International Conference on Hematology and Oncology June 29- July 1, 2017 Bangkok, Thailand

Biography:

William Strauss MD received his MD from Tufts University School of Medicine. After training in Internal Medicine, he completed fellowships in both cardiology and pulmonary. He had an academic career for over 2 decades at the Veteran’s Administration Medical Center, Brigham and Women’s Hospital and Harvard Medical School prior to joining the pharmaceutical industry designing and leading multicenter studies. He has published more than 75 original publications or book chapters.

Abstract:

Over the past 2 decades IV iron preparations have found widespread usage in multiple disease states resulting in IDA which has been inadequately treated with oral irons.  Yet, there is a remarkable paucity of large controlled studies comparing these agents  head to head , especially of sufficient size to assess the incidence of rare adverse events such as hypersensitivity reactions and major hypotension. The 2 most recently approved IV iron agents in the US, ferumoxtytol (Fer) and ferric carboxymaltose (FCM) are able to deliver a full course of iron administered in 2 doses. The FIRM study (IDA-304) is a multicenter study conducted in ~180 sites in North America and Europe. Just over 2,000 patients with a diagnosis of IDA of any etiology, who are intolerant to oral iron, received either 2x510mg of Fer, or 2x750mg of FCM in a double blind fashion. Efficacy is assessed by mean change in hemoglobin and change in hemoglobin/mg of iron over the 5 week study. Safety focuses on the occurrence of moderate or severe hypersensitivity reactions (HSRs), including anaphylaxis, and moderate to severe hypotension. All potential HSRs are adjudicated by a blinded Clinical Events Committee. 2015 patients have been randomized, with the final patient visit in January 2017. Results will be available during 2Q17 and presented. 

Biography:

Rushdi Fadhil was born in Baghdad, Iraq, in 1971. He is a graduate of Al-Mustansyria University where he received B.Sc  in microbiology in 1995. After graduation, Rushdi launched his career in both the private and public hospitals, where he began his specialization (pathologist).  In 2003, he joined the Department of cytogenetic, in Iraqi Center for cancer and Medical Genetic Researches. He received High diploma in bacteriology from college of health and medical technology, Iraq, in 2007 and master degree in virology from the same collage in 2011. Since November 2011 he has been with the Department of molecular as a Lecturer assistant and researcher Iraqi Center for Cancer and Medical Genetic Researches. He was awarded scholarship to Griffith University, Australia, in 2014 for PhD in field of molecular diagnosis of cancer from Iraqi government. His dream is finding treatment for cancer.

Abstract:

Aim: The concept of “lifestyle” includes different factors such as nutrition, behaviour, stress, physical activity, working habits, smoking and alcohol consumption. Increasing evidence shows that environmental and lifestyle factors may influence epigenetic mechanisms, such as DNA methylation, histone acetylation and microRNA expression. Since microRNAs (miRNAs) represent an emerging field of cancer research, there is an increasing interest regarding the miRNA responses to lifestyle choices. MiR-21 has been established as an oncogenic miRNA in different cancer diseases. The aim of this study was to analyse whether cigarette smoking and alcohol consumption, are associated with the increased level of the salivary miR-21 in healthy individuals.

Materials and Methods:

Fifty supernatant saliva samples from fifty healthy individual (smoker 10%  and alcohol drinker 34% ) were analysed with non-smokers and non-alcohol drinkers by real-time polymerase chain reaction. The expression level of miR-21 was compared in those samples of healthy individuals with different demographical characteristics, social status, drinking and smoking habits.

Results: Our data demonstrate overexpression of salivary miR-21 in individuals with regular alcohol consumption. Smokers showed a non-significant increase in expression of salivary miR-21.

Conclusions: Differential expression of salivary miR-21 of healthy individuals from a small geographic region’s population shows correlation with the existence of common risk factors. 

Biography:

Alexander Luchinin has completed his PhD at the age of 23 years from Kirov State Medical Academy, Russia. He is a hematologist in Kirov Research Institute of Hematology and Blood Transfusion, Russia. He has published more than 50 papers in medical journals.
 

Abstract:

This is the case of an 62-year-old man who had symptoms such as splenomegaly +10 cm below the costal arch, very high WBC (169*10/9/L), immature granulocytes in CBC ( 7%), low PLT count (85*10/9/L), low HGB level (11.2 g/dL) and monocytosis (22% or 37*10/9/L). He was admitted to hematology & oncology department in our center. He also presented with hypercellularity with high count of monocytes in bone marrow (18%) and the blasts count was 7%. We did cytogenetic test of bone marrow by standard method. The karyotype was 48, XYY, +13 [20]. In additional we did cytogenetic analysis of lymphocytes stimulated by phytohaemagglutinin. The final cytogenetic conclusion showed that the patient had XYY syndrome or superman syndrome. This is rare congenital genetic disorder which often becomes unrecognized. The patient received final hematological diagnosis of Chronic Myelomonocytic Leukemia-1 by WHO classification. Therapy was invited with Hydroxyurea during 6 months without remission and with progression to AML. The second line was chemotherapy of 6-mercaptopurinum and low doses of cytarabine. In spite of treatment, the patient ultimately died from progression AML.

It is known, that patients with some different congenital genetic disorders, such as Dawn`s syndrome, Fanconi anemia, severe congenital neutropenia, Shwachman-Diamond syndrome and others, have high risk of leukemia. However, there are very little clinical cases described in science press. It was one of these rare cases. So, can “superman” be ill CMML? Yes, if he has acquired trisomy 13.

Biography:

Abstract:

CD66 and its isoforms modulate several physiologic processes and have a role in aggressiveness of malignancies. We aimed to investigate the expression of pan CD66, CD66 a, b, and c and their clinical implication in acute leukaemia. This study included 85 cases, 50 AML, 33 ALL and 2 mixed lineage leukaemia cases from King Abdullah Medical City, Saudi Arabia. PanCD66, CD66 a, CD66 b and CD66 c were detected by flowcytometry at diagnosis and panCD66 was reanalysed at day28. The expression rate of panCD66 and CD66 c was 51.8% in B-ALL and was significantly correlated with the BCR/ABL gene, P-value 0.037. CD66 a was detected in 11.1% of B-ALL cases and  was significantly associated with shorter overall survival (OS), P-value 0.045. In AML, the expression rates were 40%, 28% and 32% for panCD66, CD66 b and CD66 c respectively. CD66b was significantly correlated with favourable cytogenetics and prolonged OS, with P-values of 0.001 and 0.025, respectively. CD66 c was correlated with CD25 positivity, with a P-value of 0.003. The expression levels of panCD66 at diagnosis and day 28 were significantly correlated, with a P-value of <0.0001. Accordingly, pan CD6 6can be added to the panel for MRD. CD66c is a suitable target for monoclonal antibody therapy in B-ALL and AML. However large-scale studies are needed to verify their association with cytogenetics, CD25 expression and survival.

Biography:

Dr. Hassan Interest are Leukemia and Anemia. He is the Director of pediatric hematology oncology fellowship program , Lebanese University, Head of Pediatric Hematology Oncology Department, Zahraa University Hospital and Head of Pediatric Hematology Oncology Society, Lebanon

Abstract:

Pediatric acute liver sickle crisis, also known as Intrahepatic Cholestasis(SCIC), is an uncommon but fatal complication of sickle cell disease observed mainly in patients with homozygous sickle cell anemia. Herein we describe a case of pediatric SCIC treated successfully with manual exchange transfusion (ET). The patient was admitted for jaundice, enlarged liver and signs of hepatic failure, such as hyperbilirubinemia and coagulopathy. There was no evidence of viral hepatitis or biliary obstruction. We performed a session of ET in order to reduce the percentage of HbS to level inferior to 30% which was successfully accomplished. The patient had complete recovery of hepatic function. This case has shown that ET is an effective treatment of pediatric SCIC and should be introduced early on the onset of this severe complication.

Biography:

Abstract:

Lrrc24 is a 513 amino acid transmembrane protein with a domain organization very similar to Kekkon-1. Preliminary data from the Fennell lab has revealed that Lrrc24 decreases ErbB receptor expression as efficiently as Lrig1, strongly suggesting that Lrrc24 is a negative regulator of the ErbB family of RTKs. Furthermore, Lrr24 is expressed in the murine mammary gland and the epithelium of the healthy human breast but may be decreased in breast cancer. Analysis of the Weigelt breast cancer dataset demonstrates that Lrrc24 expression inversely correlates with time to metastasis, suggesting that Lrrc24 could be a metastasis suppressor. Furthermore, Lrrc24 is decreased in prostate adenocarcinoma compared to normal prostate. Collectively, our preliminary data highlight several key features of Lrrc24 which suggest it could be an important growth suppressor including its ability to negatively regulate oncogenic ErbB RTKs, its expression in normal tissue in which ErbBs are expressed and its potential loss in cancer. Hypothesize that Lrrc24 is a novel negative regulator of the ErbB family of RTKs and that it functions to suppress ErbB-driven tumor cell proliferation, motility and/or invasion.

Biography:

Dr Anusree Prabhakaran completed her super specialty training in Clinical Hematology, from prestigious institute, PGIMER, Chandigarh, India, in June 2015, followed by 5month training in BMT from Tata Medical center, Kolkata. She is currently working as a consultant in Clinical Hematology in DMH, Pune, India. Her keen area of interest is in acute leukemia, BMT and thrombotic disorders.

