Day 1 :
Keynote Forum
Magnus S Magnusson
University of Iceland, Iceland
Keynote: T-patterns and self-similarity from protein to the cell to human mass-societies
Biography:
Magnus S Magnusson, Research Professor, University of Iceland. He did PhD in 1983, University of Copenhagen. He is the author of the T-pattern model regarding the real-time organization of behavior, co-directed a DNA analysis. Numerous papers. Talks and keynotes at international mathematical, neuroscience, proteomics, bioinformatics, religion and nanoscience conferences. Deputy Director 1983-1988 in the Museum of Mankind, Paris. Invited Professor in psychology and biology of behavior at the University of Paris (V, VIII, XIII). Since 1991, founder and director of the Human Behavior Laboratory in formalized collaboration with 32 European and American universities based on “Magnusson’s analytical model” initiated at University Paris V, Sorbonne, in 1995.
Abstract:
Beginning in the early 1970’s, this longstanding primarily ethological (i.e., biology of behavior) project concerning social interaction and organization in social insects and primates including humans, was initially inspired mainly by the work of N. Tinbergen, who with K. Lorenz and von Frisch shared the Nobel Prize in Medicine or Physiology in 1973 for “for their discoveries concerning organization and elicitation of individual and social behavior patterns". Lorenz’ Nobel lecture was entitled “Analogy as a source of knowledge”. The smallest creatures they studied were social insects and there was no mentioning of self-similarity or any nanoscale actors nor of Cell Societies (better-named protein societies) where behavioral and organizational analogies now appear across more than 10 orders of magnitude in size and billions of years of evolution from the RNA world to protein societies (Cell Cities) to the very recent human mass-societies. The present project has focused on behavioral real-time pattern definitions and their validation through corresponding detection algorithms and software THEMETM (see hbl.hi.is and patternvision.com) and has resulted in the self-similar fractal-like T-pattern recurring with statistically significant translational symmetry. Detection in animal and human interactions and later in brain cell interactions has followed showing T-patterned self-similarity of interaction between and within brains (Magnusson et al., 2016; Casarrubea, 2015) as well as in DNA. Moreover, T-pattern based self-similarity appears in social behavior and organization from “Cell City” (protein cities) to the only large-brain mass-societies appearing in a biological eye-blink; those of modern humans. Absent from the mass-societies of insects (hives) and cells (animal bodies), long T-patterned strings external to and more durable than the citizens, are essential in protein and human mass-societies. That is, strings of molecules in protein cities, but of letters in human cites after the gradual but fundamental invention of writing and standardized and massively copied, distributed, promoted and enforced letter strings (texts) called legal or holy and finally allowing the development of modern science and technology and mass-societies. Human and protein citizens formed with external T-patterned strings are now known to do string controlled social work in complex societies. Such self-similarity from nano to human mass-social scales providing possibilities of deeper understanding at all levels.
Keynote Forum
Petz Lawrence
StemCyte, Inc USA
Keynote: Progress toward curing HIV with cord blood transplantation
Biography:
Petz Lawrence serves as Chief Medical Officer of StemCyte, Inc. He serves as a Co-Medical Director of StemCyte International Cord Blood Center (US) of StemCyte, Inc. He is a founder and organizer of the annual International Symposium on Cord Blood Transplantation. He served as a Director of Transfusion Medicine and Professor of Pathology and Laboratory Medicine of UCLA Medical Center. He served as Section Head of Hematology and Director of the Department of Clinical and Experimental Immunology of City of Hope National Medical Center. He served as Chairman of Advisory Board of StemCyte, Inc. He has received almost all the highest honors in transfusion medicine, including the Emily Cooley Award and Morten Grove-Rasmussen Memorial Award from the American Association of Blood Banks, the Transfusion Medicine Academic Award from National Heart, Lung and Blood Institute, the Owen Thomas Award from the California Blood Bank Society. He received Tibor Greenwalt Memorial Award and Lectureship for 2006. He is a Diplomate in Internal Medicine and subspecialty board Diplomate in Hematology.
