Prognostic Impact on Survival of Early Relapse after Autologous Stem Cell Transplantation with Non-cryopreserved Stem Cells for Multiple Myeloma in Real Life: A Single-center Cohort Study from Oran (Algeria)

Background: Few studies have examined survival outcomes in relapsed childhood acute myeloid leukemia (AML) in resource-limited countries. This study aimed to evaluate the prognostic factors and survival outcomes of relapsed childhood AML in Thailand. Methods: The medical records of AML patients aged 0-15 years treated in a major tertiary center in Southern Thailand between December 1979 and December 2019 were reviewed retrospectively. The overall survival (OS) was calculated using the Kaplan-Meier method. Results: A total of 316 AML patients were included and relapse occurred in 98 (31%) patients. Of these, 57 (58.2%) and 41 (41.8%) patients had early [≤1 year from first complete remission (CR1)] and late (>1 year from CR1) relapses, respectively. Only 54 (55.1%) patients received chemotherapy after relapse. The 3-year OS of all relapsed patients was 3.5%. The 3-year OS of patients with early and late relapse were 0% and 8.5%, respectively (p=0.002). The 3-year OS of patients who received chemotherapy and those who did not were 6.5% and 0%, respectively (p <0.0001). The median survival time of patients who did not receive chemotherapy was 1.7 months. The 3-year OS of patients who achieved second complete remission (CR2) and those who did not were 12.6% and 0%, respectively (p <0.001). Conclusion: The relapsed AML rate was 31% and the survival outcome was poor with a 3-year OS of 3.5%. The adverse prognostic factors were early relapse, failure to achieve CR2 and those who did not receive chemotherapy after relapse.

Section: Discussionmentioning

confidence: 99%

Relapsed Childhood Acute Myeloid Leukemia: Experience from a Single Tertiary Center in Thailand

Songthawee

Sripornsawan

Chavananon

et al. 2022

“…Till now there are different staging methods have been introduced and some became applicable in clinic or laboratories, for instance Mohammad et al, (2019) introduced staging based on Beta2 microblubolin, percentage of bone marrow plasmacells, serum free light chaing (FLC), serum protein electrophoresis, and serum and urine immunofixation, by this approche the biochemical staging of the MM introduced three stages Mohammad et al, (2019), by the way some researches have been established the predictive or prognostic factors (Bekadja et al, 2022) based on clinical or biochemical factors.…”

Section: Introductionmentioning

confidence: 99%

Serum Levels of Interleukin-1β and Disease Progression in Multiple Myeloma Patients: A Case and Control Study

