Clofarabine in the Treatment of Elderly Patients with Acute Myeloid Leukemia

Aleem, Aamer,Anjum, Farhan,Algahtani, Farjah,Iqbal, Zafar,Alsaleh, Khalid,AlMomen, Abdulkareem Asian Pacific Journal of Cancer Prevention 2013 Asian Pacific journal of cancer prevention Vol.14 No.2

Background: Elderly patients with acute myeloid leukemia (AML) have a poor outcome because of co-morbidities, poor tolerance to intensive chemotherapy and inherently more resistant disease. Clofarabine is a second generation nucleoside analogue which has shown promising activity in elderly patients with AML. This study was conducted to review the outcome of treatment with clofarabine in a group of such patients. Methods: The records of 5 elderly patients who were diagnosed to have AML and treated with clofarabine over a 12 month period were reviewed retrospectively. Results: There were 2 female and 3 male patients with a median age of 68 years (range 65-82). At the time of treatment, 2 patients had newly diagnosed AML not considered suitable for intensive therapy, while 3 patients had partial or no response to conventional chemotherapy. The overall response rate was 100%, all patients achieving a complete remission. Induction and consolidation were well tolerated. All patients developed neutropenia with a median duration of 20 days (range 17-42). One patient developed hand and foot syndrome and a generalized rash but recovered. There was no mortality and all patients remained in remission after a median follow-up of 5.2 months (Range 3-10). Conclusion: Clofarabine (alone or in combination) is active in elderly AML patients with an acceptable safety profile and should be considered a potential option in this group.

Frequency, Clinical Pattern and Outcome of Thrombosis in Cancer Patients in Saudi Arabia

Aleem, Aamer,Diab, Abdul Rahman Al,Alsaleh, Khalid,Algahtani, Farjah,Alsaeed, Eyad,Iqbal, Zafar,El-Sherkawy, Mohamed Sherif Asian Pacific Journal of Cancer Prevention 2012 Asian Pacific journal of cancer prevention Vol.13 No.4

Objectives: Thrombotic risk is increased in patients with cancer and there are important implications for those who suffer a venous thromboembolism (VTE). We undertook this study to determine the frequency, clinical patterns, and outcome of VTE in Saudi patients with cancer. Methods: Cancer (solid tumors and lymphoma) patients who developed VTE from January 2004 to January 2009 were studied retrospectively. Demographics and clinical characteristics related to thrombosis and cancer were evaluated. Results: A total of 701 patients with cancer were seen during the study period. VTE was diagnosed in 47 (6.7%) patients (median age 52, range 18-80 years). Lower limb DVT was the most common type, seen in 47% patients, followed by PE in 19%, and 19% patients had both DVT & PE. Thrombosis was symptomatic in 72% patients while it was an incidental finding on routine workup in 28%. Cancer and VTE were diagnosed at the same time in 38% of patients, and 47% patients developed VTE during the course of disease after the cancer diagnosis. The majority of VTE post cancer diagnoses occurred during the first year (median 4 months, range 1-14). Additional risk factors for VTE were present in 22 (47%) patients and 14 (30%) of these patients were receiving chemotherapy at the time of thrombosis. Only 5 (10.6%) patients were receiving thrombo-prophylaxis at the time of VTE diagnosis. Most common types of tumors associated with thrombosis were breast cancer, non-Hodgkin's lymphoma and lung cancer. The majority of the affected patients (79%) had advanced stage of cancer. After a median follow-up of 13 (range 0.5-60) months, 38 (81%) patients had died. There was no difference in the mortality of patients with symptomatic or asymptomatic thrombosis (82% vs 78.6%). Conclusions: Thrombotic complications can develop in a significant number of patients with cancer, and almost half of the patients have additional risk factors for VTE. Thrombosis is usually associated with advanced disease and can be asymptomatic in more than a quarter of cases. Thromboprophylaxis in cancer patients is under-utilized. Community based studies are needed to accurately define the extent of this problem and to develop effective prophylactic strategies.