Abstract:

Mr J 24/M, was diagnosed with Acute Myeloid Leukemia (AML), with t(8,21), April 2015, when he presented with constitutional symptoms and cytopenias. He was managed with 3+7 induction chemotherapy followed by chemo consolidation with high dose Cytarabine, 3 cycles. He achieved complete remission (CR) and was on close follow up. He sustained relapse in December 2015 and hence was referred to our centre for further management. At admission he had 7% blasts in bone marrow, t(8,21) positive and FLT3/ITD, NPM1 and c-kit mutations negative. Examination revealed cervical and axillary lymphnodes. Possibility of chloroma was considered and he underwent a lymphnode excision biopsy- reported as Hodgkin’s lymphoma (HL) - nodular sclerosing variant. PET CT showed Stage II disease. He received FLAG-M chemotherapy followed by 2 courses of ABVD. Repeat Bone marrow showed refractory AML. Second salvage with Cladribine and Etoposide also failed. He underwent salvage haploidentical transplant, donor being his sister. He received Cyclophosphamide- total body irradiation based (Cy TBI) conditioning regimen and PTCy-Tacrolimus- MMF for GVHD prophylaxis. Post TBI, BM revealed 35% blasts. He had a stormy course peri transplant, with multiple complications. He had neutrophil engraftment on D+18 and was discharged on D+27 post transplant. D+30 bone marrow and D+90 PET CT are in CR. He is now 7 months post-transplant and remains in complete remission for both diseases.

Biography:

Jahnvi Dhar is a third year Post-graduate student in the Department of Medicine, currently pursuing Doctor of Medicine (MD) degree from Maulana Azad Medical College (MAMC) and associated with Lok Nayak Hospital, New Delhi, since 2015. She also worked as an Intern in the prestigious 1600 bedded Lok Nayak Hospital in 2014. She completed her Bachelor of Medicine, Bachelor of Surgery (MBBS) from Maulnana Azad Medical College, University of Delhi in 2013. She is interested in exploring the mechanisms of pathological processes and how they come together to manifest as a disease. She intends to learn all that can be done to enhance her understanding of how our bodies function. She aims to use this knowledge to enable research and real world implementation to solve problems we face in clinic and beyond.

Abstract:

Background: Most common manifestations in CML patients are fatigue, fever, unexplained weight loss and abdominal distension. Though rare, otoneurological manifestations have been reported in 15–40 % of all leukemic patients. The prevalence of self-reported hearing loss in CML patients is around 22.4%.  But audiometry assessments have shown a higher prevalence of 65.5%. Hence, presence of otoneurological findings in CML makes it a rare and exciting presentation.

Aims and Objectives: To analyze the prevalence of otoneurological complaints in patients of CML and to compare it with the age and sex matched healthy control population.

Methods: 33 newly diagnosed, treatment naïve CML cases and age and sex matched controls were recruited from October 2015 to January 2017. Otological complaints were noted at the time of presentation along with a complete otological examination. All the cases and controls were subjected to PTA (Pure tone audiometry) and BERA (Brainstem evoked response audiometry) to assess the prevalence of sensorineural hearing loss (SNHL) and the results were compared.

Results: Tinnitus was noted in 5 (15.2%), vertigo in 1 (3%) and subjective hearing loss in 10 (30.3%) cases as compared to no controls. 7 (21.2%) cases had speech frequency hearing loss (>25 dB) on Pure tone audiometry (PTA) as compared to no controls (p value 0.01). The hearing loss among the cases (n=33) was quantified as 18.30+15.05 dB and 19.39+14.68 dB in the left and right ear, as compared to the controls (n=33) having 7.34+2.64 dB and 8.22+3.27 dB, respectively, which was statistically significant for p value <0.0001.   

Similarly, 22 (66.7%) cases had high frequency hearing loss on PTA and Brainstem evoked response audiometry (BERA), each as compared to only 2 (6%) controls (p value <0.0001). The hearing loss (based on PTA) for cases (n=33) was 43.94+23.41 dB (left ear) and 44.55+23.56 dB (right ear) among the cases as compared to control (n=33) having 12.27+6.26 dB (left ear) and 12.42+7.08 dB (right ear), which was significant (p value <0.0001). All the 33 cases underwent BERA at the time of diagnosis and SNHL was quantified, but it was done only in 2 controls having objective evidence of SNHL on PTA, so p value was not calculated. The amount of SNHL on BERA for the cases (n=33) was 47.88+25.59 dB and 47.88+25.59 dB in the left and right ear, respectively.

Conclusions: In our study, 22 (66.7%) CML patients had SNHL as compared to the 2 (6%) in control group which shows a higher prevalence of both, self-reported and audiologically proven SNHL in CML which is most likely due to leukocytosis and/or leukemic infiltration of the cochlea. BERA is a more sensitive technique in identifying these at risk individuals.

No study had been done till date based on newly diagnosed, treatment naïve CML patients regarding their otoneurological manifestations in comparison with a age and sex matched healthy control group. Based on the analysis of our study, it is recommended that there should be a baseline audiological profile of every CML patient at the time of diagnosis, so the timely institution of chemotherapy (Imatinib) can lead to prevention and/or treatment of SNHL.

Biography:

Amel is 30 years old from Sudan.  Lecturer at university of Khartoum department of histopathology and cytology 

Abstract:

Introduction: Cytomegalovirus (CMV), a common virus, usually causes asymptomatic infections in immunocompetent hosts; however, it may lead to serious complications especially in cancer patients. Objectives: This study was conducted to determine the seroprevalence of human cytomegalovirus (HCMV) among leukemia, breast and prostate cancer patients attending at Radiation Isotope-Center-Khartoum (RICK) from April to August 2016.

Material and Methods: A total of 91subjects were included: 30 leukemic, 22 breast cancer and 29 prostate cancer patients.10 of them were healthy and used as control group, serum samples were collected and tested for CMV IgG & IgM using enzyme-linked immune sorbent assay (ELISA).

Result: Of the control group, 9/10 (9.9%) were seropositive for CMV IgG and 1/10 (1.09%) were sero positive for IgM. Also, all cancer groups demonstrated presence of IgG antibody classes as: The percentage of positive results in prostate, breast cancer and leukemia were 35.8 %, 37.2%,and 35.3%  respectively.

Conclusion: There was no significant correlation between leukemia, breast, prostate and HCMV.

Keywords: cytomegalovirus, serodiagnostic, breast cancer, immunoglobulin.

Biography:

Ojo Omotola Toyin  is a medical doctor with fellowship of Postgraduate Medical College of Nigeria, in the faculty of Pathology. She obtained her MSc in Haematology from University of Ibadan, Nigeria. She is a consultant Heaematologist with Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria. She has published  more than  10 papers in reputable journals and she is an editoral board member of Annals of Medicine.

Abstract:

Acute megakaryoblastic leukaemia (AML, M7) is a rare type of Acute myeloid leukemia (AML) evolving from primitive megakaryoblasts. It accounts for 1.2% of newly diagnosed AML by Eas tern Cooperative Oncology Group (ECOG) trials between 1984 and 1997. Patients may present with a broad variety of symptoms including low-grade fever, easy bruising, and life-threatening conditions. We report a rare case of AML,M7 in a 19-year-old lady who presented with weakness and fatigue. She was diagnosed as a case of AML M-7 on the basis of peripheral blood finding, bone marrow examination report, radiological findings and immuno phenotyping. Review of peripheral blood film showed immature mononuclear cells with cytoplasmic blebs. There were giant forms of platelet on the film. The bone marrow imprint showed increased immature mononuclear cells with abundant basophilic cytoplasm containing vacuoles and hyperchromatic and pleomorphic nuclei, some have cytoplasmic blebs, constituting over 90% of nucleated cells. Overall picture was in keeping with Acute Myeloblastic Leukaemia most likely Acute Megakaryoblastic Leukaemia (AML M7) which was confirmed by immunophenotyping of peripheral blood with positivity for CD 33, CD41 and CD 61. X-rays of tibia and fibula showed osteosclerosis in our patient which is in line with  osteosclerotic  lesions described in few case reports.To our knowledge, this is the first such case in the literature in our environment. The lesson here is never to say never and that proficiency in morphologic diagnosis remain the window through which uncommon diagnosis can be confirmed by molecular technology particularly in resource-limited environment.

Biography:

Ojo Omotola Toyin  is a medical doctor with fellowship of Postgraduate Medical College of Nigeria, in the faculty of Pathology. She obtained her MSc in Haematology from University of Ibadan, Nigeria. She is a consultant Heaematologist with Olabisi Onabanjo University Teaching Hospital, Sagamu, Ogun State, Nigeria. She has published  more than  10 papers in reputable journals and she is an editoral board member of Annals of Medicine.

Abstract:

Acute megakaryoblastic leukaemia (AML, M7) is a rare type of Acute myeloid leukemia (AML) evolving from primitive megakaryoblasts. It accounts for 1.2% of newly diagnosed AML by Eas tern Cooperative Oncology Group (ECOG) trials between 1984 and 1997. Patients may present with a broad variety of symptoms including low-grade fever, easy bruising, and life-threatening conditions. We report a rare case of AML,M7 in a 19-year-old lady who presented with weakness and fatigue. She was diagnosed as a case of AML M-7 on the basis of peripheral blood finding, bone marrow examination report, radiological findings and immuno phenotyping. Review of peripheral blood film showed immature mononuclear cells with cytoplasmic blebs. There were giant forms of platelet on the film. The bone marrow imprint showed increased immature mononuclear cells with abundant basophilic cytoplasm containing vacuoles and hyperchromatic and pleomorphic nuclei, some have cytoplasmic blebs, constituting over 90% of nucleated cells. Overall picture was in keeping with Acute Myeloblastic Leukaemia most likely Acute Megakaryoblastic Leukaemia (AML M7) which was confirmed by immunophenotyping of peripheral blood with positivity for CD 33, CD41 and CD 61. X-rays of tibia and fibula showed osteosclerosis in our patient which is in line with  osteosclerotic  lesions described in few case reports.To our knowledge, this is the first such case in the literature in our environment. The lesson here is never to say never and that proficiency in morphologic diagnosis remain the window through which uncommon diagnosis can be confirmed by molecular technology particularly in resource-limited environment.

