Biography:

Leonard Tan completed his Graduation at National University of Singapore, Faculty of Medicine in 1989 and completed his Degree in Histopathology at Royal College of Pathologists in London in 1999. He was a visiting Research Fellow in Hematopathology at Weill Medical College of Cornell University. He is now a Senior Consultant, Histopathologist at Singapore General Hospital, and has been Chief Diagnostic Pathologist of Lymphoma Work Group at National Cancer Centre, Singapore since 2006. His main research interest is in “Lymphoid immuno-architecture, particularly of peripheral T-cell lymphomas with large B-cells”.

Abstract:

Angioimmunoblastic T-cell lymphoma (AITL) ranges widely in clinical tempo, on the one hand mimicking an immune reaction and on the other, being as aggressive as any T-cell lymphoma. This is reflected by its varied histological pattern, designated one through three, with hyperplastic, regressed or effaced germinal centers (GCs), respectively. Having recently being clinched as a neoplasm of follicular helper-T (T_FH) cells by gene expression profiling, it has now become pertinent and also feasible to distinguish the changes of pattern 1 AITL from reactive lymphoid hyperplasia by immune architectural analysis. In population studies, the life cycle of any organism can be inferred by photographing individuals of various ages, juxtaposing the most similar photographs to form a spectrum, then blending or morphing them to create meta-animation, so as to impart dynamic apperception of the organism’s life cycle. This would effectively translate a cross-section of the population into a representation of an individual organism’s entire lifespan, circumventing barriers of limited contact time and interference with natural history. In the same way, immunohistological sections, which are formalin-fixed, paraffin-embedded snapshots-in-time of living tissue can be interrogated with multiple photomicrographs of the GCs in early-pattern AITL, juxtaposed in similar gradation, and then shown in sequence to produce a meta-movie of the aberrant outward migration of neoplastic T_FH cells, as though being filmed in real-time through a microscope trained on live cells. Hence, this presentation aims to demonstrate a phenomenon hitherto unexpressed through conventional histopathology, coupled with clinical and scientific observations that support this dynamic interpretation.

Biography:

Soad K Al Jaouni is a Professor and Consultant of Hematology; Professor/Consultant of Pediatric Hematology/Oncology and Senior Researcher in Hematology department, Faculty of Medicine, King Abdulaziz University Hospital- a tertiary care medical center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. She received her certificate of Royal College of Physician and Surgeon in Medicine in 1989. She yearly participates in international and local conferences with more than 260 research and 74 publications. She is well known for her dedication, active role in research on Hereditary Blood Disease, Cancer Research. She has an active role in Public Education to minimize and control inherited blood diseases, environmental pollution and cancer prevention.

Abstract:

Congenital agranulocytosis (Kostmann syndrome) is associated with severe neutropenia, recurrent infections resulting with the demise of the patient at an earlier age. Aim of this study is to evaluate applying supplementation of Nigella sativa and honey for Kostmann syndrome. 14 years old male patient diagnosed during the first few months of life as Kostmann syndrome by frequent admission for bacterial infection and peripheral blood films with automated neutrophil count (ANC) range from 0.1-0.3x10(9)/L, bone marrow aspiration confirming the diagnosis of Kostmann syndrome, patient have positive consanguinity and family history for a similar condition, elder brother died of sepsis during the first year of life. Patient has history of frequent hospital admissions for infections, starting from 2^nd day of life, including 26 inpatient admissions from 2002 to 2004 with positive blood and urine cultures. Patient received courses of filgrastim recombinant granulocyte colony-stimulating factor (G-CSF) with reported cataract after few months later. Patient was started on regular daily intake of Nigella sativa and honey from 2005; he showed dramatic improvement in several days like aspects as his hospital admissions with no single admission for infection from 2005 till 2016. Family reports marked improvement in patient quality of life with better regular school attendance after subsidence of infections. Patient was monitored regularly in hematology clinic. We conclude Nigella sativa and honey may not affect the automated neutrophil count but may improve the immune system and the quality of life in Kostmann syndrome. More research is needed to find the relation between Nigella sativa supplementation and immune modulation

Biography:

Mingzhi Zhang completed his PhD at Zhengzhou University Medical School. He is the Director of Lymphoma Diagnosis and Treatment Center in Henan Province and Department of Oncology, The First Affiliated Hospital of Zhengzhou University. He has published more than 30 papers in reputed journals and achieved honors and awards on Lymphoma Research in China.

