Iranian Journal of Blood and Cancer
Volume:7 Issue: 5, Des 2015

Hodgkin lymphoma (HL) accounts for about 10% of all childhood cancers. Five-year survival rates with modern therapies are now approaching >90-95% as a consequence of its significant sensitivity to both chemotherapy and radiation. The current challenge is to determine how much therapy is needed to improve survival and how to adapt treatment to the patient to prevent these long term toxicities. This challenge has resulted in the development of different strategies aimed at recognizing the optimal balance between preserving overall survival and avoidance of long-term treatment-related morbidity. Strategies in children could be quite different from those used for adults with HL. More defined risk stratification through imaging studies and biologic markers have been developped. Increased knowledge of the biology of HL have led to the introduction of targeted therapies in both the frontline and relapsed patients. Collaborative multicenter studies are required to develop new combination therapies for children with newly diagnosed and refractory HL.

Several studies have examined the presence of DNA methylation of CpG islands in leukemia. Methylation of SOX17 and RUNX3 genes may play a role in leukemogenesis through silencing tumor suppressor genes. We investigated the methylation status of SOX17 and RUNX3 genes in patients with acute leukemia. In this case-control study، peripheral blood samples from 100 AML and 100 ALL patients and 100 healthy controls were collected. Isolated DNA was treated with sodium bisulfite and methylation status was examined by methylation specific PCR (MS-PCR) with primers specific for methylated and unmethylated sequences of SOX17 and RUNX3 genes. The frequency of hypermethylation of SOX17 and RUNX3 genes were 36% and 28%I in patients with acute myeloid leukemia (AML)، and 21% and 22% in patients with acute lymphoblastic leukemia (ALL)، respectively. Aberrant methylation of these genes was found in all FAB classifications of AML and ALL. Hypermethylation of SOX17 (P=0. 055) and RUNX3 (P=0. 003) genes were associated with FAB-M0 and M1 subtypes of AML، respectively. Also، aberrant methylation of RUNX3 gene was associated with FAB-L1 subtype of ALL (P=0. 053). There was not any significant association between hypermethylation of SOX17 and RUNX3 genes and clinical parameters of patients with leukemia including sex، age، WBC، and platelet counts. Hypermethylation of SOX17 and RUNX3 genes was seen in patients with acute leukemia. Moreover، no significant association was observed between hypermethylation of SOX17 and RUNX3 and induction of remission.

Idiopathic thrombocytopenic purpura is an autoimmune blood disorder in which platelet destruction is mediated by anti-platelet antibodies. There are two forms of ITP: acute and chronic. The aim of the present study was to evaluate the clinical variables in adult patients with acute ITP in west of Iran. Patients and Medical records of adult patients with diagnosis of acute ITP referring to Hematology Clinic of Kermanshah from year 2004-2014 were analyzed. Demographic and hematologic data and status of H pylori infection of the patients were extracted. There were records of fifty-three patients diagnosed with acute ITP. Mean age at diagnosis was 39. 1 years (±13. 3) ranging from 14-68 years. Twenty patients (37. 7%) were male. Out of 53 patients، 25 cases (47. 2%) were positive for H pylori infection. There was significant association between Hb and platelet with sex of the patients (P≤0. 05). Mean age of adult patients with acute ITP was more than figures expected in chronic ITP patients. In addition، Prevalence of H pylori infection in acute ITP patients was more than chronic ITP patients.

Ischemic heart disease and acute myocardial infarction is one of the most dramatic manifestations in one of the most investigated fields in the past few decades. In this study, the prognostic value of white blood cells count in patients with myocardial infarction (MI) was investigated in a six months follow-up. In this cohort study, 106 patients with MI were investigated. White blood cell counts were assessed 48 hours after MI and the location of MI was determined using ECG. Mortality rate was determined and their correlation with leukocytosis was analyzed up to 6 months of follow-up. Binary logistic regression analysis was applied between factors such as mortality rate, location of the myocardial infarction, sex, hemoglobin and WBC count. Mean age of the patients was 62.5±13.3 years. 76.4% were men. 26% of patients had leukocytosis. Leukocytosis was significantly correlated with mortality in a six-month follow-up period (P<0.001). Fifteen (14.2%) patients died during the first three months of follow-up, of which 13 (86.7%) had leukocytosis. It was also shown that mean age of the patients and anemia in deceased group were significantly more than the survived group. High WBC count in the first 48-h after MI can be regarded as a poor prognostic factor and it has an independent role in determining prognosis of patients with MI for the next six months.

Red blood cell and other blood products play a crucial role in management of different disease processes, but in spite of implementation of crucial steps to improve the process of request for blood and blood consumption, there is still not enough information available regarding the proper practice in many medical centres. We aimed to evaluate the status of blood product requests and transfusion practice in surgical patients in Al-Zahra and 17th Shahrivar hospitals, Rasht, Iran. Materials: This retrospective, descriptive cross-sectional study was performed using medical records of patients undergoing major surgical procedures in Al-Zahra and 17th Shahrivar hospitals, Rasht, Iran, from April to December 2013. The cross-match to transfusion ratio (C/T ratio), transfusion probability (T%) and transfusion index (TI) were analyzed. We used SPSS analytical software to analyze the data. Transfusion index was 0.27, transfusion probability 12.8% and C/T ratio was 7.38 which were higher than standards, indicating that only 54 units out of 399 red blood cells units requested were used. Laparoscopic surgery had the worst indicator in terms of wastage of packed cell products. These findings in 17th Shahrivar hospital were 0.09, 8.82% and 12.5, respectively. In this hospital only 10 units out of 125 requested units were used. Appendectomy showed the worst indicators. Blood transfusion indexes particularly for laparoscopic and appendectomy procedures were high in two hospitals studied. In order to overcome this problems, providing teaching courses for proper transfusion practice in surgery departments to improve their knowledge of haemovigilance and preparation of defined guidelines for red blood cells’ cross matching and transfusion is recommended.

Patients with acute myeloblastic leukemia (AML) with monosomy 7 are a group of patients with refractory AML who have a very poor prognosis. Therefore، rationally designed new therapies، including metronomic chemotherapy regimen with histidine deacetylase inhibitors (Valporic acid، ATRA) are being investigated as potential treatments for the population of refractory cases of AML. Herein، we report a patient with primary refractory AML who was treated with oral low-dose chemotherapy after standard systemic chemotherapy.