Iranian Journal of Blood and Cancer
Volume:14 Issue: 1, Mar 2022

The objective of this study is to determine the major causes of early death in acute lymphoblastic leukemia (ALL). 

The following databases including PubMed, EMBASE, Science Direct and Google Scholar were searched for following terms: “acute lymphoblastic leukemia”, “early mortality”, “early death “ and “death in induction phase “. Inclusion criteria were all studies about the etiologies of early mortality in children with acute lymphoblastic leukemia. Early death means death occurs within 30 days of starting induction chemotherapy.

In total, 12 studies fulfilled inclusion criteria.7561 children under 18 years of age were studied in this review. Of these, 354 patients died during the induction phase of therapy. The early mortality rate was 4.6%±4.8. The most common cause of early death was an infection (52.5%), which was mainly bacterial. The second leading cause was bleeding (15%), and tumor lysis syndrome (4%) was the third most common cause. The other causes were septic shock (2%), hyperleukocytosis (2%), encephalopathy (1.7%), cardiomyopathy (1.7%), chemotherapy-related toxicity (1.2%), and thrombotic events (0.6%).

It is needed to advance supportive care to prevent infection by starting Intravenous immunoglobulin for infant and prophylaxis against Pneumocystis jiroveci with trimethoprim/sulfamethoxazole in neutropenic patients during induction, and bleeding by transfusion support.

Single nucleotide polymorphisms (SNPs) in the promoter region of miRNAs may disturb miRNAs processing, alter their expression, and ultimately affect an individual’s susceptibility to cancer. We conducted a case-control study to evaluate the association of rs353293 G>A with the risk of thyroid cancer in the Iranian population.

192 patients with thyroid cancer including (papillary, follicular, medullary, and undifferentiated) and 125 healthy subjects were enrolled in this case-control study. rs353293 G>A polymorphism in the promoter region of miR-143/145 were analyzed using polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) to find the association of this SNP with thyroid cancer. Logistic regression analyses were conducted to evaluate adjusted odds ratios (ORs) for the potential confounding factors (age and sex), and 95% confidence intervals (95% CIs) between patients with thyroid cancer and controls.

We found no association between rs353293 G>A polymorphism and thyroid cancer. 

This study suggests that the functional polymorphism in rs353293 is not associated with development of thyroid cancer. Future investigations with larger sample size should be performed to confirm our observations.

Diet is considered as an important contributor to the development of the cancers. In the present study, the association of dietary patterns with gastric cancer risk was studied.

In the present case-control study, 192 newly diagnosed gastric cancer patients and 365 subjects as control group were included. The participants in each group underwent face-to-face interview. For food pattern determination, a 100-item qualitative food frequency questionnaire (FFQ) and exploratory factor analysis method were used. Logistic regression was used for determination of association between derived dietary patterns and gastric cancer risk.

Four major dietary patterns with 55.48% prediction rate, namely “tubers and spices”, “cereals and dairies”, “healthy” and “Western-style”, were identified. Tubers and spices [in males: 11.42 (4.17, 26.75); in females: 6.94 (2.24, 21.56)] and “Western-style” dietary patterns [ in males: 1.16 (1.00-4.35); in females: 2.25 (1.10, 6.49] significantly increased the odds of gastric cancer risk in both sex. However, “healthy” dietary pattern and “cereals and dairies” dietary pattern were not associated with gastric cancer risk (P>0.05). 

In Iranian population, consumption of diets high in tubers, spices and salts (labelled tubers and spices), processed meat, high energy drinks, snacks and desserts (labelled western-style) tended to increase the risk of gastric cancer. More longitudinal studies with large sample size and accurate estimate of dietary intake is suggested until more precise conclusion could be achieved.

The clinical pathological features were detected by measuring the prostatic acid phosphatase (PAP) activity according to the stages and grades of prostate cancer. We also explored the relationship between the disease and age with family history among the patients.

Data were collected from direct interview and from the patient’s records. Blood samples that collected before the surgery from Baghdad hospitals. By using the ELISA device, PAP enzyme activity was determinred using Automated Chemiluminescent Immunometric Assay. 

Older individuals were more likely to develop prostate cancer since out of the 50 samples collected, most (46%) were ≥60 years old. 23 (46%) cases were in stage II of PCa and 29 (58%) had grade-II as the most dominant stage and grade. Family history from parents to sons had a significant role in the possibility of being positive for prostate cancer. A positive family history was found in 72% of the cases of PCa, and it was found that the enzymatic activity of the PAP enzyme rises in the presence of prostate cancer.

PAP enzyme is reliable in diagnosing the presence of prostate cancer, as the increase in the activity of the enzyme PAP coincides with the presence of prostate cancer.

