Background Chronic myeloid leukemia (CML) is a clonal disease, characterized by a reciprocal t(9, 22) that results in a chimeric BCR/ABL fusion gene. Regulatory T cells (Tregs) constitute the main cell population that enables cancer cells to evade immune surveillance. Objective The purpose of our study was to investigate the level of Tregs in newly diagnosed CML patients and to correlate it with the patients’ clinical, laboratory and molecular data. We also aimed to assess the effect of treatment using tyrosine kinase inhibitor (TKI) on Treg levels. Methods Tregs were characterized and quantified by flow cytometry in 63 newly diagnosed CML patients and 40 healthy controls. TKI was used in 45 patients with chronic phase CML, and the response to therapy was correlated with baseline Treg levels. Results The percentages of Tregs were significantly increased in CML patients compared to the controls. Treg numbers were significantly lower in patients with chronic phase CML versus the accelerated and blast phases, and were significantly lower in patients with complete molecular remission (CMR) compared to those patients without CMR. Conclusion Tregs may play a role in the maintenance of CML. Moreover, the decrease of their levels in patients with CMR suggests that Tregs might have a clinical value in evaluating the effects of therapy.

Background: End stage renal disease (ESRD) is a worldwide devastating health problem due to its increased prevalence in the population and high association with several pathologic conditions including immunodeficiency, which makes a significant contribution to morbidity and mortality. Aim: The present study aimed at analysis of T and B lymphocyte subpopulation and the detection of flowcytometric apoptosis markers on peripheral B and T lymphocytes in a cohort of children with ESRD. Subjects and methods: A case–control study was conducted on 28 children with ESRD. In addition, 30 age and sex matched healthy children were included as a control group. We used Annexin V-FITC binding assay as a sensitive probe for identifying cells undergoing apoptosis. Results: Circulating neutrophils, T and B lymphocytes were lower in patient group. In addition, apoptotic B and T lymphocytes occurred more frequently in children with ESRD than in the control group. Conclusion: Our finding of low numbers of circulating neutrophils, T and B lymphocytes, and increased portion of apoptotic B and T lymphocytes in children with ESRD, may emphasize the fact that these derangements are the main mechanisms responsible for the impairment of the immune system in ESRD children, also it adds to the fact that both cellular and humoral immunity affected in ESRD children. Finally, uremia and increased peripheral lymphocyte apoptosis were the major causes of lymphocyte populations’ depletion in our ESRD patients.

Background: Tri-modality bladder sparing therapy in selected bladder cancer patients may be an alternatives treatment option to immediate radical cystectomy as it may result in satisfactory Quality Of Life (QOL). The present study evaluated the effects of this conservative approach versus surgical approach, i.e. Radical Cystectomy (RC) and orthotopic neobladder, on QOL of patients. Patients and methods: This is a prospective study of patients with bladder cancer in group I (using tri-modality bladder sparing therapy) and group II (using RC and orthotopic neobladder). Patients in both groups were subjected to interview NCCN-FACT FBlSI18 questionnaire, inquiring about physical and emotional disease related symptoms, treatment side effects and function and well being. SPSS version18 software was used for statistical analysis. Results: Internal consistency of the 18 items in both groups was assessed by Cronbach’s α which was adequate at 0.89 at Group I and 0.84 at Group II. Univariate analysis showed that there were statistically significant difference (p0.05) in favor of group I patients compared to those in group II, regarding bladder function, potency and bowel symptoms. Multivariate analysis revealed that only T stage significantly affected physical and emotional disease related symptoms, and treatment side effects subscales in favor of bladder preservation group. Conclusions: Tri-modality bladder sparing therapy resulted in well-functioning bladders, mild bowel symptoms, and satisfactory sexual functioning in contrast to the surgical approach in bladder cancer patients and should be considered as a reasonable option for these patients.

