Middle East Journal of Cancer
Volume:13 Issue: 3, Jul 2022

In this study, we suggested an experimental procedure demonstrating the impact of pesticide on the development of ectopic xenografts of human glioblastomas in immuno-competent Balb/c mice. In this in-vivo study, the mice were treated with or without a mixture of pesticide (Glyphosate and Chlorpyrifos), using a concentration corresponding to 1/8 of LD50 of each pesticide. The pesticides were injected intraperitoneally every 72 hours. The human glioblastoma cell suspension was cultured with tumor cerebrospinal fluid and then injected subcutaneously into the treated and not treated mice with a mixture of pesticide (Glyphosate and Chlorpyrifos) following 18 days after the beginning of the experiment. The body mass index of the male and female mice treated with pesticide was statistically (P = 0.0048) higher than those not treated with pesticides. 66.6% of the mice treated with pesticides and xenografts of glioblastoma developed masses at the injection site. The histological analysis revealed that 41.66% of the masses were astrocytic tumors. The other found masses corresponded to inflammatory lymph nodes and fibroblastic tissue formations. The treatment of mice with pesticide mixture was found to allow the development of glioblastoma xenografts in immunocompetent mice.

Kinesin family member 23 (KIF23) has an important role in mitosis of cytoplasmic separation process. Casitas B-lineage lymphoma (c-Cbl) is a protein ligase E3 ubiquitin in tyrosine kinase pathways, involved in numerous cell types.The current study aimed to evaluate the tissue expression of KIF23 and c-Cbl in gastric cancer (GC) tissues and normal gastric mucosa using immunohistochemistry and to investigate the correlation among their expressions, clinicopathological parameters, and the prognosis of patients in order to detect their role in the progression of GC and patientsi prognosis. We conducted this prospective study on 120 samples retrieved from 120 patients; 80 samples were taken from GC patients and 40 from normal gastric mucosa. We assed tissue protein expression of KIF23 and c-Cbl using immunohistochemistry. We evaluated the correlations between KIF23 and C-Cbl expression with clinicopathological and prognostic parameters of patients. KIF23 expression level in GC tissues was positively correlated with high pTNM stage (P = 0.001), larger tumor size (P = 0.010), high tumor grade (P = 0.006), poor overall survival (P < 0.001), disease-free survival rates (P = 0.003), and tumor recurrence after therapy (P = 0.004). c-Cbl expression level in GC tissues was positively correlated with early pTNM stage (P = 0.003), lower tumor grade (P = 0.005), the absence of lymph node metastasis (P = 0.023), good response to therapy (P = 0.002), and the absence of tumor recurrence after the therapy (P = 0.004). The high KIF23 expression and low c-Cbl expression in GC tissues were attributed to progression and poor prognosis in gastric cancer patients.

The aim of this study was to investigate the association between thyroid cancer and 16C/A single nucleotide polymorphism (SNP) in C-C motif chemokine 22 (CCL22) as well as 1014C/T SNP in C-C chemokine receptor type 4 (CCR4).

In this case-control study, polymerase chain reaction restriction-fragment length polymorphism (PCR-RFLP) was performed for 113 thyroid cancer patients and 112 age-sex matched healthy controls to investigate the genotype distribution.

At position 16C/A in CCL22, 95 patients (84.3%) were found to have CC genotype, while 17 individuals (14.8%) inherited CA genotype and 1 (0.9%) had AA genotype. In the control group, 92 volunteers (82.1%) inherited CC genotype, 18 individuals (16.1%) had CA genotype, and 2 (1.8%) had AA genotype. The frequency of CC, CT, and TT genotypes of 1014C/T SNP in CCR4 gene was 60 (53.1%), 43 (38.1%), and 10 (8.8%) in the patients, and 57 (53.3%), 43 (40.2%), and 7 (6.5%) in the control group, respectively. There were no statistically significant differences between the patients and controls in terms of 16C/A polymorphism in CCL22 (P = 0.816) and 1014C/T SNP in CCR4 1014C/T gene position (P = 0.801). Nevertheless, the study of their association indicated that inheriting the CC genotype of CCR4 was significantly associated with higher stages (stages 3 and 4) in thyroid cancer.

1014C/T genetic variation in CCR4 and 16C/A polymorphism in CCL22 were not found to have a role in genetic susceptibility to thyroid cancer. Inheriting CC genotype at 1014 locus in CCR4 may; however, affect cancer progression in patients with thyroid cancer.