Biography:

Zareen Irshad is a Hematologist from Pakistan. She graduated from Sindh Medical College, Karachi in 2005 and got distinction in Pediatrics. She has done fellowship in Hematology from College of Physicians and Surgeons, Pakistan. Currently, she is working as Assistant Professor in Pathology department being involved in Under and Post-graduate medical students teaching and also Head of Department in Jinnah Sind Medical University Laboratory. She attended as organizer and active participant in many seminars and workshops. She is interested in research work and wants to continue her research studies in the field of Coagulation Studies and Transfusion Medicine.

Abstract:

Background:  Over the last few years dengue has become a major health problem in tropical and subtropical regions around the world. Dengue fever is an acute febrile disease caused by an arbrovirus in Flavivirus genus. Dengue viral infection is known to cause a wide spectrum of disease manifestations, from mild undifferentiated fever, classical dengue fever to dengue haemorrhagic fever (DHF)/ dengue shock syndrome (DSS). Haematological manifestations include thrombocytopenia, leucopenia, and deranged prothrombin time, activated partial thromboplastin time.

Objective:  The study was aimed to find out frequency of haemostatic manifestations in dengue and clinical outcome of patients

Material and Methods:

Sample Size: 135

Study design: Descriptive study. Cross Sectional.

Place of study: The study was conducted in Pathology department at PNS Shifa, Karachi.

Inclusion criteria: The study was conducted on all patients of serologically proven dengue infection.

Results: A total of 135 patients were evaluated in the study. The mean age of the patients was 29 years (Range: 2 – 63years). Out of these patients, 111(82.22%) were male and 24(17.78%) were female patients. The most common haemostatic manifestations in dengue patients were thrombocytopenia in 111(82.2%) patients. Severe thrombocytopenia was observed in 9(6.7%) cases, moderate thrombocytopenia was found in 30(22.2%) cases and mild thrombocytopenia was observed in 72(53.3%) cases. Bleeding time more than 9 minutes was observed only in 1 case. Prolonged prothrombin time observed in 8(5.6%) cases and deranged APTT was observed in 57(42.2%) cases. Increased level of fibrin degradation product (D-dimer) was in 30(22.2%) cases. Out of 135 patients, 2(1.48%) were expired and 133(98.52%) were survived and discharged

Conclusion: Dengue continues to be a significant health problem in Pakistan. It is extremely important to implement and maintain an effective, sustainable and community based disease prevention program.

Biography:

Dr. Lixin Rui trained as an oncologist in China and completed his PhD at the Australian National University. In 2006, he received a CJ Martin Postdoctoral Fellowship and started lymphoma research in Louis Staudt's lab at the National Cancer Institute. In December 2012, Dr. Rui joined the Division of Hematology/Oncology as an Assistant Professor in the Department of Medicine at the University of Wisconsin-Madison. Dr. Rui's research in his lab focuses on lymphoma biology, with an emphasis on JAK-STAT signaling in lymphomagenesis.

Abstract:

The Janus kinas (JAK)/signal transducer and activator of transcription (STAT) pathway is central to signaling by receptors of diverse cytokines, growth factors and related molecules, which is critical for normal hematopoiesis and immune response. However, this signaling pathway is deregulated in several B cell lymphomas. In activated B-cell-like diffuse large B cell lymphoma (ABC DLBCL), autocrine production of IL-6 and IL-10 can result from high NF-kappaB activity, which is caused by a variety of genetic alterations, such as mutations in MYD88 and CARD11. Our recent work has demonstrated that JAK1 is an active kinase downstream of IL-6 and IL-10 signaling that activates STAT3. Interestingly, JAK1 can function in the nucleus to regulate gene expression through phosphorylating histone H3 on tyrosine 41. There are nearly 3,000 JAK1 epigenetic target genes including MYD88, IRF4 and MYC, of which expression is essential for cancer cell survival and proliferation.

            Here we have investigated the canonical gene regulatory mechanism by STAT3 in ABC DLBCL cells. We performed STAT3 ChIP-seq assay in two ABC DLBCL cell lines TMD8 and OCI-Ly10 and identified 4,746 potential STAT3 target genes in TMD8 cells and 6,058 in OCI-Ly10 cells. RNA-seq analysis demonstrated that 53% of those in TMD8 cells and 68% of those in OCI-Ly10 cells changed their expression, suggesting direct STAT3 target genes. Of note, 2,251 genes overlapped between the two cell lines.  Gene ontology analysis of these common STAT3 target genes showed the enrichment of gene signatures that involve B cell activation, proliferation, differentiation, and apoptosis. Further gene set enrichment analysis (GSEA) revealed the type 1 interferon pathway regulated by STAT3. Indeed, RNA-seq data showed increased expression of genes in this pathway including STAT1, STAT2, IRF7, and IRF9 following knockdown of STAT3 by shRNAs. These results were further confirmed by immunoblot analysis, suggesting inhibition of type 1 interferon by STAT3. It is known that the type 1 interferon pathway is proapoptotic and is suppressed by IRF4 in ABC DLBCL cells. This pathway can be activated by Lenalidomide due to inhibition of IRF4 expression. Based on these findings, we performed in vitro cell survival assay and found that Lenalidomide indeed enhanced cell killing by STAT3 shRNA or the JAK inhibitor Ruxolitinib. We will test this synergism using an ABC DLBCL xenograft animal model. Our study provides a novel suppressive mechanism of type 1 interferon signaling by STAT3, which supports a potential targeted therapy for ABC DLBCL.

Biography:

Murugan A K completed his PhD from the Department of Molecular Oncology, Tokyo Medical and Dental University, Tokyo, Japan and Postdoctoral studies from Hoshi University, Tokyo, Japan and The Johns Hopkins University School of Medicine, Baltimore, USA. Currently, he is a Scientist in the Department of Molecular Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. He has published more than 35 papers in reputed journals and holds a patent for identification of novel ALK mutations in anaplastic thyroid cancer. His research focuses on molecular biology of head and neck squamous cell carcinoma and thyroid cancer identifying molecular therapeutic targets and biomarkers. He has been serving as Reviewer in Thyroid, PLOS One, Oncogene, Cancer Research, Tumor Biology, Endocrine Related Cancer, Oral Oncology, etc.

Abstract:

Thyroid cancer is the most common endocrine malignancy. In the past 4 decades, the incidence of thyroid cancer is consistently increasing in all parts of the world. Recently, mutations in the genes of GPCR signaling pathway were reported in thyroid cancer patients of mixed ages. However, the prevalence of mutations of the GPCR signaling pathway genes its significance is completely unknown in pure pediatric and adult DTCs. In this study, we determine the prevalence of the GPCR pathway genes (LPAR4, PIK3CA and PTEN) mutation in pure pediatric and adult DTCs. A total of 310 samples consisting of 17 multi nodular goiters (MNG), 89 pediatric (age < 18 years) and 204 adult (age > 18 years) DTC samples were analyzed for mutations in genes LPAR4 (exon 1), PIK3CA (exons 9 and 20) and PTEN (exons 5, 6, 7 and 8) of the GPCR pathway by PCR amplification of tumor genomic DNAs and direct sequencing of amplicons using Sanger sequencing. Overall, we found 2.7% (2/72) of PIK3CA and 1.4% (1/72) of PTEN in pediatric CPTC (classical papillary thyroid cancer). We identified 3.6% (2/55) of PIK3CA in FV-PTC (Follicular Variant PTC), 3.5% (1/29) of PIK3CA in TPC (Tall-cell PTC), and 1% (1/114) in CPTC of adult thyroid cancer. We did not find any mutations in LPAR4 gene in both pediatric and adult thyroid cancer. We also found two novel mutations one in the PIK3CA gene (C984Y) of a pediatric CPTC and the other in the PTEN gene of an adult CPTC sample. Our study is the first to report GPCR pathway mutations in a pure and adult DTC samples. Our results show a common occurrence of PIK3CA and PTEN mutations but not the LPAR4 mutations in both pediatric and adult DTCs suggest PIK3CA and PTEN genes of the GPCR pathway play a significant role in thyroid carcinogenesis and pave attractive target for therapeutic prevention.

Biography:

Swarali Tadwalkar has completed her Master’s in Public Health (MPH) from University of South Florida, Tampa in 2015. She has an extensive experience in primary and secondary healthcare research stemming from projects in digital health, health policy and management, and health economics and outcomes research (HEOR). She currently works with Decision Resources Group (DRG) as an Associate Epidemiologist with the Epidemiology team and develops epidemiological population forecasts for different infectious and non-communicable diseases with particular interests in the oncology space.

Abstract:

Objective: The objective of the present study is to estimate the global incidence and prevalence of Chronic Myeloid Leukemia (CML) by world regions over the next ten years using a multi-factorial forecast model.

