1.Profiling of genetic mutations among adult Filipino patients diagnosed with Acute Myeloid Leukemia using fluorescence in situ hybridization from 2014 to 2021: A single-institution study.
Aaron Pierre Calimag ; Januario Antonio Veloso, Jr.
Philippine Journal of Pathology 2023;8(1):21-26
INTRODUCTION:
Among patients with Acute Myeloid Leukemia (AML), the karyotype at diagnosis is an
important prognostic indicator for predicting outcomes. Several studies have been done to identify the
most common cytogenetic abnormalities seen in patients in other countries, however, limited studies have
been done in our setting.
OBJECTIVE:
The study aims to determine the most common abnormalities present among patients with AML
referred for Fluorescence in situ Hybridization (FISH) at the National Kidney and Transplant Institute.
METHODOLOGY:
The study included 131 adult patients with a mean age o 46. Fluorescence in situ Hybridization
was used to identify the following cytogenetic abnormalities: t(8;21), 11q23 (MLL), 16q22 (CBFB-MYH11),
t(15;17) (PML/RARA), t(9;22) (BCR/ABL), 7q31 deletion, and Monosomy 7.
RESULTS:
FISH was negative in 40% (n=53) of patients. 7q31 deletion is the most frequently identified
cytogenetic abnormality among patients with a single abnormality (n=17, 13%) present and is the most
frequently identified abnormality among patients with multiple abnormalities (n=26). 7q31 deletion is more
frequently observed among patients between the ages 51 to 60 years old and among patients with AML
with monocytic differentiation. 22% (n=29) of patients have multiple abnormalities, with the most common
abnormalities to occur together are 7q31 deletion and t(8;21) (n=20, 15%). Patients with negative results and
patients with multiple cytogenetic abnormalities are commonly seen within the 41 to 50 age group.
CONCLUSION
The current study provides a single-institution view of the cytogenetic abnormalities among
adult Filipino patients with AML using FISH. Further investigation on the clinical history of these patients,
with correlation with other methods, as well as epidemiologic studies are needed to better understand
the similarities and differences seen from previously reported incidences.
acute myeloid leukemia
;
fluorescence in situ hybridization
;
cytogenetics
;
profiling
;
hematology
;
Filipino
2.Primary thyroid lymphoma.
Claudine Ann Musngi-Paras ; Ansarie P. Salpin ; Januario D. Veloso
Philippine Journal of Otolaryngology Head and Neck Surgery 2012;27(1):38-40
pEight cases of primary thyroid lymphoma were reported in a tertiary government hospital from January 2005 to August 2011. All patients presented with a diffuse enlargement of both thyroid lobes with associated obstructive symptoms. Five of these cases were extranodal marginal zone lymphoma and three were diffuse large B-cell lymphoma. Clinical features that would favor a thyroid lymphoma include tumor size of greater than 7 cm, obstructive symptoms, clinical hypothyroidism or history of Hashimoto thyroiditis. Thus, these features must be considered in evaluating thyroid nodules during fine-needle aspiration biopsy. Histologically, extranodal marginal zone B-cell lymphoma shows vaguely nodular to diffuse infiltrates of small to intermediate size atypical lymphoid cells infiltrating the thyroid follicles while diffuse large B-cell lymphoma shows sheets of large atypical lymphoid cells infiltrating the thyroid follicular epithelium./p
Human
;
Male
;
Female
;
Aged 80 and over
;
Aged
;
Middle Aged
;
Adult
;
THYROID GLAND
;
ENDOCRINE GLANDS
;
LYMPHOMA
;
LYMPHOMA, B-CELL
;
NEOPLASM
;
NEOPLASMS BY HISTOLOGIC TYPE
;
BIOPSY, FINE-NEEDLE
3.R-CHOP and consolidation radiotherapy for limited-stage and low-IPI high-grade b-cell lymphoma with MYC and BCL2 and/or BCL6 rearrangements: A single-center case series and review of literature
Joseff Karl U. Fernandez ; Michael D. San Juan ; Edilberto Joaquin V. Fragante, Jr. ; Billionario Januario Antonio D. Veloso, Jr. ; Timothy Carl F. Uy ; Michelle Regina L. Castillo ; Benedict Mihangel P. Crisostomo
Acta Medica Philippina 2024;58(Early Access 2024):1-11
High-Grade B-Cell Lymphoma (HGBCL) with gene rearrangements in MYC and BCL2 and/or BCL6 is an aggressive malignancy usually presenting in advanced stages. Current recommendations suggest the use of regimens more intensive than R-CHOP (rituximab, cyclophosphamide, vincristine, doxorubicin, prednisone), which are based on retrospective studies and single-arm prospective trials that included patients who are mostly in the advanced stage, and did not receive consolidation radiotherapy.
The optimal approach and treatment of HGBCL, whether limited-stage (LS) or advanced-stage, remains to be
determined. Here we describe the promising outcomes of three patients with LS and low IPI HGBCL with the use of R-CHOP as induction chemotherapy regimen, which was followed by consolidation radiotherapy.
Three women, 54-, 60-, and 64-years of age diagnosed to have HGBCL with MYC, and BCL2 and/or BCL6 rearrangements, with Ann Arbor stages I-IIE were included in this case series. All three patients had complete metabolic response to 6 cycles of R-CHOP and was subsequently treated with consolidation involved site radiotherapy (ISRT; total dose 30-36 Gy). Chemotherapy and radiotherapy were tolerated very well. All patients remain to be in remission, with the longest being at 23 months.