Auraptene is a coumarin derivative extracted from citrus species, such as lemon, grapefruit, and orange. To date, auraptene has shown antioxidant, antibacterial, anti-inflammatory, antiproliferative, antiapoptotic, and antitumor activities. Among these, antitumor activity has become more important over the recent years, while its underlying mechanism is not fully understood. The current study was conducted to evaluate the antiproliferative effect of auraptene and its mechanisms on MCF7 cell line.

This experimental study investigated whether hesperidin affected the proliferation of MCF-7 human breast cancer cells. MCF7 cells were cultured in DMEM medium with 10% fetal bovine serum, 100 μg/ml streptomycin, and 100 units/ml penicillin. The cells were incubated in order to be treated with different concentrations of auraptene and time points. Subsequently, the amount of cytotoxicity and apoptosis was measured utilizing MTT and PI staining.

The MTT assay revealed that auraptene had a significant effect on cell viability and induced apoptosis in MCF7 cells at concentrations of 75, 100, 130, 170, and 200 μM.

In this study, through the induction of apoptosis, auraptene prevented the growth and inhibited the proliferation of MCF7 cells at high concentrations in a dose-dependent manner. However, further investigation is needed to reveal the mechanisms of auraptene concerning apoptosis induction.

Prostaglandin-endoperoxide synthase 2, recognized as cyclooxygenase 2 (COX-2), is an important enzyme contributing to the generation of proinflammatory prostaglandins. It can play a role in increased tumor angiogenesis, apoptosis inhibition, metastasis, and invasion of tumors. Single nucleotide polymorphisms (SNPs) of the COX-2 promoter may associate with the cancer predisposition. In the present work, we aimed to explore whether SNPs of COX-2 gene affect both the risk of development and grade of bladder cancer.

This case-control study was performed and the genetic polymorphisms of six COX-2 SNPs including, intron 1 (rs2745557), intron 5 (rs16825748), intron 6 (rs2066826), T+8473C (rs5275), G-765 (rs20417), and A-1195G (rs68946) were genotyped in 80 healthy controls and 80 bladder cancer patients using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). To select independent prognostic factors, the univariate and multivariate analyses were implemented.

Univariate logistic regression model indicated a significant association between COX-2 765G>C heterozygous GC genotype and greater risk of bladder cancer (OR: 2.07; 95% CI: 1.03 - 4.15; P = 0.04). However, the multivariate logistic regression analysis showed no associations between COX-2 variants and bladder cancer development.

We concluded that COX-2 polymorphisms do not contribute to the genetic susceptibility to urothelial bladder cancer in an Iranian population. However, the only genotype in which the frequency of alleles significantly differed between the two groups of high-grade tumors and low-grade tumors was COX-2 8473T> C (rs5275). Moreover, our findings showed that both smoking and family history of cancer play a role in susceptibility to bladder cancer.

Hodgkin lymphoma (HL) is one of the best curable malignancies. Randomized controlled studies have validated the benefit of hematopoietic stem cell transplant (HSCT) for patients with relapsed or primary refractory HL. This analysis aimed to identify significant prognostic factors on the recurrence of the disease after HSCT applying a cure rate model.

In this retrospective cohort study, there were 92 patients with HL who underwent HSCT from 2007 to 2014 with 18 months of follow-up in Tehran, Iran. The survival time was set as the time interval between transplantation and the recurrence of HL. In addition, we utilized hyper-Poisson distribution as discrete frailty to account the unobserved heterogeneity and random effects.

In non-cured cases, the mean of survival time was 318 (95% confidence interval, 144-493) days. The 1-, 3-, and 5-year survival rates were 88.9%, 83.4%, and 80.7%, respectively. A significant association was observed between the cured patients and the variables such as age, the experience of pre-transplantation relapse, hemoglobin (Hb), mononuclear cells (MNCs), and body surface area (BSA) at the time of transplantation.

The study concluded that less than 30 years of age, a high level of Hb (g/dl), a low level of MNCs and BSA (m2), and the absence of pre-transplantation experience of relapse were associated with better survival following HSCT. Based on this study, post-transplant consolidation therapies could be considered for the treatment of HL patients after HSCT.