Methods: Using a critically appraised set of country-specific cancer registries, CML incidence was estimated for 45 countries, representing approximately 90% of the world’s population in 2017. Measures of economic development across countries such as gross domestic product (GDP) were considered as key indicators for access to healthcare and the adoption of potentially leukemogenic dietary patterns and lifestyles. Observed correlations between GDP, CML risk, and survival were used to trend CML incidence over the next ten years. CML survival was trended using an attenuated function of the historical trend, representing the continuing optimization of tyrosine kinase inhibitor-based treatment. Prevalence was estimated as a cumulative incidence over preceding twenty years with adjustments for disease-specific and competing-cause mortality for each year. To estimate incident and prevalent CML globally, aggregate estimates for each region were divided by the proportion of countries in that region for which direct estimates were made using the methods described above.

Results: The incidence of CML in Africa, Latin America, lower-income Asia Pacific countries, high-income Asia Pacific countries, Europe, and North America is 0.4, 0.7, 0.7, 1.2, 1.4, and 2 cases per 100,000/year. The prevalence of CML in Africa, Latin America, lower-income Asia Pacific countries, high-income Asia Pacific countries, Europe, and North America is 3, 5, 6, 10, 11, and 15 cases per 100,000 in 2017. Latin America is expected to see the highest growth in prevalent cases over the next ten years: 36% by 2027.

Conclusion: The incidence and prevalence of CML is expected to increase globally. Improvements in the survival of CML patients will result in 20000 additional cases surviving by 2027 worldwide.

Biography:

Jahnavi Dhar is a third year post graduate student in the Department of Medicine, currently pursuing DOCTOR OF MEDICINE (M.D.) degree from Maulana Azad Medical College (M.A.M.C.) and associated Lok Nayak Hospital, New Delhi, since 2015. I have also worked as an intern in the prestigious 1600 bedded Lok Nayak Hospital in 2014. I have completed my Bachelor of Medicine, Bachelor of Surgery (M.B.B.S.) from Maulnana Azad Medical College (M.A.M.C.), University of Delhi in 2013. I am a student in medicine, interested in exploring the mechanisms of pathological processes and how they come together to manifest as a disease. I intend to learn all that I can so as to enhance my understanding of how our bodies function. I aim to use this knowledge to enable research and real world implementation to solve problems we face in clinic and beyond. I stood first in the University of Delhi in my final professional examination in 2013 with an aggregate of 72.4%, with a Roll of honors and 8 gold medals. I secured All India rank 1 in class 10th board conducted by C.B.S.E. in 2007. I have a publication of “Chronic myeloid leukemia – an overview” in API textbook medicine in January 2017. I also secured first position in a Case presentation on “familial type 2a hyperlipoprotenemia” in 2016 at API DSC conference 2016 held at Ashoka hotel, Chanakyapuri, New Delhi.

Abstract:

Background: CML is the most common adult leukemia in India, accounting for 50-70% of all leukemias in our country. The median age of presentation in India is 40-50 years which is a decade younger compared to the age of presentation in the western countries, which is around 66 years. The introduction of Tyrosine Kinase inhibitors (TKIs) mostly Imatinib mesylate has greatly enhanced survival from <30% to 85% in developing countries.

Aims and Objectives: This study was undertaken to analyze the newly diagnosed, treatment naïve CML patients based on the symptomology, hematological, clinic-pathological and cytogenetic analysis at the time of diagnosis and to compare these parameters post 6 weeks of chemotherapy (Imatinib). A comparison of the data obtained was done with data of the western world to analyze any differences.

Methods: 33 newly diagnosed CML patients (>18 years) were recruited from January 2015 to January 2017. Every patient underwent a complete set of hematological, radiological and cytogenetic analysis at the time of diagnosis. The patients were started on Imatinib Mesylate. The patients underwent an analysis of the hematological parameters after 6 weeks of chemotherapy to assess for Hematological remission (HR). Outcome of the patients was also noted.

Results: Total 33 newly diagnosed treatment naïve CML patients were recruited in 2 years. The range of age distribution was between 18-50 years. 23 (69.69%) of them were in the age group of 18-40 years. There were 20 (60%) males and 13(40%) females.

11 (34%) patients had presented with a duration of 3-4 months. The most symptom of the patients at the time of diagnosis was fatigue (88%) which was followed by pain/discomfort in the left hypochondrium (79%) and unexplained weight loss (64%).

On examination, pallor was present in all 33 (100%) patients and hepatomegaly and splenomegaly was noted in all the cases (100%). On ultrasound, the average size of the liver was around 15.47 ± 1.66 cm and the average size of the spleen was 19.80 ± 2.48 cm. HIV status was negative in 32 (97%) patients.

All the cases underwent a complete blood analysis at the time of diagnosis. Total leucocyte count (TLC in lacs) was significantly raised to the value of 319537+180886. Basophils accounted for 4.51+2.76%, myelocytes for 16.85+10.31% and blasts for 9.81+11.39% of the TLC. LDH (IU/L) and uric acid (mg/dl) were raised significantly to a value of 1567+541.4 and 10.67+6.83, respectively. L.A.P. score was reduced to a value of 7.54+1.88. Bone marrow aspirate and biopsy was done in all patients of CML. 22 (67%) patients were in the chronic phase, 7 (21%) in the accelerated phase and 4 (12%) were in blast crisis. Four cases had presented in Tumour lysis syndrome out of which one was in chronic phase, one in accelerated and 2 in blast crisis. BCR-ABL Mutation was positive in 32 (97%) patients.

Follow up of all the 33 patients was done after starting them on chemotherapy (Imatinib). Two of them died. Hence, 31 cases underwent a complete blood analysis after 6 weeks of chemotherapy. All the parameters were analysed along with hematological remission. 4 cases had presented in tumour lysis syndrome, in which one died (in blast crisis) and the remaining 3 did not achieve hematological remission (HR).

Majority of the parameters showed significant improvement after chemotherapy (p value <0.0001). TLC (lakhs) showed marked improvement from 319537+180886 to 8965+4373 (p value <0.0001), basophils (%) from 4.51+2.76 to 0.87+0.99 (p value <0.0001), myelocytes (%) decreased from 16.85+10.31 to 0.41+1.40 (p value <0.0001) and blasts (%) showed marked improvement from 9.81+11.39 to 0.61+2.04 (p value <0.0001).

Out of 33 cases, 2 (6%) had died. In the remaining 31 cases, hematological remission was assessed after 6 weeks of Imatinib mesylate. 27 (87%) out of 31 patients achieved HR and 4 (13%) did not. Out of the 4 cases who did achieve HR, 1 was in chronic phase, 1 in accelerated phase and 2 in blast crisis.

Conclusions: In our study, a prospective analysis was made for newly diagnosed, treatment naïve CML patients at the time of diagnosis and after 6 weeks of Imatinib mesylate. The mean age of presentation is a decade younger than the west. The patients hardly get detected in the asymptomatic stage in our country. There is a higher proportion of patients in the accelerated and blast crisis. Furthermore, TKIs (mostly Imatinib) is the chemotherapy available in majority. All these factors combined herald dismal prognosis for patients in a developing country as compared to the West.

In our study, majority of the hematological parameters showed remarkable improvement on Imatinib, which highlights the importance of an early diagnosis and timely institution of chemotherapy in all the patients of CML.

Biography:

Abstract:

Background: Bone marrow biopsies are generally included in the initial staging evaluation of NHL and BM involvement has unique prognostic implication in different histological subgroups of the disease. Flow cytometeric data should always be correlated with BM biopsy finding, immunophenotyping of core biopsy allows parallel morphologic examination and is capable of generating multivariate, quantitative, immunophenotypic data useful in diagnosis of NHL.

Aim:  To evaluate the role of flow cytometric immunophenotyping (FCI) of lymphoma biopsy samples next to immunohistochemistry and histopathology for better diagnosis and characterization among Egyptian patients.

Subjects and methods: 60 B-NHL patients stage IV, diagnosed after histopathological examination of lymph node biopsy or Fine needle aspiration (FNA) of other primary site and staged according to Ann Arbor system. Clonality assessment was established using Flow cytometric (FCM) immunophenotypic analysis of BMA and biopsy after obtaining single cell suspensions by mechanical disaggregation, with a restricted panel of (CD45, CD20, CD3, CD19, anti Kappa and anti Lambda) using (BD FACSscan 4 color flowcytomtery). In addition to Histopathology of paraffin- embedded BM trephine biopsy with immunohistochemical (IHC) staining   for morphological BM evaluation and clonality assessment.

Results: FCI analysis of BMB samples showed 24/60 cases  (40%) positive for infiltration by B- monoclonal lymphocytes with light chain restriction and 36/60 (60%) negative cases, while BMA positive in only 16.7%, negative in 76.7%, and 6.7% dry tap with difficult FCM analysis. FCI of core biopsy versus histopathological assessment and light chain expression and restriction detection by IHC revealed concordance rates of (63.6 % and 85%) and discordance rates of (36.4% and 15%). Clonality assessment and light chain expression detection revealed a kappa value of 0.708 for IHC versus FCM with concordance of 85% and discordance 15%. 

Conclusion: Our results showed fair agreement level for IHC and FCM of BMB, yet FCM is faster, specific and has a more definite role in detection of monoclonality of NHL, so accurate assessment of hematolymphoid neoplasms requires an integrated multiparameter approach. Although morphologic histopathologic examination remains the mainstay of initial assessment, immunophenotypic analysis of core biopsy is essential to determine the pattern of differentiation and detect minimal disease when morphology is inconclusive. Fnally, an integrated approach using multimodality technologies is a must with identifying the strengths, weaknesses, and limitations to be an efficient and cost-effective method for better assessment.

