Mukhriz, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
| | - Raja Zahratul Azma Raja Sabudin
- Hospital Canselor Tuanku Mukhriz, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Mohd Ramzisham Abdul Rahman
- Hospital Canselor Tuanku Mukhriz, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, Kuala Lumpur, Malaysia
- Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
| | - Nadiah Sulaiman
- Centre for Tissue Engineering and Regenerative Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Cheras, Malaysia
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Za’im Sahul Hameed M, Nordin R, Ismail A, Zulkifley MA, Sham ASH, Sabudin RZAR, Zailani MAH, Saiboon IM, Mahdy ZA. Acceptance of medical drone technology and its determinant factors among public and healthcare personnel in a Malaysian urban environment: knowledge, attitude, and perception. Front Public Health 2023; 11:1199234. [PMID: 38045974 PMCID: PMC10693296 DOI: 10.3389/fpubh.2023.1199234] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Accepted: 10/23/2023] [Indexed: 12/05/2023] Open
Abstract
Introduction Unmanned aerial vehicles (UAVs) are used for commercial, medical, public safety, and scientific research purposes in various countries. Methods This study aimed to explore the acceptance of medical delivery drones among medical practitioners as well as the public community in Malaysia using a knowledge, attitude, and perception (KAP) model and statistical analysis to decrease uncertainty. Bivariate and multivariate analyses of the results were performed in SPSS. Results A total of 639 respondents took part in the survey, of which 557 complete responses were finally analyzed. The results showed that the overall acceptance rate for medical delivery drones was positive. The acceptance rate was significantly correlated with knowledge, attitude, and perception scores but not with sociodemographic factors. Discussion Raising awareness and educating the medical as well as public communities regarding the potential role and benefits of drones are therefore important in garnering support for drone usage for medical purposes.
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Affiliation(s)
| | - Rosdiadee Nordin
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Aniza Ismail
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Muhammad Aidiel Zulkifley
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Aina Suraya Helmy Sham
- Department of Electrical, Electronic and Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | | | | | - Ismail Mohd Saiboon
- Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zaleha Abdullah Mahdy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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Zailani MAH, Raja Sabudin RZA, Ithnin A, Alauddin H, Sulaiman SA, Ismail E, Othman A. Population screening for glucose-6-phosphate dehydrogenase deficiency using quantitative point-of-care tests: a systematic review. Front Genet 2023; 14:1098828. [PMID: 37388931 PMCID: PMC10301741 DOI: 10.3389/fgene.2023.1098828] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 05/22/2023] [Indexed: 07/01/2023] Open
Abstract
Background: Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked hereditary disorder and a global public health concern that is most prevalent in malaria-endemic regions including Asia, Africa, and the Mediterranean. G6PD-deficient individuals are at high risk of developing acute hemolytic anemia following treatment with antimalarial drugs including Primaquine and Tafenoquine. However, the currently available tests for G6PD screening are complex and often have been misclassifying cases, particularly for females with intermediate G6PD activity. The latest innovation of quantitative point-of-care (POC) tests for G6PD deficiency provides an opportunity to improve population screening and prevent hemolytic disorders when treating malaria. Aim(s): To assess the evidence on the type and performance of quantitative point-of-care (POC) tests for effective G6PD screening and hence, radical elimination of Plasmodium malaria infections. Methods: Relevant studies published in English language confined from two databases, Scopus and ScienceDirect were searched from November 2016 onwards. The search was conducted using keywords including "glucosephosphate dehydrogenase" or "G6PD", "point-of-care", "screening" or "prevalence", "biosensor" and "quantitative". The review was reported following the PRISMA guidelines. Results: Initial search results yielded 120 publications. After thorough screening and examination, a total of 7 studies met the inclusion criteria, and data were extracted in this review. Two types of quantitative POC tests were evaluated, namely, the CareStartTM Biosensor kit and the STANDARD G6PD kit. Both tests showed promising performance with high sensitivity and specificity ranging mostly from 72% to 100% and 92%-100%, respectively. The positive and negative predictive values (PPV and NPV) ranged from 35% to 72% and 89%-100%, with accuracy ranging from 86% to 98%. Conclusion: In areas with a high prevalence of G6PD deficiency that overlap with malaria endemicity, availability and validation of the diagnostic performance of quantitative POC tests are of absolute importance. Carestart™ biosensor and STANDARD G6PD kits showed high reliability and performed well in comparison to the spectrophotometric reference standard.
