COVID-19 Infection in Chronic Myeloid Leukemia Patients Receiving Tyrosine Kinase Inhibitor in Makassar, Indonesia: A Six-Case Report and Literature Review.

Management of chronic myeloid leukemia (CML) in patients who are infected with COVID-19 is a challenging task due to disease-related or treatment-related factors that place such patients at a higher risk of complications. However, a low-infectivity-rate mechanism has been proposed by some researchers. In CML patients with COVID-19 infection, the most important treatment-related factor involves tyrosine kinase inhibitors (TKIs). In this case report, six patients with chronic-phase CML who experienced COVID-19 of mild-moderate severity all continued to receive TKI treatment for CML concurrently with COVID-19 treatment. All patients fully recovered. In the present study, we also review four other cases of COVID-19 infection in CML patients. Outcomes for TKI-treated CML patients who contract COVID-19 are influenced by many factors. Tyrosine kinase inhibitor therapy may benefit CML patients due to its antiviral effect, but the interaction between TKIs and drugs used for COVID-19 treatment requires careful monitoring. An individual approach is needed in every case.

Interleukine-2 serum level in breast cancer patients.

Background: Breast cancer is a form of cancer that typically affects females. In general, cancer is caused by an imbalance between oncogene and supressor gene factors, including immunity factors against cancer cells. This study aims to compare the levels of IL-2 between breast cancer patients and healthy women, and also compare the levels of IL-2 between HER-2 positive and HER-2 negative, ER/PR positive and ER/PR negative, and among different malignancy grades of breast cancer patients. Methods: This is an observational study using case control method. We include 46 breast cancer patients and 40 healthy women. Blood samples were taken from 46 breast cancer patients (20 HER-2 negative and 26 HER-2 positive patients); 40 of them received hormonal status (29 ER/PR negative and 11 ER/PR positive patients); and from 46 breast cancer patients, 37 of them were divided into malignancy grade. The level of IL-2 was compared between cases and controls and also among the breast cancer patients with HER-2 negative and positive; ER/PR negative and positive; and breast cancer with low, moderate and high grade. Results: IL-2 level was higher in breast cancer patients than in controls (9.400 pg/mL and 3.990 pg/mL respectively, P=0.003). IL-2 level is significantly higher in the breast cancer cases with positive HER-2 compared to negative HER-2 expression (11.154pg/mL and 7.120pg/mL respectively, P=0.001. No association between ER/PR expression nor breast cancer grading with IL-2 level. Conclusion: IL-2 level is higher in breast cancer patients, especially breast cancer patients with HER-2 positive expression.

The Association Between Triglyceride-Glucose Index as a Marker of Insulin Resistance and the Risk of Breast Cancer.

Background: This study aims to evaluate the association and dose-response between triglyceride-glucose (TyG) index and breast cancer. Method: This is a multicenter case-control study conducted in six public referral hospitals in Indonesia. Cases are individuals aged 19 years or above who were diagnosed with breast cancer within 1 year of diagnosis, based on histopathology and immunohistochemistry. Controls were recruited from corresponding hospitals. TyG index was determined by the formula: ln (fasting TG [mg/dl] × fasting glucose [mg/dl]). Results: There were 212 participants in the breast cancer group and 212 participants in the control group. TyG index was higher in patients with breast cancer (median 8.65 [7.38, 10.9] vs. 8.30 [7.09, 10.84], p < 0.001). When compared with TyG quartile of Q1, Q4 was associated with an OR of 2.42 (1.77, 3.31), p < 0.001, Q3 was associated with an OR of 1.53 (1.21, 1.93), p < 0.001, Q2 was associated with an OR of 1.39 (1.12, 1.73), p = 0.002 for the risk of breast cancer. The dose-response relationship was nonlinear (p < 0.001). On univariate analysis, smoking (OR 2.15 [1.44, 3.22], p < 0.001), use of contraception (1.73 [1.15, 2.60], p = 0.008), alcohol consumption (OR 2.04 [0.96, 4.35], p = 0.064), and TyG Index >8.87 (OR 3.08 [1.93, 4.93], p < 0.001) were associated with risk of breast cancer. Independently associated with increased risk of breast cancer included smoking (OR 1.93 [1.23, 3.01], p = 0.004), use of contraception (OR 1.59 [1.02, 2.48], p = 0.039), and TyG Index >8.87 (OR 2.93 [1.72, 4.98], p < 0.001). Conclusion: TyG index was associated with breast cancer in a nonlinear dose-response fashion.

Association Between PAI-1 Activity Levels and t-PA Antigen with Glycemic Status in Prediabetic Population.

AIM: to evaluate an association between fibrinolysis defect and glycemic status in prediabetic population by assessing the levels of t-PA antigen and PAI-1 activity. METHODS: it was an observational study with cross-sectional approach. There were 72 subjects aged 30-50 years who had met the inclusion criteria. The diagnosis of diabetes mellitus (DM) and glycemic index were determined based on the American Diabetes Association (ADA) criteria. The PAI-1 and t-PA antigen levels were measured quantitatively using enzyme-linked immunosorbent assay (ELISA). Analysis between the levels of t-PA antigen and PAI-1 activity was performed using ANOVA. RESULTS: the t-PA antigen level was significantly higher in subjects with impaired glucose tolerance (IGT) and impaired fasting blood glucose (IFBG) as well as subject with impaired fasting blood glucose (IFBG) than those with normal glucose tolerance (NGT) (p=0.047). The PAI-1 activity was significantly higher in subjects with IGT, IFBG and subjects with IFBG than NGT (p=0.024). There was a significant association between glycemic status in prediabetic subjects and PAI-1 activity (p=0.04). CONCLUSION: the level of t-PA antigen and PAI-1 activity were significantly higher in prediabetic subjects than those with NGT; and there was a significant association between glycemic status in prediabetic subjects and PAI-1 activity.