Poster Session : PS 0415 ; Infectious Disease ; QuantiRERON-TB Gold In-Tube in the Prevalence of Latent Tuberculosis Infection among Healthy Saudi Population

( Jamal Al Wakeel ),( Ziyad Makoshi ),( Mohammed Al Ghonaim ),( Ali Al Harbi ),( Abdulkareem Al Suwaida ),( Farjah Algahtani ),( Mogbil Al Hedaithy ),( Sultan Almogairin ),( Sami Habiballa Abdullah ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1

Background: Mycobacterium tuberculosis infection is the result of large number of morbidity and mortality worldwide. Saudi Arabia has an incidence rate ranged between8.6 and 12.2/100,000. QuantiFERON-TB Gold in-tube is approved to detect latent tuberculosis infection and TB disease. We conduct this study to estimate the prevalence of latent Tuberculosis in healthy population in Saudi Arabia and detect the sensitivity, specifi city and positive and negative predictive values for QuantiFERON-TB Gold in-tube. Methods: A cross-sectional study of blood sampling for QuantiFERON-TB Gold intube testing took from healthy blood donor were recruited from blood bank at King Saud University (KSU) and volunteers from Riyadh region, with further contact and follow up for positive results for two years for activation of latent tuberculosis. The study supported by King Saud University and King Abdul-Aziz City for Science and Technology. Project number ARP-245-29. Results: The study consists of 563 participants, their mean age was 34.2±13.17 year, 292 (51.9 %) male and mean BMI was 27.5 ±5.53 kg/m2. 363 (65.6%) had a BCG scar, the contact to the TB patients represented by 33 (5.9%) and 7 (1.2%) had a previous TB infection. Positive result for QFT-GIT was found in 72 (12.8%) participants, 48 (69.6%) of them had a BCG scar, only 2 (2.8%) and 4 (5.6%) had history of previous TB and contact of TB patients, respectively. Our study showed sensitivity of 90.62% (75-98%) and specificity of 91.53% (89-94%) with a positive predictive value of 39.19% (28-51%) and negative predictive value of 99.39% (98-99.9%) Conclusions: In face of reduction of the limits of other technique, QFT-GIT is not a signifi cant in diagnosis of latent TB. However, it is signifi cant in ruling out the presence of disease.

Thromboprophylaxis after bariatric surgery

Feras M. Almarshad,Mosaad Almegren,Turki Alshuaibi,Nadiah Alobaodi,Ali Almutawa,Hajer Basunbl,Farjah AlGahtani,Bader Al Rawahi 대한혈액학회 2020 Blood Research Vol.55 No.1

BackgroundVenous thromboembolism (VTE), which includes deep vein thrombosis (DVT) and pul-monary embolism (PE), is a known cause of morbidity and mortality after bariatric surgery. However, the data concerning appropriate thromboprophylaxis after bariatric surgery is uncertain. The objective of this study was to evaluate the efficacy and safety of extended duration thromboprophylaxis in post-bariatric surgery patients.MethodsWe conducted a retrospective study of consecutive patients who underwent bariatric sur-gery from November 2014 to October 2018 at King Fahad General Hospital in Jeddah, Saudi Arabia. All included patients were treated with extended duration thromboprophylaxis.ResultsWe identified 374 patients who underwent bariatric surgery during the study period. Of these, 312 patients (83%) were followed for at least 3 months. The most common type of surgery was a laparoscopic sleeve gastrectomy (N=357) and the median weight was 110 kg. The cumulative incidence of symptomatic postoperative VTE at 3 months was 0.64% (95% confidence interval, 0.20‒1.52). All events occurred after hospital discharge. The most commonly used pharmacological prophylaxis (91%) for VTE prevention after bariatric surgery was enoxaparin 40 mg subcutaneously twice daily for 10‒14 days after hospital discharge. There were no reported cases of bleeding or VTE related mortality after 3 months.ConclusionExtended thromboprophylaxis after bariatric surgery appears to be an effective and safe strategy for VTE prevention. Large prospective studies are needed to evaluate the optimal thromboprophylaxis regimen after bariatric surgery.