Background: Tri-modality bladder sparing therapy in selected bladder cancer patients may be an alternatives treatment option to immediate radical cystectomy as it may result in satisfactory Quality Of Life (QOL). The present study evaluated the effects of this conservative approach versus surgical approach, i.e. Radical Cystectomy (RC) and orthotopic neobladder, on QOL of patients. Patients and methods: This is a prospective study of patients with bladder cancer in group I (using tri-modality bladder sparing therapy) and group II (using RC and orthotopic neobladder). Patients in both groups were subjected to interview NCCN-FACT FBlSI18 questionnaire, inquiring about physical and emotional disease related symptoms, treatment side effects and function and well being. SPSS version18 software was used for statistical analysis. Results: Internal consistency of the 18 items in both groups was assessed by Cronbach’s α which was adequate at 0.89 at Group I and 0.84 at Group II. Univariate analysis showed that there were statistically significant difference (p0.05) in favor of group I patients compared to those in group II, regarding bladder function, potency and bowel symptoms. Multivariate analysis revealed that only T stage significantly affected physical and emotional disease related symptoms, and treatment side effects subscales in favor of bladder preservation group. Conclusions: Tri-modality bladder sparing therapy resulted in well-functioning bladders, mild bowel symptoms, and satisfactory sexual functioning in contrast to the surgical approach in bladder cancer patients and should be considered as a reasonable option for these patients.

Background: Tri-modality bladder sparing therapy in selected bladder cancer patients may be an alternatives treatment option to immediate radical cystectomy as it may result in satisfactory Quality Of Life (QOL). The present study evaluated the effects of this conservative approach versus surgical approach, i.e. Radical Cystectomy (RC) and orthotopic neobladder, on QOL of patients. Patients and methods: This is a prospective study of patients with bladder cancer in group I (using tri-modality bladder sparing therapy) and group II (using RC and orthotopic neobladder). Patients in both groups were subjected to interview NCCN-FACT FBlSI18 questionnaire, inquiring about physical and emotional disease related symptoms, treatment side effects and function and well being. SPSS version18 software was used for statistical analysis. Results: Internal consistency of the 18 items in both groups was assessed by Cronbach’s α which was adequate at 0.89 at Group I and 0.84 at Group II. Univariate analysis showed that there were statistically significant difference (p0.05) in favor of group I patients compared to those in group II, regarding bladder function, potency and bowel symptoms. Multivariate analysis revealed that only T stage significantly affected physical and emotional disease related symptoms, and treatment side effects subscales in favor of bladder preservation group. Conclusions: Tri-modality bladder sparing therapy resulted in well-functioning bladders, mild bowel symptoms, and satisfactory sexual functioning in contrast to the surgical approach in bladder cancer patients and should be considered as a reasonable option for these patients.

Objectives: Patients with painful bone metastasis treated with palliative radiation therapy (RTH) may require re-irradiation. This work aims at assessing the efficacy and safety of re-irradiation for painful bone metastases using single 8 Gy fractions versus (4 Gy × 5 fractions). Methods: From June 2011 to December 2012, previously irradiated bone metastases were re-irradiated with single 8 Gy fractions (group I) or, 4 Gy × 5 fractions (group II). Pain management index (PMI) was determined. Pearson’s r correlation coefficient was calculated between negative PMI at presentation and age, ECOG Performance Status, sex, and primary cancer site. Results: Two months after RTH, about one fifth of patients achieved no pain, mild pain in 75.5% of the remaining patients and no patient suffered from severe pain. There was no significant difference (p>0.05) between groups (I and II) regarding pain relief. Negative PMI score, was reduced to from 37% at presentation to 25%, at 2 months follow up. A strong negative association between PMI and performance status (p=0.0057, 95% confidence interval between 0.109 and 0.557) was found. Conclusion: Palliative re-irradiation with either single 8 Gy fraction or with, 4 Gy × 5 fractions was effective and safe in pain relief.

The aim of this study was to evaluate the effects of bacterial pneumonia and malnutrition on the frequency of micronuclei (MN) in peripheral blood of pediatric patients through flow cytometric analysis. The study was an analytical case-control study carried out on 35 malnourished children with bacterial pneumonia and 20 well-nourished children with bacterial pneumonia, in addition to 20 healthy children as controls. Complete physical examination including; anthropometric measurement, Chest roentgenograms were done for all cases. Assessment of MN was done by FACSCalibur flow cytometry. The frequency of micronucleated reticulocytes (MN-RETs) was higher both in the malnourished children with pneumonia and well-nourished children with pneumonia than the controls. Within the malnourished children with pneumonia, patients with kwashiorkor had more micronucleated mature erythrocytes (MN-RBCs) and MN-RETs than patients with marasmus. In conclusion: Pneumonia is associated with an increased frequency of MN and this increment is more pronounced in children with severe malnutrition especially kwashiorkor group.