Nobari

Rasmi

Ansari

2022

Objective: Multiple myeloma (MM) is known as an incurable heterogeneous plasma cell malignancy that presents with a variety of clinical manifestations. Inflammation plays an important role in this disease. Cytokines and Chemokines cause the progression of the disease. One of them is interleukin-1β (IL-1β), which may be involved in the pathogenesis of MM. Other markers such as calcium, albumin, creatinine, globulins, and total protein are also used to diagnose and prognosis patients. The main purpose of this study was to evaluate the serum level of IL-1β and various forms of calcium (total calcium, ionized calcium, and corrected calcium), albumin, creatinine, globulin, and total protein on stage-I of MM patients and healthy controls. Methods: Serum samples from 30 stage-I MM patients and 30 healthy subjects as controls were examined in this study. The protein concentrations of serum IL-1β was assessed by enzymelinked immunosorbent assay (ELISA), total calcium, albumin, creatinine, total protein, and globulin Measured by auto analyzer BT3000, an electrolyte analyzer was used to measure ionized calcium (Ca++) and a special equation was used to calculate the corrected calcium. Result: The mean level of IL-1β was significantly elevated in stage-I MM. The mean levels of IL-1β were 7.04±1.15 ng/ml in stage-I MM and 3.12± 0.90 ng/ml in controls (p<0.001). The mean levels of total calcium (total Ca) were 9.45±0.56 mg/dl in stage-I MM and 9.09±0.43mg/dl in controls (p=0.008). The mean levels of ionized calcium (Ca++) was 4.65±0.28mg/dl in stage-I MM and 4.75±0.33mg/dl in controls (p=0.2). The mean ratio of serum ionized calcium to total calcium (Ca++/ total Ca) was 0.49±0.054 in stage-I MM and 0.52±0.047 in controls (p=0.02). The mean ratio of serum ionized calcium to corrected calcium (Ca++/corrected Ca) was 0.42±0.033 in stage-I MM and the Mean ratio of serum ionized calcium to calcium total (Ca++/ total Ca) was 0.52±0.047 in controls, Comparison of the mean of the two groups shows a significant difference (p<0.001). The mean level of albumin was 1.72±0.35 g/dl in stage-I MM and4.32±0.41g/dl in controls (p<0.001). The mean level of total protein was 12.65±0.81g/ dl in stage-I MM and 7.07±0.4 g/dl in controls (p<0.001). The mean level of globulin was 11.00±0.96 mg/dl in stage-I MM and 2.85±0.77 mg/dl in controls (p<0.001). The mean level of creatinine was 1.15±0.25 mg/dl in stage-I MM and 0.96±0.15 mg/dl in controls (p=0.001). Conclusion: The results of the study indicate the possible involvement of IL-1β at stage-I MM and it can indicate the role of chemokines in the disease process, especially in the early stages. Changes in the chemical profiles mentioned can help in the diagnosis and prognosis of the disease.

“…Multiple myeloma (MM) is a treatable but incurable cancer. High expression of abnormal M protein in blood and urine will accumulate and result in organ dysfunction such as bone damage and kidney problems, then the patient becomes symptomatic (Khalife et al, 2021;Bekadja et al, 2022).…”

Section: Introductionmentioning

confidence: 99%

Cancer Stem Cells as a Prognostic Biomarker and Therapeutic Target Using Curcumin/ Piperine Extract for Multiple Myeloma

Mekkawy

Abdalla²,

Omran³

et al. 2022

Background: Multiple myeloma (MM) is a hematological bone marrow malignancy that can be treated but is usually fatal. Medication resistance is the major cause of relapses due to cancer stem cells (CSCs). As a result, this study aimed to identify multiple myeloma cancer stem cells (MMCSCs) in the bone marrow of twelve MM patients with pathological complete response (pCR) after chemotherapy and to investigate the potential effect of Curcumin/Piperine (C/P) extract as an anti-MMCSCs treatment in twenty newly diagnosed patients. Methods: This study included twenty bone marrow (BM) samples from newly diagnosed MM patients and twelve BM samples from pCR patients after a year of treatment. The MTT test was performed to assess the treatment’s effective dosage. A flow cytometer was used to identify MMCSCs, cell cycle profile, extract’s apoptotic activity, and proliferation marker in the selected samples. Also, a colony formation test and stemness protein were investigated. Results: In newly diagnosed MM patients, the C/P extract suppressed MMCSCs by 64.71% for CD138-/CD19- and 38.31% for CD38++. In MM patients’ samples obtained after one year of treatment, the MMCSCs inhibition percentage reached 44.71% (P < 0.008) for CD138-/CD19- and 36.94% (P < 0.221) for CD38++. According to cell cycle analyses, the number of cells treated with C/P extract was significantly reduced in the S and G0/G1 phases (87.38%: 35.15%, and 4.83%: 2.17% respectively), with a rapid increase in the G2/M phases (1.1%: 2.2%.). MMCSCs apoptosis was identified using a flow cytometer and Annexin-V. Multiple myeloma stem cell (MMCSC) proliferation was inhibited. Clonogenicity was suppressed by 60%, and stemness protein expression was reduced by 70%. Conclusion: MMCSCs in the bone marrow of MM-pCR patients can be utilized as a prognostic tool to predict recurrent multiple myeloma incidence. Also, the therapeutic potential of C/P extract as a prospective anti-MM drug targeting MMCSCs.