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Affiliation(s)
| | | | - Azlin Ithnin
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Hafiza Alauddin
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Siti Aishah Sulaiman
- UKM Medical Molecular Biology Institute (UMBI), Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Endom Ismail
- Department of Biological Sciences Dan Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Bangi, Malaysia
| | - Ainoon Othman
- Department of Pathology, Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Nilai, Malaysia
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Zailani MAH, Raja Sabudin RZA, Ismail A, Abd Rahman R, Mohd Saiboon I, Sabri SI, Seong CK, Mail J, Md Jamal S, Beng GK, Mahdy ZA. Influence of drone carriage material on maintenance of storage temperature and quality of blood samples during transportation in an equatorial climate. PLoS One 2022; 17:e0269866. [PMID: 36070297 PMCID: PMC9451063 DOI: 10.1371/journal.pone.0269866] [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] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 05/27/2022] [Indexed: 11/18/2022] Open
Abstract
The disruptive potentials of drones are rapidly growing including for the delivery of blood samples in healthcare. Maintenance of the quality of blood samples is important to ascertain that the drone is a safe mode of transportation, particularly during emergencies and in critical cases. The influence of the drone carriage material on blood samples transportation was investigated in this study. Two phases of drone simulation flights were conducted in Cyberjaya, Malaysia. In Phase 1, the effect of drone carriage material on the internal storage temperature during blood samples transportation was determined. Three types of carriage materials were compared: aluminium, expanded polystyrene (EPS) foam, and polypropylene (PP) plastic. In Phase 2, the quality of drone-transported blood samples was assessed, using the best material from Phase 1 as the drone carriage material. Biochemical and hematological analyses of 60 blood samples were conducted using five parameters. In Phase 1, EPS foam was found to be the best material to maintain a stable and favorable internal storage temperature at mean kinetic temperature ±SD of 4.70 ±1.14°C. Much higher and unfavorable mean kinetic temperatures were recorded for aluminium (11.46 ±0.35°C) and plastic (14.17 ±0.05°C). In Phase 2, laboratory tests show that the quality of blood samples was well maintained, and the mean biochemical and hematological parameters of drone-transported blood samples showed no significant alteration compared to ground controls. Drone carriage material is an important determinant of the quality of blood samples transported by drone, particularly in hot equatorial climates as in Malaysia. The blood storage temperature was best maintained using EPS foam, as evidenced by the favorable average temperature and preservation of hematological and biochemical parameters of the blood samples.
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Affiliation(s)
| | | | - Aniza Ismail
- Department of Community Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Rahana Abd Rahman
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Ismail Mohd Saiboon
- Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Shahnaz Irwani Sabri
- Queen Elizabeth II Hospital (QEHII), Ministry of Health (MOH), Kota Kinabalu, Malaysia
| | - Chan Kok Seong
- Sabah Women and Children Hospital (SWACH), Ministry of Health (MOH), Kota Kinabalu, Malaysia
| | - Jamaludin Mail
- Sabah Women and Children Hospital (SWACH), Ministry of Health (MOH), Kota Kinabalu, Malaysia
| | - Shamsuriani Md Jamal
- Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
| | - Gan Kok Beng
- Department of Electrical, Electronic & Systems Engineering, Faculty of Engineering and Built Environment, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Zaleha Abdullah Mahdy
- Department of Obstetrics and Gynecology, Faculty of Medicine, Universiti Kebangsaan Malaysia (UKM), Kuala Lumpur, Malaysia
- * E-mail:
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Zailani MAH, Sabudin RZAR, Rahman RA, Saiboon IM, Ismail A, Mahdy ZA. Drone for medical products transportation in maternal healthcare: A systematic review and framework for future research. Medicine (Baltimore) 2020; 99:e21967. [PMID: 32899033 PMCID: PMC7478386 DOI: 10.1097/md.0000000000021967] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
INTRODUCTION Medical products transportation has become an important research topic requiring multidisciplinary collaboration among experts in medicine, engineering, and health economics. Current modes of transportation are unable to overcome the limited settings in maternal healthcare, particularly during the event of obstetric emergencies. The drone is a promising medical product aerial transportation (MedART) that holds an enormous potential for delivery of medical supplies in the healthcare system. We conducted a systematic review to examine scientific evidence of positive impact of drone transportation on maternal health. METHODS The following electronic databases were searched from inception to July 2019: ScienceDirect, PubMed, and EMBASE. The report was made in accordance with the principles of PRISMA guidelines. The search terms used were related to drones including unmanned aerial vehicle (UAV) and unmanned aerial system (UAS), and related to obstetric/maternal including obstetric emergencies and postpartum hemorrhage. Studies were selected if the intervention used were drones, and if