Abstract:
In 2007 a patient who was infected with HIV and who also had acute myelogenous leukemia received a hematopoietic cell transplant using stem cells from an adult donor who had a homozygous CCR5 mutation (CCR5-/-). Persons with this mutation are known to be resistant to infection by HIV and, indeed, the patient was cured of his HIV as well as leukemia. This patient remains the only person to have been cured of HIV. This cure has not been repeated because the CCR5-/- mutation is very unusual and transplants using stem cells from adults require a very close HLA match between donor and patient. Cord blood transplants require significantly less stringent HLA matching, and thus it is more feasible to transplant HIV-infected patients with CCR5-/- donor cells from cord blood. Combined haploidentical and cord blood (haplo/cord) transplantation eliminates two problems associated with cord blood transplants, i.e., prolonged time to engraftment and cell dose needs. Inventories of hundreds of cryopreserved CCR5-/- cord blood units have been developed and are now available for transplantation, and one such transplant was performed in 2017. Further, an estimated 800,000 cryopreserved cord blood units exist worldwide which indicates that transplantation with CCR5-/- cord blood units is feasible for large numbers of patients. Cure of HIV is very important because even patients who are adequately treated with antiretroviral drugs for HIV are not protected from serious adverse effects of long-standing HIV infection, including the life-long stigma associated with the infection. Cure by transplantation is also economically beneficial because the estimated lifetime cost for persons who become infected with HIV at age 35 is ~$326,500. A rigidly held opinion by many is that patients with HIV should not be transplanted with intent to cure the infection unless they also have an underlying indication for a transplant such as leukemia. However, even in this antiretroviral era, thousands of patients die of HIV annually, and it is our opinion that the serious adverse effects of long-standing HIV are greater than the adverse effects of haplo/cord transplants of young HIV-infected patients who have no co-morbidities. The time has come to accelerate research on this topic of tremendous public health potential including transplantation of CCR5-defective cells, especially those derived from cord blood.
Keynote Forum
Niranjan Bhattacharya
Calcutta School of Tropical Medicine, India
Keynote: Placental umbilical cord whole blood transfusion in an emergency when the hemoglobin concentration is less than 8gm percent in pediatric to the geriatric age group from 1999
Biography:
Niranjan Bhattacharya, Head of the Department, Regenerative Medicine and Translational Science, Calcutta School of Tropical Medicine, Kolkata, India. He is credited as the first person to conduct more than 1,200 cord blood transfusions in patients with severe anemia (less than 8gm/100ml) without the report of single adverse event. Long-term follow-up studies confirm that nearly all patients achieved a sustainable rise in hemoglobin levels, imparting a positive impact on background conditions. The following method of cord blood transfusion under the titles “A study on Human Umbilical Cord Blood Transfusion in Case of Bone marrow suppression” and “Placental Umbilical Cord Whole Blood Transfusion” is also globally patented by the Department of Science and Technology, India. He is credited with setting up India’s first public cord blood bank and is the one of the few clinical researchers in India to get a Doctor of Science Award in Obstetrics and Gynaecology for his award-winning work on “Intra-amniotic antigenic disruption of human fetal growth: search for a new safe and cheaper method of abortion in third world countries.
Abstract:
We conducted over 1260 cord blood transfusions in consented volunteers with anaemic (Haemoglobin less than 8gm/100ml) from 1999 till date in children and adults for various indications of transfusion-caused by Cancer to Malaria, Leprosy, HIV, Rheumatoid arthritis, Tuberculosis, Thalassaemia only to name a few. Not a single case of immediate or delayed graft vs host or other immunological or nonimmunological reaction was noted in any of the patients. Stem cells (0.01% nucleated cells) is used for stem cell transplantation purposes only, while the rest, i.e., 99.99% is discarded. But the discarded part has many potential uses in resource-restricted countries for transfusion purposes, after due screening for the transfusion-transmitted diseases like HIV (1&2) or Hepatitis B/C etc. Cord blood is practically free from infection due to the structural or functional integrity of the placental barrier up to 34-35 weeks. This makes the fetal blood practically free from infection apart from its intrinsic hypoantigenicity in nature, an altered metabolic profile and, is enriched with growth factors and inflammatory and noninflammatory cytokine filled plasma. This blood with 60-70 percent fetal hemoglobin content which has the potentiality to carry at least 60 percent more oxygen than adult and its use can be extremely beneficial in case of attempted revival after cardiac arrest. The placental vessel at term contains approximately 150ml of cord blood. Cord blood contains three types of hemoglobin, HbF (major fraction), HbA (15-40%) and HbA2 (trace amounts). HbF, which is the major component, has a greater oxygen binding affinity than HbA. The blood volume of a fetus at term is around 80-85ml/kg
Keynote Forum
Chiara Pride
Trinity University, USA
Keynote: The efficacy of trauma-informed and structurally-competent models of HIV testing and treatment by healthcare centers in addressing stigma and health disparities within marginalized communities
Time : 11:30-12:10
Biography:
Chiara Pride is an undergraduate researcher at Trinity University in San Antonio, TX. She is researching the double-edged sword of epidemiology as a tool for incredible healing and a contributor to biosocial isolation. She is also a performer with the “End Stigma, End HIV/AIDS: Forum Theatre Project”. Her theatre team has crafted impromptu scenes, drawn from interviews with local PLWH, illustrating clinician and family stigma and presents them to HCs and community centers. The audience may intervene to halt oppressive actions thereby fostering a dialogue on the importance of empathy and compassion, something Chiara hopes to do with her future scholarship.