Outcomes of patients with HGBCL generally remain to be poor, but this may not be the case for patients with
limited-stage disease and favorable clinicopathologic risk profile. Nevertheless, the treatment of HGBCL is currently evolving and more studies are needed to determine the ideal approach and preferred chemotherapy regimen. Also, more studies are needed to elucidate the potential role of consolidation radiotherapy in patients with limited-stage HGBCL to improve survival outcomes. Findings of this case series suggest that patients with LS HGBCL may still derive benefit from R-CHOP followed by consolidation ISRT, but prospective trials are needed to confirm this.
4.An evaluation of pooling strategies for RT-qPCR testing for SARS-CoV-2 infection: A pragmatic multi-site parallel operational study
Raymundo Lo ; Agnes Barrientos ; Bernadette Espiritu ; Farrah Kristine Santiago ; Amado Tandoc III ; Januario Veloso ; Soccoro Yañ ; ez
Philippine Journal of Pathology 2020;5(2):12-33
Background and Objectives:
Sample pooling of COViD-19 PCR tests has been recently proposed as a low-cost alternative to individual tests. This multi-site, laboratory-based, proof-of-concept study explores the feasibility of pooled SARS-CoV-2 RT-qPCR testing, by demonstrating the effect of pooling on sensitivity, specificity, accuracy, number of tests saved, and turnaround time.
Methodology:
The research was conducted in two experiments. In Experiment 1, archival nasopharyngeal (NPS) and oropharyngeal (OPS) swab samples were diluted to simulate 5, 10, and 20 sized pools, and tested for SARS-CoV-2 RNA using RT-qPCR. In Experiment 2, actual nasopharyngeal and oropharyngeal swab samples were collected from asymptomatic low-risk volunteers. Aliquots of the samples were pooled following the 5, 10-5, and 20-10-5 multi-staged Dorfman pooling methods and tested. The sensitivity, specificity, accuracy, test savings, and turnaround time for each pooling method were documented.
Results and Conclusions
The study provided evidence that pooling of NP and OP samples for SARS-CoV-2 RNA detection using RT-qPCR is feasible and can be implemented in the Philippines. A 2-stage Dorfman 5 pooling strategy appears to be the best method, because it has the highest over-all accuracy, while still achieving acceptable test savings, and turnaround time. Pooling of nasopharyngeal and oropharyngeal swab samples prior to RT-qPCR testing may be considered by select molecular diagnostic laboratories to further increase testing capacity and at the same time reduce the cost of testing.
COVID-19
;
SARS-CoV-2
5.Convalescent plasma as adjunctive therapy for hospitalized patients with COVID-19:The Co-CLARITY Trial
Deonne Thaddeus V. Gauiran ; Teresita E. Dumagay ; Mark Angelo C. Ang ; Cecile C. Dungog ; Fresthel Monica M. Climacosa ; Sandy Chiong Maganito ; Rachelle N. Alfonso ; Anne Kristine H. Quero ; Josephine Anne C. Lucero ; Carlo Francisco N. Cortez ; Agnes Lorrainne M. Evasan ; Ruby Anne Natividad King ; Francisco M. Heralde III ; Lynn B. Bonifacio ; German J. Castillo, Jr. ; Ivy Mae S. Escasa ; Maria Clariza M. Santos ; Anna Flor G. Malundo ; Alric V. Mondragon ; Saubel Ezreal A. Salamat ; Januario D. Veloso ; Jose M. Carnate, Jr. ; Pedrito Y. Tagayuna ; Jodor A. Lim ; Marissa M. Alejandria ; Ma. Angelina L. Mirasol
Acta Medica Philippina 2024;58(2):5-15
Background and Objective:
Convalescent plasma therapy (CPT) may reduce the risk of disease progression among patients with COVID-19. This study was undertaken to evaluate the efficacy and safety of CPT in preventing ICU admission among hospitalized COVID-19 patients.
Methods:
In this open-label randomized controlled trial, we randomly assigned hospitalized adult patients with
COVID-19 in a 1:1 ratio to receive convalescent plasma as an adjunct to standard of care or standard of care alone. The primary endpoint was ICU admission within first 28 days of enrolment. Primary safety endpoints include rapid deterioration of respiratory or clinical status within four hours of convalescent plasma transfusion and cumulative incidence of serious adverse events during the study period including transfusion-related acute lung injury (TRALI), transfusion-associated circulatory overload (TACO), severe allergic reactions, and transfusion-related infections.
Results:
A total of 22 patients were assigned to receive convalescent plasma as an adjunct to standard of care and 22 to receive standard of care alone. The median time from onset of COVID-19 symptoms to study enrolment was eight days (IQR, 4 to 10). Two patients (9.1%) in the CPT group and one patient (4.5%) in the control group were admitted to the ICU. The primary outcome measure, ICU admission, was not different between the two groups (q-value >0.9). No patient who received convalescent plasma had rapid deterioration of respiratory/clinical status within four hours of transfusion and none developed TRALI, TACO, anaphylaxis, severe allergic reactions, or transfusion-related infections. There was also no significant difference in the secondary outcomes of 28-day mortality (two patients in the CPT group and none in the control group, q-value >0.90), dialysis-free days, vasopressor-free days, and ICU-free days.
Conclusions
Among hospitalized COVID-19 patients, no significant differences were observed in the need for
ICU admission between patients given CPT as adjunct to standard of care and those who received standard of
care alone. Interpretation is limited by early termination of the trial which may have been underpowered to
detect a clinically important difference.
COVID-19
;
COVID-19 Serotherapy