Biography:

Sehmus Ertop has completed his PhD at the age of 24 from Dicle University and post doctoral studies from Dicle University School of Medicine. He is directory of Bulent Ecevit University, School of Medicine, Department of Hematology, a medicine organization depend on government. He has published more than 50 papers in domestic and reputed journals and still he has been serving general secretary of Hematology Specialist Association and scientific secretary of Euroasian Hematology Congress 2016 and 2017

Abstract:

Objective: In the present study, we aimed to consider the relation between the manifestations of venous thromboembolism (VTE) and gene mutations including factor V Leiden (FVL), prothrombin G20210A and MTHFR C677T.

Methods: One hundred and forty four patients with idiopathic VTE were enrolled in this study. The data of patients were obtained from the medical records in hospital information system. The patients were grouped according to the location of VTE. In all subjects FVL, prothrombin G20210A, and MTHFR C677T were analyzed by specific polymerase chain reactions and restriction enzymes. Univariate and multivariate analysis were used to evaluate the relation between the groups and the gene mutations including factor V Leiden (FVL), prothrombin G20210A and MTHFR C677T.

Results: The mean age of patients was 41.16 ± 13.23 years and the male / female ratio was 1.18. Among the patients with VTE, 44 (30.6%) had only DVT, 41 (28.5%) had only PE, 26 (18.1%) had both DVT and PE, 23 (16%) had cerebral veins thrombosis (CVT) and 10 (6.9%) had abdominal vein thrombosis The prevalence was found to be 46.5% for FVL, 13.2% for prothrombin G20210A and 45.1% for MTHFR C677T gene mutation among patients. There was no statistically difference between the manifestations of VTE regarding the gene mutations (p>0,05).

Conclusion: The findings of this study suggest that gene mutations including factor V Leiden (FVL), prothrombin G20210A and MTHFR C677T are not sufficient to determine the location of VTE.

Biography:

Patrick Van Dreden is a Head of Clinical Research Department and Prospective Research Manager at Diagnostics Stago. He has Degree of Hemostasis study: Pathogenesis and pharmacology of thrombosis. He is an International Member of Society of Haemostasis and Thrombosis, Member of the European Thrombosis Research Organization, Member of the Mediterranean League against Thromboembolic Diseases, Member of the American Society of Hematology and Member of International Academy of Clinical and Applied Thrombosis/Hemostasis.

Abstract:

Backround: Multiple myeloma (MM) and the associated immunomodulatory (IMiD)treatments are associated with risk of vascular complications. Thrombin generation (TG) assessment reflects the equilibrium between procoagulant and anticoagulant activities in the plasma.

Aim: We conducted a multicenter study to explore the relationship between stages of MM and alterations of thrombin generation profile.

Methods: Patients with MM (n=129) were recruited from July 2014 to December 2016 and stratified to the following groups: 44 newly diagnosed treatment-naïve patients (ND), 33 patients receiving IMiDs (IM), 45 in complete remission (CR) and 7 patients in partial remission on IMiDs (PR/IM). Patients on anticoagulant treatment were excluded from the study. The control group (CG) consisted of 30 healthy age and sex-matched individuals. Samples of platelet-poor plasma (PPP) were assessed for thrombin generation (TG) with the TF 5pM PPP-Reagent^® on Calibrated Automated Thrombogram (Stago, France). The upper and lower normal limits (LNL and UNL) were calculated by the mean±2 SD.

Results: Patients with ongoing MM (ND, IM, PR/IM) had significantly lower Peak, ETP and MRI as compared to the CG. In contrast, patients in CR had Peak, ETP, MRI values similar to the CG. Patients with PR had lower ETP and MRI values as compared to the CR group (Table 1). In ND 8% had TG >UNL and 20% had TGUNL and 57% had TGUNL and 33% had TGUNL and 14% had TG

Conclusion: Patients with active MM showed attenuated TG which was enhanced in the presence of IMiD treatment. Complete remission was associated with normalization of TG. The unexpected decrease of TG in patients with active MM and its normalization when the disease is in a remission might indicate that this test reflects vascular aggression which is followed by release of thrombomodulin, heparin cofactor II, sEPCR and TFPI.

Biography:

Abstract:

Pediatric acute liver sickle crisis, also known as Intrahepatic Cholestasis(SCIC), is an uncommon but fatal complication of sickle cell disease observed mainly in patients with homozygous sickle cell anemia. Herein we describe a case of pediatric SCIC treated successfully with manual exchange transfusion (ET). The patient was admitted for jaundice, enlarged liver and signs of hepatic failure, such as hyperbilirubinemia and coagulopathy. There was no evidence of viral hepatitis or biliary obstruction. We performed a session of ET in order to reduce the percentage of HbS to level inferior to 30% which was successfully accomplished. The patient had complete recovery of hepatic function. This case has shown that ET is an effective treatment of pediatric SCIC and should be introduced early on the onset of this severe complication.

Biography:

At the current moment Artem Dakhovnyk is a second year student of the  Educational and Scientific Centre "Institute of biology and medicine", Taras Shevchenko National University of Kyiv. He have a strong background and experience in biochemistry. He has presented 2 abstracts in reputed international specialized conferences.    
 

Abstract:

Multiple sclerosis (MS) is an autoimmune disorder of the central nervous system. A lot of findings support the prominent role of the coagulation system in development of MS. It is well known the IgG levels are higher in patients with MS.

This study aimed to determine whether effect of IgG, accumulated in the bloodstream after suffering the MS, on the amidolytic activity of anticoagulation factor. Further to compare their effect with the analogical effect of healthy donor's IgG.

IgG was separated by affinity chromatography on protein A Sepharose from the blood plasma samples obtained from 35 healthy donors and 20 patients with multiple sclerosis. All donors and patients or their relatives had been informed consent in accordance with the Declaration of Helsinki and a protocol approved by the Ethics Committees of the ESC “Institute of Biology and Medicine”, Kyiv, Ukraine.

To examine the IgG influence on PC during its zymogens activation the mixture was prepared: 25μl of healthy donor's plasma was mixed with vehicle, and 25 μl of activators derived from the venom Agkistrodon blomhoffi ussuriensis and then IgG (in a concentration 100 or 300 mkg/ml) was added. After 5 min incubation at 37° C chromogenic substrate S₂₃₆₆ in final concentration 0,3 mM was added. Registration of absorption was carried out in two-wave mode at the primary 405 and references 492 nm wavelength by the spectrophotometer during 60 minutes. Control sample included vehicle instead of IgG.

Results showed the ability of IgG to affect the amidolytic activity of hemostasis enzymes such protein C activated from zymogens in plasma. The statistically significant was observed under the influence of MS IgG in a concentration 300 mkg/ml. Thus the level of PC activation was elevated of the 21 % comparing to the control. 

The observed impact of MS IgG on the PC may therefore provide future targets for therapeutic strategies.

Biography:

Patrick Van Dreden is a Head of Clinical Research Department and Prospective Research Manager at Diagnostics Stago. He has Degree of Hemostasis study: Pathogenesis and pharmacology of thrombosis. He is an International Member of Society of Haemostasis and Thrombosis, Member of the European Thrombosis Research Organization, Member of the Mediterranean League against Thromboembolic Diseases, Member of the American Society of Hematology and Member of International Academy of Clinical and Applied Thrombosis/Hemostasis.

Abstract:

Introduction: The hypercoagulable state of malignancy occurs due to the ability of tumor cells to activate the coagulation system. The prominent role is attributed to exposure of tissue factor (TF) and procoagulant phospholipids (PPL) by the tumor cell. We recently showed that contact of human plasma with pancreas adenocarcinoma cells (BXPC3) or breast cancer cells (MCF7) enhances thrombin generation (TG). We demonstrated that the procoagulant activity of the cancer cells alone was not sufficient to induce hypercoagulability  We analyzed the specific procoagulant role of microparticles (MVs) originate from the cancer cells and we estimated their association with cancer cells for cancer induced hypercoagulability
Methods: BXCP3 and MCF7 cells were culturedin 96-well plates.Primary human umbilical vein cells (HUVEC) were used as normal control experiment. The CAT® assay (Stago France) was used to study TG of normal platelet poor plasma added in wells carrying (a) cancer cells, (b) cancer cells in presence of their respectively isolated MVs, or (c) MVs alone.TF activity (TFa) of cells and MVs was assessed with a specific clotting assay. 
Results: The TFa were found in abundant amounts BXPC3 cells, and BXPC3 MVs compared to MCF7 cells and MCF7 MVs. The HUVEC cells and HUVEC MVs showed TF activity comparable to a normal pool. Analytical data of TG are depicted in Table 1

 Table1: Thrombin generation on cells in presence and absence of MVs in normal pool Plasma

Conclusions: This experiment showed that hypercoagulability induced by cancer cells is the resultant of the combination of the procoagulant properties of cancer cells with procoagulant elements of the plasma microenvironment. To the best of our knowledge, the present study showed for the first time that the inherent procoagulant properties of cancer cells are not sufficient to induce hypercoagulability and documents that procoagulant elements of the microenvironment, namely MVs are necessary elements for cancer induced hypercoagulability. 

Biography:

Dr. Iranpour has completed MD when she was 25 and then achieved Internal medicine specialty at the age of 29. She has published 8 papers in different journals.

Abstract:

Aortic mural thrombosis is a clinical entity usually seen in atherosclerotic or aneurysmal aorta but rarely could occur in normal aorta as a result of thrombophilia, malignancies or even without any definable etiology. We present two cases with extensive thrombus formation in non-atherosclerotic and non-aneurysmal aorta that present with peripheral embolization. The first patient had left hand ischemia and once evaluated, was found to have extensive thrombosis in left subclavian artery, aortic arch with embolization to left renal artery. The second patient presented with severe pain in right lower extremity that also turned out to have a large hypermobile echogenic mass in proximal section of descending aorta. Investigations to establish the probable underlying aetiology including; coagulation factors, malignancies and vasculitis were all negative. Both were treated with anticoagulation, which resulted in clot size reduction and in one case thrombus resolution. The aim of the present study is to report the clinical characteristics and evaluation of two patients who suffered from extensive aortic thrombosis associated with distal arterial emboli and also highlights the fact that it could occur without any identifiable etiology. It is crucial to note that clinical management of these patients could be challenging due to the risk of developing clot and involvement of vital organs.