Abstract:
People living with HIV (PLWH) in marginalized communities face oppression from their social network while navigating their illness amidst systemic resource deprivation. A vast network of federal agencies and community health centers (HCs) are devoted to helping control HIV among these acutely affected populations. Moreover, the United States’ epidemiological community is cognizant of the difficult lived experiences of individuals who are newly diagnosed with HIV, including the challenges they face while “coping with the reactions of others to a stigmatizing illness” (CDC, 2015). HCs however, struggle to transform their technical understanding of biosocial suffering into interventions that simultaneously address the social determinants of health, structural barriers to care, and trauma. This paper places the interviews of 33 San Antonio residents, at-risk for HIV or seropositive, in conversation with current medical anthropology and public health literature to examine the efficacy of trauma-informed and structurally-competent models of healthcare. As HCs combat stigma and health disparities within marginalized communities, these models may supplement the ‘biomedicalization’ of the clinical encounter. The larger study from which this paper is drawn interviewed mostly Latino men who have sex with men (MSM) about their experiences with HIV testing and treatment. The participants discussed their fears of rejection, traumas, and negative encounters with testing and treatment in relation to stigma and poor health outcomes. HIV/AIDS care that is rooted lived experiences like these, when combined with an applied scholarly understanding of structural violence and trauma, may result in greater positive outcomes along the ‘care continuum’ for marginalized communities.
Keynote Forum
Sanjukta Bhattacharya
Jadavpur University, India
Keynote: Ethics of human fetal tissue transplant: Some observations
Time : 12:10 -12:50
Biography:
Sanjukta Bhattacharya, currently retired, was a Professor of International Relations at Jadavpur University, Kolkata, India, for over 25 years till June 2016. Prior to that, she taught at Gargi College, Delhi University, and in Delhi University (American History) for 10 years. She has a Master’s degree in History from Delhi University and a PhD from Jawaharlal Nehru University in International Relations, New Delhi (specialization in American Studies). She has received the prestigious Fulbright Award twice (1987-88 and 2004), the first time to do post-doctoral work on a comparison between affirmative action programmes in the US and the reservation system in India, and the second time as a Visiting Scholar, based in Texas College, Tyler, a historically Black college.
Abstract:
The concepts of a tissue transplant, autograft, allograft, and the use of redundant material for regeneration existed prior to their scientific discoveries in the West and the formation of terminology to describe them. The issue of bioethics was not raised in the societies where these things were practiced because the culture of these societies saw the cure of diseases and preservation of life as a primary focus of medicine, and their philosophical bases were humanistic and benevolent toward all living beings. Morality and the issue of right and wrong (which may vary from culture to culture and country to country) are at the center of ethical thinking. Bioethics concerns issues that arise from the relationship between medicine and the life sciences and religion, philosophy, law, and also politics. While bioethics as a discipline is relatively new, ethics in medical treatment can be traced back to the earliest religious literature of all ancient civilizations, be it Jewish, Christian, or Hindu. The Talmudic tradition speaks of a “compassionate God,” and there is the parable of the Good Samaritan in the New Testament, both of which imply kindness and care for those suffering from the disease. Medical lore in Hinduism was encased in a philosophy that emphasized the transcendent character of human life, the duty to preserve individual and communal health and the duty to rectify imbalances in nature that threatened the life and well-being of both humans and nonhumans, so much so that an entire Veda was dedicated to medicine as then known. Medical ethics in the ancient world meant if one can draw inferences from the religious texts, care for the sick and cure when possible because life was held in high esteem.
- Hematology| Blood Disorders| Hemato-Oncology |Awareness and Knowledge on HIV/AIDS, STDs and STIs|Paediatric Hematology| Blood Banking |Hematology Nursing| Viral Immunology and Vaccines Development
Location: Plaza II
Session Introduction
Jongkol Akahat
Khon Kaen University, Thailand
Title: Move forward to blood safety in Blood Transfusion Centre
Biography:
Jongkol Akahat has completed her MSc (Clinical Pathology) , BSc (Med. Tech) from Mahidol and Khon Kaen University, respectively. She is a medical technician specialist in All blood transfusion science; HLA, genotyping, serology, etc. At present, her position is the head of blood components preparation in Blood Transfusion Centre, Faculty of Medicine, Khon Kaen University, Thailand.