The prognostic impact of CA15-3 level in different molecular subtypes of metastatic breast cancer is not well elucidated yet; therefore, we conducted the present study to determine the reliability of CA15-3 tumor marker in terms of monitoring therapeutic response in different molecular subtypes of breast cancer. In this prospective study, we assessed the levels of CA15-3 in 83 patients with metastatic breast cancer assessable by RECIST, who were treated and followed up in Mosul Oncology hospital during 2017 and 2018. We evaluated the mode of changes of CA15-3 level after two cycles of systemic therapy (chemotherapy, endocrine therapy, or target therapy) and analyzed the relation between CA15-3 level changes and response to therapy in different molecular subtypes of breast cancer. Herein, CA15-3 level was more frequently elevated in Luminal subtypes of metastatic breast cancer compared with that in other subtypes. Additionally, the reduction in CA15-3 level after two cycles of systemic therapy was significantly correlated with the good response and longer progression-free survival. The mode of change of CA15-3 level was closely correlated with the clinical therapeutic response and survival advantage rather than the pretreatment level of CA15-3 in metastatic breast cancer. This finding revealed equivalent quality of CA15-3 with medical imaging at lower cost. Therefore, measurement of CA15-3 level at regular intervals before and after starting systemic therapy could predicate the clinical response and replace imaging examination used routinely for monitoring the responses in patients with Luminal subtypes of metastatic breast cancer.

Ovarian cancer is the second most prevalent gynecological malignancy. Its prognosis is poor with a five-year survival rate of <50% with the available therapies. There is a constant need for new biological markers. Therefore, we conducted the present study to evaluate the association between human epidermal growth factor receptor (HER2) neu and the clinicopathological features of epithelial ovarian cancer. A prospective, observational analytic study was conducted at Fauji Foundation Hospital, Rawalpindi between November 2018 and October 2019. It was a cross-sectional study with a quantitative correlational study design. We recruited 90 patients. The mean age of diagnosis was 53 ± 8.022 years; 81.1% (n = 73) had raised pretreatment CA-125 levels with stage III (56.7%, n = 51) and grade III (54.4%, n = 49) at presentation. It was seen that 24.4% (n = 22) of the tumors expressed HER2/neu, 65.6% (n = 59) were negative and 10% (n = 9) were equivocal. 72.2% had platinum sensitive disease. According to HER2/neu status, 20% HER2/neu positive patients had platinum sensitive disease and 3.3% had resistant disease; meanwhile, 47.8% HER2/neu negative patients had platinum sensitive disease and 10% were platinum resistant. HER2/neu expression was significantly associated with grade (P = 0.040) and pretreatment CA-125 levels (P = 0.032) whereas our study failed to show a significant association between stage (P = 0.383) and chemotherapy response (P = 0.055). The current study demonstrated that HER2/neu was positive in 24.4% of the patients, which was significantly associated with grade and pretreatment CA-125 level. However, a longer follow-up is needed for survival analysis and establishment of HER2/neu as a prognostic marker for epithelial ovarian cancer.

Hyperthermic intraperitoneal chemotherapy (HIPEC) is increasingly used to treat peritoneal carcinomatosis (PC). The objective was to evaluate the outcomes of cytoreductive surgery (CRS) and HIPEC in our center.

In this retrospective study, data were collected from 43 patients with PC who underwent CRS-HIPEC in 2016 at Faghihi Hospital of Shiraz University of Medical Sciences. Outcomes were collected and analyzed. Analyses were conducted through SPSS 23. P-value < 0.05 was considered to be statistically significant.

The mean age of the patients was 52.23 ± 11.82 years. The participants in the study analysis consisted of 36 female (83.7%) and seven male patients (16.3%). The most common primary tumor was ovarian cancer (62.8%). Completeness of the cytoreduction score of CC0/CC1 was obtained in 87.7% of the patients. The 1- and 3- year overall survivals were 88% and 60%, respectively.

Our study supports that employing CRS and HIPEC for PC is feasible with acceptable morbidity in our center.

Squamous cell carcinoma (SCC) is the most prevalent malignancy of the larynx. Non-squamous cell carcinomas of the larynx are rare and consist of different pathology types. The present work is a retrospective study of non-SCC of the larynx in the south of Iran during a seven-year period. Among 517 patients with laryngeal cancers, seven (0.13%) had non-SCC. The mean age was 59.1 (39-71) years, and six were male. The main complaint of two of the patients was neck mass, five cases had hoarseness, and one had dyspnea. One subject had both dyspnea and hoarseness. Out of three cases of neuroendocrine tumor, two had radical surgery and afterwards, radiotherapy (RT) was given for one of them. Both cases are well and disease-free. The other patient was a 58-year-old man and was treated with chemoradiation. He died due to brain metastasis following 12 months. Our patient with osteosarcoma is well controlled with surgery, chemotherapy, and RT. We had two male cases of adenoid cystic carcinoma who had undergone total laryngectomy and supraglottic laryngectomy. Both of them received RT (60 or 70 Gy dose) and both are well after 60 and 48 months. A 51-year-old patient with chondrosarcoma had undergone total laryngectomy, who was well after 36 months. Treatment of non-SCC of the larynx is an extrapolation from the treatment of the more common site of each pathology type. Further studies are needed to draw a firm conclusion.

