Clinical and pathological correlation of P53 expression in oral cancers.

In our study, we aimed to evaluate the overexpression of P53 in 155 oral squamous cell carcinomas and to correlate with various clinicopathological features like depth of invasion, lymph nodal involvement, and margin status, which affect the local recurrence and prognosis. This cross-sectional study included 155 oral squamous cell carcinoma patients who underwent surgical resection of primary and nodal disease. The histopathological and clinical features were noted. Immunohistochemical expression was reported, and other clinicopathological features were correlated. Statistical analysis was performed using SPSS software. In the present study, out of 155 patients, 127(81.9%) are males, and the majority are more than 50 years (55%). The most common site of oral carcinoma is the tongue, followed by buccal mucosa. An aberrant or mutational type of P53 was seen in 90 cases (58%), while the wild type was observed in 65 patients (42%). Expression of P53 is not similar in different sites of the oral cavity but is more frequently seen in the Gingiva, followed by retromolar trigone, lip, buccal mucosa, and tongue. There is a significant association between P53 expression and degree of tumor differentiation, T staging, and depth of invasion, involved margin, node positivity, and extranodal extension.

Multiple Myeloma in Young Adults: A Single Centre Real World Experience.

Multiple Myeloma accounts for 1% of all cancers. In India myeloma accounts for 1.23% of all cancers. The median age at diagnosis varies from 65 to 70 and only a small proportion of MMs are diagnosed at younger age, before 40 (approximately 2%). The present study is designed to analyse the clinical, haematological profile and outcomes in young adults with multiple myeloma. Data of all patients with age ≤ 40 years, diagnosed with multiple myeloma from 2013 to 2018 was analysed. A total of 258 patients were diagnosed with multiple myeloma between 2013 and 2018, of which 22 (8.5%) were aged ≤ 40 years. The median age was 33.5 years(range,18-40). Male to female ratio was 1.75:1. Bone pain (59%) and fatigue (45.4%) were the most common symptoms at presentation. Majority of patients were ISS stage 3(63.6%). Cytogenetic data was available only in seven patients and IgH translocation and del 13q were the most common abnormalities, seen in four and three patients respectively. Of 22 patients, 17 patients had at least one response evaluation and were evaluated for outcomes. Eleven patients (64.7%) had responses greater than VGPR. Six (41.6%) patients underwent Auto HSCT. Four patients received second line therapy and only two received further lines of therapy. At a median follow up of 18 months, 2-year EFS was 76.5% and 2-year OS was 94.1%. Patients younger than 40 years, constitute higher proportion of patients in Indian sub-continent. Renal failure was more common in young myeloma patients. Light chain myeloma was more common in young adults. Most patients were ISS stage 3 at presentation and survival seems to be better in young adults when compared to elderly patients.

Outcomes in Adult Acute Promyelocytic Leukemia: A Decade Experience.

BACKGROUND: Acute promyelocytic leukemia (APL), a distinct variant of acute myeloid leukemia (AML), accounts for 10% of AML cases. Over the past decade, APL has emerged from a highly fatal disease to a highly curable one. The published data on outcomes of APL from India are scant. The present study was designed to analyze the clinicopathologic features and outcomes in adult APL. MATERIALS AND METHODS: The present report is a single institutional, observational, retrospective study, and data of patients diagnosed with APL from 2006 to 2018 were analyzed. All patients with APL, diagnosed by morphology and confirmed by reverse transcriptase polymerase chain reaction (promyelocytic leukemia/retinoic acid receptor alpha) and over 18 years of age, were included in this study. SPSS software v25.1 was used for statistical analysis. RESULTS: A total of 1396 patients with AML were seen between January 2005 and June 2018, of which 190 (13.6%) had APL. Of these, 111 patients met the inclusion criteria and were analyzed. The median age at presentation was 33 years (range, 19-60 years). The median duration of symptoms before presentation was 15 days (range, 3-180 days). High risk, intermediate risk, and low risk were seen in 43.3%, 41.4%, and 15.3% of patients, respectively. At the end of induction chemotherapy, 88 (79%) patients achieved complete hematologic remission, and 23 (21%) succumbed during induction. The median time to attain complete hematologic remission was 30 days (range, 19-47 days). At a median follow-up of 34 months, the event-free survival and overall survival were 69.3% and 74.7%, respectively. On univariate analysis, bcr3 variant and high-risk category at presentation had significant impact on event-free survival (P = .029 and P = .003, respectively) and overall survival (P ≤ .001 and P = .007, respectively). On multivariate analysis, only high risk at presentation was significant for event-free survival (P = .04) and overall survival (P = .02). CONCLUSION: APL constituted one-tenth of patients with AML. The majority of patients were high risk at presentation. Sanz high risk category and bcr3 variant at presentation had significant impact on outcomes in APL.