Abstract:
Introduction: Safety of blood components considers the relative freedom from harmful effect to patients, directly or indirectly, of a prudently administered product taking into account the character of the product and the condition of the recipient at the time of the transfusion. To assure blood component safety, several measures are taken into consideration during product manufacturing and storage. Additionally, testing for infectious agents, including viruses, bacteria, and parasites, is routinely or seasonally performed by different blood operator. Transfusion of blood products carries certain inherent risks and hence it should be undertaken only if it improves patient outcome. Our blood transfusion center tries to produce high-quality blood components to increase every year for an added safety to the patients. This study aimed to compare the trends of using blood components in patients and blood components production of our agency.
Study Design and Methods: The studies were conducted from 2015-2017, on the use of blood components in patients and blood components production trends of our agency. The data collection by excel. The mean and standard distribution results were compared by Chi-Square test with red blood cell concentrates (leukocyte-poor red blood cells: LPRC, packed red blood cells: PRC) and plasma (fresh frozen plasma: FFP, frozen plasma: FP, cryo-removed plasma: CRP) in each year.
Results: Production units of blood components, LPRC equal 12980, 15368, 13683 (46.85%, 49.82%, 52.22%) and PRC equal 14725, 15480, 12523 (53.15%, 50.18%, 47.79%), respectively. Plasma production units were, FFP equal 27921, 28597, 24924(84.45%, 81.17%, 73.74%), FP (include CRP) equal 5143, 6636, 8875 (15.56%, 18.83%, 26.26%), respectively. The subscription requests for blood components in patients since 2015-2017 were 34625, 34810 and 32177, respectively. The use of blood components were, LPRC equal 14193, 15428, 14549(50.74%, 53.26%, 56.37%), PRC equal 13778, 13542, 11259 (46.26%, 46.74%, 43.63%), FFP equal 16390, 15712, 13893 (86.74%, 89.09%, 88.69%), FP (include CRP) equal 2506, 1924, 1771 (13.26%, 10.91%, 11.31%), respectively.
Conclusion: Trend of using the LPRC in patients has increased, while the PRC has decreased all over three years with significant statistically (p<0.05), consistent with the production of blood components. FFP production rates decline every year with statistical significance (p<0.05), but the rate of using in patients increased, while the rate of FP and CRP reduction, which does not correspond to production rates.
Thipaporn Jaroonsirimaneekul
Khon Kaen University, Thailand
Title: T-ACE II+: Semi-automated in blood components preparation
Biography:
Thipaporn Jaroonsirimaneekul has completed her Master Degree in the year 2001 at the age of 24 years from Faculty of Public Health, Khon Kaen University, Thailand. She is the supervisor of Blood Transfusion Sciences.
Abstract:
Introduction: Previously, blood components preparation in Blood Transfusion Centre, Faculty of Medicine, Khon Kaen University, all procedure handled by the manual. Qualitative were depended on the expertise of staffs. Packed red blood cells (PRC) are produced from a unit of whole blood by centrifugation and removal of most of the plasma, leaving a unit with a hematocrit of about 60 to 70%. Retrospective data for PRC preparation from April to December 2016 was 11,663 units, in 2017 was 12,477 units and January to June 2018 was 6,588 units, respectively. Plasma was separated from packed red cells by plasma extractors, clamp transfer line and seal to separate. All procedures are done by manual. Since 2001, T-ACE II+ was installed with the protocol of quadruple bags for leukocyte-poor red blood cells (LPRC) preparation, the instrument can apply and set parameter for double and triple blood bag. Then T-ACE II+ are available for all blood bags first time at Blood Transfusion Centre, Faculty of Medicine, Khon Kaen University, Thailand in 2017. Therefore, this study aimed to monitor and compare PRC separation between T-ACE II+ and manual.
Study Design and Methods: Survey was conducted in 2017 to 2018 at 1% of PRC, which were separated by T-ACE II+ (A protocol) and hematocrit (Hct.) measured by complete blood count (Matrix 3000). Data collection was excel. The mean and standard distribution results were compared by Z-test with PRC from manual in 2015 (B protocol).
RESULTS: 83 and 263 samples of PRC from protocol A and B preparation were hematocrit and volume measurement. The results found 68.62+5.03 and 73.11+2.91 % hematocrit and 200+19.37 and 221+26 mL. (mean+SD). The average of the A's population is considered to be not equal to the average of the B's population. The difference between the average of the A and B populations is big enough to be statistically significant (p=1.45).
Conclusion: A and B protocol for PRC preparation are statistically significant. Hematocrit percentage and volume of both procedures were accepted by international standard. Therefore, T-ACE II+ completely success instead of manual procedure and benefit to support routine PRC preparation.
