Background and Objectives: Classic HODGKIN lymphoma (CHL), anaplastic large cell lymphoma (ALCL) and some cases of diffuse large B cell lymphoma (DLBCL) have overlapping morphologic features. Since they all represent distinct clinico-pathologic entities, we explored the differential diagnostic impact of immunophenotyping to discriminate between them.Materials and Methods: We included 61 cases diagnosed as CHL, ALCL, and anaplastic variant of DLBCL. We reviewed morphologic microscopic findings by conventional staining and immunohistochemistry (IHC) with antibodies against PAX-5, CD30, CD15, CD45, EMA, ALK-1, and LMP-1.Results: Fifty cases corresponded to CHL (81.97%), 4 cases to ALCL (6.56%), and 4 cases to DLBCL (6.56%) excluding 3 cases, which remained unclassifiable (4.92%). PAX-5 was expressed in 94% of CHL and 100% of DLBCL cases. LMP-1 was expressed in 52% of CHL and 25% of DLBCL cases. EMA was invariably expressed in all 4 cases of ALK+ALCL. It was expressed in 4/50 cases (8%) of CHL and in 2/4 cases (50%) of DLBCL. CD45 was expressed in all cases of ALCL and DLBCL but also in 3/50 cases (6%) of CHL.Conclusion: The differentiation between ALCL and CHL based on EMA and CD45 is not reliable.Utilization of PAX-5 in combination with other markers such as CD15 and LMP-1 is recommended.CD20 and PAX-5 are not too helpful in the differentiation of CHL and DLBCL, while CD15 and CD79a were found to be quite useful discriminative markers for this purpose.

Background and Objectives: Human Herpes 6 virus (HHV-6) could remain latent and chronic in the host cells after primary infection. HHV-6 genome encodes certain transactivation proteins which may results in development of malignant lymphoma. The association of human herpes six virus (HHV-6) infection and HODGKIN and Non-HODGKIN lymphomas is strongly supported by epidemiological studies. The aim of this study was to determine the prevalence of HHV-6 among the patients with HODGKIN, Non- HODGKIN`s lymphoma.Materials and Methods: Overall 44 blocks of formalin-fixed, paraffin-embedded of the patients including 22(50%) HODGKIN and 22(50%) Non-HODGKIN Lymphoma were collected. Initially the section of 5μm-thickness were prepared from the formalin-fixed, paraffin-embedded tissue blocks. Then the deparaphinazation was carried out for each sample. The DNA was extracted, followed by nested PCR for detection of HHV-6. Based on PCR product size and sequencing, the HHV-6 A or B subtypes were characterized.Results: 12.22 (54.54%) cases of HODGKIN and 8.22 (36.36%) Non-HODGKIN’s lymphoma were shown as positive for HHV-6. Out of 12 positive HHV-6 in HODGKIN lymphoma, 10 patients (45.45%) belonged to variant A while 2 cases (9.09%) were found positive for both HHV-6A and HHV-6B. All the Non HODGKIN samples (n=8, 36.36%) showed positive for HHV-6 variant A.Conclusion: High prevalence of HHV-6 was found among the patients with HODGKIN and Non-HODGKIN’s lymphoma. Two patients with HODGKIN lymphoma had mixed HHV-6A and HHV-6B infections. It is recommended patients with HODGKIN and Non-HODGKIN should be screened for HHV-6 detection before chemotherapy.

Background: Hepatitis B Virus (HBV) is responsible for chronic, acute, and fulminant hepatitis, which are prevalent worldwide. Chronic HBV may lead to cirrhosis and hepatocellular carcinoma. Several epidemiological studies have indicated that hepatitis B virus is involved in B-cell HODGKIN and Non-HODGKIN Lymphoma (NHL).Objectives: The aim of this study was to evaluate the association between hepatitis B infection and HODGKIN and non-HODGKIN Lymphoma.Materials and Methods: Paraffin embedded of 41 block samples including 12 (29.26%) HODGKIN and 29 (70.73%) non-HODGKIN patients were collected. Next, DNA extraction was carried out for all the samples followed by HBV DNA detection by the nested polymerase chain reaction (PCR). The positive HBV DNA samples were sequenced, and HBV genotypes and HBV subtypes were determined.Results: Three out of 12 (25%) HODGKIN samples and seven out of 29 (24.13%) non-HODGKIN showed positive HBV DNA results. The results of sequencing revealed that the D genotype was predominant among the positive HBV patients. Interestingly an unpredictable amino acid proline was detected in position 88 of the HBs gene, which indicates a new mutation in the “S” region of HBV DNA in patients with HODGKIN and non-HODGKIN lymphoma.Conclusions: A high rate of 25% and 24.13% of HBV DNA was detected among patients with HODGKIN and non-HODGKIN lymphoma, respectively.

Background and Objectives: Hepatitis C virus (HCV) is a major public health problem worldwide. Replication and persistenceof HCV genome have been described in the liver tissue as well as B cells lymphocyte. Several investigations havereported that long-term persistence of HCV in B cells may result in HODGKIN and Non-HODGKIN lymphoma. This studywas aimed to determine frequency of HCV RNA in histological tissues obtained from patients suffered from HODGKIN andNon-HODGKIN lymphoma.Materials and Methods: 52 formalin-fixed paraffin-embedded tissue blocks including 23 (44.3%) HODGKIN and 29 (55.7%)Non-HODGKIN samples were collected and five micrometer sections were prepared. RNA was extracted and cDNA was synthesized.Two consecutive Nested RT-PCR assays were carried out for detection of HCV 5’ UTR and core gene. RT-PCRproducts were sequenced and aligned to construct HCV phylogenic tree to evaluate the homology of sequences in comparisonto the reference sequences retrieved from Genbank.Results: Overall, 6 Non-HODGKIN (20.6%) and 3 HODGKIN lymphoma (13.04%) samples showed positive PCR results forboth 5’ UTR and HCV core RNA via nested PCR (P<0.469). Sequencing results revealed that all detected HCV RNA samplesbelonged to the genotype 3a.Conclusion: Despite low prevalence of HCV infection in Iran, high frequency of HCV RNA genotypes 3a (17.3%) has beenfound in patients with HODGKIN and Non-HODGKIN lymphoma. To improve treatment regimens, screening of HCV RNA inpatients suffered from HODGKIN or Non-HODGKIN lymphoma is recommended which can be done through highly sensitivemolecular means before and after immunosuppression status.