Abstract:

Natural killer/T-cell lymphoma (NKTCL) is a subtype of non-Hodgkin’s lymphoma, which has a higher incidence in East-Asia compared with United States and Europe. This tumor is characterized by highly aggressive nature, rapid progression and poor survival. However, optimal treatment strategies for advanced NKTCL have not been defined. Traditional CHOP and CHOP-like regiments usually provide poor clinical outcomes. Recently, L-asparaginase (L-Asp) based regimen including dexamethasone, methotrexate, ifosfamide, L-Asp and etoposide (SMILE) has been devised and showed a relatively improved efficacy, but at the same time, severe hematologic toxicity were seen. We formulated a novel pegaspargase based chemotherapy regimen: dexamethasone, cisplatin, gemcitabline, pegaspargase (DDGP) and performed clinical trial (No. NCT01501149). Patients were newly diagnosed in stage III-IV and had performance scores in 0-2. Six cycles of DDGP or SMILE chemotherapy were randomly assigned to them. In conclusion，DDGP chemotherapy resulted in significant improvement in one-year PFS (86% versus 38%, P=0.006), two-year OS (74% versus 45%, P=0.027) and better tolerability compared with SMILE chemotherapy. We also discussed and elucidated the mechanisms concerned with the better effect of DDGP on DNA damage, nucleic acid metabolism, and ATP-binding cassette transporters-dependent multidrug resistance. In addition, we are making great efforts to explore new approaches including hematopoietic stem cell transplantation with a unique induction chemotherapy and application of PD-1 immune checkpoint inhibitor, which greatly benefit the patients after chemotherapy failure.

Biography:

Jean-François Schved is a Doctor and Professor of Hematology at Faculty of Medicine, Montpellier University. His main theme of study and research is Haemostasis, especially hemorrhagic disease and hemophilia. His other research work focused on “Thrombotic disease and the risk factors for thrombosis”. His team has also conducted important scientific work on red blood cells and genetic iron overload. He published, in collaboration with various units of research or hospital services, more than 200 scientific articles in international journals and participated in writing of many medical books. He reviews frequently manuscripts for major journals.

Abstract:

With the well-known increase of the life expectancy in patients with hemophilia (PWH), patients are faced with age-related comorbidities. Thus, over the last few years, hematologists appear to be witnessing an increase in the frequency of cardiovascular diseases, mainly ischemic cardiopathies or atrial fibrillation. These diseases raise major difficulties in PWH while the recommended treatments rely on antiplatelet agents and anticoagulants. Anticoagulants and antiplatelet treatments increase the risk of bleeding in hemophiliacs and cardiovascular interventions commonly complicate bleeding. To minimize these risks, the clotting factor deficiency needs to be adapted. To get more information on the possibility of treatment, we launched an observational study called COCHE (comorbidity of cardiovascular origin in hemophilia) including PWH treated for atrial fibrillation or ischemic cardiopathies. Some patients underwent endovascular procedures, the minimal follow-up being two years. From these data, it appears that anti-platelet agents can be used with caution and under certain conditions in most hemophiliacs. Invasive cardiovascular interventions are possible and anticoagulants treatments or dual anti-platelet therapy can often be used. In all cases, close collaboration between the cardiologist and hematologist is necessary to offer the patient an optimum treatment. 