Biography:

Safia Bibi is workindg as Research Officer at Pakistan Health Research Council, JPMC, Karachi, Pakistan. has completed her Masters from University of Karachi and is Currently doing PhD from Dadabhoy Institute of higher Education, Karachi. She has 12-research papers on her credit. Her fields of interest are epidemiology, Infection control and drug resistance

Abstract:

Implementation of infection control standards in blood banks is important to prevent transmission of blood borne infections like HIV, HBV and HCV. No study from Pakistan evaluated the infection control practices in the blood banks of Pakistan. This cross sectional study was conducted to evaluate 1) safe blood supply 2) staff safety and 3) waste disposal practices in blood banks of Karachi through a structured questionnaire followed by an educational intervention. Mean scores for overall infection control practices and specific practices regarding safe blood supply, staff safety and waste disposal were calculated and compared with different factors using statistical tools. Patient safety scores of 49(92.5%) blood banks were within the satisfactory range but staff safety and waste disposal scores of only 26(49.1%) and 4(7.5%) blood banks were satisfactory. Significantly lower IC scores were observed for stand-alone blood banks and those working in the absence of hematologist (p-value<0.001). Availability of written SOPs and IC guidelines correlated positively (p-value<0.001) with mean IC scores.  Blood banks in Karachi lack implementation of IC standards particularly with reference to staff safety and waste management & disposal. Sindh blood transfusion  authority (SBTA) should take measures to increase IC compliance within blood banks. 

Biography:

Dr. Beatrice Olatundun Oluwatayo (Mrs) completed her Ph.D, From the University of Benin, Benin City, Edo State, Nigeria. She was the Head of Haematology Department of Federal College of Veterinary and Medical Laboratory Technology Vom (2006- 2014). Served as pioneer Head of Department of Basic Laboratory Studies of the same College (2014). Currently, she is a Senior Lecturer at the Department of Physiology, Madonna University  Elele, Rivers State Nigeria. She has  more than15 reputable  journal publications and 18 conference papers and has supervised  many students projects.

Abstract:

Cocoa tree (Theobroma cacao) products like the seeds and seed coats have been used to treat variety of ailments including diabetes, blood pressure and chest complaint. In recent times, the stem bark of Theobroma cacao has form part of ingredients in concoction used in treating sickle cell anaemia in some part of Nigeria but the properties responsible for the relief this treatment offers is unknown. Phytochemical constituents and mineral cations of the aqueous extract of Theobroma cacao stem bark and its effect on haematological parameters in rat model was investigated. Powdered sample was used for the phytochemical and mineral analysis following standard methods. For haematological studies, 20 male Sprague Dawley rats (124-214kg/bwt) were randomly divided into 4 oral treatment groups of 5 rats per group as follows: Group 1 (control) received feed and water only. Groups 2, 3 & 4 were given 20mg, 40mg and 80mg/kg b.w. of the aqueous extract respectively, using oral cannula and were fed with normal feed and water ad libitum for 28days. Some of the phytochemical content include: glycosides, saponins, tannins, flavonoids, steroids, alkaloids, etc. and  minerals and vitamins like; sodium, calcium, phosphorus, manganese,  vitamins A, B1, B2, B3, C, E and K.  There was a significant increase (p<0.001) in WBC and RBC counts while the haematocrit and haemoglobin reduced significantly (p<0.001) in a dose dependent patern. Rats haematology is still being studied, increasing the dosage of the extract administered to the animals which might reveal the actual levels of change in the parameters.

Biography:

Swarali Tadwalkar has completed her Master’s in Public Health (MPH) from University of South Florida, Tampa in 2015. She has an extensive experience in primary and secondary healthcare research stemming from projects in digital health, health policy and management, and health economics and outcomes research (HEOR). Swarali currently works with Decision Resources Group (DRG) as an Associate Epidemiologist with the epidemiology team and develops epidemiological populations forecasts for different infectious and non-communicable diseases with particular interests in the oncology space.

Abstract:

Objective: estimate the global incidence and prevalence of Chronic Myeloid Leukemia (CML) by world regions over the next ten years using a multi-factorial forecast model.

Methods: using a critically appraised set of country-specific cancer registries, CML incidence was estimated for 45 countries, representing approximately 90% of the world population in 2017. Measures of economic development across countries such as gross domestic product (GDP) were considered as key indicators for access to healthcare and the adoption of potentially leukemogenic dietary patterns and lifestyles. Observed correlations between GDP, CML risk, and survival were used to trend CML incidence over the next ten years. CML survival was trended using an attenuated function of the historical trend, representing the continuing optimization of Tyrosine Kinase Inhibitor-based treatment. Prevalence was estimated as a cumulative incidence over preceding twenty years with adjustments for disease-specific and competing-cause mortality for each year. To estimate incident and prevalent CML globally, aggregate estimates for each region were divided by the proportion of countries in that region for which direct estimates were made using the methods described above.

Results: the incidence of CML in Africa, Latin America, lower-income Asia Pacific countries, high-income Asia Pacific countries, Europe, and North America is 0.4, 0.7, 0.7, 1.2, 1.4, and 2 cases per 100,000/ year. The prevalence of CML in Africa, Latin America, lower-income Asia Pacific countries, high-income Asia Pacific countries, Europe, and North America is 3, 5, 6, 10, 11, and 15 cases per 100,000 in 2017. Latin America is expected to see the highest growth in prevalent cases over the next ten years: 36% by 2027.

Conclusion: the incidence and prevalence of CML is expected to increase globally. Improvements in the survival of CML patients will result in 20 thousand additional cases surviving by 2027 worldwide. 

Biography:

Abstract:

Background: Antiplatelet therapy with clopidogrel is generally used to decrease the risk of ischemic heart disease. Environmental and genetic factors including SNPs in CYP3A5 and P2RY12 genes are attributed for this inter-individual variation in response to drug.

Objective: To examine the role of CYP3A5 rs776746 and P2RY12 rs2046934 polymorphisms in clopidogrel resistance in IHD patients.

Methods: A total of 237 IHD patients were recruited who had received 75mg clopidogrel for more than 07 days. Platelet aggregation studies were performed on Innovance® PFA-200 system. The rs776746 and rs2046934 polymorphism were determined by PCR-RFLP.

Results: Out of selected IHD cases, 85.7% were clopidogrel responders and 14.3% were non- responders. Genotype for CYP3A5 responder, 5.4% were homozygous (*1/*1), 89.7% were heterozygous (*1/*3) and 4.9% were homozygous (*3/*3). Non-responders CYP3A5 indicated that 8.8% were homozygous (*1/*1), 64.7% were heterozygous (*1/*3) and 26.5% were homozygous (*3/*3). The allele frequencies difference among responders and non-responders were highly significant (p<0.05). P2RY12 genotypes with clopidogrel responder patients showed that 78.3% were TT alleles, 19.7% were CT alleles and 2.0% were for CC alleles. Similarly, non-responder patients showed 91.2% were with TT alleles, 8.8% were CT alleles and no patient were with CC alleles. So, these frequencies difference in alleles among clopidogrel responder and non-responder P2RY12 patients were not statistically significant (p>0.05).

Conclusion: The allele CYP3A5*3/*3 showed a significant association with clopidogrel resistance whereas, P2RY12 did not show association with clopidogrel resistance in studied samples.

Biography:

Murugan A K completed his PhD from the Department of Molecular Oncology, Tokyo Medical and Dental University, Tokyo, Japan and Postdoctoral studies from Hoshi University, Tokyo, Japan and The Johns Hopkins University School of Medicine, Baltimore, USA. Currently, he is a Scientist in the Department of Molecular Oncology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia. He has published more than 35 papers in reputed journals and holds a patent for identification of novel ALK mutations in anaplastic thyroid cancer. His research focuses on molecular biology of head and neck squamous cell carcinoma and thyroid cancer identifying molecular therapeutic targets and biomarkers. He has been serving as Reviewer in Thyroid, PLOS One, Oncogene, Cancer Research, Tumor Biology, Endocrine Related Cancer, Oral Oncology, etc.

Abstract:

PI3Ks are heterodimeric lipid kinases that regulate cellular activities such as proliferation, survival, motility and morphology through the second messenger PIP3. Studies have reported that the P110α (PIK3CA), the catalytic subunit of PI3-kinase is somatically mutated in human cancers. Here, we found PIK3CA mutations in 29.4% of head and neck squamous cell carcinoma cell lines, 10.5% of Indian, 11.7% of Japanese (unpublished data) and no mutation in Vietnamese tumors. Functional analysis of these mutations including a novel insertion mutation in Indian tumor showed increased PI3 kinase activities, followed by growth factor-independent proliferation, changes in morphology, a higher rate of cell migration and invasion. Our findings suggest that PIK3CA mutations in HNSCC are likely to be oncogenic and may significantly contribute to HNSCC carcinogenesis and pave an attractive target for therapeutic prevention.