Background: Regulatory T cells have an important role in the control of immune reactivity against self antigens and probably play a role in pathogenesis of type 1 diabetes (T1D). We aimed to determine the frequency of regulatory T cells in recently diagnosed children with/T1D. Materials and Methods: 20 children with/T1D and 20 healthy children of matched age and sex as controls were enrolled in this study. All cases were subjected to a thorough history taking, full clinical examinations and investigations which include; insulin C peptide levels and flow cytometric detection of B-, T-lymphocytes and regulatory T cells. Results: Insulin C peptide level was significantly lower in children with/ T1D compared with controls. The percentages of B and T-lymphocytes were not significantly different between patients and controls. The percentages of CD4+CD25+High and CD4+CD25+High Foxp3+ cells both in total lymphocytes and in CD4+ lymphocytes were significantly decreased in patients than controls, while the percentages of total CD4+CD25+ and CD4+CD25+Intermediate both in total lymphocytes and in CD4+ lymphocytes were not significantly different between patients and controls. The geometric mean of fluorescence intensity (MFI) of Foxp3+ expression in CD4+CD25+High cells was significantly decreased in patients than controls. Positive correlations were observed between both age and insulin C peptide and frequency of CD4+CD25+High Foxp3. Conclusion: The percentage of regulatory T cells; CD4+CD25+High Foxp3 was decreased in children with recent T1D and may have a role in its pathogenesis. Their role as a prognostic signifi cance and their relation to various complications should be explored.

Background: Regulatory T cells have an important role in the control of immune reactivity against self antigens and probably play a role in pathogenesis of type 1 diabetes (T1D). We aimed to determine the frequency of regulatory T cells in recently diagnosed children with/T1D. Materials and Methods: 20 children with/T1D and 20 healthy children of matched age and sex as controls were enrolled in this study. All cases were subjected to a thorough history taking, full clinical examinations and investigations which include; insulin C peptide levels and flow cytometric detection of B-, T-lymphocytes and regulatory T cells. Results: Insulin C peptide level was significantly lower in children with/ T1D compared with controls. The percentages of B and T-lymphocytes were not significantly different between patients and controls. The percentages of CD4+CD25+High and CD4+CD25+High Foxp3+ cells both in total lymphocytes and in CD4+ lymphocytes were significantly decreased in patients than controls, while the percentages of total CD4+CD25+ and CD4+CD25+Intermediate both in total lymphocytes and in CD4+ lymphocytes were not significantly different between patients and controls. The geometric mean of fluorescence intensity (MFI) of Foxp3+ expression in CD4+CD25+High cells was significantly decreased in patients than controls. Positive correlations were observed between both age and insulin C peptide and frequency of CD4+CD25+High Foxp3. Conclusion: The percentage of regulatory T cells; CD4+CD25+High Foxp3 was decreased in children with recent T1D and may have a role in its pathogenesis. Their role as a prognostic signifi cance and their relation to various complications should be explored.

Background: Regulatory T cells have an important role in the control of immune reactivity against self antigens and probably play a role in pathogenesis of type 1 diabetes (T1D). We aimed to determine the frequency of regulatory T cells in recently diagnosed children with/T1D. Materials and Methods: 20 children with/T1D and 20 healthy children of matched age and sex as controls were enrolled in this study. All cases were subjected to a thorough history taking, full clinical examinations and investigations which include; insulin C peptide levels and flow cytometric detection of B-, T-lymphocytes and regulatory T cells. Results: Insulin C peptide level was significantly lower in children with/ T1D compared with controls. The percentages of B and T-lymphocytes were not significantly different between patients and controls. The percentages of CD4+CD25+High and CD4+CD25+High Foxp3+ cells both in total lymphocytes and in CD4+ lymphocytes were significantly decreased in patients than controls, while the percentages of total CD4+CD25+ and CD4+CD25+Intermediate both in total lymphocytes and in CD4+ lymphocytes were not significantly different between patients and controls. The geometric mean of fluorescence intensity (MFI) of Foxp3+ expression in CD4+CD25+High cells was significantly decreased in patients than controls. Positive correlations were observed between both age and insulin C peptide and frequency of CD4+CD25+High Foxp3. Conclusion: The percentage of regulatory T cells; CD4+CD25+High Foxp3 was decreased in children with recent T1D and may have a role in its pathogenesis. Their role as a prognostic signifi cance and their relation to various complications should be explored.