Maher Sughayer | King Hussien Cancer Center (KHCC) (original) (raw)

Papers by Maher Sughayer

Clinical Laboratory

BACKGROUND The introduction of checkpoint inhibitors in solid cancer therapy showed successful re... more BACKGROUND The introduction of checkpoint inhibitors in solid cancer therapy showed successful results. The role of Programmed Death-1/Programmed Death-Ligand 1 (PD1/PD-L1) in hematologic malignancies is currently being investigated and clinical trials are ongoing. Preliminary findings showed conflicting results. In this study, we examined the degree of PD-L1 and PD-L2 expression in primary acute leukemia patients. METHODS Flow cytometry expression of PD-L1 and PD-L2 was evaluated in de novo acute leukemia in the collaborating institutions between 2018 - 2020. RESULTS One hundred forty patients were identified. PD-L1 was positive in 34/70 (49%) of AML, 25/50 (50%) of B-ALL, and none (0/20) of T-ALL patients. In contrast, PD-L2 was solely expressed in eight (19%) AML patients. The expression of PD-L1 showed statistically significant correlation with the type of acute leukemia (AML and B-ALL > T-ALL, p < 0.001) and with age group (adults > children, p = 0.048), but not with blast count, immunophenotype or cytogenetic mutations. The positivity for PD-L1 was associated with worse overall survival in AML, but not in B-ALL. CONCLUSIONS The expression of PD-L1 is common among newly diagnosed AML and B-ALL patients and is not restricted to relapsed cases as previously described. PD-L2 is less commonly expressed and is accompanied by PD-L1 expression. Positive PD-L1 patients may benefit from treatment with immune checkpoint inhibitors, especially in AML. Further studies are recommended.

Vaccines

Background: Dexamethasone is used to treat cancer, relieve chemotherapy-induced nausea and vomiti... more Background: Dexamethasone is used to treat cancer, relieve chemotherapy-induced nausea and vomiting, enhance cancer patients’ appetites, and treat COVID-19 patients. There is little evidence of the impact of a dexamethasone treatment plan on the severity of COVID-19 infections in cancer patients. This study explores whether dexamethasone treatment plan influences the severity of COVID-19 in dexamethasone-treated cancer patients. Methods: The medical records of 108 cancer patients receiving dexamethasone at King Hussein Cancer Center with a COVID-19 infection and 343 without corticosteroid treatment were reviewed. Patients on dexamethasone within seven days before infection, after infection, or both were included. Ventilation support, hospitalization, and mortality within 28 days of a COVID-19 diagnosis were key severity factors. Results: We found that dexamethasone before a COVID-19 infection increased the risk of requiring ventilation assistance and mortality within 28 days by a fa...

Frontiers in Immunology

ObjectivesWe aimed to study the outcomes, severity, and seroconversion post SARS-CoV-2 infection ... more ObjectivesWe aimed to study the outcomes, severity, and seroconversion post SARS-CoV-2 infection in immunocompromised children and adolescents treated at our center.MethodFor this observational study, all pediatric patients who had COVID-19 infection from Sep-22-2020 to Nov-10-2021were identified by reviewing our laboratory records. Their charts were reviewed to determine clinical severity and outcome. Blood samples were drawn for anti-SARS-CoV-2 antibody assay. Serious COVID-19 infection (SVI) was defined if the patient had moderate, severe, or critical illness. A cutoff of 100 U/mL anti-SARS-CoV-2 antibodies was used to categorize low and high titer seroconversion.ResultsWe identified 263 pediatric patients with COVID-19; most (68%) were symptomatic: 5% had severe or critical infection, 25% were hospitalized, 12 required respiratory support, 12 were admitted to the ICU, and five patients (2%) died. Multivariable analysis revealed several factors that predict SVI: Age above 12 year...