Ezeama Martina
Imo State University, Nigeria
Title: The effectiveness of classroom-based HIV and AIDS education among in-school adolescents in Orlu Senatorial zone, Imo state, Nigeria
Biography:
Ezeama Martina currently works at Imo State University, Nigeria
Abstract:
Introduction: Adolescents in secondary schools are engaging in risk behaviors that put them at risk of HIV infection and AIDs. Although HIV and AIDS educational interventions have been widely implemented in secondary schools in Nigeria, the effectiveness of these programme studies in this area are limited in Nigeria. This study investigated the effects of using Classroom Instruction (CI) and Drama (DR) for HIV and AIDS prevention among in-school adolescents in Orlu Senatorial Zone, Nigeria.
Materials and Method: A quasi-experimental design using 165 students from three randomly selected co-educational secondary schools was adopted. The knowledge and attitude of 55 students who received classroom-based HIV and AIDS education intervention (CBI) were compared with those that received drama intervention (DRI) and the control group (CG) without intervention. Baseline and follow up data were collected using a semi-structured questionnaire with 29-point knowledge and 9-point attitudinal scales. Knowledge, scores of <15 and ≥15 were classified as poor and good respectively; while attitude scores of <5 and ≥5 were categorized as negative and positive. The results for baseline studies were used to design interventions that were implemented for 8 weeks followed by the conduct of mid-term and follow-up evaluations. Data were analyzed using descriptive statistics, t-test, and ANOVA at p=0.05.
Results: There was no statistically significant difference (P<0.05) in mean ages of respondents in CBI, DRI and CG groups (13.4±1.2, 13.9±1.5, and 13.8±1.2 years respectively). Knowledge scores on HIV/AIDS at baseline were 20.5±2.7, 20.4±2.6 and 21.1±2.7 for CBI, DRI and CG groups respectively. These scores increased to 22.7±2.7, 22.6±1.8 and 21.2±0.3 at mid-term for CBI, DRI, and CG respectively. At follow-up, knowledge scores for CBI and DRI increased to 23.9±1.8 and 24.5±1.4 respectively while the score for the control dropped to 20.0±2.8. Scores for attitude among CBI, DRI and control groups during the baseline study were 5.3±1.4, 4.9±1.5 and 5.3±1.0 respectively. For mid-term, attitude scores were 5.1±1.2, 5.0±0.9 and 4.7±1.5 for CBI, DRI, and CG respectively while scores at follow-up were 5.3±1.2, 5.6±0.7 and 4.5±1.2, indicating greater increase among the intervention groups than of control.
Conclusion: The use of drama intervention yielded the most positive outcomes for knowledge increase and attitudinal change among the students. This strategy is recommended for adolescents’’ HIV and AIDS prevention education in rural secondary schools in Imo State, Nigeria.
Heba Gouda
Cairo University, School of Medicine, Egypt
Title: Breast cancer resistance protein in acute myeloid leukemia: Clinical relevance and prognostic significance
Biography:
Heba Gouda has completed her MD degree since 2005 she has more than 26 international publication in the field of hematology and stem cell research, she is a full professor of clinical and chemical pathology since 2010 at the school of medicine Cairo University (ranked among the first 250 medical schools all over the world). She has a professional health care and hospital management diploma from the American University in Cairo since 2017.
Abstract:
Acute myeloid leukemia (AML) is a genetically heterogeneous clonal disorder characterized by the accumulation of acquired genetic alterations in hematopoietic progenitor cells. The multidrug transporter Breast Cancer Resistance Protein (BCRP) gene expression is an important prognostic marker in adult AML. In this study, we measured BCRP mRNA expression by quantitative real-time RT-PCR in 100 de novo cytogenetically normal adult AML patients and 50 healthy normal controls. The expression was evaluated in relation to other clinical and prognostic factors as well as response to treatment and disease-free survival. There was a positive correlation between BCRP gene over-expression and the percent of CD34 expression. This coexpression was associated with a lower complete response (CR) rate and with worse event-free survival and overall survival. We conclude that co-expression of CD34 and BCRP reflects a clinically resistant subgroup of adult AML.
