Chronic exposure of BTX (benzene, toluene, xylene) may lead to progressive degeneration of bone marrow, aplastic anemia and/or leukemia. In Brazil there is no self-service fuel in gas stations and attendants fill the fuel themselves. Due to this they are chronically exposed to high concentration of BTX. Occupational exposure to benzene has been associated with increased chromosomal aberrations in peripheral blood lymphocytes. Fluorescence in situ hybridization (FISH) using whole chromosome painting (wcp) probes allows the rapid detection of chromosomal aberration. In the present study three-color wcp probes for chromosomes 1, 2 and 4 were used for monitoring 60 gas station attendants.
27 September 2011 in Journal of Hematology & Oncology
A 54-year-old woman was diagnosed with infiltrative ductal breast carcinoma. Two years after treatment, the patient developed an acute myeloid leukemia (AML) which harbored del(11q23) in 8% of the blast cells. The patient was submitted for allogeneic stem cell transplantation (aSCT) from her HLA-compatible sister. Ten months after transplantation, she relapsed with an AML with basophilic maturation characterized by CD45low CD33high, CD117+, CD13-/+, HLA Drhigh, CD123high, and CD203c+ blast cells lacking expression of CD7, CD10, CD34, CD15, CD14, CD56, CD36, CD64, and cytoplasmic tryptase. Karyotype analysis showed the emergence of a new clone with t(2;14) and FISH analysis indicated the presence of MLL gene rearrangement consistent with del(11q23). Interestingly, AML blast cell DNA tested with microsatellite markers showed the same pattern as the donor's, suggesting that this AML emerged from donor cells. Additionally, polymorphisms of the XPA, XPD, XRCC1, XRCC3 and RAD51 DNA repair genes revealed three unfavorable alleles with low DNA repair capacity.
Central nervous system involvement is considered a rare complication of chronic lymphocytic leukemia, and so there is the risk of being overlooked. We report a case of central nervous system involvement in a 75-year-old mulatto woman with chronic lymphocytic leukemia after 5 years of follow-up and a literature review on the subject. The clinical course, treatment and outcome are described. A systematic, meticulous and comprehensive analysis of existing publications regarding chronic lymphocytic leukemia with central nervous system involvement was performed. We concluded that central nervous system involvement of chronic lymphocytic leukemia is probably not associated with any evident risk factors. Diagnostic approach differs by institutions but often includes imaging, morphology and flow cytometry. Resolution of central nervous system symptoms can usually be accomplished with intrathecal chemotherapy or irradiation followed by systemic treatment. The recognition of this entity by clinicians could lead to early detection and treatment, resulting in better outcomes in this rare complication.
Brazilian gas station workers are chronically exposed to benzene, toluene, xylene (BTX) during their working time. Describe below two cases of latin female gas station workers with benzene poisoning symptoms and miscarriage history. In both cases were identified complex chromosomal rearrangements (CCR) with fluorescence in situ hybridization, applied to whole chromosome paints by chromosomes 1, 2 and 4. The lower natural killer cell (NK) cells have also been observed in cases correspondents, especially the rare type of NK (NKbright) in their peripheral blood cells. It is known that acquired chromosomal aberrations are positively correlated with cancer and reproductive risk. In concordance, lower NK cytotoxicity increases the risk for cancer, as well. Thus, this is the first study providing hints on a possible causative relation of lower NK cytotoxicity and increase rates of chromosomal rearrangements including CCRs.
Performance of qualified professionals committed to cancer care on a global scale is critical. Nevertheless there is a deficit in Cancer Education in Brazilian medical schools (MS). Projects called Academic Leagues (AL) have been gaining attention. However, there are few studies on this subject. AL arise from student initiative, arranged into different areas, on focus in general knowledge, universal to any medical field. They are not obligatory and students are responsible for the organizing and planning processes of AL, so participation highlights the motivation to active pursuit of knowledge. The objective of this study was to explore the relevance of AL, especially on the development of important skills and attitudes for medical students. A survey was undertaken in order to assess the number of AL Brazilian MS. After nominal list, a grey literature review was conducted to identify those with AL and those with Oncology AL. One hundred eighty of the 234 MS were included. Only 4 MS selected held no information about AL and 74.4 % of them had AL in Oncology. The majority had records in digital media. The number of AL was proportional to the distribution of MS across the country, which was related to the number of inhabitants. The real impact and the potential of these projects can be truly understand by a qualitative analysis. AL are able to develop skills and competencies that are rarely stimulated whilst studying in traditional curriculum. This has positive effects on professional training, community approach through prevention strategies, and development on a personal level permitting a dynamic, versatile and attentive outlook to their social role. Besides stimulating fundamental roles to medical practice, students that participate in AL acquire knowledge and develop important skills such as management and leadership, entrepreneurship, innovation, health education, construction of citizenship. Oncology AL encourage more skilled care to patients and more effective policies for cancer control.