Biography:

Ayesha Junaid completed her Graduation at King Edward Medical University, Lahore. She is a member of Clinical Pathology (2000) and Fellow of Clinical Hematology (2002) at College of Physicians & Surgeons, Pakistan. She has completed her training in Cytogenetics & FISH technique at UCLA, USA (2008). She is a Consultant Hematologist and In-charge of Blood Transfusion Services & Hematology department at Tertiary Care Hospital, Islamabad. She also works as a Transplant Consultant mainly involved in Hematological Malignancies. She is presently working as Professor of Pathology at Shifa College of Medicine, Islamabad. She is an elected syndicate member of Shifa Tameer-e Millat University, Islamabad.

Abstract:

Introduction: Selection of an uninfected donor is of extreme importance in enhancing transfusion safety. Presence of week’s long window period of fatal viral infections in serologically screened donors provides an ever existing possibility of fatal disease transmission through transfusion. We introduced nucleic acid amplification testing for viral screening and also scanned donors for two common endemic parasitic infections, Plasmodium and Treponema pallidum. Our institute provides 500 bedded tertiary care facilities with around 15,000 blood donors walking in annually to meet transfusion demand for a varied mix of oncology, dialysis, obstetric, pediatric, surgical and critical care patients. Malaria screening was added as our country falls in malaria endemic zone, while syphilis screening is lately added to prevent STD transmission.

Aim: Aim of this study is to minimize transfusion transmissibility of viral and parasitic infections to critical in-patients.

Methods: We tested 6,411 sero-negative donors (out of 6588 total donors) on NAT for HBV, HCV & HIV viruses in a period of six months (July-December 2015) using a minipool of six donors. Malaria screening was performed on 6588 donors using rapid testing based on species specific plasmodium LDH detection in human blood. 296 donor samples were screened for syphilis using qualitative electrochemiluminescence immunoassay.

Results: Five donors were found NAT positive for HBV out of a total of 6,411, saving 20 possible HBV transmissions through transfusion. Two donors out of 6588 were positive for Plasmodium vivax. Two donors out of 296 were positive for syphilis. Improved screening saved 36 possible infectious disease transmissions through transfusion over a period of six months.

Conclusion: Donor screening plays a vital role in improving transfusion practice. Hemovigilance activity upgrading and standardizing screening practices should be part of our vision to prevent infectious disease spread. Our next mission is to screen donors for dengue infection as the disease has lately shown marked increase in incidence in our country.

Biography:

Abstract:

Multivalent and multifunctional bioactive molecules offer the promise of more effective therapeutics. In this work, we present selegrin, a new bispecific molecule that prevents the interaction of leukocytes circulating in the blood vessels with the endothelial barrier cells and could modulate the over flux of activated PMN to inflamed tissues. Prior to the development of selegrin, we have demonstrated using a rat model of skeletal muscle injury, that a recombinant form of the beta 2 integrin alpha chain CD11b, A or I domain prevents muscle inflammatory injury by transiently preventing leukocyte transmigration through the vascular endothelial cell barrier. Selegrin molecular design consisted in combining the CD11b A domain with the L selectin CD62, lectin-like domain in a single 52KDa fusion protein. Recombinant selegrin was produced in CHO cells under two structural forms, a linear and an IgG-like structure. Both form exhibited specific biological activity in real time of flow in physiological and inflammatory states using the ex vivo real-time imaging of leukocyte adhesion to the vascular endothelium of Sprague Dawley rats carotid arteries and HUVEC cell layers. Indeed, under inflammatory conditions, selegrin showed a significant inhibition of leukocytes tethering, rolling and adhesion to vascular endothelial cells. In addition, the transcription of IL6, ICAM1, VCAM1 and MCP1 gene and the expression of the corresponding proteins by respectively RT-PCR and immune fluorescence using specific Mabs, were significantly down regulated in endothelial cells treated with TNFa and in presence of selegrin. This delineates the underlying causes of the biological activity displayed by selegrin. This work demonstrated that selegrin exerts inhibitory effects on human leukocytes interaction with vascular endothelium cells under flow in physiological and inflammatory conditions. The data provide strong mechanistic information behind the anti-inflammatory properties of selegrin and are translatable in preclinical trial.

