Iranian Journal of Blood and Cancer
Volume:2 Issue: 1, Autumn 2009

To study methaemoglobin content and NADH-methaemoglobin reductase activity of three human erythrocyte genotypes (HbAA, HbAS and HbSS). Studies to ascertain methaemoglobin concentration and level of NADH-methaemoglobin reductase activity of three human erythrocyte genotypes (HbAA, HbAS and HbSS) were carried out in forty-three (43) healthy male participants of confirmed erythrocyte genotypes: HbAA (N=15), HbAS (N=15) and HbSS (N=13). Spectrophotometric method was used for determination of the two erythrocyte parameters. Whereas methaemoglobin concentrations in the three erythrocyte genotypes was in the order: HbASp>0.05) in methaemoglobin concentration and NADH-methaemoglobin reductase activity between HbAA and HbAS erythrocytes. The results showed a relationship between erythrocyte NADH-methaemoglobin reductase activity and methaemoglobin concentration.

Medulloblastoma is the most common malignant brain tumor in children. The important factors in predicting survival are the extent of disease, proliferation index of the tumor cells, histopathologic class and the age at diagnosis. The percentage of Ki-67 positive cells reflects the proliferation of the cells and is one of the critical factors which determine the growth of the tumor. Monoclonal MIB-1 antibody can be targeted against recombinant Ki-67 and then demonstrated by immunohistochemical methods. Formalin-fixed, paraffin-embedded tissue of 18 pediatric patients with medulloblastoma at Mofid Children Hospital between January 2003 and December 2008 were used to perform Ki-67 (MIB-1) immunohistochemical analysis. Proliferative labeling index (LI) was scored in the tumor cells to determine the extent of proliferation. The mean±SD of MIB-1 LI index was 53%±21% (range 25% to 85%). Kaplan–Meier curves showed that patients with MIB-1 LI <40% had higher 5-year survival than patients with MIB-1 LI> 40% (p=0.04). This difference remained statistically significant in Cox regression analysis. We suggest that MIB-1 LI is helpful as a prognostic factor in predicting survival of patients with pediatric medulloblastoma.

Environment of Basrah is seriously contaminated with chemical leukomogens as a result of recent military conflicts. Many studies in the past few years have reported an increase in the incidence of leukemia in Basrah. This study was designed to study the risk and pattern of childhood leukemia in Basrah, Iraq, from 2003 to 2007. This hospital-based cancer registry study was conducted on the hospital registry between June to December 2009. All children with leukemia, aged 1 to 14 years diagnosed from January 2003 to December 2007 in the Pediatrics’ Oncology Word, Maternity and Children Hospital in Basrah, Iraq were included in the study. The records of all confirmed childhood leukemia were retrieved and studied. The specific incidence rates were calculated. The patterns of leukemia classified by age at diagnosis, gender, morphological subtypes and geographical distribution were also determined. From January 2003 to December 2007, the total number of the cases of childhood leukemia was 159. The overall age standardized incidence rate (ASIR) at this period was 5.45/100000. No temporal increase in incidence rates of childhood leukemia during this 5 year period was observed. The highest incidence rate was observed in the North of Basrah. The most common type of leukemia in this study was acute lymphoblastic leukemia (ALL), followed by acute myeloid leukemia (AML) and chronic myeloid leukemia (CML) respectively. All subtypes of leukemia were more common in males. The highest percentages of ALL and CML were observed at ages between 2 to 5 years. AML occurred more commonly at age of 6 to 14 years. Leukemia was the most common childhood malignancy in Basrah. Although we observed no temporal increase in the incidence rates of childhood leukemia during the 5 year period from 2003 to 2007, leukemia incidence in children in Basrah was higher in comparison with other countries. There is a need for epidemiological studies to understand the etiology of childhood leukemia in Basrah.