As there were no mutations found in PIK3CA of Vietnamese oral cancers, we hypothesized that the RAS could be more likely activated as an upstream effector of PI3K. We, therefore, sequenced the exons 1 and 2 of H-RAS. The RAS mutations were detected in 10 of 56 tumors (18%) suggesting that RAS is an important member in the PI3K/Akt signaling and could play an important role in the tumorigenesis of oral carcinoma. SWAP-70 is a PIP3 binding protein involved in actin rearrangement, especially in membrane ruffling. Mouse embryo fibroblast (MEFs) deficient in SWAP-70 show impaired membrane ruffling and fail to grow on soft agar after transformation by v-Src. Here, we show that MEFs transformed by v-Src-expressing SWAP-70 are highly invasive. MEFs expressing SWAP-70 or v-Src alone were far less invasive, suggesting that both proteins were required for the cells to be invasive.

Biography:

Ayishah Choudhary is doing her MPhil from Universirsty of Health Sceinces, Lahore, Pakistan. Currently, she is also working as Demostarator at University of Lahore Pakistan. She has completed her MBBS from Liaquat University of Health Sciences, Jamshoroo, Pakistan. Recently, she has completed her Certificate of Medical Teaching from University of Health Sciences in collabration with University of Liverpool, UK.

Abstract:

Background: Childhood obesity is often related to cardiovascular diseases and accompanied by a dysregulation of coagulation and fibrinolytic systems. Obesity have been found to be associated with increased levels of Factor VII, Fibrinogen, Plasminogen activator inhibitor (PAI-1) and PAI-1 gene (-675bp 4G/5G) polymorphism. Therefore, we investigated the hemostatic parameters i.e. factor VII, fibrinogen, plasminogen activator inhibitor and PAI-1 4G/5G gene polymorphism in childhood obesity.

Methods: In this cross-sectional study, 42 obese (mean age, 8.91±2.56) and 42 healthy weight (mean age, 9.27±2.29) children, classified by Body Mass Index (BMI) were recruited. They were assessed for anthropometric measures. Factor VII levels were determined by chromogenic assay, fibrinogen levels were determined by clotting method of Clauss and PAI-1 levels in plasma were determined by Colorimetric Assay. PAI-1 4G/5G polymorphism was analyzed by polymerase chain reaction-restriction fragment length polymorphism.

Results: BMI, waist and hip circumference (p<0.001) were significantly higher in obese children. Plasma factor VII level, fibrinogen were significantly higher in obese group as compared to other group (p<0.001). Plasma PAI-1 in obese (mean 32±16) is higher than non-obese (mean 26±16) but statistically not significant. The allele frequency of 4G (obese 0.66% and non-obese 0.34%, odds ratio 0.385, p value-<0.001) was significantly higher. The genotype frequency of 4G/4G in obese 15% and in non-obese 2%, 4G/5G in obese was 5% and non-obese is 37% and 5G/5G in obese was 5% and non-obese is 37%.

Conclusion: The results suggest that obesity may play role in regulation of hemostatic factors. Even in childhood, obesity is associated with unfavorable concentration of hemostatic factors that are in turn implicated in cardiovascular morbidity and mortality later in life.

Biography:

Abstract:

Introduction: Acute fatty liver of pregnancy (AFLP) is a rare but life-threatening disease.AFLP is characterized by liver failure with different degrees of coagulopathy. Outcome and survival can be dramatically improved with prompt recog n i t i on and treatment. Thromboelastometry has been considered a point of care for the management of bleeding patients. It could, therefore, be an alternative tool to treat the complex cases of AFLP involving liver failure and coagulopathy. Through this study, we present our successful experience of an AFLP case that was submitted to an emergency cesarean section in which blood transfusion was guided by thromboelastometry.

Case presentation: We report the case of a previously healthy 28-year-old woman, Afro-Brazilian, in her first pregnancy with no medical records until the 36th pregnancy week. She presented to our emergency department with an acute onset of abdominal pain, jaundice, nausea and vomiting. The laboratory examinations revealed metabolic acidosis, acute kidney injury (serum creatinine 3.4mg/dL), platelets 97 x 103/mm3, serum fibrinogen 98mg/dL and increased international nationalized ratio (INR 6.9) without acute bleeding. An emergency cesarean section was indicated. Based on the results of the thromboelastometric tests EXTEM and FIBTEM, prothrombin complex concent rate and fibrinogen concentrate were administered at the beginning of the cesarean section, which succeeded with no major bleeding and without need of further transfusion.

Conclusions:Thromboelastometry may be considered a useful, feasible and safe tool to monitor and manage coagulopathy in obstetric patients with acute fatty liver of pregnancy, with the potential advantage of helping avoid unnecessary transfusion in such patients.

Biography:

Dr. Rizza Antenor finished her Doctor of Medicine degree at the age of 24 years at Davao Medical School Foundation and had her postgraduate internship at the Philippine General Hospital, Manila, Philippines. She is currently a second year resident-in-training of the Department of Internal Medicine of the Southern Philippines Medical Center in Davao City. 

Abstract:

Autoimmune hemolytic anemia is an uncommon condition caused by antibodies directed against red blood cells causing their premature destruction.  Clinical manifestations include anemia, jaundice, splenomegaly, reticulocytosis, elevated serum bilirubin, and positive direct antiglobulin test.  AIHA can either be idiopathic or secondary to an underlying disease process.  Infection accounts for 5% of cases of secondary AIHA. AIHA in asymptomatic hepatitis B carrier is rare with only 2 cases reported worldwide.  Both cases were pediatric patients. We are presented with a case of a 27 year old male who came in due to anemia.  Patient presented with the classic manifestation of AIHA and workup for underlying cause revealed a carrier state of Hepatitis B infection.  Patient was unresponsive to steroid and was persistently dyspneic and tachycardic. Blood transfusion with an incompatible blood was done which resolved the patient’s symptoms.  Steroid remains to be the mainstay of treatment for AIHA. However, blood transfusion may be beneficial to symptomatic patients at risk for complications of severe anemia. Although sustained remission is typical in inactive carriers of hepatitis B, reactivation remains a possibility, hence, patient education and good follow up is essential.

Biography:

Abstract:

Background: In metastatic non small cell lung cancer (NSCLC)-adenocarcinoma patients, ALK positivity is reported in 4-6% cases and in these patients crizotinib has been associated with effective response rates and survival benefit. There is paucity of data from Indian subcontinent regarding epidemiology of ALK positive patients and responses with crizotinib.

Methods: We have evaluated ALK-rearrangement in metastatic adenocarcinoma patients from January 2013 to June 2016 via FISH as well as IHC. In patients with ALK positivity from either test, treatment with crizotinib 250 mg twice a day was done till progression or significant toxicities. In this study we assessed efficacy and toxicity of crizotinib in ALK positive patients. Results: In total, 360 adenocarcinoma tumour samples were evaluated. 25 (6.94 %) patients were positive via IHC while 14 (3.88 %) patients were positive via FISH. Moreover 2 patients were FISH positive but IHC negative. ALK positive patients consist of 15 men and 12 women, median age 60.5 years. All of these patients were treated by crizotinib. The CR was achieved in one (3.70 %) patient, PR in 14 (51.85%) and SD in 7 (25.92%) and PD in 5 (18.51%) patients. Out of 5 patients, 3 patients progressed with brain only metastasis. Disease control rate (CR, PR and SD) was seen in (81.5%) patients. The median PFS was 7.2 months. The main grade 3/4 side effects seen were neutropenia in 2 (7.47%), elevation of liver enzymes in 4 (14.81%) and fatigue in 3 (11.11%) patients.

Conclusion: Crizotinib has good efficacy with reasonable toxicity profile in Indian advanced NSCLC-adenocarcinoma patients similar to literature reported in western countries. In our study we have seen more ALK positivity with IHC testing. There is some discordance between these two methods. So, both of these tests should be done so that maximum number of patients can be benefited with ALK inhibiting TKIs treatment. This observation should be confirmed in further studies with more number of patients.

Biography:

Abstract:

Breast cancer is the most common cancer of urban Indian women and the second most common in rural women. Owing to lack of awareness of the disease in India and in absence of breast cancer screening programs, majority of breast cancers are diagnosed at a relatively advanced stage. Government agencies, NGOs and charity organisations have put great emphasis on improved breast cancer awareness among masses for promotion of early detection, providing comprehensive treatment module, providing support for breast cancer management and for screening and rehabilitation. The efforts have resulted in an improved survival and quality of life of Indian breast cancer patients but the improvement is more pronounced in urban population. In rural areas, there is still a lack of good health care and awareness among masses regarding the importance of early breast cancer screening and thus cases of late diagnosis are more prevalent. In addition, there is still an identified lack of breast cancer screening programs in rural areas which further causes late diagnosis. The other common factors that lead to late diagnosis include delays on the part of womenfolk of rural areas to seek advice for a recognized health problem which is mainly due to financial reasons, social/cultural reasons such as general inhibition of women to see the doctor for breast ailments, general scare of people towards cancer like disorders and a general indifference of women towards their health.  In rural areas Illiteracy is widespread and also people are inhibited and not motivated to come to the hospitals for screening/check up.

Considering various factors of cancer incidence rate, to address the most common barriers such as lower cancer literacy, lesser availability and accessibility of proper medical facilities, three Indian states were shortlisted to initiate the project “ECHO” by organizing Breast Cancer Awareness and Screening Programs for Rural and Semi-Urban Indian Population. In addition to being a CSR approach, Project ECHO also increased the cancer literacy amongst the rural population and emphasized on health education, early diagnosis of breast cancers and more public facilities for breast cancer treatments.