any direct or indirect maternal health indicators were reported. Meta-analysis was not done throughout the study in view of the anticipated heterogeneity of each study. RESULTS Our initial search yielded a total of 244 relevant publications, from which 236 were carried forward for a title and abstract screening. After careful examination, only two were included for systematic synthesis. Among the reasons for exclusion were irrelevance to maternal health purpose, and irrelevance to drone applications in healthcare. An updated search yielded one additional study that was also included. Overall, two studies assessed drones for blood products delivery, and one study used drones to transport blood samples. CONCLUSION A significant deficiency was found in the number of reported studies analyzing mode of medical products transportation and adaptation of drones in maternal healthcare. Future drone research framework should focus on maternal healthcare-specific drone applications in order to reap benefits in this area.
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Affiliation(s)
| | | | | | | | - Aniza Ismail
- Department of Community Health Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysi
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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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Norunaluwar J, Raja Sabudin RZA, Hafiza A, Azlin I, Badrulzaman H, Kah-Mei C, Sanada AB, Ainoon O. HPLC Tosoh HLC-723 G8 Analyzer Performance in Detection of β-Thalassemia and Hb E Traits. Hemoglobin 2020. [DOI: 10.1080/03630269.2020.1717734] [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)
- Jalil Norunaluwar
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
- Department of Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | | | - Alauddin Hafiza
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Ithnin Azlin
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Hussin Badrulzaman
- Department of Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | | | | | - Othman Ainoon
- Faculty of Medicine, Department of Medical Sciences II, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
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Azma Raja Sabudin RZ, Fauzi AM, Abdul Jalil D, Ithnin A, Alauddin H, Fook-Choe C, Ayub NA, Malisa MY, Norunaluwar J, Ainoon O. Updates on Laboratory Tests for Diagnosis of Glucose-6-Phosphate Dehydrogenase Deficiency in Malaysia. Hemoglobin 2020. [DOI: 10.1080/03630269.2020.1718291] [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)
| | - Alina Md Fauzi
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
- Laboratory Diagnostic Services, UKM Medical Centre, Kuala Lumpur, Malaysia
| | | | - Azlin Ithnin
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Hafiza Alauddin
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Cheah Fook-Choe
- Department of Medical Sciences II, Faculty of Medicine, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | | | - Moh Yusuf Malisa
- Paediatric Department, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Jalil Norunaluwar
- Department of Pathology, UKM Medical Centre, Kuala Lumpur, Malaysia
- Paediatric Department, UKM Medical Centre, Kuala Lumpur, Malaysia
| | - Othman Ainoon
- Laboratory Diagnostic Services, UKM Medical Centre, 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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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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Chia WC, Khoo TS, Abdul Wahid SFS, Razak NFA, Alauddin H, Raja Sabudin RZA, Othman A, Hassan R, Hussin NH. Multiplex STR panel for assessment of chimerism following hematopoietic stem cell transplantation (HSCT). Ann Hematol 2019; 98:1279-1291. [PMID: 30783731 DOI: 10.1007/s00277-019-03626-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2018] [Accepted: 01/28/2019] [Indexed: 11/26/2022]
Abstract
Short tandem repeat (STR) analysis is used in chimerism monitoring after allogeneic hematopoietic stem cell transplantation (HSCT) for patients with various hematologic malignancies. Commercial forensic STR kits often contain loci with huge differences in power of discrimination (PD) across populations, causing some loci to be less informative for chimerism analysis in certain populations. This study aimed to construct a new STR multiplex panel with highly informative loci for efficient chimerism analysis. Thirteen STR markers which exhibit high PD (> 0.9) in at least 80% of 50 populations globally were selected to form a new panel and used in STR analysis of 253 Malaysian subjects. Cumulative power of discrimination (CPD) and combined power of exclusion (CPE) were determined from 253 Malaysian individuals. Loci informativity was assessed and compared to the commercial AmpFLSTR Identifiler PCR Amplification kit in 14 donor-recipient pairs. The new panel had detected 202 unique alleles including five novel alleles from the 253 individuals with high CPD and CPE (> 0.99999999999999999 and > 0.999999997 respectively). All loci from the new panel in the donor-recipient pair analysis showed higher than 50% informativity, while five loci from the commercial kit demonstrated lower than 50% informativity. Four loci from the new panel ranked the highest informativity. A sequenced allelic ladder which consists of 202 unique alleles from the 253 subjects was also developed to ensure accurate allele designation. The new 13-loci STR panel, thus, could serve as an additional powerful, accurate, and highly informative panel for chimerism analysis for HSCT patients.
