P033 Quantification of CMV-specific T cell responses in immunosuppressed renal transplant recipients
Maura RossettiYael KorinTiffany SidwellGemalene SungaNicholas HarreTara K. SigdelSuphamai BunnapradistFlavio VincentiMinnie SarwalElaine F. Reed
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Immunophenotyping
Cytomegalovirus
Immunophenotyping
Minimal Residual Disease
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The RAM immunophenotype has been recently described as a subtype of acute myelogenous leukemia (AML) that is characterized clinically by extremely poor prognosis. We present a case of AML with RAM immunophenotype in a 5-year-old patient that resulted in poor outcome despite early hematopoietic cell transplant. We describe the unusual morphologic features that, along with the distinct immunophenotype, may provide initial diagnostic clues and further justify the classification of this AML variant as a rather distinct subtype.
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Objective To analyze the immunophenotype of acute lymphocytic leukemia(ALL) in children and its clinical presentation and prognosis.Methods Flow cytometry was used for immunophenotyping of 111 ALL child cases.The clinical characteristics,chemotherapy response and prognosis were compared among different immunophenotype groups.Results Three categories could be identified,including 81 cases(73.0%) of B lineage ALL,16 cases(14.4%) of T lineage ALL and 14 cases(12.6%) of B/T lineage ALL.There were 25 cases(22.5%) of ALL expressing myeloid-associated antigens.There was no relationship between FAB morphology classification and immunophenotype of ALL.T-ALL was significantly associated with markedly lymphadenopathy,splenomegaly,hepatomegaly,mediastinal mass,high white blood cell count and poor response in induction chemotherapy.The 3-year survival rates were 76.9% in B-ALL,75.0% in T-ALL and 83.3% in B/T-ALL.There was no significant difference between the My+-ALL and My---ALL of complete remission rates,3-year survival rates or relapse rates.Conclusion The immunophenotyping for estimation of the therapeutic effect and prognosis of ALL patients be combined with cytogenetics,molecular biology and clinical manifestations.
Immunophenotyping
Acute lymphocytic leukemia
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Over the last 10 years, immunophenotyping of haematologic malignancies has become an indispensable diagnostic supplement to the classical morphological approach. Immunophenotyping of haematopoietic cells is performed with the use of a number of monoclonal antibodies (MOABs), which are directed specifically against structures of blood cells that become expressed at the different stages of differentiation and maturation. Cells to which the fluorescently labelled MOABs are directed can be recognised and measured using fluorescence microscopy or fluorescence flow cytometry. Many MOABs, fluorochromes and user-friendly flow cytometers have become available in the last 15 years, as a result of which immunophenotyping is now routinely applied in clinical practice. Immunophenotyping has the potential to classify leukaemias and other malignant lymphomas according to cell type and stage of maturation. This information is important for the establishment of the right diagnosis and prognosis, and for the optimal treatment choice. In a number of cases immunophenotyping provides information which cannot be obtained by simple morphological investigation. The immunophenotyping of blood and bone-marrow cells is also a sensitive method for detecting minimal residual disease after an apparent complete remission has been achieved.
Immunophenotyping
Minimal Residual Disease
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Background: Acute leukemia area a group of neoplastic disorders characterized by proliferation and accumulation of immature hematopoeitic cells in bone marrow, blood, and other tissues. The present study was conducted to have a detailed understanding of immunophenotyping profi le, the morphologic and immunophenotypic discrepancy and importance of immunophenotyping in diagnosis of acute leukemia. Objectives: To study immunophenotyping profi le in acute leukemia (acute myeloid leukemia [AML], acute lymphoid leukemia, and mixed lineage leukemia) and to study its importance in diagnosis. Materials and Methods: This study was performed in Medical College, Jabalpur. 160 patients diagnosed morphologically with AML, acute lymphoblastic leukemia and mixed lineage leukemia seen were included in the study. Results: Only in 73% cases of acute leukemia did fi nd similarity in morphological appearance and immunophenotyping. In remaining 27% cases morphological fi ndings did not correlate with immunophenotyping expression. Diagnosis in these 27% patients changed after immunophenotyping. Conclusions: It is imperative and absolutely essential to ascertain the lineage of leukemia by immunophenotyping before starting on treatment as more than 25% of patients would not respond or later relapse if treatment is initiated on morphological diagnosis.
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Background: Acute leukaemia (AL) are a heterogenous group of haematological malignancy characterized by uncontrolled clonal proliferation of haematopoietic progenitor cells. Objectives: The study was conducted to have a detailed understanding of immunophenotyping profile, the frequency of discrepancy between bone marrow morphology and immunophenotyping and importance of immunophenotyping in diagnosis of acute leukaemia. Methods: This prospective type of observational study was carried out with an aim to correlate the immunophenotype with bone
marrow morphology and to see the discrepancy between this two in acute leukaemia. A total of 38 untreated acute leukemia patients attending in the Department of Haematology, Bangabandhu Sheikh Mujib Medical University, Dhaka, during the period from October 2016 to September 2017were included in this study. At first the morphological diagnosis was done. Then the immunophenotypic profile was compared. Result: Around eighty-two cases of acute leukaemia did find similarity with immunophenotyping and remaining 18.4% shows discrepancy. Diagnosis in this 18.4% changes after immunophenotyping. Aberrant phenotypes were detected in 20 (52.6%) samples among them 13 (34.21%) cases were AML, 3 (7.8%) cases were B-ALL and 4 (10.52%) cases were T-ALL. Significant relation was not found between aberrant marker and FAB subtypes. Conclusion: In acute leukaemia morphological appearance of bone marrow does not always match with immunophenotyping. It is therefore imperative and absolutely essential to ascertain the lineage of leukaemia by immunophenotyping before starting treatment.