Biopreservation and Biobanking

Background: Antibodies with the specialized ability to fight infection can be found in the blood ... more Background: Antibodies with the specialized ability to fight infection can be found in the blood of individuals who have recovered from or have been vaccinated against COVID-19. As a result, plasma from these individuals could be used to treat critically ill patients. This treatment is known as convalescent plasma (CCP) therapy. Methods: Plasma units from 1555 consented healthy blood bank donors were collected from February to September 2021. Blood units were tested for the quantitative determination of Immunoglobulin G (IgG) antibodies to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) virus using one of the following assays based on the availability of the kits: The LIAISON Ò SARS-CoV-2 TrimericS IgG assay or the Abbott SARS-CoV-2 IgG II Quant assay. Results: Among the tested donors, 1027 participants tested positive for neutralizing anti-SARS-CoV-2 IgG antibodies (66.04%). There were 484 donors whose plasma qualified to be used for CCP therapy (47.13%) and 214 CCP units were stored in the COVID-19 convalescent biobank. Conclusion: We were able to identify and store 214 fresh frozen plasma units qualified for CCP-plasma therapy for COVID-19 patients according to World Health Organization standards. Hence, we established the first COVID-19-convalescent plasma data and plasma biobank for treating COVID-19-infected cancer patients in Jordan and the region.

Frontiers in Public Health

Background:Aside from the pandemic's negative health effects, the world was confronted with p... more Background:Aside from the pandemic's negative health effects, the world was confronted with public confusion since proper communication and favorable decisions became an ongoing challenge. As a result, the public's perceptions were influenced by what they knew, the many sources of COVID-19 information, and how they interpreted it. With cancer patients continuing to oppose COVID-19 vaccines, we sought to investigate the COVID-19 pandemic and vaccine sources of this information in adult cancer patients, which either helped or prevented them from taking the vaccine. We also assessed the relevance and impact of their oncologists' recommendations in encouraging them to take the vaccine.MethodsFrom June to October 2021, an online survey was conducted at King Hussein Cancer Center. A total of 441 adult cancer patients took part in the study. Patients who had granted their consent were requested to complete an online questionnaire, which was collected using the SurveyMonkey ques...

A 60-year-old diabetic patient, G5P5, presented with postmenopausal bleeding for two months. The ... more A 60-year-old diabetic patient, G5P5, presented with postmenopausal bleeding for two months. The clinical assessment was unremarkable. The computed tomography of the chest, abdomen, and pelvis showed a right-sided complex ovarian mass measuring 7 cm with multiple nodular deposits in the omentum, with a dimension of 4 cm for the largest one. Debulking laparotomy, total abdominal hysterectomy, bilateral salpingo-oophorectomy, and infracolic omentectomy were performed. A histopathologic examination revealed primary ovarian low-grade endometrioid stromal sarcoma. Postoperatively, the patient received hormonal therapy. Citation: Alaaraj R, Lataifeh I, Elsaadi J, Salameh M, Sughayer M. Primary low-grade endometrioid stromal sarcoma of the ovary with multiple omental metastases. Gulf Medical Journal. 2016;5(1):69– 73.

Hematology/Oncology and Stem Cell Therapy, 2014

A 31-year-old male patient presented with fever and pancytopenia. He was diagnosed as a case of c... more A 31-year-old male patient presented with fever and pancytopenia. He was diagnosed as a case of chronic anemia since early childhood. The etiology of the anemia was not known. The patient was transfusion dependent, and he had been maintained on erythropoietin for three years prior to admission. A bone marrow examination revealed prominent proliferation of immature and dysplastic erythroid precursors. Acute erythroid leukemia of the pure erythroid subtype was suspected. However, because of the history of erythropoietin therapy a definite diagnosis was not made. On follow-up one month later, the marrow changes had reversed to normal.