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Affiliation(s)
- Wui Chuen Chia
- Hematology Unit, Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Tze Sean Khoo
- UKM Medical Molecular Biology Institute, National University of Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - S Fadilah S Abdul Wahid
- Cell Therapy Center, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Noor Farisah Abdul Razak
- Hematology Unit, Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Hafiza Alauddin
- Hematology Unit, Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Raja Zahratul Azma Raja Sabudin
- Hematology Unit, Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia
| | - Ainoon Othman
- Department of Medical Science II, Faculty of Medicine and Health Science, Islamic Science University of Malaysia, Kuala Lumpur, Malaysia
| | - Roshida Hassan
- National Blood Centre, Jalan Tun Razak, Titiwangsa, 50400, Kuala Lumpur, Malaysia
| | - Noor Hamidah Hussin
- Hematology Unit, Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Bandar Tun Razak, Cheras, 56000, Kuala Lumpur, Malaysia.
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Koh DXR, Raja Sabudin RZA, Mohd Yusoff M, Hussin NH, Ahmad R, Othman A, Ismail E. Molecular Characterisation of α- and β-Thalassaemia among Indigenous Senoi Orang Asli Communities in Peninsular Malaysia. Ann Hum Genet 2017. [PMID: 28620953 DOI: 10.1111/ahg.12201] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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: 11/28/2022]
Abstract
Thalassaemia is a public health problem in Malaysia, with each ethnic group having their own common mutations. However, there is a lack on data on the prevalence and common mutations among the indigenous people. This cross-sectional study was performed to determine the common mutations of α- and β-thalassaemia among the subethnic groups of Senoi, the largest Orang Asli group in Peninsular Malaysia. Blood samples collected from six Senoi subethnic groups were analysed for full blood count and haemoglobin analysis (HbAn). Samples with abnormal findings were then screened for α- and β-globin gene mutations. Out of the 752 samples collected, 255 showed abnormal HbAn results, and 122 cases showing abnormal red cell indices with normal HbAn findings were subjected to molecular screening. DNA analysis revealed a mixture of α- and β-globin gene mutations with 25 concomitant cases. The types of gene abnormalities detected for α-thalassaemia were termination codon (T>C) Hb CS (αCS α), Cd59 (G>A) haemoglobin Adana (Hb Adana) (αCd59 α), initiation codon (ATG>A-G) (αIniCd α), two-gene deletion (-SEA ), and single-gene 3.7-kb deletion (-α3.7 ). For β-thalassaemia, there were Cd26 (G>A) Hb E (βE ), Cd19 (A>G) Haemoglobin Malay (Hb Malay) (βCd19 ), and IVS 1-5 (G>C) (βIVS 1-5 ).
