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The glutathione S-transferases (GSTs) are phase II xenobiotic metabolizing enzymes known to be involved in the detoxification of carcinogens and anticancer drugs. Individual genetic variation linked to inherited polymorphisms of GSTT1 and GSTM1 leading to a complete loss of enzyme activity could expose subjects to develop cancer or to induce drug resistance. Indeed, despite the impressive results obtained with the imatinib, some patients with chronic myeloid leukemia (CML) fail to achieve the expected results or develop resistance. The present study aimed to examine the impact of GSTT1 and GSTM1 polymorphisms on the response to imatinib in patients with CML. Multiplex polymerase chain reaction was used to detect the genotypes of GSTT1 and GSTM1 in 60 CML patients. We found that side effects were more frequent in patients carrying GSTT1 null when compared to GSTT1 present carriers (31 vs. 16.6 %; χ = 6.2; p = 0.013). The loss of hematologic response was statistically greater in patients carrying the combined genotype GSTT1 present/ GSTM1 present (26.3 %) when compared to GSTT1 null/ GSTM1 present (12.8 %), GSTT1 present/ GSTM1 null (8.3 %) and GSTT1 null/ GSTM1 null (0 %), ( χ = 18.85; p < 0.001). The complete cytogenetic response was higher in patients harboring the GSTT1 null/ GSTM1 null (75 %) compared with GSTT1 null/ GSTM1 present (55.6 %), GSTT1 present/ GSTM1 null (50 %) and GSTT1 present/ GSTM1 present (47.8). On the other hand, the frequency of none cytogenetic responders was more common in patients carrying GSTT1 present/ GSTM1 present (34.8 %) when compared to other genotype combinations ( χ = 20.99; p = 0.05). Moreover, the GSTT1 present/ GSTM1 present appeared to be associated with a final dose of 600 or 800 mg of imatinib, but not significantly. Based on these findings, we find that the interaction between GSTT1 and GSTM1 seems to influence treatment outcome in patients with CML. Therefore, further investigations are required to confirm these results, for better genotype-phenotype correlation. [ABSTRACT FROM AUTHOR]

Although several centers are now performing allogeneic hematopoietic SCT (HSCT) in the Eastern Mediterranean (EM) region, the availability is still limited. Special issues including compatible donor availability and potential for alternative donor programs are discussed. In comparison to Europe and North America, differences in patterns of diseases and pre-HSCT general status, particularly for patients with BM failure, are described. Other differences including high sero-positivity for CMV, hepatitis B and C infection, and specific observations about GVHD and its relation to genetically homogeneous communities are also discussed. We report that a total of 17 HSCT programs (performing five or more HSCTs annually) exist in 9 countries of the EM region. Only six programs are currently reporting to European Group for Blood and Marrow Transplantation or Center for International Blood and Marrow Transplantation Research. A total of 7617 HSCTs have been performed by these programs including 5701 allogeneic HSCTs. The area has low-HSCT team density (1.56 teams per 10 million inhabitants vs 14.43 in Europe) and very low-HSCT team distribution (0.27 teams per 10 000 sq km area vs <1–6 teams in Europe). Gross national income per capita had no clear association with low-HSCT activity. Much improvement in infrastructure and formation of an EM regional HSCT registry are needed.Bone Marrow Transplantation (2009) 43, 1–12; doi:10.1038/bmt.2008.389; published online 1 December 2008 [ABSTRACT FROM AUTHOR]

The first hematology department in Morocco was created in Casablanca in 1980 and it is still the only public facility where adult patients can be treated for hematological diseases. Two other units treat pediatric hematological disorders and cancer. Some patients are treated in private clinics located primarily in Casablanca and Rabat. The public hospitals have very limited resources and rely heavily on nongovernmental organizations (NGOs) for the care of these patients. The NGOs have also played an important role in developing successful cooperative programs with hospitals and groups in Europe and the United States. Till 2004, all patients who needed BMT and could afford the cost went to Europe. In 2004, SCT was initiated in Casablanca, with a four-bed ward set up and properly equipped. By May 2007, 27 patients have received autologous PBSCs. With 15 patients in continuous CR, the program is considered a success so far. The development of allogeneic transplantation in Morocco planned in the current year is also considered a real challenge.Bone Marrow Transplantation (2008) 42, S106–S108; doi:10.1038/bmt.2008.130 [ABSTRACT FROM AUTHOR]