Hai peng Lin - Academia.edu (original) (raw)

Papers by Hai peng Lin

Journal of Clinical and Experimental Hematopathology, 2002

Endemic and sporadic Burkitt's lymphoma differ in site and age of presentation, and Epstein-Barr ... more Endemic and sporadic Burkitt's lymphoma differ in site and age of presentation, and Epstein-Barr virus (EBV) association. This study aimed to describe the clinical presentation, EBV association and p53 expression of Burkitt's lymphoma in 59 Malaysian patients. Expression of Bcl-2, retinoblastoma and Ki67 proteins was also investigated. EBV was detected by EBER in situ hybridization. Expression of p53, Bcl-2, pRb and Ki67 proteins was detected by immunohistochemical staining. Polymerase chain reaction was employed for EBV subtyping and detection of translocation t (14; 18). The male to female ratio was 3.9: 1. The most common age group was children younger than 15 years (72.9%), with a mean of 15.8 y. The disease is more common in ethnic Chinese. EBV association is 33.3% and all were infected with type-A virus. Expressions of p53, Bcl-2, pRb and Ki67 proteins were detected in 42/49 (85.7%), 9/54 (16.7%), 47/51 (92.2%) and 35/39 (89.7%) of the biopsies, respectively. Translocation t (14; 18) was not detected in cases expressing the Bcl-2 protein. Clinical presentation and EBV association of Burkitt's lymphoma in Malaysian patients corresponds with that of sporadic Burkitt's lymphoma. This study also reveals that a substantial proportion of cases express high levels of p53 and retinoblastoma proteins, in contrast to the Bcl-2 protein.

Journal of Clinical Oncology, 2012

Purpose To improve treatment outcome for childhood acute lymphoblastic leukemia (ALL), we designe... more Purpose To improve treatment outcome for childhood acute lymphoblastic leukemia (ALL), we designed the Malaysia-Singapore ALL 2003 study with treatment stratification based on presenting clinical and genetic features and minimal residual disease (MRD) levels measured by polymerase chain reaction targeting a single antigen-receptor gene rearrangement. Patients and Methods Five hundred fifty-six patients received risk-adapted therapy with a modified Berlin-Frankfurt-Münster–ALL treatment. High-risk ALL was defined by MRD ≥ 1 × 10−3 at week 12 and/or poor prednisolone response, BCR-ABL1, MLL gene rearrangements, hypodiploid less than 45 chromosomes, or induction failure; standard-risk ALL was defined by MRD ≤ 1 × 10−4 at weeks 5 and 12 and no extramedullary involvement or high-risk features. Intermediate-risk ALL included all remaining patients. Results Patients who lacked high-risk presenting features (85.7%) received remission induction therapy with dexamethasone, vincristine, and as...

Journal of pediatric hematology/oncology, Jan 23, 2015

Review of the management of 6 young girls with vaginal yolk sac tumor over 25 years showed that t... more Review of the management of 6 young girls with vaginal yolk sac tumor over 25 years showed that the α-fetoprotein levels normalized in 5/6 within 4 cycles of primary cisplatin, bleomycin, etoposide (PEB)/carboplatin, etoposide, bleomycin (JEB)/cisplatin, vinblastine, bleomycin (PVB) chemotherapy. Radioimaging revealed residual tissue but viable tumor was found in only 1 of 2 biopsied. Resection/biopsy is necessary to avoid giving additional primary chemotherapy or to identify patients who need different treatment. If markers do not decay appropriately, PEB/JEB/PVB chemotherapy should not be continued. Taxol-containing salvage chemotherapy regimens, adjuvant modern radiotherapeutic treatment, and fertility-saving curative surgery should then be considered. Despite having mostly advanced disease, 5/6 patients were cured, 2 with chemotherapy alone.