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Affiliation(s)
- Danny Xuan Rong Koh
- School of Biosciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Selangor, Malaysia
| | | | - Malisa Mohd Yusoff
- Department of Diagnostic Laboratory Services, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Noor Hamidah Hussin
- Department of Pathology, Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - Rahimah Ahmad
- Haematology Unit, Cancer Research Centre, Institute for Medical Research, Kuala Lumpur, Malaysia
| | - Ainoon Othman
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia
| | - Endom Ismail
- School of Biosciences and Biotechnology, Faculty of Science and Technology, Universiti Kebangsaan Malaysia, Selangor, Malaysia
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Osman NH, Sathar J, Leong CF, Zulkifli NF, Raja Sabudin RZA, Othman A, Ahmad Asnawi AW. Importance of extended blood group genotyping in multiply transfused patients. Transfus Apher Sci 2017; 56:410-416. [PMID: 28438419 DOI: 10.1016/j.transci.2017.03.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Revised: 10/20/2016] [Accepted: 03/12/2017] [Indexed: 11/15/2022]
Abstract
Blood group antigen systems are not limited to the ABO blood groups. There is increasing interest in the detection of extended blood group systems on the red cell surface. The conventional method used to determine extended blood group antigens or red cell phenotype is by serological testing, which is based on the detection of visible haemagglutination or the presence of haemolysis. However, this technique has many limitations due to recent exposure to donor red cell, certain drugs or medications or other diseases that may alter the red cell membrane. We aimed to determine the red cell blood group genotype by SNP real time PCR and to compare the results with the conventional serological methods in multiply transfused patients. Sixty-three patients participated in this study whose peripheral blood was collected and blood group phenotype was determined by serological tube method while the genotype was performed using TaqMan® Single Nucleotide Polymorphism (SNP) RT-PCR assays for RHEe, RHCc, Kidd and Duffy blood group systems. Discrepancies were found between the phenotype and genotype results for all blood groups tested. Accurate red blood cell antigen profiling is important for patients requiring multiple transfusions. The SNP RT-PCR platform is a reliable alternative to the conventional method.
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Affiliation(s)
- Nadila Haryani Osman
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia.
| | - Jameela Sathar
- Department of Haematology, Hospital Ampang, Selangor, Malaysia.
| | - Chooi Fun Leong
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia.
| | - Noor Fadzilah Zulkifli
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia.
| | | | - Ainoon Othman
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia.
| | - Asral Wirda Ahmad Asnawi
- Faculty of Medicine and Health Sciences, Universiti Sains Islam Malaysia, Kuala Lumpur, Malaysia.
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Loong TY, Chong DLS, Jamal ARA, Murad NAA, Sabudin RZAR, Fun LC. First reported case of Haemoglobin-M Hyde Park in a Malay family living in Malaysia. EXCLI J 2016; 15:630-635. [PMID: 28096792 PMCID: PMC5225734 DOI: 10.17179/excli2016-613] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2016] [Accepted: 10/14/2016] [Indexed: 11/10/2022]
Abstract
Haemoglobin (Hb)-M Hyde Park, also known as Hb-M Akita is a rare type of hereditary Hb M due to autosomal dominant mutation of CAC>TAC on codon 92 of β globin gene resulting in the replacement of histidine by tyrosine on β globin chain. This variant Hb has a tendency to form methaemoglobin (metHb). The iron ion in metHb is oxidized to ferric (Fe3+) which is unable to carry oxygen and the patients manifest as cyanosis clinically. A 9-year-old Malay girl was incidentally found to be cyanotic when she presented to a health clinic. Laboratory investigations revealed raised methaemoglobin levels and Hb analysis findings were consistent with Hb-M Hyde Park. β gene sequencing confirmed a point mutation of CAC>TAC on codon 92 in one of the β genes. The family study done on the individuals with cyanosis showed similar findings. A diagnosis of heterozygous Hb-M Hyde Park was made. Patients with this variant Hb usually presented with cyanosis with mild haemolysis and maybe misdiagnosed as congenital heart disease. No further treatment is needed as patients are relatively asymptomatic. Although the disease is harmless in the heterozygous carriers but the offspring of the carriers may suffer severe haemolytic anaemia when the offspring also inherit other β haemoglobinopathies/thalassemia. This can happen due to high prevalence of β thalassemia carrier (3.5-4 %) found in Malaysia. At the time of writing, this is the first case of hereditary Hb-M Hyde Park diagnosed in a Malay family living in Malaysia.
