Background: Acute myeloid leukemia is a type of hematological malignancy. Chemotherapy is the first-line treatment for AML. The main aim of treatment is to achieve complete REMISSION in patients. Although complete REMISSION is achieved in most patients, still the rate of relapse remains high. Recent studies revealed that drug resistance is an important cause of treatment failure in AML patients. Autophagy as a conserved catabolic process has a significant role in drug resistance of AML. Autophagy can act as a chemoresistance mechanism in response to chemotherapy in AML patients. However, the role of this pathway in response to treatment of AML patients is not yet fully clarified. Objectives: The aim of this study was to investigate the effect of the BECN1 gene, as a key regulator of autophagy on REMISSION and response to chemotherapy in AML patients. Methods: The BECN1 gene expression was evaluated in 30 AML patients at diagnosis stage, on 18 patients with complete REMISSION and 15 controls using qRT-PCR. Results: The results showed that BECN1 gene expression level was significantly higher in AML patients than controls at the rate of 5/3 fold, P < 0. 0001. We found that expression level of BECN1 was significantly reduced in patients with complete REMISSION in comparison with newly diagnosed AML patients at the rate of 0. 73 fold, P = 0. 004. Conclusions: Low expression of BECN1 gene might be associated to complete REMISSION. Therefore, perhaps BECN1 gene can be used as a biomarker to assess REMISSION status. Moreover, targeting BECN1 can be used as a potential strategy to improve treatment in AML patients.

Background: Transcription factors (TFs) play a key role in the development, therapy, and relapse of B-cell malignancies, such as B-cell precursor acute lymphoblastic leukemia (BCP-ALL). Given the essential function of Forkhead box protein P1 (FOXP1) transcription factor in the early development of B-cells, this study was designed to evaluate FOXP1 gene expression levels in pediatric BCP-ALL patients and NALM6 cell-line. Materials and Methods: This case-control study was done on the NALM6 cell-line and bone marrow specimens of 23 pediatric BCP-ALL patients (median age: 7. 5 years; range: 2. 0 – 15. 0 years) at different clinical stages including new diagnosis, 15th day after the treatment, and relapse. Also, 10 healthy children were included as the control group. FOXP1 gene expression was analyzed by quantitative real-time polymerase chain reaction (qRTPCR). The correlation analysis was performed between the FOXP1 gene expression and patients’ demographic and laboratory characteristics. Results: The results showed that FOXP1 gene expression was significantly downregulated in the NALM-6 cellline (median=0. 05, P<0. 001) and patients at new diagnosis (median=0. 06, p<0. 0001), and relapse (median=0. 001, p<0. 0001) phases, compared to the control group (median=0. 08). FOXP1 gene expression on the 15th day of the treatment was significantly higher than its level at the new diagnosis stage (p<0. 001). Moreover, FOXP1 gene was significantly downregulated in the relapse phase compared to the new diagnosis. Patients whose number of bone marrow blasts on the 15th day of the treatment was below 5% had higher FOXP1 gene expression at the diagnosis phase (Spearman’ s correlation, P<0. 05, r=-0. 485) and higher ratio of diagnosis/day 15 (p<0. 001, Mann-Whitney U test). Conclusions: FOXP1 levels could be a potential biomarker of therapy response in REMISSION INDUCTION therapy for pediatric BCP-ALL patients.

Background: Complete response (CR) and very good partial response (VGPR) are targeted with pre-ASCT INDUCTION regimens in patients by diagnosed multiple myeloma (MM), who are candidates for ASCT. In this study, it was aimed to compare the response and survival evaluations of cases who underwent INDUCTION treatment by vincristine-doxorubicin-dexamethasone (VAD) protocol versus bortezomib containing regimens. Materials and Methods: The data of 96 ASCT eligible patients, retrospectively analyzed. P value> 0. 05 was considered statistically significant. Results: While 66 cases had received bortezomib containing regimens as INDUCTION regimen, 30 cases had received VAD protocol. The total survival was 91. 3 (st. s 6) months and 43 (st. s 7. 9) months, respectively, when we compared the cases without ASCT and with ASCT (p = 0. 001). The OS of patients who underwent ASCT after reaching at least VGPR was longer than the underwent ASCT without reaching VGPR (p=0. 019). Post-ASCT PFS (p=0. 717) and OS (p = 0. 126) analyzes were performed in 74 cases undergoing ASCT treatment, there was no significant statistical difference when patients with treated by VAD protochol and treated by bortezomib containing regimens as pre-ASCT INDUCTION regimens was compared to each other. Conclusion: Whatever the type of INDUCTION regimen is, the level of response achieved before ASCT is important. The survival of the myeloma patients are much more influenced with HDT-ASCT as well as post-transplantation strategies to keep the patients in REMISSION. Even though it is outdated, we think that the VAD protocol may be an option in patients who are not responding with the new generation of agents in the following days.