Hematology/Oncology and Stem Cell Therapy, 2011

Pediatric and Developmental Pathology, 2006

International Journal of Radiation Oncology*Biology*Physics, 2011

D espite the widespread adoption of multimo-dality therapy, the diagnosis of glioblastoma multifo... more D espite the widespread adoption of multimo-dality therapy, the diagnosis of glioblastoma multiforme (GBM) continues to carry a dismal prognosis with a grave overall survival estimate set at 9 to 12 months. 1-3 Surgery followed by radiotherapy was considered the standard of care. 3 Temozolomide (TMZ) administered in addition to adjuvant radio-therapy (RT) has been shown to significantly prolong overall survival. 4 Currently, TMZ concurrent with RT

Acta Cytologica, 2012

Objective: We aimed to investigate the validity of the Bethesda System for Reporting Thyroid Cyto... more Objective: We aimed to investigate the validity of the Bethesda System for Reporting Thyroid Cytopathology (TBSRTC) through meta-analysis. Study Design: All publications between January 1, 2008 and September 1, 2011 that studied TBSRTC and had available histological follow-up data were retrieved. To calculate the sensitivity, specificity and diagnostic accuracy, the cases diagnosed as follicular neoplasm, suspicious for malignancy and malignant which were histopathologically confirmed as malignant were defined as true-positive. True-negative included benign cases confirmed as benign on histopathology. The nondiagnostic category was excluded from the statistical calculation. The correlations between the 6 diagnostic categories were investigated. Results: The publications review resulted in a case cohort of 25,445 thyroid fine-needle aspirations, 6,362 (25%) of which underwent surgical excision; this group constituted the basis of the study. The sensitivity, specificity and diagnostic...

JCO Global Oncology

PURPOSE Estrogen receptors (ERs), progesterone receptors (PRs), and human epidermal growth factor... more PURPOSE Estrogen receptors (ERs), progesterone receptors (PRs), and human epidermal growth factor receptor 2 (HER2) are the mainstay of breast cancer management, and their prevalence rates vary among different populations possibly related to ethnic/genetic and/or socioeconomic status. In a previous study conducted at the King Hussein Cancer Center (published 2006), Jordan ER/PR/HER2 rates for patients diagnosed in 2003-2004 were 50.8%/57.5%/17.5%, respectively. The aim of this study is to revisit the prevalence rates to see if they have changed over the years with changing socioeconomic status. MATERIALS AND METHODS We retrieved clinicopathologic data of all patients (1,185) diagnosed with breast cancer during 2018. The data included age, histologic type, grade, and ER/PR/HER2 status as determined by immunohistochemistry and/or fluorescence in situ hybridization for HER2. RESULTS The mean age of patients was 52 (median = 51, range = 25-92) years, and the majority (73.2%) had invasiv...

medRxiv, 2021

Objectives: To determine the impact of the second wave of COVID-19 and the vaccination campaign o... more Objectives: To determine the impact of the second wave of COVID-19 and the vaccination campaign on the seroprevalence rates of SARS-CoV-2 antibodies among healthy blood donors in Jordan. Methods: Sera from 536 healthy adult blood donors collected in June -2021 were tested using a commercially available quantitative assay for the total antibodies including IgG against the spike (S) protein receptor binding domain (RBD) of the SARS-CoV-2. Results: 399 (74.4%) of the donors tested positive for the antibodies of whom 69 (17.3%) were confirmed to have been previously infected, 245(61.4%) have received at least one dose of the vaccine and 123(30.8%) were neither diagnosed nor vaccinated. The seropositive donors were significantly more likely to have been vaccinated or previously infected. Conclusion: The crude seroprevalence rate of 74.4% among this group of healthy donors may be encouraging in terms of approaching herd immunity, however with predominance of the delta variant and the unce...

Autopsy & Case Reports, 2021

Objective : Langerhans cell histiocytosis (LCH) is an uncommon entity of unknown etiology. It con... more Objective : Langerhans cell histiocytosis (LCH) is an uncommon entity of unknown etiology. It contains a wide range of clinical presentations. The discovery of oncogenic BRAF V600E mutation in LCH has provided additional evidence that LCH is a neoplasm. Papillary thyroid carcinoma is the most common cancer of the thyroid characterized by a high incidence of BRAF V600E mutations. LCH with concomitant PTC is rare, with few cases reported in the literature. Cases summary We identified two cases of LCH with concomitant papillary thyroid carcinoma in adult patients. The first was a 49-year-old female with a thyroid nodule diagnosed with papillary thyroid carcinoma. Later, the patient had a left neck mass; Ultrasound-guided lymph node FNA was diagnosed with Langerhans histiocytosis. Subsequently, a chest CT scan revealed signs of Langerhans cell histiocytosis in the lung. The second case refers to a 69-year-old male who presented with a left thyroid nodule diagnosed on FNA cytology as pap...

BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has resulted in more than 106 million ... more BackgroundThe coronavirus disease 2019 (COVID-19) pandemic has resulted in more than 106 million cases of confirmed infection and more than 2.3 million deaths worldwide as of February 11th 2021. Seroprevalence studies are extremely useful in studying and assessing the epidemiological status in the community and the degree of spread. They help decision makers in implementing or relaxing mitigating measures to contain the disease in addition to other benefits.ObjectiveTo study the seroprevalence rates of SARS-CoV-2 antibodies among healthy blood donors in Jordan, at various points of time as the pandemic evolves in the community.MethodsA total of 1374 blood donor were tested for the SARS-CoV-2 antibodies in 3 groups.The first group of 746 and the second of 348 individuals were tested in June and September of 2020 respectively. The 3rd group of 292 were tested in early February of 2021. We utilized a qualitative assay that uses Electrochemiluminescence method (ECLIA) that has a specifi...

Breast Cancer: Basic and Clinical Research

Background: Viral cause of sporadic breast cancer (SBC) has been suggested based on the experimen... more Background: Viral cause of sporadic breast cancer (SBC) has been suggested based on the experimental murine model of mammary tumor caused by mouse mammary tumor virus (MMTV), Epstein-Barr virus (EBV), and human papillomavirus (HPV). While some studies have demonstrated the presence of viral sequences of MMTV, HPV, and EBV in breast cancer cells, others failed. These contradictions may be attributed to the geographical distribution of breast cancer incidence and/or technical variations. In the current study, we aimed to investigate the correlation of MMTV, HPV, and EBV infections with the development of breast cancer in Jordanian patients. Methods: One hundred SBC tissue samples were subjected to laser capture microdissection for the selection of tumor cells populations. Fluorescence polymerase chain reaction (PCR) was used to detect the presence of the MMTV env-like sequences. Real-time PCR was used for HPV and EBV detection, and EBV was further confirmed by chromogen in situ hybrid...

Hematology/Oncology and Stem Cell Therapy

Breast Cancer Research and Treatment

Purpose Breast cancer that overexpresses the human epidermal growth factor receptor-2 (HER2) and ... more Purpose Breast cancer that overexpresses the human epidermal growth factor receptor-2 (HER2) and both estrogen (ER) and progesterone (PR) receptors is recently recognized as a subtype (triple-positive) with distinctive behavior and response to treatment. In this study, we investigate the treatment outcomes and the beneficial effect of anti-HER2 treatment in relation to level of hormone-receptor (HR) expression. Methods Consecutive breast cancer patients with triple-positive disease, diagnosed, treated and followed at our institution between 2006 and 2016 were enrolled. Disease-free survival (DFS) was studied in relation to the level of HR-positivity. Results During the study period, a total of 312 were enrolled; median age (range) was 47 (20–83) years. Fifty (16.0%) of the enrolled patients received adjuvant chemotherapy without trastuzumab (cohort A). All remaining patients were treated with both chemotherapy and trastuzumab and were divided into two groups: Cohort B with both ER and PR scores ≥ 50% ( n = 130, 41.7%) and Cohort C with ER and/or PR < 50% ( n = 132, 42.3%). After a median follow-up of 47 months, 14 (28.0%), 30 (23.1%) and 20 (15.2%) patients in cohorts A, B, and C had an event in a form of local/system relapse or death while disease-free. The estimated 5-year DFS was 56.2%, 75.4%, and 80.8%, respectively, and at 7 year was 56.2%, 67.1%, and 78.0%, respectively ( p < 0.001). Conclusions HER2-positive tumors are not homogeneous; stronger ER/PR co-expression may weaken the beneficial effect of anti-HER2 therapy. Such findings may have potential implication on modifying anti-HER2 treatment based on the strength of HR expression.