Biography:

Abstract:

Background: Antiplatelet therapy with clopidogrel is generally used to decrease the risk of ischemic heart disease. Environmental and genetic factors including SNPs in CYP3A5 and P2RY12 genes are attributed for this inter-individual variation in response to drug.

Objective: To examine the role of CYP3A5 rs776746 and P2RY12 rs2046934 polymorphisms in clopidogrel resistance in IHD patients.

Methods: A total of 237 IHD patients were recruited who had received 75mg clopidogrel for more than 07 days. Platelet aggregation studies were performed on Innovance® PFA-200 system. The rs776746 and rs2046934 polymorphism were determined by PCR-RFLP.

Results: Out of selected IHD cases, 85.7% were clopidogrel responders and 14.3% were non- responders. Genotype for CYP3A5 responder, 5.4% were homozygous (*1/*1), 89.7% were heterozygous (*1/*3) and 4.9% were homozygous (*3/*3). Non-responders CYP3A5 indicated that 8.8% were homozygous (*1/*1), 64.7% were heterozygous (*1/*3) and 26.5% were homozygous (*3/*3). The allele frequencies difference among responders and non-responders were highly significant (p<0.05). P2RY12 genotypes with clopidogrel responder patients showed that 78.3% were TT alleles, 19.7% were CT alleles and 2.0% were for CC alleles. Similarly, non-responder patients showed 91.2% were with TT alleles, 8.8% were CT alleles and no patient were with CC alleles. So, these frequencies difference in alleles among clopidogrel responder and non-responder P2RY12 patients were not statistically significant (p>0.05).

Conclusion: The allele CYP3A5*3/*3 showed a significant association with clopidogrel resistance whereas, P2RY12 did not show association with clopidogrel resistance in studied samples.

Biography:

Abstract:

Background: Hemophilia is a rare X-linked recessive congenital bleeding disorder and has been classified as Hemophilia A (deficiency of Factor VIII), and Hemophilia B (Deficiency of factor IX). The overall incidence is 1 per 10,000 male live births with 80% cases of Hemophilia A. the characteristic phenotype is the bleeding tendency and most of the patients present with easy bruising, prolonged post traumatic bleeds and hemarthrosis. The severity of bleeding in Hemophilia correlates with the level of factor deficiency. Late diagnosis and improper management can lead to lifelong complication of chronic arthropathy. Therefore timely and proper factor replacement therapy can prevent complications and improve quality of life.

Objective: The study was conducted to analyze the clinical data of disease in a developing country with limited resources so that we can predict how can we prevent morbidity and improve the quality of life in our set up.

 Methods: The population of the research was patients of Hemophilia, who were reported, in last one year, in Children’s Hospital & Institute of Child Health, Lahore. A sample of 55 patients of Hemophilia A and B were reviewed retrospectively. The data was collected irrespective of any discrimination based on demographic factors and following factors were recorded: Clinical features, age at first presentation, age at diagnosis, severity of disease, frequency of admission, factor replacement, and life threatening bleed. Blood complete picture, bleeding time, PT/APTT, mixing studies and factor assays were noted.

Results: Among these 55 patients all were male. Around 93% of the patients were diagnosed as Hemophilia A and approximately 7% as Hemophilia B. Most of the patients diagnosed after 1 year of age (96.4%) although approximately 62% were symptomatic before 1 year of age. About 49% of them were having moderate disease, mild disease was noted in 18%, and rests were with severe disease. Family history was positive in 51% and in all the patients who presented before 6 months of age had severe hemophilia. APTT was prolonged in all the patients with the mean value of >1minute.Severity of disease and family history has significant relation at p<0.005, while relation between severity of disease and the age at diagnosis is significant but compromised at p=0.05, i.e. critical line. In this research, post circumcision bleed (45.5%) was observed prominently as primary symptom followed by bruises and epistaxis, respectively. However, life threatening bleed was reported in 9% and about 66% developed hemarthrosis. Only 2 patients had APTT done before circumcision. Most of the patients were on demand factor replacement therapy i.e.74.6% and only 5.4% of them were on primary prophylaxis.

Conclusion: On the basis of early presentation and family history we can predict the severity of the disease. Since family history has strong correlation with severity of disease, therefore performing PT/APTT before circumcision will be helpful and cost effective as screening and early diagnosis of Hemophilia.  Early diagnosis, adequate and timely prophylaxis can prevent complications like hemarthrosis leading to chronic arthropathy and severe life threatening bleeds. It can help to improve the quality of life and decrease the morbidity and mortality in a developing country.

Biography:

Abstract:

Introduction:  Prenatal CVS DNA analysis in pregnanat ladies with family history of Beta Thalassaemia is done  in many centrs to diagnose Beta chain defect in the sample.In case  where heterozygous (minor)DNA mutation resembling mother's mutation is detected the possibility of  mother's sample contamination cannot be ruled out.STR analysis is carried out to determine nature of DNA(Fetal or non-informative)in CVS.

Aims & Objective: To perform the STR analysis on chorionic villus samples(CVS) and confirm the fetal origin of DNA.

Material and Methods: Prospectively those CVS samples showing one Beta chain mutation (Beta Thalassaemia Minor) resembling the mother's mutation were also tested for STR by ARMS PCR .DNA was extracted with Qiagen extraction Kit.The Primers used for the different STR markers included D13,D18, and D21. PCR amplification was performed and result interpretated on Polyacrylamide gel electrophoresis (PAGE).  

Results: From 12th Aug 2014 to 31^st Dec 2014 total 135 CVS mutation analysis for Beta Thalassaemia were performed. Beta Thalassaemia single mutation resembling mother's mutation was seen in 47 cases among STR analysis D13,D18,and D21 were informative in 33(70%),27(57%),and 29(62%) samples respectively.In 04 (09%)sample STR analysis was    non-informative.

Conclusion: STR analysis should ideally be done in all prenatal Chorionic villus samples to confirm the fetal origin of DNA .Where STR analysis 

Biography:

I get PhD at the age of 32 years (2014) from Tehran University of Medical Sciences, Tehran. I have published more than 25 papers in reputed journals and have been serving as an editorial board member of some ISI journals.

Abstract:

Cancer is a major cause of death in the world today. The International Agency for Research of Cancer estimated that 94.4 thousands deaths would occur in 2012 due to blood cancer in the countries of the European Union.

All cancers demand new treatments, and we focus on specific type of cancer: blood cancers or haematological malignancies. There are four broad categories of blood cancers: leukaemia, myeloma, Hodgkin lymphoma and non-Hodgkin lymphoma. Together, these account for around 9 % of all cancers and are currently the fourth most common in both males and females in the world

Because of this high mortality rate, the development and progressive evolution of stem cell transplantation in recent decades has been an important medical advance. haematopoietic stem cell transplantation (HSCT) has become an effective treatment for malignant and benign haematological diseases that could not be cured by other therapies, allowing for an increasing number of patients to become long-term survivors. It is an essential part of the therapeutic strategy which is clinically recommended for blood cancer patients whose clinical condition indicates transplantation.

Hematopoietic stem cells (HSCs) are found at the apex of this system and are defined by their ability to self-renew and to give rise to all hematopoietic lineages.HSCs can be identified through the expression of CD34 on their surface and a lack of expression of CD38.

Biography:

Abstract:

Background: Myelodysplastic syndromes (MDS) are clonal stem cell disorders characterized by cytopenias, ineffective hematopoiesis and morphological dysplasia. Bone marrow cytogenetics, inspite of being incorporated as mandatory tool in diagnosis are done less frequently due to limited availability of this technique in Pakistan. Most of the cases of refractory cytopenias are not diagnosed for MDS. Impact of racial difference on disease biology and clinical behavior was evaluated in previous Asian study but  not been well established.

Objective: The study was done to evaluate  baseline clinicohematological characteristics of patients presenting with MDS, evaluate their cytogenetic profile and compare our analysis to what has been reported previously.

Material and Methods: Cross sectional retrospective study done at National Institute of Blood Diseases and Bone Marrow Transplant, Karachi Pakistan from 2010 till 2016.

Results: Total of 177 patients diagnosed with de novo MDS were included in the study having median age 51 years and male to female ratio of 3:1. Pancytopenia was observed in 80(45%) patients and bicytopenia in 74(42%). However, 23(13%) of our patients had cytopenia with one cell lineage. Mean Hb% was 7.8±2.18 g/dl, mean total leukocyte count 8.8±13.6x10^9/L, and mean platelet count was 82 ±95.7x10^9/L. Absolute neutophil count (ANC) of <1.8 was found in 78(44%) and  >1.8  in 99(56%). Out of total, 170 (96%) were transfusion dependent. Most common presenting complaint was loss of appetite in 173(98%). History of recurrent infection was found in 21(12%). Bacterial infections were observed to be the most common. Co morbidities were observed in 116(66%) of patients including hypertension and diabetes miletus . Refractory cytopenias with multilineage dysplasia (RCMD) was the most common encountered WHO category. 98(55%) patients had their karyotype done at the time of diagnosis out of which 44(45%) had abnormal karyotype; complex karyotype was most common abnormal karyotype in 12(12.2%) patients followed by Monosomy 7 in 7(7.1%).

Conclusion: We found younger median age at diagnosis, higher mean WBC count and majority of patients without history of recurrent infections. Karyotypic abnormalities carry a very important role in the diagnosis and prognosis of MDS. Complex karyotype and Monosomy 7 carry bad prognostic implications and early disease transformation to acute myeloid leukemia. Monosomy 7 being associated with bad overall survival, such patients must be identified early with close clinical follow up and offered allogenic stem cell transplant. This is the largest cohort of patients of MDS evaluated for baseline clinical and cytogenetic characteristics in our country.