Long-term central venous access is used in children for various reasons specially for delivering chemotherapy. Since vessels in children have smaller diameters, they are more prone to injury and complications such as thrombosis. Different methods are used for implantation of port-a-cath in children. We aimed to compare the complications of insertion of central venous access ports between two methods of open and ultrasound (US) guided. 

All children who were referred to pediatric surgery department of a children hospital from April 2018 to March 2020 for implantation of port-a-cath were included. Right jugular vein was the target vein and patients were randomly divided between two methods of insertion of open lateral neck exploration and ultrasound real-time guided percutaneous insertion and the reservoir was fixed in subpectoral fascia pouch. All open cases in which jugular vein was ligated proximally were excluded. Patients were followed up for early and late complications two days and one week later by the surgical team, then monthly by a trained nurse and were referred to the surgeon if any complication or malfunction had occurred for at least 6 months.

We included 76 patients (21 girls and 55 boys) less than 18 years of age: 24 patients with ultrasound guided method (1-13 years, median 3 years) and 52 patients with open exploration method (4 months-17 years, median 6 years). We observed no statistically significant difference between two groups with respect to sex, underlying disease, and complications. Most patients had hematological malignancies including ALL (52.9%), AML (19.1%) and the rest had solid organ malignancies. Early complications were observed in 2 (3.8%) in the open and 1 (4.2%) in the US- guided group (P=1). Late complications were observed in 9 (17.3%) patients in the open group and 1 (4.2%) in the US guided group. Infection was observed in 9.6% and malfunction in 5.8% of the open group leading to earlier removal of the catheter. There was not any complication indicative of infection in the US-guided group.

US-guided method can be suggested for routine use as a safe method of insertion of port venous access in children.

The diagnosis of B-cell acute lymphoblastic leukemia (B-ALL) on the basis of the World Health Organization (WHO) recommendations in 2016 requires the expression of CD19 with CD79a (CD79a), cCD22 and CD10. CD79a is an integral B cell antigen expressed at all stages. Its absence in B-ALL has only been rarely reported. In this study, we described three cases of B-ALL showing complete loss or extremely weak expression of CD79a.

Seventy-five patients with B-ALL diagnosed by flow cytometry over a period of 3.5 years were taken out from the records. Cases lacking for CD79a by flow cytometry were further analysed.

Out of 75 cases, CD 79a negativity was seen in 4% (3/75). However, every three cases expressed other B cell markers. No aberrant expression of myeloid and lymphoid antigens was seen in any of these three cases. The prognosis of these three cases was similar to CD79a positive cases.

Rarely, B cell ALL may lack CD79a. Thus, to avoid the misdiagnosis, a comprehensive antibody panel should be used. There was no prognostic impact of CD79a negativity in this study, however larger studies are needed to confirm these results.

Thromboembolic events represent the main cause of morbidity and mortality in patients with polycythemia vera. Leukocytosis has been identified as an important risk factor for development of vascular thrombosis. A 47-year-old woman with polycythemia vera presented with pain and swelling in her right calf. She was scheduled to receive anagrelide which was effective on polycythemia and thrombocytosis, but leukocytosis persisted. She was diagnosed with thrombosis in right popliteal vein and left common femoral vein by duplex ultrasonography. We suggested a role for leukocytosis in inducing thrombotic phenomenon in our patient with polycythemia vera.

Erythrophagocytosis refers to the removal of old and damaged red blood cells by leukocytes and macrophages. Observation of erythrophagocytosis in peripheral blood smear is a rare phenomenon that is mostly observed in paroxysmal cold hemoglobinuria and sporadically in some other pathological conditions. Here, we report a case of erythrophagocytosis by monocyte in peripheral blood of a patient with urinary tract infection.

A novel coronavirus, SARS-CoV-2 was identified as the cause of a cluster of pneumonia cases in Wuhan, China in December 2019. Coronavirus Disease 2019 (COVID-19) has rapidly spread worldwide. Numerous studies have shown diverse findings on chest CT scan of the patients with COVID-19. The established well-known features of COVID-19 on chest imaging include bilateral multilobar ground-glass opacification (GGO) predominantly with peripheral distribution, mainly in the lower lobes. Atypical presentation of consolidative opacities superimposed on GGO may be found in a smaller number of cases, mainly in the elderly populations. Pleural and pericardial effusion, lymphadenopathy, cavitation, halo sign on CT scan, and pneumothorax are uncommon but may be seen with disease progression. We report a case of severe COVID-19 in an athlete man with development of bilateral pneumothorax, pneumomediastinum and subcutaneous emphysema during progression of the disease. The only risk factor for severe COVID-19 in our patient was suggested to be chronic use of dexamethasone as anabolic steroids. Our patient also received three sessions of plasmapheresis. Unfortunately, the patient expired due to recurrence of bilateral pneumothorax and pneumomediastinum.