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Background: Neuroblastoma (NB) is remarkable for its wide spectrum of clinical behavior and biological characteristics in relation to outcome. The use of aggressive therapy, including autologous hematopoietic stem cell transplantation (HSCT) and the addition of isoretionin (cis-Retinoic Acid/cis-RA), has increased survival rates of patients with advanced disease. Methods: Pediatric 271 newly diagnosed high risk NB patients were prospectively enrolled into the study. Patients received neoadjuvant chemotherapy of alternating cycles: [cyclophosphamide, doxorubicin, vincristine (CAdO)] and [etoposide, carboplatin]. Intensification courses of "ICE" (ifosfamide, carboplatin, and etoposide) regimen were administered to patients with bone marrow (BM) residual infiltration. Whenever safely feasible, complete surgical resection or debulking of the primary tumor was attempted for patients achieving partial response. Eligible patients underwent HSCT, while radiation therapy to the primary and metastatic sites, as well as maintenance with cis-RA was given for 6 months. Results: The median age of our patients was 2.8 years with male to female ratio of 1.65:1. At 4 years, the overall and event free survivals were 33.7% and 23.3% for the entire group under study, with significantly higher rates (42.7% and 35.6%, respectively) for HSCT patients (n = 94; p < 0.001). The outcome was also significantly correlated with response to induction therapy, pathological subtype, as well as other variables. Conclusion: Myeloablative therapy followed by stem cell rescue is regarded as the most important goal of high risk NB treatment to improve survival till present. Each of consolidation HSCT, post induction disease status, as well as international neuroblastoma pathology classification (INPC) subtype was an independent predictive variable of survival. A collaborative effort with an emphasis on biologic characteristics of aggressive disease and tailored therapy needs to be strengthened to further our understanding of this disease.

Background: Recently, numerous studies have associated polymorphisms in 11beta-hydroxysteroid dehydrogenase type 1 (HSD11β1) gene and T2DM risk. However, there is still a lack in the published literature evaluating the association between HSD11β1gene polymorphism and the risk of T2DM. Objective: The Aim of the study was to assess the association of HSD11β1gene polymorphism (rs846910) with Type 2 diabetes mellitus (T2DM) in a sample of the Egyptian population. Patients and methods: Our study was conducted on 100 subjects; their mean age was 50.26 ± 9.1 years old. They were selected from Diabetes Outpatient Clinics of our institution for 6 months in the period from June 2019 to December 2019. They were divided into two groups: 60 type 2 diabetic obese patients with BMI > 25 kg/m 2 (Group I) and 40 age-and sex-matched controls (Group II). Results: There was no statistically significant difference between cases and controls in terms of HSD11β1 polymorphism (rs846910). The regression analysis showed that the HSD11β1 polymorphism did not significantly increase the risk of diabetes mellitus (DM). Detection of HSD11β1 gene polymorphism in the study showed that homozygous GG genotype was more prevalent than GA genotype. However, there was no significant difference between GG and GA in terms of fasting and postprandial sugar and in terms of lipid profile. Conclusion:The present study showed no significant association between HSD11β1 polymorphism (rs846910) and T2DM. Moreover, the HSD11β1polymorphism (rs846910) is not correlated with glycemic status or lipid profile.

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