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Alauddin H, Mohamad Nasir S, Ahadon M, Raja Sabudin RZA, Ithnin A, Hussin NH, Alias H, Loh CK, Abdul Latiff Z, Abdul Murad NA, Othman A. Hb lepore/β0-thalassaemia with α+-thalassaemia interactions, a potential diagnostic pitfall. Malays J Pathol 2015; 37:287-292. [PMID: 26712677] [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: 06/05/2023]
Abstract
Haemoglobin (Hb) Lepore is a variant Hb consisting of two α-globin and two δβ-globin chains. In a heterozygote, it is associated with clinical findings of thalassaemia minor, but interactions with other haemoglobinopathies can lead to various clinical phenotypes and pose diagnostic challenges. We reported a pair of siblings from a Malay family, who presented with pallor and hepatosplenomegaly at the ages of 21 months and 14 months old. The red cell indices and peripheral blood smears of both patients showed features of thalassaemia intermedia. Other laboratory investigations of the patients showed conflicting results. However, laboratory investigation results of the parents had led to a presumptive diagnosis of compound heterozygote Hb Lepore/β-thalassaemia and co-inheritance α+-thalassaemia (-α3.7). Hb Lepore has rarely been detected in Southeast Asian countries, particularly in Malaysia. These two cases highlight the importance of family studies for accurate diagnosis, hence appropriate clinical management and genetic counseling.
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Affiliation(s)
- Hafiza Alauddin
- UKM Medical Centre, Department of Pathology, Pre-Clinical Building, Level 15, Jalan Yaacob Latiff, 56000 Cheras, Kuala Lumpur, Malaysia.
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Tang YL, Raja Sabudin RZA, Leong CF, Ko CCH, Chia WK, Salwati S, Wong CL. Double Philadelphia chromosome-positive B acute lymphoblastic leukaemia in an elderly patient. Malays J Pathol 2015; 37:275-279. [PMID: 26712675] [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: 06/05/2023]
Abstract
A rare case of double Philadelphia chromosome-positive B Acute lymphoblastic Leukaemia (B-ALL) is reported here. A 60-year-old lady presented with one month history of fever, submandibular lymphadenopathy, loss of appetite and weight loss. Physical examination revealed multiple palpable cervical lymph nodes. Blood film showed leucocytosis with 72% blasts. Bone marrow assessment confirmed a diagnosis of B-ALL with presence of double Philadelphia (Ph) chromosomes. As she was very ill, she was initially treated with an attenuated regimen of induction chemotherapy consisting of rituximab, cyclophosphamide, vincristine and prednisolone (R-CVP) along with intrathecal chemotherapy comprising methotrexate, cytarabine and hydrocortisone. Bone marrow examination post-induction chemotherapy showed >5% blasts. She was subsequently re-induced with rituximab, cyclophosphamide, doxorubicin, vincristine and prednisolone (R-CHOP) along with intrathecal chemotherapy, following which she went into complete remission. Consolidation chemotherapy consisting of methotrexate, methylprednisolone, cytarabine, intrathecal chemotherapy and imatinib was subsequently administered followed by maintenance chemotherapy consisting of vincristine, prednisolone and imatinib (IDEAMOP). She developed spontaneous bruises and relapsed four months into her maintenance chemotherapy with 90% blasts in the bone marrow which was treated with fludarabine, cytarabine and granulocyte colony stimulating factor (FLAG). Unfortunately she developed neutropenic sepsis which was complicated by invasive lung aspergillosis. Bone marrow examination post-FLAG showed 80% blasts. Despite aggressive antifungal therapy, her lung infection worsened and she finally succumbed to her illness 13 months after the initial diagnosis. We highlight a rare case of elderly B-ALL with double Ph chromosomes which carries a poor prognosis despite aggressive treatment for the disease and its complications.
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Affiliation(s)
- Yee-Loong Tang
- Universiti Kebangsaan Malaysia Medical Centre, Faculty of Medicine, Department of Pathology, Jalan Yaacob Latif, Bandar Tun Razak 56000 Cheras, Kuala Lumpur, Malaysia.
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