Ogbonna Collins Nwabuko
Federal Medical Center, Nigeria
Title: Challenges of managing multiple myeloma in a developing country: The case of Nigeria
Biography:
Ogbonna Collins Nwabuko was born on the 12th of November, 1972. He hails from Umuode Nsulu in Isiala-Ngwa North Local Government Area of Abia State, Nigeria. He obtained his post-doctoral (FMCPath) fellowship in Hematology from the National Post-graduate Medical College of Nigeria in 2010. In 2012, he obtained a post-graduate certificate training in Palliative Medicine (PGCert.Pallia.Care) from the Institute for Hospice and Palliative Care in Africa, Kampala, Uganda. He is an international active member of American Society of Hematology, USA (ASH), a combined Master’s and PhD student of Public Health (Epidemiology) of University of South Wales (United Kingdom) and Walden University, Baltimore, USA respectively; a lecturer with Abia State University, and a consultant Hematologist with Federal Medical Center, Umuahia, Abia State, Nigeria. He is currently an editorial advisory board member of “The Open Orthopedics Journal”, Bentham Open; Cancer Management Research, Dove press, Journal of Blood & Lymph just to mention but a few.
Abstract:
Background: Multiple myelomas (MM) is one of the commonest hematological malignancies of public health importance in low-income countries of sub-Saharan Africa. It accounts for 1% of all cancer diagnosis and second commonest hematologic malignancy after malignant lymphoma. MM accounts for about 8.2% of hematological malignancies in Nigeria. The diagnosis of multiple myeloma is based on a constellation of haematologic, immunologic, histologic, and radiographic features. The two major challenges in the management of MM in Nigeria are in the diagnosis and treatment. Though primarily a disease of the bone marrow, it often poses a diagnostic dilemma for the orthopedic surgeons because of the frequent skeletal manifestations”. It is usually misdiagnosed as an orthopedic disease when in the real sense it is a hematologic disease with orthopedic complications. Lack of modern equipment for diagnosis is key players in the late diagnosis of MM in Nigeria. The mean duration from onset of symptoms to diagnosis in a study was 13.12 months (95% CI, 6.65-19.58). The diagnosis of MM is made late between Durie-Salmon Stages II-A and III-B. This late staging contributes to the poor survival outcome of people living with MM in Nigeria. The last step in the management of multiple myeloma is the therapeutic intervention. The current standard holistic treatment for MM is palliative care. Palliative care offers supportive, definitive and psychosocial care for people living with MM. There is a gross inadequacy in the palliative care of MM in Nigeria. There are less than three functional radiotherapy machines serving a population of about 180 million people in Nigeria. The definitive treatment in Nigeria still remains Melphalan-Prednisolone (MP) combination regimen (>84% of MM patients) as against the standard Bortezomib-lenalidomide-dexamethasone (RVD) triplet regimen (0%). About 28% of MM patients could afford a “partial-standard” triplet regimen made up of either one proteasome inhibitor (VMP/7.7%) or one immunomodulatory agent (Thalidomide-MP/19.7%). “Partial” in this context connotes combination of a novel therapy with the old conventional regimen (i.e. MP). Stem cell transplantation (i.e. ASCT) is still a far cry in the treatment of MM in Nigeria. Only 3.8% benefited from SCT intervention carried out outside Nigeria. About 7.6% of MM patients survive up to 5 years post-diagnosis. This was below estimated 5 years post-diagnosis period survival of 44.9% recorded by SEER cancer statistics review of 1975-2007 in the USA. This study highlights some of the challenges encountered in the management of people living with multiple myeloma in developing countries using Nigeria as a case scenario. It also tends to proffer possible solutions on how to mitigate these challenges in order to improve their quality of life.
Conclusion and Recommendations: Late diagnosis and inadequate palliative care are the hallmarks of poor prognostic and survival outcome of MM in Nigeria. The government, stakeholders in health institutions and donor agencies passionate for MM have a role to play towards improving the quality of life of people living with MM in Nigeria and developing countries.
Jacobus Hendricks
University of KwaZulu-Natal, South Africa
Title: B cell exhaustion in HIV: A role for programmed death receptor 1 (PD-1) immune checkpoint
Biography:
Jacobus Hendricks is a qualified Molecular Biologist. He is a lecturer in the Discipline of Human Physiology at the School of Laboratory Medicine and Medical Sciences at UKZN. He is responsible for the supervision of research students within the School of Health Sciences. He completed his Doctoral Degree in the field of Immunogenetics at the University Medical Center Groningen, Netherlands (2015). The tile of his Doctoral study is: “Heterogeneity of memory marginal zone B lymphocytes”, where he has studied the nature and origin of these memory B-cells in the Marginal Zone.