Introduction: Management of early relapsed or refractory lymphoma [HODGKIN & non- HODGKIN Lymphoma (HL & NHL)] is a matter of problem, especially when hematopietic stem cell support is not available. The aim of this study was to evaluate effectiveness of IEV Regimen (Ifosfamide, Epirubicin, VP16), in lymphoma patients who are not candidate for stem cell transplantation. Because the majority of our patients are nonadequate for stem cell transplantation (refuse of this modality and economic problem). This reason leads to use of more effective treatment. This trial approved with ethic committee of medical university.Patients and Methods: Twenty four patients (16 male and 8 female) with early relapsed i.e. before 6 months of primary therapy (N=21) or refractory lymphoma (N=3) were entered. Of 24 patients 18 were diagnosed as NHL and 6 as HL. 10 cases were in stage II, 12 cases in stage III and 2 cases in stage IV. In an inpatient setting all of the patients received 3- 4 consecutive cycles of IEV (Ifosfamide, Epirubicin, VP16) and MESNA equal to Ifosfamide for uroprotection. Cycles were repeated every 21 days, for a total of three courses.Results: The overall response rate was 92% (50% complete response and 42% partial response). Complete response were observed in 8 with NHL and 4 with HL and partial response in 9 with NHL and 1 with HL respectively. There was no response in 8% (1 patient with NHL and another with HL). Toxicities were: grade 1 neutropenia (10%) and 4 (40%), grade 1 thrombocytopenia (20%), grade 2 anemia (40%) nausea (100%), fever in 80%, neutropenic fever in 30%, pneumonia in 20%, of patients, but the majority of patients improved over treatment. One case died from progressive disease and co infection with no response to antibiotic therapy. The major cause of drug toxicity was Ifosfamide (high dose usage and 3 days continuous IV infusion). Tolerance to the regimen was good.Conclusions: Our results revealed the efficacy of the IEV regimen as salvage therapy in primary refractory and early relapsed NHL & HL without stem cell support.

Background: Antineoplastic drugs are among medications that have narrow therapeutic index and high toxicity. For this reason, medication errors in patients with cancer are important and there have been myriads of efforts to decrease them. In this study, we attempted to assess the medication errors by designing chemotherapy standard forms for patients with HODGKIN’ s and non-HODGKIN’ s lymphomas. Method: This cross-sectional study was performed in Omid and Imam Reza Hospitals, Mashhad, Iran from January 2016 to October 2016. The forms have been designed by clinical pharmacist based on available international guidelines and validated by clinical oncologists working in these two centers. Therapeutic regimens were selected by clinical oncologists and adherence of the oncologists and nurses to this form and probable medication errors were identified by the pharmacy students. Result: In 206 visits of 62 HODGKIN’ s and non-HODGKIN’ s lymphoma patients, overall 790 antineoplastic drugs were administered to patients in whom 160 drugs were associated with medication error. The most common errors included improper dose (65%) and wrong infusion time (35%). One of the most important reasons for dosing errors was miscalculation of the BSA (40%). Conclusion: This study shows that about two third of errors were improper dose. It seems that chemotherapy standard forms, if properly followed by nurses and physicians, could be useful and effective to reduce medication errors.

The current study designated to evaluate Gray scale Ultrasound (US) parameters of the lymphomatous cervical lymph nodes (CLN) in HODGKINʼs, Non HODGKINʼs lymphoma (HL and NHL) patients, and normal CLN in normal control group, 92 CLN in 50 patients newly diagnosed with HL and NHL and 29 normal CLN in 25 healthy persons. (US) parameters including shape, echo pattern, fatty hilum, nodal border, cystic necrosis, coagulation necrosis and internal calcification, homogeneity, site of involvement, and status to the adjacent tissue of lymph nodes were noted. The shape (round), fatty hilum (absent), homogeneity (homogenous), lymph node status (matted), and echogenic pattern (reticular) presented with significant relationship (Si) that segregate NHL and HL in contrast to control group, cystic necrosis (present) presented with (Si) that segregate NHL in contrast to control groups with (Si) relation toward HL group, nodal border (regular) presented with (Si) in NHL in contrast to control group with no significant (NS) relationship with leftover groups, with (68.9%) in HL to be informative hyperechoic echogenic pattern presented with (Si) in control group in contrast to NHL, HL groups. The other parameters such as site of involvement, coagulation necrosis, internal calcification, and hypoechoic and isoechoic echogenic pattern presented with (NS) relation among studied groups. Gray-scale US parameters outcome round shape, absent Hilum, homogenous architecture, lymph node status (matted), and reticular echo pattern were a strong clinical diagnostic features in lymphomatous CLN that predict occurrence of NHL, HL, with more presented matted lymph nodes in NHL than HL group. Cystic necrosis (present) was strong clinical indicator for the NHL occurrence prediction.