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Home > Prevalence of Double Myc/Bcl2 Expression and the Cell of Origin in Diffuse Large B-Cell Lymphomas Diagnosed at a Tertiary Level Referral Laboratory

Prevalence of Double Myc/Bcl2 Expression and the Cell of Origin in Diffuse Large B-Cell Lymphomas Diagnosed at a Tertiary Level Referral Laboratory

Thesis Info

Author

Wawire, Jonathan

Department

Pathology (East Africa)

Program

MMed

Institute

Aga Khan University

Institute Type

Private

City

Karachi

Province

Sindh

Country

Pakistan

Thesis Completing Year

2017

Thesis Completion Status

Completed

Subject

Medicine

Language

English

Added

2021-02-17 19:49:13

Modified

2024-03-24 20:25:49

ARI ID

1676728061016

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Introduction: Diffuse large B-cell lymphoma (DLBCL) is the most commonly diagnosed non-Hodgkin’s lymphoma in adults worldwide. In Kenya DLBCL accounts for 64% of all non-Hodgkin’s lymphomas diagnosed in adults. It is a heterogeneous disease and patients show varying outcomes despite standard treatment. This variability is attributed to the differences in the biology and molecular pathogenesis of DLBCL. The five most important prognostic factors for DLBCL include scores for the revised international prognostic index (R-IPI), the cell of origin (COO), presence of myelocytomatosis (MYC) and B-cell lymphoma 2 (BCL2) gene rearrangements by fluorescent in situ hybridisation (FISH) or standard cytogenetics, the absolute lymphocyte and monocyte count, and imaging with positron emission tomography (PET scan). Current data shows that the use of immunohistochemistry in identifying cases of DLBCL with MYC and BCL2 protein over-expression (double-expressing lymphomas) yields important prognostic information since these patients form a higher proportion of cases compared to those with concurrent MYC and BCL2 translocations (double-hit lymphomas) using FISH/cytogenetics . The double expressing DLBCL have a poorer prognosis compared to cases of DLBCL lacking MYC/BCL2 double-expression. With advances in targeted therapy for DLBCL, it is important to also identify patients who may benefit from new regimens by determining their cell of origin. Gene expression profiling (GEP), the technique for determining the COO is not available to the routine diagnostic laboratory. Consequently, robust immunohistochemistry surrogates have been developed in place of GEP for this purpose. Hans’ algorithm which uses three antibodies in sequence (CD10, BCL6 and MUM1) is the most widely applied for determining COO. The World Health Organization (WHO) guidelines currently recommend definition of the cell of origin and testing for double MYC/BCL2 expression for every patient diagnosed with diffuse large B cell lymphoma. Furthermore, in order to establish a diagnosis of DLBCL, NOS with certainty, other high-grade B-cell lymphomas, such as Burkitt lymphoma and plasmablastic lymphoma, need to be excluded. This can be achieved by a comprehensive antibody panel that includes MYC and BCL2. These antibodies need to be optimised and standardised for the settings in which a particular laboratory operates. Objectives: To determine the prevalence of MYC/BCL2 double-expression among diffuse large B cell lymphomas diagnosed at The Aga Khan University Hospital, Nairobi (AKUH, N) Laboratory. To define the cell of origin of DLBCL diagnosed at AKUH, N laboratory. Methods: Formalin fixed Paraffin embedded (FFPE) blocks of DLBCL cases diagnosed between January 1st 2012 and December 31st 2015
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نواب حبیب اﷲ خان

نواب حبیب اﷲ خان
یہ سال مسلمان والیان ریاست کے لئے خاص طور سے اندوہناک ثابت ہوا، مرحومہ سرکاریہ بھوپال کے سانحہ وفات کے بعد ان کے پوتے حبیب اﷲ خان، رامپور کی اسلامی ریاست کے مسند نشین پھر نواب صاحب والی ٹونک کی وفات کے سانحے یکے بعد دیگر پیش آئے اور دنیا کے انقلابات کے نئے نئے نقشے آنکھوں کے سامنے پھرنے لگے، کل من علیھا فان ویبقی وجہ ربکّ ذوالجلال ولاکرام[الرحمن: ۲۶۔۲۷]، دعا ہے کہ اﷲ تعالیٰ مرنے والوں کو مغفرت اور ان کے جانشینوں کو توفیق حسن عمل عطا فرمائے۔ (سید سلیمان ندوی، جولائی ۱۹۳۰ء)

 

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A qualitative phenomenological approach was used in this study to describe the lived experiences of Tagumpay National High School (TNHS) teachers on Online Learning Action Cell (LAC) session. LAC is a school-based professional development for teachers implemented by the Philippine Department of Education (DepEd). Due to teacher’s lack of participation on classroom LAC, a fully-online mode option is explored by offering TNHS teachers Online LAC session using Facebook as a Learning Management System (LMS). To capture the lived experience of teachers, an in-depth interview with a purposive sample of one TNHS teacher is done in the process. The data gathered went through “Hycner’s Explicitation Process” (1999, in Groenewald, 2004) which includes bracketing, delineating, clustering, summarizing and extracting unique themes. Validity and Credibility were accomplished through an intercoder agreement between researchers, Facebook chat records, bracketing, and member checking. Results identified three themes in relation to teacher’s experience of Online LAC session including usefulness, barriers, and preference. Findings revealed the major role of TNHS teacher’s context on how Online LAC is utilized. Recommendations include administrator and expert teacher working with classroom teachers and the inclusion of teachers’ voices as input in the program design, implementation and evaluation stages of Online LAC to better address curriculum needs and facilitate the delivery of high-quality professional development for teachers’ professional growth.

Investing Job Satisfaction of Teachers in Karachi, Pakistan: A Survey Study

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