Abstract:
Programmed cell death protein 1 (PD-1) and PD-L1 function as major immune checkpoint regulators, which are the inhibitory pathways in the immune system that maintain self–tolerance and modulate the immune response. The most studied of these checkpoints is PD-1 pathways in T cells. Generally, PD-1 a surface protein expressed on B cells and T cells transmits inhibitory signals when bound to its ligands, programmed cell death ligands 1 and 2 (PD-L1/PD-L2) expressed on other antigen presenting cells. Various studies suggest that during the HIV infection the up-regulation of PD-1 could possibly cause the diminishing of B cell responses thereby interfering with antibody production. Suggesting that using anti-PD-1 antibodies could enhance antibody responses in infections like HIV that comprises B cell responses. Failure of immune protection is caused in patients with HIV partly due to B cell dysfunction and the reduction of viral-specific T cells during the chronic infection. It is possible that the exhaustion of these cells is characterized by lowering the competence of the cells to proliferate due to the up-regulation of the inhibitory receptors, therefore making them poorly responsive to stimulation. Whether the upregulation of inhibitory receptors in exhausted B cells includes the canonical immune checkpoint inhibitor programmed cell death protein 1 (PD-1) is unknown. Therefore we have investigated the HIV-driven expression of inhibitory surface molecules, specifically PD-1, to explain any impairment of SHM in the HIV infected patients.
Amitabha Bhattacharya
Calcutta School of Tropical Medicine, India
Title: Garbage to gold: Experience of placental umbilical cord whole blood transfusion in Eastern India
Biography:
Amitabha Bhattacharya MPhil student of Regenerative Medicine and Translational Sciences School Of Tropical Medicine, Kolkata. He passed MBBS in the year 1979 from Kolkata Medical College and also passed Diploma in Public Health from All India Institute Of Hygiene in 1988. He wrote several editorials as Editor of “YOUR HEALTH”-An Indian Medical Association Publication for the people to propagate Health Awareness amongst Community. He is at present Henry Associate Editor of “Journal Of the Indian Medical Association”- Indexed in Index Medicus. He retired as Deputy Chief Medical Health Officer Kolkata Municipal Corporation. Throughout his career, he worked as Tuberculosis control officer of RNTCP Kolkata. He also worked for of Malaria and Dengue control programme.
Abstract:
After birth or placenta is generally regarded as a discarded product. However umbilical cord blood is an admixture of fetal and adult hemoglobin, high platelet and WBC counts, several cytokine and growth factors and as well as its hypo-antigenic nature and altered metabolic profile, is a potentially safe alternative to adult blood transfusion. In under developed and developing countries there is a huge dearth of safe transfusion facilities and infrastructures like leukoreduction, selective apheresis, irradiation of the blood, viral inactivation of blood by solvent and/or detergent treatment and cytomegalovirus safe blood. We transfused 413 U (range 50ml to 146ml; mean 86±7.6ml; median 80ml; mean packed cell volume 48±4.1%; mean hemoglobin concentration 16.2g/dl±1.8g/dl) of placental umbilical cord whole blood, after lower uterine cesarean section from consenting mothers, to 129 informed consenting patients, after screening by the institutional ethics committee between 1999 to 2005. The list of consenting patients included 54 men and 75 women. Patient age varied from 2 years to 86 years. Seventy-three patients (56.58%) suffered from advanced cancer and 56 (43.42%) patients had diseases like ankylosing spondylitis, systemic lupus erythematosus, rheumatoid arthritis, tuberculosis, aplastic anemia, and thalassemia major. In non-malignant diseases like tuberculosis and rheumatoid arthritis, the peripheral blood hematopoietic stem cell (CD34) estimation revealed a rise from the pretransfusion base level (0.09%), varying from 2.99% to 33%, which returned to the base level in most patients at the end of three months. None of the transfusions were associated with the immunologic or nonimmunologic reaction so far. Umbilical cord blood is a gift of nature, free from infection, hypoantigenic with an altered metabolic profile, the high oxygen carrying capacity and hence can be used as an emergency source of blood for the management of disaster or crises anywhere in the world.
Meravt Khorshied
Kasr Al Ainy School of Medicine, Cairo, Egypt
Title: Genetic variations in tumor necrosis factor related apoptosis-inducing ligand-1 and the susceptibility to B cell Non-Hodgkin lymphoma in Egypt
Biography:
Meravt Khorshied has completed her MD at the age of 34 years from Kasr Al Ainy School of Medicine, Cairo University and postdoctoral studies from CairoUniversity School of Medicine. She is the director of Teaching module of the master of Clinical and Chemical pathology, Faculty of Medicine, Cairo University. A former member of the committee responsible for directing and improving blood banks as well as conduction of point of care system, Kasr Al Ainy Teaching Hospitals, Cairo University. She has published more than 25 papers in reputed journals and has been serving as an editorial board member of repute.