Ductal carcinoma in situ (DCIS) is widely recognized as the precursor of invasive ductal carcinoma (IDC). We aimed to compare clinicopathological characteristics and prognosis between IDC with and without coexisting DCIS stratified by biological subtypes to evaluate the clinical outcome of these two groups.
Data from 5814 patients with IDC (32.4) and IDC/DCIS (67.6%), who underwent surgery from December 1993 through December 2019, were retrospectively assessed. We evaluated the prognosis of IDC with coexisting DCIS in different molecular subtypes.
IDC/DCIS patients were younger (P < 0.001). They also presented with a low tumor grade and had less lymph node involvement compared with the pure IDC patients. Compared with the patients with IDC, luminal B subtype was more frequent in those with IDC/DCIS, with 19.4% versus 13.2 %; human epidermal growth factor receptor-2 enriched subtype was also more frequently observed, with 12.2 vs. 8.7%. The 5-year disease-free survival (DFS) was higher in the IDC/DCIS patients (P = 0.036). The survival outcomes significantly improved in the cases with a higher amount of DCIS. The presence of coexisting DCIS (P =0.038), tumor size (P < 0.001), lymph node status (P = 0.005), lymph vascular invasion (P = 0.02), and molecular subtypes (P < 0.001) were found to be DFS-associated independent prognostic factors.
DCIS along with IDC were associated with improved prognosis. The presence of DCIS may be a marker of lower aggressiveness, and could be noticed as a prognostic factor in future treatment algorithms.

The incidence of hepatocellular carcinoma has significantly increased over the last decades and the prognosis of hepatocellular carcinoma still remains poor. The present study aimed to evaluate the efficacy and safety of 3D conformal hypofractionated radiotherapy in patients with small hepatocellular carcinoma.
Between 2015 and 2018, a total of 61 patients presented to our institution with hepatocellular carcinoma ≤ 5cm, who were recruited in this prospective study. All the patients underwent 3D conformal hypofractionated radiotherapy with a total dose of 51 Gy in 17 fractions. We evaluated the treatment response and toxicity and calculated the local progression-free survival and overall survival.
The objective response rate was 68.9%, including seven patients (11.5%) achieving complete response and 35 patients (57.4%) with partial response. In addition, nine subjects (14.8%) had stable disease. The 1-, 2-, and 3-year overall survival rates were 65.1%, 38.7%, and 26.4%, respectively. In multivariate Cox regression model, GTV was found to be the only prognostic factor for local control (P = 0.001) and overall survival (P < 0.001). Only one patient showed grade 3 radiation-induced hepatic toxicity (1.6%).
3D conformal hypofractionated radiotherapy could be effective and safe in small hepatocellular carcinoma.

Female breast cancer (FBC) is a public health issue which represents the third leading cause of deaths in Mauritius (accounting for 13.5% of all the deaths in 2017), after diabetes and cardiovascular diseases. The present research aimed to identify the potential causative factors associated with FBC in Mauritius, given the genetic polymorphisms of different ethnic groups.
From January to August 2019, a questionnaire was administered to women who had consented to participate in this case-control study. Overall, there were 394 women, comprising 149 cases and 245 controls. The cases were BC patients who visited two non-governmental organizations (NGOs) involved in providing support and counselling to BC patients in Mauritius. The controls were women matched by age approached from these NGOs as well as the public at large. A logistic regression model was then applied in R statistical software to identify the potential significant factors associated with BC in Mauritius.
Herein, age, family history of cancer, the prolonged use of female hormone as contraception, smoking habits, consumption of non-bio food products, and the frequent use of plastic bottles and Styrofoam containers to serve hot food were identified as the determinant factors attributing to BC incidence.
The extended use of female hormones for birth controls, smoking habits, consumption of non-bio food products, along with the frequent use of plastic bottles and Styrofoam containers to serve hot food were identified as modifiable factors. There is an urgent need for sensitizing people to change their lifestyle in order to minimize their risk of developing breast cancer.

