Cytogenetics has now been well established as one of the most valuable prognostic factors in acute myeloid leukemia (AML). This is the first study to describe the cytogenetic findings in Iranian AML patients. During 1998 to 2001, 104 patients with adult de novo AML (excluding M3) were diagnosed and treated with the standard protocols in our center. Adequate cytogenetic analysis performed on bone marrow at diagnosis was available in 39 of these patients. Clonal chromosomal abnormalities were detected in 74.4% of the patients. The chromosomal changes seen in this study in order of frequency were: t(9;22), trisomy 11 [n=4, 10.3%], trisomy 8, Abn (3q)[n=3, 7.7%], trisomy 22, monosomy 7/del (7q), monosomy X, complex karyotype [n=2, 5.1%], and t (8;21), t (6;9), trisomy 21, monosomy 5/del (5q), monosomy Y, and Abn (11q) [n=1, 2.6%]. We also categorized the patients into favorable (2.6%), intermediate (74.4%), and unfavorable (23.1%) prognostic groups based on the criteria defined by Grimwade et al in MRC-AML-10. The frequencies of different clinical and paraclinical indices were studied in these groups. Notably, complete remission (CR) rates after one cycle of chemotherapy were 60.0% and 25.0% in intermediate and unfavorable prognostic groups respectively. The overall CR rates were 83.3% and 66.6% in the mentioned groups.These findings are somewhat comparable to the results of the larger studies in other countries, suggesting the importance of cytogenetics in Iranian patients. The differences could be due to methodological variations (notably exclusion of AML-M3 in this study), and the small sample size, although ethnic and geographical differences should not be disregarded. To further clarify these results with statistical significance a larger analytical study with a greater sample size is certainly needed

Background: Blood cancer (leukemia) is the cancer of blood tissue and Acute Myeloid Leukemia (AML) is the third most prevalent type in Iran. Survival time after diagnosis and its risk factors are one of the most important indicators for assessing the treatment.Methods: Data for this prospective study belong to Valiasr 2 (Imam Khomeini Hospital) AML patients during 2008-2013. A total of 85 patients were enrolled and death time was considered as failure event for them. Kaplan-Meier method and Cox proportional hazard model were used to identify the risk factors of patient’s survival. The SPSS v.21 and SAS v. 9.2 were used for analysis of data and a=0.05 was considered as significant level.Results: Of 85 patients, 46 (54.1%) were male. The mean age at diagnosis time was 41.38 yr., and median survival time was 17.27, and 53 patients died. Age at diagnosis, marital status, smoking, bone marrow transplants, disease history, region, lodging and resistance to treatment, and some laboratory factors (such as the number of white blood cells and red blood cells, mean corpuscular hemoglobin, sodium, potassium and calcium) were significant on survival time of patients.Conclusion: Because of the importance of leukemia, especially the role of AML type in mortality, an emphasis on age at diagnosis, marital status, smoking, bone marrow transplant, disease history, region and resistance to treatment and some laboratory factors are very important in the prognosis of death in patients.

Purpose: Up-regulation of Mcl-1, a known anti-apoptotic protein, is associated with the survival and progression of various malignancies including leukemia. The aim of this study was to explore the effect of Mcl-1 small interference RNA (siRNA) on the proliferation and apoptosis of HL-60 acute myeloid leukemia (AML) cells.Methods: siRNA transfection was performed using LipofectamineTM 2000 reagent. Relative mRNA and protein expressions were quantified by quantitative real-time PCR and Western blotting, respectively. Trypan blue assay was performed to assess tumor cell proliferation after siRNA transfection. The cytotoxic effect of Mcl-1 siRNA on leukemic cells was measured using MTT assay. Apoptosis was detected using ELISA cell death assay.Results: Mcl-1 siRNA clearly lowered both Mcl-1 mRNA and protein levels in a time-dependent manner, leading to marked inhibition of cell survival and proliferation. Furthermore, Mcl-1 down-regulation significantly enhanced the extent of HL-60 apoptotic cells.Conclusion: Our results suggest that the down-regulation of Mcl-1 by siRNA can effectively trigger apoptosis and inhibit the proliferation of leukemic cells. Therefore, Mcl-1 siRNA may be a potent adjuvant in AML therapy.

Acute Myeloid Leukemia is a malignant and clonal hematopoietic disorder and accounts about 80% of adult acute leukemia's that presents as de novo or following MDS. It shows typical clinical and cytological pattern of presentation hence most of the time fatigue, fever and symptoms related to anemia, thrombocytopenia, neutropenia and rarely Leukostasis are the presenting symptoms. Hepatosplenomegaly presents in one third of the cases and Lymphadenopathy, extramedullary involvement are rarely seen except in monocytic variants.Isolated involvement of liver and bone is rare and lytic bone lesions have been reported only in few cases.In this case study we tried to report an uncommon occurrence of AML in a 21 y/o female who admitted in Rheumatology service as a spondilytis. She experienced low back pain, anorexia, sever weight loss, fever, tenderness of lumbar spines and head of left humorous together with limited left shoulder girdle movements, and hematocytologic and pathologic challenges were not clear enough for specific diagnosis.The clinical and Para clinical findings of the case looked uncommon for de novo leukemia or MDS-AML, hence close follow up of a medical student brought op the case into specific attention. Even thought there were so many questions left without clear answer but an uncommon progression, clinical and Para clinical presentation uncovered, that stressed the necessity of cytogenetic and molecular evaluation for diagnosis in malignant case of solid tumors as well as acute leukemias.

Nucleophosmin1 is a multifunctional protein that shuttles between nucleus and cytoplasm in some subtypes of acute myeloid leukemias. Mutated Nucleophosmin1 expresses aberrantly in the cytoplasm of the cell and transports from nucleolus to the cytoplasm. It is diagnosed by immunohistochemical techniques, flow cytometry assay and mutational analysis.The aim of this study is to evaluate the effects of Nucleophosmin1 mutation on the clinical presentations, prognosis, diagnosis and the treatment of acute myeloid leukemia. Thirteen articles were extracted from PubMed, Google scholar and Scopus in which the Nucleophosmin1 mutation correlated with gingival hyperplasia, high white blood cell count, lymphadenopathy, high platelet count and other signs and symptoms of myelomonocytic and monocytic acute myeloid leukemias.This mutation is a provisional entity in the classification of acute myeloid leukemia, which influences on the prognosis, clinical course and the treatment of some subtypes of acute myeloid leukemias. Nucleophosmin1 mutation has favorable prognostic value in the absence of other concomitant mutations.

A 62-year-old man diagnosed with acute myeloid leukemia (AML) showed limited responses to two courses of azacitidine (AZA)+Venetoclax (VEN) therapy. Twenty days after being transferred to our hospital, flow cytometry with broad antigen coverage and mutation analysis confirmed the presence of a second malignancy, hairy cell leukemia (HCL). Following haploidentical combined umbilical cord blood transplantation, the patient achieved complete remission (CR) for both AML and HCL. This CR has been maintained for the past 14 months. Patients with dual hematologic malignancies may not respond well to conventional therapy regimens. Early initiation of hematopoietic stem cell transplantation is beneficial for improving prognosis and extending overall survival.