International Journal of Infectious Diseases, 2000

Objectives: To evaluate prevalence of ceftazidime-resistant Klebsiella pneumoniae (CRKP) in the p... more Objectives: To evaluate prevalence of ceftazidime-resistant Klebsiella pneumoniae (CRKP) in the pediatric oncology unit of University Hospital, Kuala, Lumpur, and to identify differences between febrile neutropenic pediatric patients with CRKP and ceftazidime-sensitive K. pneumoniae (CSKP) bacteremia.Materials and Methods: Febrile neutropenic patients treated between January 1996 and December 1997 at the pediatric oncology unit of University Hospital, Kuala Lumpur, were prospectively studied. Empirical antibiotic therapy consisted of ceftazidime and amikacin. Those who developed K. pneumoniae bacteremia were identified, and clinical features analyzed. Ceftazidime-resistance was documented via disk-diffusion testing. Production of extended-spectrum beta-lactamase (ESBL) was inferred on the basis of synergy between ceftazidime and amoxicillin-clavulanic acid. The different features between the two groups and variables associated with the development of CRKP bacteremia were analyzed using chi-square and t-tests and calculation of odds ratios. A multivariate analysis was used to identify independent factors for CRKP development.Results: Ceftazidime-resistance was seen in 51.6% of all K. pneumoniae isolates, and all these isolates were inferred to be ESBL producers. All isolates were sensitive to imipenem. Susceptibility to gentamicin was 90.5%. The mean continuous hospital stay prior to the detection of bacteremia was 13.7 days overall, but significantly longer in the CRKP group (21.9 d) compared to the CSKP group (4.3 d) (P = 0.003). Children with CRKP were more likely to have received antibiotics in the 2 weeks prior to detection of bacteremia (87.5% of cases) than the CSKP group (20.0% of cases) (P = 0.0008). Sepsis-related mortality was higher in those with CRKP (50.0%) than in the CSKP group (13.3%) (P = 0.02). Patients who did not receive CRKP-directed antibiotics within 48 hours of admission were more likely to have a fatal outcome than those who did (P = 0.009). Logistic regression analysis identified use of third-generation cephalosporins 2 weeks prior to presentation and a hospital stay of 2 weeks or more as independent risk factors for development of CRKP.Conclusions: More than half of total K. pneumoniae isolated from blood cultures in the unit were ceftazidine-resistant. Children with febrile neutropenia with prolonged hospital stay and recent prior antibiotic exposure are at high risk of developing CRKP bacteremia. Mortality was significantly higher in this group. Early commencement of appropriate antibiotics (e.g., imipenem with or without gentamicin), according to susceptibility study results, may be beneficial in such circumstances.

Journal of Clinical and Experimental Hematopathology, 2002

Endemic and sporadic Burkitt's lymphoma differ in site and age of presentation, and Epstein-Barr ... more Endemic and sporadic Burkitt's lymphoma differ in site and age of presentation, and Epstein-Barr virus (EBV) association. This study aimed to describe the clinical presentation, EBV association and p53 expression of Burkitt's lymphoma in 59 Malaysian patients. Expression of Bcl-2, retinoblastoma and Ki67 proteins was also investigated. EBV was detected by EBER in situ hybridization. Expression of p53, Bcl-2, pRb and Ki67 proteins was detected by immunohistochemical staining. Polymerase chain reaction was employed for EBV subtyping and detection of translocation t (14; 18). The male to female ratio was 3.9: 1. The most common age group was children younger than 15 years (72.9%), with a mean of 15.8 y. The disease is more common in ethnic Chinese. EBV association is 33.3% and all were infected with type-A virus. Expressions of p53, Bcl-2, pRb and Ki67 proteins were detected in 42/49 (85.7%), 9/54 (16.7%), 47/51 (92.2%) and 35/39 (89.7%) of the biopsies, respectively. Translocation t (14; 18) was not detected in cases expressing the Bcl-2 protein. Clinical presentation and EBV association of Burkitt's lymphoma in Malaysian patients corresponds with that of sporadic Burkitt's lymphoma. This study also reveals that a substantial proportion of cases express high levels of p53 and retinoblastoma proteins, in contrast to the Bcl-2 protein.