Biography:

Sally Saad Mandour Esawy completed his Master’s degree at Menoufia University. She is an Assistant Lecuturer in Clinical Pathology department at National Liver Institute, Menoufia University.

Abstract:

Background: Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer and shows a growing incidence worldwide related to the increased prevalence of the various risk factors of chronic liver diseases, such as hepatitis infection with hepatitis C and B viruses. Each year hepatocellular carcinoma is diagnosed in more than half a million people worldwide. Therefore, prompt diagnosis of HCC is imperative.

Aim: Aim of this study is to determine the efficacy of serum squamous cell carcinoma antigen (SCCA) in comparison to alpha-fetoprotein in the detection of hepatocellular carcinoma.

Methods: This study was carried out in Clinical Pathology department, Faculty of Medicine at National Liver Institute, Menoufia University all over the period from June 2012 to November 2013. The study included 30 patients with liver cirrhosis and 30 patients with HCC in addition to 17 unrelated healthy adult subjects with matched age and gender were included as controls. Serum alpha fetoprotein (AFP) and serum squamous cell carcinoma antigen level were estimated by enzyme linked immunosorbent assay.

Results: Although SCCA has more sensitivity than AFP in detection of HCC, AFP remains a relatively good diagnostic marker for HCC with high specificity.

Conclusion: AFP is a relatively good diagnostic test for cirrhosis with high specificity. Moreover combination of the two markers may improve the sensitivity making them combined a perfect screening tests for prediction of HCC

Biography:

Osaro Erhabor is a Professor of Hematology, Transfusion Medicine and Laboratory of Total Quality Management. He is an Alumni of Rivers State University of Science and Technology, Nigeria, University of Greenwich in the United Kingdom and Francis Tuttle College of Technology in Oklahoma, USA. He is the Author of five scientific books. He has published more than 190 scientific papers in the field of Infectious Diseases, Hematology, Blood Transfusion Science and Total Quality Management. He is a member of the editorial board as well as an article Reviewer of several international scientific journals.

Abstract:

Conditions associated with refractory anemia require repeated blood transfusion. Despite the benefits of red cell transfusion, it is associated with complications including iron overload. The aim of this study was to determine some serum iron parameters, antioxidant vitamins and micronutrients levels among transfusion-dependent subjects. The study included 101 transfusion-dependent subjects and 50 apparently healthy controls that had no history of blood transfusion. Some iron parameters such as ferritin, serum iron and percentage transferrin saturation were significantly higher among the transfusion-dependent subjects (p=0.000) compared to controls. There was no correlation observed between ferritin and C-reactive protein (r=0.059, p=0.558). This study showed a significant decrease in HB, PCV, RBC, MCV, MCH and increase in platelet and white cell count among the subjects compared to the control (p<0.05). Vitamin A, B5, E and copper were significantly lower among the subjects compared to the control participants (p<0.05). There was no correlation between ferritin and vitamin A, B5, E and copper among the study subjects (p>0.05). Similarly, there was no significant correlation between the ferritin and zinc levels among the study subjects (p>0.014). There was a significant elevation in the serum iron parameters and simultaneous decrease in the antioxidant vitamins and micronutrients levels among the transfusion-dependent subjects. There may be need to routinely provide iron chelating treatment and supplementation of vitamin A, B5 and E for transfusion-dependent subjects in the area to obviate the possible negative effect of iron overload among the subjects.

Biography:

Osaro Erhabor is a Professor of Hematology, Transfusion Medicine and Laboratory of Total Quality Management. He is an Alumni of Rivers State University of Science and Technology, Nigeria, University of Greenwich in the United Kingdom and Francis Tuttle College of Technology in Oklahoma, USA. He is the Author of five scientific books. He has published more than 190 scientific papers in the field of Infectious Diseases, Hematology, Blood Transfusion Science and Total Quality Management. He is a member of the editorial board as well as an article Reviewer of several international scientific journals.

