Objective: Vitamin D is a fat soluble vitamin responsible for calcium metabolism and more recently discovered effects. This led to an increase in requests for vitamin D test by clinicians. New automated assays have been introduced for 25-hydroxyvitamin D measurement. Methods: Results from these new method have to be related to a Standard method to obtain best results for practical usage. In our study, one hundred venous blood samples were analyzed for 25-OH vitamin D on three immunological methods in our lab and correlated with ultra-performance liquid chromatography (UPLC) method as a reference method. Results: Statistically analysis of results obtained for correlations between the 3 methods against the reference UPLC was done by Spearman's Correlation. It showed positive correlation in all methods with significant p value < 0.001. Differences and biases between methods were evaluated using a Bland-Altman plot and Cohen's Kappa agreement. Best agreement was found in Cobas 6000 followed by the Access2 then comes Architect. Conclusions: All immunoassays can be used in routine 25(OH) D measurements, still some methods are better than others. A clinical laboratory must at least be aware of its method to avoid misinterpretation of results.

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Background: Castleman disease (CD) describes a group of rare lymphoproliferative disorder with characteristic histopathology. It presents with heterogeneous clinical features whether unicentric (UC) or multicentric disease (MCD). The aim of the work was to describe clinic-pathological characteristics, management and outcome of different types of castleman disease in CCHE. It is a retrospective study, all children with (CD) treated from July 2007 till end of 2017 were analyzed as regard diagnosis, management and outcome. The results showed that, twelve patients with a median age of 11.5 years (ranging from 4 -to 17 years) were enrolled. Eight of them (66.6%) were males and 4 (33.3%) were females (33.3%). Histopathology was either hyaline vascular in 8 patients (66.6%) or plasma cell variant in 4 patients (33.3%). Nine patients (75%) had unicentric disease (UC) with lymphadenopathy. Three patients (25%) were multi-centric disease (MCD); out of them one patient had immune bi-cytopenia, small intestinal thickening and splenomegaly and another one had extensive pulmonary involvement and respiratory distress, while the third patient had pleural effusion and ascites. HIV antibody was negative for all patients. Regarding the three MCD patients, IL-6 was normal in one patient, and extremely high in second one, while it hasn't been done for the third patient. All UC patients underwent surgical excision and are alive with no active disease till now. All MCD patients received systemic steroids as initial therapy, followed by R-CHOP (Rituximab-cyclophosphamide-doxorubicinvincristine-prednisone) as salvage therapy, except for one patient with pulmonary involvement who didn't achieved clinical response and received single agent Rituximab with Anti IL-6. Unfortunately this patient is still having uncontrolled systemic manifestation, while the other two patients showed partial response. In conclusion, Uni-centric castleman disease is a localized surgically cured disease. MCD treatment remains challenging, and the outcome is controversial, so Uniform treatment guidelines are mandatory.