Journal of Clinical Oncology, 2012

Purpose To improve treatment outcome for childhood acute lymphoblastic leukemia (ALL), we designe... more Purpose To improve treatment outcome for childhood acute lymphoblastic leukemia (ALL), we designed the Malaysia-Singapore ALL 2003 study with treatment stratification based on presenting clinical and genetic features and minimal residual disease (MRD) levels measured by polymerase chain reaction targeting a single antigen-receptor gene rearrangement. Patients and Methods Five hundred fifty-six patients received risk-adapted therapy with a modified Berlin-Frankfurt-Münster–ALL treatment. High-risk ALL was defined by MRD ≥ 1 × 10−3 at week 12 and/or poor prednisolone response, BCR-ABL1, MLL gene rearrangements, hypodiploid less than 45 chromosomes, or induction failure; standard-risk ALL was defined by MRD ≤ 1 × 10−4 at weeks 5 and 12 and no extramedullary involvement or high-risk features. Intermediate-risk ALL included all remaining patients. Results Patients who lacked high-risk presenting features (85.7%) received remission induction therapy with dexamethasone, vincristine, and as...

Journal of pediatric hematology/oncology, Jan 23, 2015

Review of the management of 6 young girls with vaginal yolk sac tumor over 25 years showed that t... more Review of the management of 6 young girls with vaginal yolk sac tumor over 25 years showed that the α-fetoprotein levels normalized in 5/6 within 4 cycles of primary cisplatin, bleomycin, etoposide (PEB)/carboplatin, etoposide, bleomycin (JEB)/cisplatin, vinblastine, bleomycin (PVB) chemotherapy. Radioimaging revealed residual tissue but viable tumor was found in only 1 of 2 biopsied. Resection/biopsy is necessary to avoid giving additional primary chemotherapy or to identify patients who need different treatment. If markers do not decay appropriately, PEB/JEB/PVB chemotherapy should not be continued. Taxol-containing salvage chemotherapy regimens, adjuvant modern radiotherapeutic treatment, and fertility-saving curative surgery should then be considered. Despite having mostly advanced disease, 5/6 patients were cured, 2 with chemotherapy alone.

International Journal of Infectious Diseases, 2000

Objectives: To evaluate prevalence of ceftazidime-resistant Klebsiella pneumoniae (CRKP) in the p... more Objectives: To evaluate prevalence of ceftazidime-resistant Klebsiella pneumoniae (CRKP) in the pediatric oncology unit of University Hospital, Kuala, Lumpur, and to identify differences between febrile neutropenic pediatric patients with CRKP and ceftazidime-sensitive K. pneumoniae (CSKP) bacteremia.Materials and Methods: Febrile neutropenic patients treated between January 1996 and December 1997 at the pediatric oncology unit of University Hospital, Kuala Lumpur, were prospectively studied. Empirical antibiotic therapy consisted of ceftazidime and amikacin. Those who developed K. pneumoniae bacteremia were identified, and clinical features analyzed. Ceftazidime-resistance was documented via disk-diffusion testing. Production of extended-spectrum beta-lactamase (ESBL) was inferred on the basis of synergy between ceftazidime and amoxicillin-clavulanic acid. The different features between the two groups and variables associated with the development of CRKP bacteremia were analyzed using chi-square and t-tests and calculation of odds ratios. A multivariate analysis was used to identify independent factors for CRKP development.Results: Ceftazidime-resistance was seen in 51.6% of all K. pneumoniae isolates, and all these isolates were inferred to be ESBL producers. All isolates were sensitive to imipenem. Susceptibility to gentamicin was 90.5%. The mean continuous hospital stay prior to the detection of bacteremia was 13.7 days overall, but significantly longer in the CRKP group (21.9 d) compared to the CSKP group (4.3 d) (P = 0.003). Children with CRKP were more likely to have received antibiotics in the 2 weeks prior to detection of bacteremia (87.5% of cases) than the CSKP group (20.0% of cases) (P = 0.0008). Sepsis-related mortality was higher in those with CRKP (50.0%) than in the CSKP group (13.3%) (P = 0.02). Patients who did not receive CRKP-directed antibiotics within 48 hours of admission were more likely to have a fatal outcome than those who did (P = 0.009). Logistic regression analysis identified use of third-generation cephalosporins 2 weeks prior to presentation and a hospital stay of 2 weeks or more as independent risk factors for development of CRKP.Conclusions: More than half of total K. pneumoniae isolated from blood cultures in the unit were ceftazidine-resistant. Children with febrile neutropenia with prolonged hospital stay and recent prior antibiotic exposure are at high risk of developing CRKP bacteremia. Mortality was significantly higher in this group. Early commencement of appropriate antibiotics (e.g., imipenem with or without gentamicin), according to susceptibility study results, may be beneficial in such circumstances.