Routine excision of submandibular gland along with level Ib lymph nodes is carried out as a part of standard neck dissections. The current study aimed to evaluate the incidence of submandibular gland involvement in oral squamous cell carcinoma cases undergoing neck dissections with clinically positive nodes. We carried out a retrospective observational experiment. The records of 520 patients diagnosed with oral cavity squamous cell carcinoma, who underwent neck dissection, were retrospectively reviewed. We recorded the incidence of submandibular gland involvement by the primary tumour. Metastasis to level 1 lymph nodes was found in 35.6% of the patients. The involvement of submandibular gland in our study sample was 0.96%. Recent literature has recommended sparing of the submandibular gland in certain cases; that is, because its removal causes postoperative xerostomia with exaggeration due to radiotherapy, which is considered morbid, based on various anatomical models. However, this finding is controversial. Our study suggested submandibular gland sparing neck dissections in all subsites, except for tongue, anterior alveolus, and floor of mouth tumours.

Adenoid cystic carcinomas is a rare tumor occurring in major salivary glands. Despite definitive treatment, these aggressive cancers often recur and metastasize with no known effective chemotherapy regimen. The present study aimed to evaluate the recurrence and survival rates of head-and-neck adenoid cystic carcinoma and assess the prognostic factors related to the patients' local recurrence and survival.
A retrospective study was conducted on 54 patients with adenoid cystic carcinoma. Demographic data, operative factors of patients before, during, and after surgery were reviewed and finally calculated using the Kaplan-Meier method.
Among the 54 patients, 61.1% were female, and 38.9% were male with an average age of 46.00 ± 14.52 years. The survival rate at 12, 24, 36, 60, 84, 100 and 120 months post-surgery were 100, 93.3, 84.4, 48.9, 24.4, 20.0 and 13.3%, respectively. Both the marital status (P = 0.002) and the type of surgery (P = 0.045) were significantly related to the overall survival of the patients, and the local recurrence significantly correlated with overall survival (P = 0.027).
According to the findings, marital status, type of surgery, metastases, histological staging, and local recurrence rate were related to the overall survival of the patients. Hence, it is of utmost importance to pay attention to these factors in health centers. It is recommended to opt for case-control and prospective studies with more samples for further investigation in the future.

The present study aimed to present computed tomography (CT) scan characteristics of different mediastinal masses in children to correlate CT findings of the mediastinal masses with histopathology; we also sought to differentiate between benign and malignant mediastinal mass lesions based on CT findings. This prospective cohort study analyzed 60 patients who underwent multi-slice CT scan for characterization of mediastinal mass. Subsequently, imaging findings were verified with pathological diagnosis. The median age of the patients was 5.3 years. The common symptoms among these patients were cough, dyspnea, chest pain, and fever. There were 24 benign (40%) and 36 (60%) malignant cases. According to their origins, 20 (33.3%) presented as neurogenic tumors, 16 (26.7%) as lymphomas, (15%) as germ cell tumors 9, and the remaining 15 (25%) as tumors: thymic pathologies, lymphangiomas, and bronchogenic cyst. 22 (36.7%) tumors were located in the posterior mediastinum, followed by 21 (35%) in the anterior mediastinum and 11 (18.3%) in the middle mediastinum. CT scan was found to be able to distinguish specific tissue densities and their ability to display mediastinum in axial plane. Reconstruction in sagital and coronal planes makes it a useful technique for the evaluation of a mediastinal mass.

The present dosimetric study aimed to evaluate the dosimetric benefits of using three-dimensional conformal radiotherapy (3D-CRT), dynamic intensity-modulated radiation therapy (D-IMRT), and Hybrid CRT/IMRT plans.
In this dosimetric research, 10 patients with locally advanced lung cancer (Stage-IIIB) were selected. The patients with centrally located tumors were particularly chosen to underline the complexity of the treatment plans. We performed 3D-CRT, D-IMRT, and Hybrid CRT/IMRT treatment plans using Varian with the Eclipse treatment planning system. The treatment plans were compared with respect to the doses received by the organs at risk, including total lungs, contralateral lung, ipsilateral lung, heart, spinal cord, esophagus, the dose homogeneity index, and conformity indexes. Paired samples t-test was performed for statistical analyses.
Hybrid method significantly advanced the target conformity index when compared with 3D-CRT and D-IMRT methods (P = 0.000). The total lung volume receiving 5 to 10 Gy was significantly lower in the 3D-CRT plans compared with that in D-IMRT and Hybrid plans (P = 0.025 and P = 0.003). V20 of the total lung was significantly lower in Hybrid plans (P =0.036). The average mean doses to heart in all the plans were similar with no significant differences. There was a statistically significant difference concerning the maximum doses for spinal cord, when D-IMRT plans were compared with 3D-CRT and Hybrid (P = 0.000).
Hybrid technique could be highly conducive to the treatment, while 3D-CRT and D-IMRT techniques are not adequate alone for maintaining the spinal cord, heart, and esophagus in the treatment of LALC patients.