Hepatitis-C infection is a major problem in chronically transfused patients. We compared Interferon-α (INF-α) monotherapy with combination of INF-α and amantadine in the treatment of β-thalassemia major patients who were chronically infected with HCV. Forty six thalassemia major patients who were chronically infected with HCV were randomly divided into two groups. One group (22 patients) was treated by INF-α, 3 million units every other day plus amantadine 2 mg/kg/day (case group) and the other group (24 patients) was treated by INF-α and placebo tablet (control group). The duration of treatment was 12 months in both groups. PCR for HCV and liver function tests were performed 3 months after beginning of treatment and 6 months after treatment cessation in both groups and the results were compared. Sixteen patients were excluded from the study (12patietns in case group and 4 patients in control group) due to drug intolerance and inadequate follow up. 20 patients out of 24 patients who were treated with INF-α alone (control group) and 10 patients out of 22 patients who were treated with INF-α plus amantadine (case group) were followed for 18 months. PCR for HCV was performed two times for all patients. Initial PCR revealed that 15 patients (75.0%) became HCV negative in control group while 10 patients (100%) became HCV negative in case group.The second PCR which was performed 6 months after termination of treatment disclosed that 16 patients (80.0%) in control group were HCV negative compared to 6 patients (60.0%) in case group (P>0.05). Addition of amantadine to interferon does not improve the remission rate in HCV positive major thalassemic patients.

In 1997, a novel DNA virus was isolated from the serum of a patient in Japan, and it was named TT virus (TTV). As the virus is replicated in liver and has the ability to induce apoptosis in hepatocytes (Hepatocellular carcinoma cells) it is hypothesized that TTV is an opportunistic virus and in certain conditions causes liver damage. In this study the frequency of infection with TTV was detected in two groups of healthy and hepatitis B infected blood donors in the West Azerbaijan Province. Serum samples were collected from 100 healthy and 40 HBs Ag positive donors in west Azerbaijan Blood Transfusion Center. Patients’ characteristics, sex, age and blood groups were recorded. The levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) in the sera were measured and then DNA was extracted and polymerase chain reaction (PCR) was performed using T801 and T935 consensus primers to amplify a 199 bp segment of a much conserved non-coding region of the genome (UTR). TTV was detected in 69% and 75% of healthy and hepatitis B infected blood donors respectively. No significant difference was observed in the frequency of the infection with TTV in different blood groups or age groups (P>0.05). In each group of blood donors the level of ALT and AST were not significantly different in TTV infected and non-infected individuals (P>0.05). Regarding the high frequency of infection in healthy individuals and considering the level of hepatic enzymes in TTV infected individuals; it seems that the virus or at least its investigated genotypes have not been pathogenic for the infected individuals examined.

NT-proBNP is a marker that is released from ventricles in response to pressure and volume overload. Raised plasma level of NT-proBNP is seen in ventricular dysfunction, ventricular muscular mass reduction or ventricular ischemia. Anthracyclines are widely used in treatment of pediatric cancer but their use is associated with cardiotoxicity which increases mortality and morbidity. We measured the plasma levels of NT-proBNP to determine whether it might serve as a simple prognostic indicator of anthracycline-induced cardiotoxicity and to estimate the toxic levels of anthracyclines in children with malignancy treated with anthracycline containing regimens in Tehran’s Mofid hospital. This study was performed as a before and after clinical trial. Twenty-nine pediatric patients less than fifteen years old with newly diagnosed cancer were enrolled in this study. All patients received anthracycline-containing chemotherapy with 120 to 150 mg/m² in accumulative dose. Serial measurements of plasma NT-proBNP levels and echocardiographies were taken before onset of chemotherapy, simultaneous with accumulative dose of 120 to 150 mg/m² and two weeks after that dose. Plasma levels of NT-proBNP were within normal limits before treatment and increased significantly after the mentioned accumulative dose (P=0.002) in 26 patients out of 29. All patients had normal echocardiograms and none developed heart failure during the two-year period of the study. NT-proBNP levels increases significantly after 120 to 150 mg/m² as accumulative dose in a subset of pediatric cancer patients. This increase is not associated with echocardiographic or clinical evidence of cardiac dysfunction. Longer follow-up of these patients is necessary to determine whether NT-proBNP can be used as an early and prognostic marker for anthracycline-induced cardiotoxicity and whether 120 to 150 mg/m² as accumulative dose of anthracycline is a safe dose or not.