Background: Chronic myeloid leukemia (CML) is a hematopoietic stem cell disease, associated with a reciprocal translocation between chromosomes 9 and chromosome 22, lead to the formation of the BCRABL fusion gene (Philadelphia chromosome). This fusion gene is believed to play golden role in the initial development of CML with constitutive tyrosine kinase activation. Successful use of tyrosine kinase inhibiters (TKIs) play a role in improve survival and increase prevalence of CML, but un fortunately mutations in the BCR-ABL kinase domain (...) may cause, or contribute to increase, resistance to TKIs in CML patients. . Objective: This study was designed to assess the association of five most common BCR-ABL kinase domain mutations (T315I, M351T, E255K, M244V and E255V) with resistance state of CML patients on TKIs in Iraqi Middle Euphrates region. Patients and methods: A retrospective case-control study in which 85 patients with chronic myeloid leukemia in chronic phase (45 patients as cases group and 40 patient as control group) were selected from three hemato-oncology centers in middle Euphrates in Iraq during the period from January 2016 till October 2016 out of a total of 240 CML patients (108 male and 132 female) who were registered during this period in these three centers and all patients on TKI (Imatinib and Nilotinib). Venous blood sampling done for BCRABL kinase domain mutations screening. Results: four patients from cases group (4/45) were carriers of one of five selected ABL kinase domain mutations and no one of control group. T315I mutation was detected in 3/45 (6.6 %) of resistant patients, with a significant risk association to develop resistance to TKI therapy (odd ratio and C. I.) (6.67, 0.3340 - 133.2255). E255V was detected in 1/45 (2.2 %) and also had significant risk association to develop resistance to TKIs (odd ratio, C.I.) (2.73, 0.1081 -68.9424). No one of these mutations had significance correlation with demographic or hematological features. M351T, E255K and M244V were not detected in any one of our study groups CML patients. Conclusions: T315I and E255V among five ABL kinas domain mutations were detected in our CML patients with resistance to TKIs. All of them may play a role in development variable degree of resistance to first and second generation TKIs weather primary or secondary.T315I mutation is most common mutation within BCR-ABL domain kinase gene. (shrink)

Poniższa dyskusja odbyła siȩ we wrześniu 2018 w Szkole Głównej Handlowej w Warszawie. Skupiła zarówno badaczy problematyki polityki senioralnej, ekspertów, analityków. Dyskusjȩ moderował i zaplanował Andrzej Klimczuk, zwi¸a}zany z SGH, natomiast zaproszenie do dyskusji przyjȩli: Barbara Szatur-Jaworska, polityk społeczny i gerontolog z Uniwersytetu Warszawskiego, Paweł Kubicki, ekonomista, SGH, Marek Niezabitowski, socjolog z Politechniki Śl¸a}skiej, Ryszard Majer, polityk społeczny, Agnieszka Cieśla, architektka i urbanistka, Politechnika Warszawska, Marzena Rudnicka, fundatorka oraz prezeska Krajowego Instytutu Gospodarki Senioralnej. Paneliści podczas dyskusji analizowali nastȩpuj¸a}ce zagadnienia: I. (...) pocz¸a}tki polityki senioralnej, jej definiowanie, dokumenty strategiczne państwa, II. rola samorz¸a}dów w animowaniu działań w obrȩbie polityki senioralnej oraz organizacji pozarz¸a}dowych, III. powstanie i rola ustawy o seniorach, IV. zróżnicowanie środowiska osób w wieku senioralnym, V. działania w innych krajach w obrȩbie polityki senioralnej, VI. zmiany w świadomości społecznej, ewolucja postaw wobec osób starszych, starości, starzenia siȩ, VII. rynek produktów i usług dla seniorów, VIII. aktywność seniorów, formalna i nieformalna, infrastruktura aktywności, IX. mieszkalnictwo dla osób starszych i starzej¸a}cej siȩ ludności X. rola państwa i samorz¸adu w polityce senioralnej, dialog z władz¸a, partnerstwo publiczno-prywatne, XI. wyzwania i kierunki rozwoju polityki senioralnej, XII. deficyt usług opiekuńczych XIII. polityka senioralna i emerytalna, XIV. konwergencja i dywergencja w polityce senioralnej. ** The following discussion took place in September 2018 at the Warsaw School of Economics. It focused on both senior politics, experts, and analysts. The discussion was moderated and planned by Andrzej Klimczuk, associated with the Warsaw School of Economics, and invited to the discussion: Barbara Szatur-Jaworska, social politician and gerontologist from the University of Warsaw, Paweł Kubicki, economist, Warsaw School of Economics, Marek Niezabitowski, sociologist from the Silesian University of Technology, Ryszard Majer, social politician, Agnieszka Cieśla, architect and urban planner, Warsaw University of Technology, Marzena Rudnicka, founder and president of the National Institute of Senior Management. Panelists during the discussion analyzed the following issues: I. Beginnings of the senior policy, its definition, strategic documents of the state, II. The role of local governments in animating activities within the framework of senior policy and non-governmental organizations, III. Creation and role of the law on seniors, IV. Diversification of the environment of seniors, V. Activities in other countries within the framework of the senior policy, VI. Changes in social awareness, the evolution of attitudes towards older people, old age, ageing, VII. The market for products and services for seniors, VIII. Seniors’ activity, formal and informal, activity infrastructure, IX. Housing for older people and ageing population X. The role of the state and self-government in the senior policy, dialogue with the authorities, public-private partnership, XI. Challenges and directions of development of the senior policy, XII. The deficit of care services, XIII. Senior and pension policy, XIV. Convergence and divergence in the senior policy. (shrink)