Abstract:
B-cell non-Hodgkin lymphomas (B-NHL) represent a heterogeneous group of disorders characterized in most cases by genetic alterations and chromosomal translocations. As lymphoma is a multi-hit phenomenon, other genetic abnormalities including concurrent deregulation of other dominant oncogenes and/or inactivation of tumor suppressor genes (TSGs) are necessary for lymphomagenesis. Tumor necrosis factor-related apoptosis inducing ligand-1 (TRAIL1) and its receptor (TRAIL-R) engage the suicide machinery of cells and activates the apoptotic proteases to mediate apoptosis. Dysregulation of their function due to genetic alterations has been reported to play a crucial role in the pathogenesis of different cancers. To explore the possible association between TRAIL1-C626G, -A683C and -A1322G single nucleotide polymorphisms (SNPs) and the susceptibility to B-NHL in a cohort of Egyptians, we conducted a case-control study. The study included 100 B-NHL patients and 150 healthy controls. Genotyping of TRAIL1 (rs20575, rs20576, and rs2230229) SNPs was done by polymerase chain reaction technique.
Results: The frequency of polymorphic alleles of TRAIL1-C626G and A1322G SNPs was higher in B-NHL cases compared to controls and conferred twofold increased risk of B-NHL in Egyptians (OR=1.76, 95%CI=1.01-3.07 and OR=2.04, 95%CI=1.02-4.07 respectively). There was no statistical difference in the distribution of TRAIL1-A683C genotypes between B-NHL patients and controls (OR=1, 95%CI=0.5-2). Combined genotypes analysis revealed that coinheritance of TRAIL1-C626G and A1322G conferred fivefold increased the risk of B-NHL (OR=5.02, 95%CI=2.35-10.73), while coinheritance of A683C and A1322G was associated with almost threefold increased risk of B-NHL (OR=2.6, 95%CI=1/05-6.73). Co-existence of the variant genotypes of the three SNPs conferred fourfold increased risk of BNHL (OR=4.1, 95%CI=1.01-17.63). In conclusion, genetic variations in TRAIL1 gene could be considered as molecular risk factor for B-NHL among Egyptians. Deeper insight into the contribution of TRAIL1 genetic polymorphism in lymphomagenesis is recommended. Furthermore, TRAIL is a novel promising treatment target for hematological malignancies. Ultimately, functional studies concerning the role of these polymorphisms may allow the identification of potential therapeutic targets.
Biography:
Rubiya Nadaf currently doing her fellowship in the branch of Pediatric Hematology Oncology with a special interest in Bone marrow transplant, in India. She worked very hard in order to secure MD with Gold Medal at one the most reputed institutes in India and she was also selected as a young scholar from the entire western part of India and represented west India at a young scholar meet. She works with dedication and honestly which enables her to acquire essential knowledge and skills for safe and expected practice in pediatrics and in the field of Oncology.
Abstract:
The outcome of pediatric Acute promyelocytic leukemia (APL) has improved after the introduction of All-trans retinoic acid (ATRA) given with anthracycline-based regimen. Differentiation syndrome (DS) is a severe sometimes life-threatening complication of ATRA occurring during induction therapy. Cardiac manifestations in the form of myopericarditis associated with LV dysfunction have rarely been documented. Here we report a rare case of myopericarditis with LV dysfunction as a result of DS-related to ATRA administration during induction treatment of APL. A 5-year-old male child presented with bleeding diathesis characterized by bruises and bleeding gums. He was evaluated and diagnosed to have an Acute promyelocytic leukemia-high risk, FLT3-ITD mutation positive. As per the AIDA-2000 trial of the GIMEMA group he was initiated on induction with ATRA plus idarubicin. On the fourth day of induction, he developed fever, peripheral edema, hepatomegaly, tachycardia with gallop and dyspnea with a drop in saturation requiring oxygen. A chest X-ray revealed bilateral pulmonary infiltrates and an enlarged cardiac shadow. Electrocardiography showed non-specific ST elevations. Cardiac enzymes were elevated. 2D Echocardiography with Doppler showed global hypokinesia of the left ventricle with an ejection fraction of 40% and features were consistent with myocarditis. ATRA was temporarily withheld. Considering cardiac involvement due to differentiation syndrome, dexamethasone was started. A dramatic relief of symptoms and resolution of radiological signs were observed during the following days. Repeat 2D-ECHO was done which was normal. Pericardial effusion is a common cardiac manifestation of DS but myocarditis had been rarely documented. The differential diagnosis between DS and acute cardiac toxicity induced by anthracyclines might be challenging. In this case disappearance of myocardial dysfunction after treatment with a corticosteroid, confirmed the diagnosis of DS resulting in myopericarditis. In conclusion, a better knowledge of the spectrum of DS can be a useful tool for early decision-making in patients who develop this syndrome.