Abstract:

Conditions associated with refractory anemia require repeated blood transfusion. Despite the benefits of red cell transfusion, it is associated with complications including iron overload. The aim of this study was to determine some serum iron parameters, antioxidant vitamins and micronutrients levels among transfusion-dependent subjects. The study included 101 transfusion-dependent subjects and 50 apparently healthy controls that had no history of blood transfusion. Some iron parameters such as ferritin, serum iron and percentage transferrin saturation were significantly higher among the transfusion-dependent subjects (p=0.000) compared to controls. There was no correlation observed between ferritin and C-reactive protein (r=0.059, p=0.558). This study showed a significant decrease in HB, PCV, RBC, MCV, MCH and increase in platelet and white cell count among the subjects compared to the control (p<0.05). Vitamin A, B5, E and copper were significantly lower among the subjects compared to the control participants (p<0.05). There was no correlation between ferritin and vitamin A, B5, E and copper among the study subjects (p>0.05). Similarly, there was no significant correlation between the ferritin and zinc levels among the study subjects (p>0.014). There was a significant elevation in the serum iron parameters and simultaneous decrease in the antioxidant vitamins and micronutrients levels among the transfusion-dependent subjects. There may be need to routinely provide iron chelating treatment and supplementation of vitamin A, B5 and E for transfusion-dependent subjects in the area to obviate the possible negative effect of iron overload among the subjects.

Biography:

Albara Abdulfatah Mohammed has completed his PhD at University of Khartoum, Sudan; BSc and MSc at University of Medical Sciences and Technology. He is the Coordinator of Medical Laboratories Sciences Program at Alfajr College. His research interest is in Hemostasis.

Abstract:

Aim: Neonatal sepsis is lethal disease represents one of the most common causes of neonatal morbidity and mortality worldwide. Aim of this study is to assess platelets count, prothrombin time (PT), activated partial thromboplastin time (APTT), thrombin time (TT), fibrinogen, protein C, protein S, antithrombin (AT) and vitamin K (VK) in Sudanese septic neonates and compare them with healthy neonates in order to study hemostatic alteration among septic neonates.

Methods: Prospective study was conducted in Omdurman Maternity Hospital in the period June 2013 to April 2015 on total of 100 samples divided into case and control group (50 for each). Blood culture was done routinely for all neonates with suspected sepsis; the first 50 neonates with a positive culture were taken as case group. Platelets were counted by cell counter haematology analyzer Sysmex KX-21. PT, APTT, TT, fibrinogen, PC and PS were assessed by clotting procedure via coagulometer Stago Start four. AT assessed spectrophotometrically by turbidimetric method via chemistry analyzer Mindray BA-88A. VK assessed by the Schmiatzu.10 ADVP. Data were tabulated; means were compared and analyzed by SPSS20 via one sample t test.

Results: In case group, 17 neonates underwent early onset sepsis (0-7 days) and 33 late onsets (7-28 days). In the outcome, 10 neonates were died. Means of platelets count, PT, APTT, TT, fibrinogen, PC, PS, AT and VK were 60,289 c/mm³, 16.6 s, 47.8 s, 18.6 s, 482.2 mg/dl, 34.4%, 33.4%, 183.9 mg/ml and 0.86 ng/ml; and 212,030 c/mm³, 13.9 s, 37.5 s, 20.6 s, 393.7 mg/dl, 36.8%, 34.7%, 221.5 mg/ml and 1.23 ng/ml for case and control respectively.

Conclusions: Platelets count significantly decreased, PT and APTT significantly prolonged, TT significantly shorted, fibrinogen significantly increased and AT significantly decreased in neonatal sepsis. APTT and PC showed significant correlation with outcome, so both can predict early mortality, PT and TT showed significant correlation with early sepsis.

Biography:

Salem Khalil completed his MBBS at King Saud University Riyadh in 1984; fellowship of the Royal College of Pathologists of Australasia, Australia in 1992 and; fellowship in Molecular Hematopathology at MD Anderson Cancer Center, Huston, Texas, USA.