Introduction: Childhood acute lymphoblastic leukemia (ALL) is a highly heterogeneous disease with distinct biological subgroups. Objective: To detect the incidence of the most common fusion gene transcripts in a large cohort of de novo Egyptian pediatric precursor B-ALL as well as relapsed cases for the first time in Egypt. To compare our results with other Western and Eastern countries to see if there is ethnic variation. Procedure: The study included 1080 consecutive patients with de novo precursor B-ALL and 58 relapsed cases with age ≤ 18 years that were admitted and treated at Children Cancer Hospital Egypt (CCHE) from July 2007 till December 2013. Diagnosis was established by morphological examination and immunophenotyping. All cases were subjected to cytogenetic and molecular analysis. RT-PCR was carried out to test for the most common fusion gene transcripts t(12;21) ETV6/RUNX1, t(1;19) TCF3/PBX1, t(9; 22) BCR/ABL and t(4; 11) MLL/AF4. Results: Out of 1080 newly diagnosed cases, ETV6-RUNX1 was found in 165 (15.3%), E2A-PBX1 in 74 (6.9 %), BCR-ABL in 41 (3.9%) and MLL-AF4 in 20 (1.9 %). The incidence in relapsed cases was 6.7%, 6.7%, 1.7% and 5.1% respectively. As regards immunophenotyping, ETV6-RUNX1 was highly correlated with CALL, E2A-PBX to Pre-B and MLL-AF4 to Pro-B (p 0.0001, 0.0001, 0.0001) while BCR-ABL was not related to any phenotype. As regarding age, all fusion genes were highly correlated to the age group 1-10 years (p 0.0001, 0.007, 0.0001) except MLL-AF4 was correlated to 0-1 age group (p 0.0001). As regards total leucocytic count (TLC), E2A-PBX1 and BCR-ABL were correlated to &lt; 50x103/µl and MLL-AF4 to &gt; 100x103/µl while ETV6-RUNX1 showed no correlation. ETV6-RUNX1 (15.3%) was much lower than that reported by United States and Western Europe that have range 19-26% with a median of 23% while it is nearly comparable with Far East range of 13.4-17.5%. BCR-ABL (3.9%) is a little bit higher than western 2% while lower than Far East 6.65%. E2A-PBX1 (6.9%) was little higher than Western 3-5% and Far East 4.9%. MLL-AF4 1.9% was comparable with both Western and Far East (2-3%). Comparison with Middle East which is of limited number of studies; ETV6-RUNX1 was higher than Iraq, Kuwait, and Jordan 12.1%, 11.7%, 12% but much lower than Saudi Arabia 21%. E2A-PBX1 was much higher than Kuwait, Iraq and Saudi Arabia (1.8%, 4.2%, and 4.2%). BCR-ABL was comparable.MLL-AF4 was comparable with Saudi Arabia (2.5%) but lower than Kuwait and Iraq (3.6%, 4.2%). About relapsed cases, ETV6-RUNX1, BCR-ABL and MLL-AF4 were much lower than Western Europe and Far East. Conclusion: These frequency differences of molecular markers in childhood ALL confirm the Ethnic and geographic variation. Other factors may play a role such as exposure to environmental oncogenic factors and of course differences among laboratories may play part in this difference. So we should put into consideration that this frequency difference may have important implication for prognosis, drug selection and treatment outcome. Citation Format: Dina Yassin, Sonya Soliman, Khaled Shaaban, Sherine Salem, Nayera Hamdy, Hala Reda, Iman Sidhom, Abeer Mokhles, Nesreen Aly, Amr EL Nashar, Wafaa Rashed, Mai Mahmoud, Sarah Hesham, Alaa ELHaddad. Prevalence of the most common fusion gene transcripts in 1080 Egyptian pediatric acute lymphoblastic leukemia patients: Children Cancer Hospital Egypt (CCHE) experience. [abstract]. In: Proceedings of the AACR Special Conference on Hematologic Malignancies: Translating Discoveries to Novel Therapies; Sep 20-23, 2014; Philadelphia, PA. Philadelphia (PA): AACR; Clin Cancer Res 2015;21(17 Suppl):Abstract nr B07.

Introduction::Neuroblastoma (NBL) is the most common extracranial solid tumor in children. It accounts for 15% of the deaths from cancer in the pediatric age group. Approximately half of the newly diagnosed children are at “high risk” (HR) of treatment failure. This study aim was to evaluate the impact of salvage chemotherapy ICE (ifosfamide, carboplatin, and etoposide) versus TC (topotecan/cyclophosphamide) when administered to NBL HR patients having residual bone marrow disease after primary tumor control on the first line treatment regimen.Materials and Methods:The present retrospective study included two groups of eligible stage 4 NBL patients with persistent bone marrow disease. Group (1), 29 patients, received ICE whereas less intensive TC was administered to Group (2), 32 patients. Data analysis included epidemiological variables, pathology subtype, MYCN gene status, primary tumor response and their correlation with bone marrow disease clearance on each regimen.Results:A higher tendency of complete bone marrow clearance was reported in patients who received ICE compared to TC; 41.4% versus 25.0%, respectively. However, the difference was not statistically significant (p= 0.174).Conclusion:TC regimen appears to be a good alternative to ICE as salvage treatment in an attempt to clear NBL bone marrow residual, with the privilege of being less toxic and can be given on outpatient basis. Further randomized trials of larger study sample size with survival impact analysis are warranted.