We aimed to evaluate the survival rate and define the prognostic factors in children with acute lymphoblastic leukemia (ALL).

In this retrospective study, the data were extracted from the medical records of 176 children with ALL who referred to Motahari Hospital in Urmia from 2011 to 2019. Endpoints of overall survival study were event-free survival, disease-free survival, and recurrent mortality. Overall survival and disease-free survival were the time from diagnosis to death of any cause or recurrence. Event-free survival time was calculated as the distance from the date of diagnosis to the date of the last prevention with the first event. Non-recurrent mortality included all non-recurrent deaths. Data analysis was performed using a cause-specific hazard model.

The mean age of the patients was 5.61 ± 3.56 years and the median of diagnosis of ALL to death was 3.47 ± 2.61 years. The 1-year, 3- year and 5-year probability of survival were 83.1%, 75.10%, and 68%, respectively. Sex, hemoglobin level, and hepatosplenomegaly were significant in univariate and multivariate analysis (P < 0.05).

The competing risks model was applied to identify the risk factors for all causes of death. The factors affecting the survival rate of patients in the model can be employed in making clinical decisions and proposing therapeutic protocols. Furthermore, it reduces the duration of response to therapy, thereby decreasing the rate of mortality in children.

In the present research, we aimed to estimate the effect of the number of resected lymph nodes (LN) on the survival outcomes of patients with resectable gastric cancer; we investigated whether 16 LNs remained the optimal threshold and whether a specific subset of patients could benefit from further LN dissected.
This cohort study included consecutive patients who underwent surgical resection for gastric cancers from the start of 2012 to the end of 2014. Demographic, clinic-pathologic, laboratory data (including complete blood picture, renal function tests, liver function tests, C-reactive protein, Prothrombin profile, and electrolytes), type of surgery, systemic chemotherapy, treatment, and survival data were retrospectively collected from the patients' files.
The mean overall survival ± standard error (SE) was 23.051 ± 2.249 months with 95% confidence interval (CI) = 18.644-27.459, while the mean disease-free survival ± SE was 20.675 ± 2.414 months with 95% CI = 15.944-25.906. D2 dissection was associated with significantly better OS and disease-free survival (P = 0.001 and P = 0.001, respectively). The mean OS for the patients with <16 lymph node dissected was 13.480 ± 1.468 with 95% CI = 10.603-16.357; whereas for those patients with <16 lymph nodes dissected, it was 20.738 ± 2.065 with 95% CI = 16.690-24.786 months, log-rank = 8.030 (P = 0.005).
The benefit of D2 lymphadenectomy, and subsequently dissecting more LNs, still remains under question; however, if morbidity and mortality are kept at a minimum level, D2 dissection could be advantageous. Our study concluded that harvesting further LNs was associated with more survival benefit.

In the present research, we reported an acute myeloid leukemia subject. The patient was treated with Cytarabine 200 mg/m2 per day with continuous IV infusion on days 1, 2, 3, 4, Etoposide 100 mg/m2 per day with continuous IV infusion on days 1, 2, 3, 4, Idarubicin 12 mg/m2 as a 4-hour IV infusion on days 2, 4, 6, and Mitoxantrone 10 mg/m2 as a 30-minute IV infusion on days 1, 2, 3. During treatment, the patient suffered from 3 life-threatening complications caused by chemotherapy drugs include sinusoidal obstruction syndrome (SOS), refractory thrombocytopenia, and pericardial effusion with pericardiocentesis limitation. To this end, we tried three novel approaches for patient management by Corticosteroid and Colchicine. Intravenous immunoglobulin infusion and oral prednisolone (2 mg/kg/d) were not effective in thrombocytopenia. However, eltrombopag (25 mg/kg/d) response was dramatic. Moreover, pericardial effusion and respiratory distress during the first chemotherapy course were managed with Lasix (2 mg/kg/d) and Spironolactone (25 mg/d); meanwhile, the massive pericardial effusion during the second chemotherapy course was managed with Colchicine (0.5 mg/d) through the mentioned treatment. Fortunately, these approaches were effective and life-saving.