Introduction: Exclusive enteral nutrition (EEN) is considered the first line treatment to induce disease REMISSION in paediatric Crohn’ s disease (CD). The study aim was to identify paediatric patients with a new diagnosis of CD and investigate clinical outcomes of EEN use. Methods: Patients aged 0-16 years with CD diagnosed at Starship Child Health 2010-2020 were identified by retrospective chart review. Demographics collected include age, gender, ethnicity and socioeconomic status (SES) using the NZ Deprivation Index. Disease location and behaviour were classified according to the Paris classification. REMISSION was determined using clinical factors by physician global assessment. EEN duration and method were also collected with biochemical markers, anthropometric z-scores and malnutrition status at the start and end of EEN. Results: 103 patients were identified (60% male, mean age 11. 6 years). 66% were NZ European and 24% Indian with low numbers of patients from other Asian, Maori and Pasifika ethnicities. 60% were in the highest 2 SES quintiles, though this was not statistically significant. Eighty six (83%) patients completed 6 weeks EEN, of whom 54 (63%) achieved clinical REMISSION of disease. Achievement of clinical REMISSION was significantly associated with improved weight and body mass index z-scores (p<0. 0001) and improvement in biochemical markers including CRP (p<0. 0001), ESR (p=0. 0003), haemoglobin (p=0. 011), albumin (p<0. 0001) and faecal calprotectin (p=0. 0001). Of those who failed to complete the EEN, 17 discontinued due to lack of clinical response and 4 due to poor adherence. Disease location, behaviour, and malnutrition status at diagnosis did not significantly affect clinical outcome, nor the number of clinician points of contact, EEN duration or method of delivery. Conclusions: Exclusive enteral nutrition is an effective treatment for INDUCTION of clinical REMISSION in paediatric CD. Adherence is not an issue in this patient cohort, however REMISSION rates in Auckland are lower than recent published literature.

Objective: The purpose of this study was studying of explicit motor learning in Relapse-REMISSION (RR) MS patients and compare with healthy subject.Material & Methods: A serial reaction time task by using software was applied for studying explicit motor learning in 15 RRMS patients and 15 matched healthy subjects. In this task four squares with different colors appeared on the computer screen and the subjects were asked to press 1 of 4 keys corresponding to the appropriately colored square immediately after observing it.In the first day subjects practiced 8 motor blocks with a retention test consisted of 2 patterned blocks, 48 hours later. Before test, the subjects were told the order of random and patterned blocks, and then RT values were calculated for each block and K-S test, paired T test and independent-samples t-test were used to analyse the measured blocks times.Result: The patient groups performed this task slower than healthy groups (P<0.05). Blocks time difference between the first block and tenth block, were significant in both groups (P<0.05). But Explicit motor learning in healthy subjects was higher than patient groups (P<0.05).Conclusion: although patient groups performed this task slower than healthy subjects, there was motor learning in RRMS patient but this explicit motor learning was less than healthy matched subjects.

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Background and Objectives: Survivin (SVV) is an inhibitor of apoptosis. Its expression rises in most cancer types and is associated with resistance to chemotherapy, increased recurrence, and decreased patient survival. In this study, the expression of SVV gene was analyzed in APL(Acute Promyelocytic Leukemia) patients.Materials and Methods: In this case-control study, the blood samples of 50 patients were collected in three groups; diagnosis, REMISSION, and recurrence. Then, SVV gene expression was studied using absolute quantitative real time PCR. The data were analysed with SPSS version 17, Kruskal-Wallis and Tukey tests.Results: For the first time, this study demonstrated that SVV overexpressed significantly in APL patients compared with the control (Mean ± SD; 910.5 ± 699) (p <0.01). This overexpression was seen both in diagnosis (4981.4 ± 4112.2) and recurrence groups (4584.2 ± 5133.6) (both p<0.01). After arsenic trioxide therapy (ATO) the SVV expression declined significantly as compared to the diagnosis group (p<0.01).Conclusions: Findings indicate that SVV may have a role in survival of APL cells and INDUCTION of apoptosis by decreasing SVV expression can be a probable mechanism of ATO. This study indicates that the SVV may be used as a biomarker in APL patients during the course of the disease.

Introduction: Atypical hemolytic uremic syndrome (HUS) is defined as a heterogeneous group of disorders. Plasma infusion or plasma exchange is the rescue therapy for this life-threatening syndrome. There is no evidence for the volume of plasma required to induce REMISSION. Materials and Methods: Between 2007 and 2018, Forty – two patients (M=20, F=22) with a diagnosis of recurrent or familial atypical hemolytic uremic syndrome (aHUS) who were admitted to Ali-Asgar Children’ s Hospital were enrolled in this observational retrospective study. The total volume of plasma required for normalizing platelet (>150000) and LDH (<500 IU), eliminating hemolysis, and decreasing serum creatinine at first presentation of disease was calculated. Patients with TTP, vasculitis, and post infectious HUS were excluded. Results: The mean age of the patients was 53 months (3-144 m). The majority of patients achieved REMISSION at first presentation by plasma infusion (5 under peritoneal dialysis and 4 under hemodialysis) but ten patients required plasmapheresis. A total of 980 units of FFP perfused with a total volume of 195. 975 L. The median (range) total plasma volume required for REMISSION was 166 ml/kg (43-2850 ml/kg). Conclusions: This study showed that the required plasma volume for the acute phase of atypical HUS for controlling the first attack of disease.