Tehran University Medical Journal

Background: Acute myeloid leukemia (AML) is blood and bone marrow malignancy. Low-density oxidative lipoprotein (oxLDL) is a pro-inflammatory factor that has free radicals in its structure. OxLDL levels are also rising in diseases such as diabetes, cardiovascular disease, and some cancers. Studies have shown that oxLDL and dyslipidemia are more common in patients with various cancers. This study aimed to evaluate the level of blood lipids and oxLDL in these patients with acute myeloid leukemia.
Methods: In a descriptive study, 36 patients who were diagnosed with acute myeloid leukemia from April 2016 to March 2017 were enrolled. This study was done in Shahid Ghazi Blood Department of Imam Reza Hospital, Tabriz University of Medical Sciences, Iran. Basic information including age, sex, type of disease, cause for referrals of the patients were collected. After obtaining informed consent from patients and 12 hours of fasting, 5 cc blood samples were sent to the Central Laboratory of Shahid Ghazi Hospital to measure the level of blood lipids including cholesterol, triglyceride, low density lipoprotein, high density lipoprotein (HDL), and oxLDL levels. Blood lipid and oxLDL levels were measured by automatic analyzer (Abbott Laboratories, Abbott Park, IL, USA) (ELISA method).
Results: 23 patients (54.8%) were male and 19 (45.2%) were female. The mean age of the patients was 44.06±14.48 years. The lowest age was 25 and the highest was 80 years. In the study, the mean serum cholesterol level was 147.64±42.28 mg/dl, the blood triglyceride was 183.28±79.34 mg/dl, the LDL was 84.89±26.35, and the HDL 29±14.51, the mean oxLDL was 1482.5±6031.85 ng/ml.
Conclusion: The results of this study indicate that dyslipidemia in patients with acute myeloid leukemia has not been evident. Concerning oxLDL, an oxidative stress factor involved in acute myeloid leukemia requires further investigation and studies.

Background: Acute myeloid leukemia (AML) is a malignant hematological disorder which has numerous manifestations at the initial step such as infections and hemorrhagic signs. This is the first report in which the diagnosis of AML was made after managing of Bartholin gland site swelling and pain as the chief complaint of a patient.
Case presentation: Herein, we present a young girl who was referred to us in our tertiary level hospital, Firoozgar Hospital, Tehran, Iran, in october, 2017 just with pain and swelling of the left Bartholin gland. At first, it was suspected to be a cyst or abscess of Bartholin gland, she did not have any history or symptoms of infection on comprehensive physical examinations such as pneumonia, meningitis, Nevertheless, the ultimate diagnosis of AML was made after generalized and precise systemic examination and laboratory findings were done. According to the guidelines for the treatment of AML, systemic chemotherapy with multiple drugs was given immediately but unfortunately, she died due to severe septicemia which was resistant to broad-spectrum antibiotics and disseminated intravascular coagulation.
Conclusion: Based on our searching, this is the first case. Because we expected other more common symptoms of acute lukemia, systematic and precise generalized examination must be performed gently in all of the patients even in women just with genital symptoms as their chief compliant for instance, pain and swelling of Bartholin gland. Finally, not focusing just on the perineal site and detailed examination for all parts of the body may reveal an accurate diagnosis of the main underlying disease.

Background: Acute myeloid leukemia (AML) is characterized by the proliferation of myeloid precursors and abnormal differentiation of hematopoietic stem cells, which results in the accumulation of immature cells in the bone marrow (BM). The accumulation of these cells in the bone marrow causes molecular and cellular changes in the microenvironment of the bone marrow. The adiponectin hormone originates from adipose tissue of the bone marrow, which in addition to effective functions in cellular metabolism, suppresses cancer through various mechanisms, including inhibition of metastasis, angiogenesis, and proliferation. In the bone marrow sample, patients with acute myeloid leukemia are associated with different subtypes of the disease.
Methods: In this basic-fundamental research, a total of 40 BM samples from de novo AML patients and 15 BM samples from healthy volunteers as the healthy group referred to the Stem Cell Transplantation Laboratory and Cell Therapy of Taleghani Hospital and with assisting the Research Center, Shahid Beheshti University of Medical Sciences, Tehran, from March 2015 to February 2017, were entered into the study. Then used the Real-time polymerase chain reaction (RT-PCR) method for diagnosis level of adiponectin gene expression in BM samples patients and the healthy group.
Results: The results of the present study showed that the level of adiponectin gene expression in the BM sample of patients was significantly decreased in comparison with the healthy group (P=0.002). While, there was no significant difference (P<0.05) in adiponectin gene expression in AML subtypes myeloblastic, promyelocytic, and myelomonocytic/monocytic.
Conclusion: The results of this study indicate that there was a decrease in adiponectin gene expression in the bone marrow of acute myeloid leukemia patients compared to healthy controls. This decrease in adiponectin expression may be due to myeloid hyperplasia and a decrease in bone marrow adipocytes. In fact, The nutritional, metabolic, and mechanical stresses associated with myeloid cells accumulation cause alterations in bone marrow microenvironment structure and destruction of bone marrow adipose tissue. Therefore, reduced adiponectin gene expression in AML patients is one of the key indicators of bone ‎marrow microenvironmental changes in AML patients.‎‎