IRANIAN JOURNAL OF BLOOD AND CANCER
Year:2019 | Volume:11 | Issue:2|Papers Count:8

The consequence of repeated blood transfusions in thalassemia is iron overload in different organs. Magnetic resonance imaging (MRI) is a reliable, noninvasive and accurate method for iron detection in various tissues, hence the introduction of MRI has revolutionized the management of these patients and improved the life expectancy of them. Cardiac MRI T2* has a profound effect not only on estimation of severity of cardiac siderosis, but on intensification of chelation regimens and survival of patients. Liver hemosiderosis is also a common morbidity among thalassemia patients, since the liver represents the dominant iron storage organ in the body; however, the relationship between total body iron and liver iron concentration (LIC) is challenging. Pancreatic iron overload occurs in 75-100% of patients with thalassemia major, but the association between pancreatic R2* and development of diabetes mellitus has not been established in the studies. On the other hand, there is a strong correlation between pancreatic R2* and cardiac R2*, so pancreatic R2* could predict left ventricular function. The most prevalent endocrinopathy in patients with thalassemia is hypogonadotropic hypogonadism which has been correlated with pituitary iron overload. Published data about kidney and adrenal MRI is limited, and further studies are needed to determine their clinical significance.

Background: Human T-cell lymphotropic viruses 1 (HTLV1) is endemic in specific regions. We aimed to determine the prevalence of HTLV I infection among blood donors in southeast Iran. Methods: This cross-sectional study was conducted between April 2005 and March 2015. Sera were collected from blood donors and were tested for the presence of HTLV1 specific antibody using ELISA. Reactive samples were then tested by Western blot for confirmation. Results: Of the 165, 267 blood donors tested for HTLV 1 antibody, 45 (0. 027%) donors were positive. Out of 45 positive donors, 41 were first time blood donors, 3 were repeat blood donors and 1 as regular donor. Most HTLV-1-positive donors were male and married. Co-infection with HBV was observed in one subject. The percentage of positive samples had increasing patterns from 0. 016% in 2009 to 0. 084% in 2010 and decreased after that to 0. 014% in 2015. Conclusion: The results indicated a low level of infection of HTLV1 in this part of our country.

Background: Nephrotoxicity secondary to doxorubicin (DOX) may be associated with high morbidity and mortality rates. We aimed to assess the efficacy of Deferoxamine (DFO) in preventing DOX-induced nephrotoxicity in pediatric malignancy. Methods: This Parallel-group randomized clinical trial was done on 62 children aged 2-18 years who had new onset malignancy treated with DOX. They were randomly assigned in three groups; group 1 (no intervention, n=21), group II (DFO 10 times DOX dose, n=20), group III (DFO 50mg/kg, n=21). Patients in the intervention groups received DFO concomitant with DOX 8-hour intravenous infusion in each chemotherapy course. Blood urea nitrogen, serum creatinine, electrolytes, calcium, phosphorus, magnesium and albumin levels, urine microalbumin, urine protein/creatinine ratio, and urine N-acetyl-β-Dglucosaminidase (NAG) as well as findings of kidney ultrasonography were compared between the groups after the last course of chemotherapy. The primary outcome was to compare the radiologic and serologic markers of glomerular and tubular damage between the 3 groups. Results: Sixty patients were analyzed. Patients treated with DFO 10 times the dose of DOX had significantly lower urine NAG level compared to the control group (P=0. 032). No significant renal damage was reported in their ultrasonography in the 3 groups. DFO was safely tolerated without any adverse effect. Conclusion: DFO with 10-times the DOX dose may effectively prevent DOXinduced nephrotoxicity at least at the molecular level. Increasing the dose of DFO is not accompanied by better efficacy.

Background: Acute lymphoblastic leukemia (ALL) results from genetic alterations in a single lymphoid progenitor cell. Expression of ROR1 is reported to be increased in ALL and mantle cell lymphoma. In this study the expression of ROR1 was assessed in newly diagnosed patients with ALL. Methods: This study was carried out on 40 patients with newly diagnosed ALL and healthy individuals as control group. Quantification of ROR1 mRNA expression by Real Time quantitative PCR was performed. The expressions of ROR gene in patients were compared with the control group. Results: ROR1 mRNA expression (Fold Changes) in patients with ALL was 2. 85± 3. 51. ROR1 mRNA expression in patients with ALL was significantly higher than normal individuals (P<0. 001). There was not any relationship between the expression of ROR1 and cytogenetic abnormalities. Conclusion: We assessed ROR1 gene expression on mRNA of 40 ALL patients at diagnosis. The results showed that ROR1 expression had significant increase in ALL patients compared with healthy controls.

Background: Hypofractionated radiotherapy (HF) method was introduced to overcome the quickly growing tumor cells as well as shortening whole treatment course in solid tumors such as breast cancers. Here, we compared the incidence of dermatitis and pharyngitis among patients undergoing HF versus conventional fractionationated (CF) radiation therapy following surgery for breast cancer. Methods: During this prospective study, women who had undergone breast surgery since 2015-2017 were included in the initial sample population. 40 patients were included for analysis in each arm of CF and HF. Patients treated by CF received 50 Gy with 2. 0 Gy per each fraction session and in group of HF; 42. 4 Gy was delivered in 2. 66 Gy per fraction sessions for 3 months. Severity of acute dermatitis and pharyngitis was recorded for all patients in both groups based on regular examinations during and after the radiation therapy. Results: 18 out of 40 patients in the conventional group experienced dermatitis of which 11 and 3 were grade 2 and 3, respectively. In the HF group, 8 experienced only grade 1 acute dermatitis. Thus, acute radiation-induced dermatitis occurred more frequently (P=0. 017) and more severely (P=0. 002) in the conventional group within 3 months of follow-up. There was no statistically significant difference in incidence of pharyngitis between the two groups. Conclusion: There was a statistically significant difference in occurrence of dermatitis between the two groups of conventional radiotherapy and those who received hypofractionated radiation. Incidence and severity of dermatitis was more common in those who received conventional radiotherapy in comparison to hypofractionated method.

Renal cell carcinoma (RCC) is an aggressive malignancy which can metastasize to the bone. Long bones or the small bones of the limbs could be rarely the destinations for metastatic RCCs. We report two cases of metastatic RCC to the humerus bone with the initial presentation of pathological fracture. The pathologists must be aware of metastatic RCC to the arm and consider it in the differential diagnosis of any arm lesion with clear cell feature, whether there is a history of RCC or not. Complete clinical data and a history of the patient are of significant importance for pathologists to avoid unnecessary laboratory procedures.

Hodgkin lymphoma (HL) as a malignant tumor presents with lymphadenopathy and systemic complaints. The origin of this tumor is mostly suggested to be B lymphocytes. There is a close relationship between autoimmunity and HL, but the mechanism of this immune syndromes is unclear. Immune thrombocytopenia (ITP) is the most common autoimmune syndrome which may present before, at the same time, and even after treatment of the HL. We present a case of ITP as a primary sign of relapse of HL in a 15-year-old boy after complete treatment of HL.

A 8-year-old girl was referred to hematology clinic because of easy bruising and several ecchymotic lesions mostly over his lower extremities. She had been symptomatic since early childhood. The parents were consanguineous. They also complained of loose skin, twisting ankles and recurrent falling in their child causing old scars. On physical examination, she was in good general condition. The facies was noticeable with epicanthal fold, mild prominent eyes and fixed lip borders. The most remarkable signs were dispersed ecchymoses throughout lower extremities, ulcerated hematomas on his knees, stretchy loose skin visible over elbows and hypermobility in small joints of the hands (Figure 1-4)..