Abstract:

Background & Aim: Mutation analysis testing and targeting selected regions of multiple genes to facilitate diagnosis, classification and selection of therapy in patients with hematological diseases including acute myeloid leukemia (AML), myeloproliferative neoplasms (MPN), and beta thalassemia was reviewed.

Method: Genetic examinations were carried out by polymerase chain reaction using specific primers to amplify regions of interest. The amplified sequences were then determined by direct sequencing (Sanger sequencing) and quantitative real time PCR.

Results & Discussion: This study analyzed JAK2 mutations (exons 12–15) in 1811 patients tested between 2010 and 2013. 271 patients (16%) were positive for JAK2 mutations with median patient age of 54 years. In agreement with previous reports, 262 patients (96.7%) were positive for the JAK2 p.V617F mutation. Non-p.V617F JAK2 mutations were detected in the remaining nine (3.3%) patients. 87 patients (84%) were diagnosed with MPN, 40.2% with PV, 25.2% with ET, 12.6% with MF, 19.5% with unclassifiable MPN and 2.2% with CML. A variety of AML-specific mutations were screened in bone marrow samples of 100 adult and pediatric AML patients diagnosed between 2012–2014 showed 45% positivity for different kind of gene mutations. However, the frequency of these different mutations in AML is lower in our population compared to previously published studies from different international centers. In a total of 123 CML patients analyzed, 25 (20%) were positive for 11 different mutations across the ABL1 kinase domain mutations (11 patients had T315I, three patients with Y253H, two patients with E255K, and two more patients with F317L). 19 different mutations of the HBB gene were identified in all detectable cases (103 patients). Among these mutations c.315+1 G>A, c.118C>T and c.92+5 G>C were detected in majority of cases (66%) with five novel mutations (c.410 G>A, c.-151C>T, c.68_74delAAGTTGG, c.316-3C>A, and c.-31 C>T) that are first time reported in Saudi population.

Conclusions: The results of this study underscore the importance of screening for genetic mutations in the initial evaluation of patients with suspected MPNs and AMLs or during a workup for relapse and TKI therapy resistance.

Biography:

Kamran Mansouri completed his PhD at Tehran University of Medical Sciences, Iran. He is the Head of Department of Molecular Medicine at Kermanshah University of Medical Sciences, Iran. He has published more than 50 papers in reputed journals.

Abstract:

Aim: This study aims to investigate L-arginine, nitric oxide (NO) precursor, in combination with 5-fluorouracil (5-FU) decreases 5-FU adverse effects on normal cells but not cancer cells which is among important chemotherapy goals especially during pregnancy.

Methods: The human umbilical vein endothelial cells (HUVECs) and human breast cancer cell line (BT-20) were treated with L-arginine/5-FU to study their effect on cell survival, NO concentration, and glycolytic activity. Moreover, using molecular docking study, L-arginine effect on glycolysis enzymes activity was evaluated. L-arginine/5-FU effect on angiogenesis was also assessed in vivo and in vitro. Furthermore, L-arginine effect on 5-FU toxicity was assessed by measuring embryo weight. Real-time PCR and zymography were used to evaluate VEGF and MMP2, 9 expression and enzyme activities, respectively.

Results: L-arginine/5-FU treatment increased cell survival in HUVECs but induced cell death in BT-20. NO concentration in both cell lines was increased. An inhibitory effect of L-arginine on glycolysis enzyme, human glucokinase (HG) was affirmed through molecular docking study and further supported by glycolysis experiment showing glucose and lactate levels decrease in cancer cells but not in normal cells. Angiogenesis induction in HUVECs was confirmed through VEGF and MMP-2, 9 up-regulated gene expressions and increased MMP-2, 9 activities but a down-regulation in BT-20 treated with both drugs alone and in combination. Furthermore, increase in vivo angiogenesis and decrease embryo cytotoxicity was observed.

Conclusion: Altogether, findings speculate that L-arginine inhibits cell death induced by 5-FU in normal cells by attenuating the adverse effects of 5-FU, while it doesn’t do so in cancer cells (BT-20).