Immunophenotyping
Hematology
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Despite the researchers’ efforts, the cause and development of breast cancer is still incompletely understood. Currently, in some reports, human cytomegalovirus has been referred as a risk factor for breast cancer. This study aimed to determine relative frequency of cytomegalovirus in tissue samples of women with breast cancer in Sanandaj County. In this study, to determine the relative frequency of the human cytomegalovirus (CMV) 50 formalin-fixed tissues of breast cancer, which all were invasive ductal carcinoma, were studied using the nested-polymerase chain reaction. In 26 cases of breast cancer tissues (26/50), human cytomegalovirus was detected. Seventeen cases of breast cancer tissues were in a moderately differentiated stage, and nine cases had poor-differentiated stage tissues that were positive for viral DNA. At older ages (>45 years) the prevalence rate of human cytomegalovirus DNA was higher, but no significant association was seen (p=0.16). In general, due to the high prevalence of the DNA of human cytomegalovirus (58%), in this study it is assumed that human cytomegalovirus (HCMV) has a contributing role in breast cancer; although more study is required to clearly define its part in this type of cancer.
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The possible correlation between cytomegalovirus, human herpesvirus types 6, 7 and cytomegalovirus-related clinical symptoms was studied in kidney transplant patients in Kuwait. Cytomegalovirus infection was diagnosed using the pp65 antigenemia assay. DNA of cytomegalovirus was detected by nested polymerase chain reaction (nested-PCR). PCR was also used to amplify the genes coding for structural proteins of human herpesvirus-6 (240 bp) and human herpesvirus-7 (186 bp). Glycoprotein B genotypes of cytomegalovirus were determined by restriction fragment length polymorphism. The average number of cells positive for cytomegalovirus pp65 antigen showed a steady increase with the severity of the cytomegalovirus-related symptoms. Furthermore, cytomegalovirus pp65 antigen positivity was significantly more frequent among recipients of cadaver kidney (45.5%) than among those who received live related kidneys (22.6%). Cytomegalovirus gB genotype 1 was detected more frequently (P<0.036) in recipients with live related donor kidney (38%) than in patients of cadaver kidney (13%). The genome of human herpesvirus-6 was detected at the same rate in patients with or without cytomegalovirus-related symptoms. However, the genome of human herpesvirus-7 was detected significantly more frequently (P<0.0001) in asymptomatic patients (41.7%) than in recipients with symptomatic cytomegalovirus infection (17%). We conclude that cytomegalovirus gB genotypes are not associated with the outcome of a cytomegalovirus infection in kidney transplant patients, that human herpesvirus-6 does not play a role in cytomegalovirus pathogenesis and that the role of human herpesvirus-7 in cytomegalovirus-related morbidity in kidney recipients remains unclear.
Cytomegalovirus
Betaherpesvirinae
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Since murine cytomegalovirus (MCMV) was first described in 1954, it has been used to model human cytomegalovirus (HCMV) diseases. MCMV is a natural pathogen of mice that is present in wild mice populations and has been associated with diseases such as myocarditis. The species-specific nature of HCMV restricts most research to cell culture-based studies or to the investigation of non-invasive clinical samples, which may not be ideal for the study of disseminated disease. Initial MCMV research used a salivary gland-propagated virus administered via different routes of inoculation into a variety of mouse strains. This revealed that the genetic background of the laboratory mice affected the severity of disease and altered the extent of subsequent pathology. The advent of genetically modified mice and viruses has allowed new aspects of disease to be modeled and the opportunistic nature of HCMV infection to be confirmed. This review describes the different ways that MCMV has been used to model HCMV diseases and explores the continuing difficulty faced by researchers attempting to model HCMV congenital cytomegalovirus disease using the mouse model.
Cytomegalovirus
Betaherpesvirinae
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Objective To study the relationship of immunophenotype and FAB phenotype and guide clinical analysis and treatment.Methods Cell morphology checking and immunophenotyping were performed at the same time for the 505 patients with leukemia,flow cytometry had used for immunophenotype,on the end the results had been analyzed to understand the relationship between the two phenotypes.Results ①Among the 505 cases of leukemia,there were AML(248)、ALL(200)、CML(18)、CLL(15)、HAL(14)、UAL(10) in FAB phenotype and AML(163)、Ly+AML(83)、ALL(108)、My+ALL(106)、HAL(32)、UAL(13) in immunophenotype.② In AML the accordance rate and part accordance rate of the two phenotypes was 61.3% and 30.2%.In ALL the accordance rate was and part accordance rate was 53% and 44.5%.In HAL the accordance rate was 42.9%.Conclusion Immunophenotype plays an important role to distinguish AML、ALL subtype、variants leukemia and HAL.Immunophenotyping was shaper and more accurate than FAB phenotype,and is a supplementary and correction,but it can not replace the FAB phenotype.Combination of both can improve the diagnostic accuracy.
Immunophenotyping
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