Iranian Journal of Blood and Cancer
Volume:15 Issue: 2, Jun 2023

Acute lymphoblastic leukemia (ALL) causes uncontrolled cell proliferation and prevents normal cell differentiation at any stage of hematopoiesis. Therefore, timely diagnosis and treatment are very important. Complete blood count (CBC) can be a simple, but valuable initial test to diagnose ALL. In this study, we investigated the diagnostic value of hematological parameters, including Platelet to lymphocyte ratio (PLR), neutrophil-to-lymphocyte ratio (NLR), and hemoglobin to Platelet ratio (HPR) indices in ALL.

In this study, 54 ALL patients (Mean ages: 5.29) and 58 healthy controls (Mean ages: 5.53) were evaluated. They were compared in terms of hematological parameters, including PLR, NLR, and HPR; cytogenetic and immunophenotypes were also analyzed.

In the analysis of hematological factors between the studied groups, all indices except lymphocytes showed a statistically significant relationship (P-Value ˂0.05). In terms of hematological factors, only WBC and ESR were statistically significant between the B-ALL and T-ALL groups (P-Value ˂0.05). The ROC curve was generated to select the appropriate cut-off values for NLR, PLR, and HPR based on analysis. NLR and PLR have cut-off values of 0.50 and 62.24, respectively; they are good biomarkers to distinguish ALL individuals from normal people. HPR value was significant between case and control groups, but it was not a suitable indicator for distinguishing patients from the control group.

CBC is a simple and valuable test for early detection of ALL, and the new PLR and NLR markers are good hematologic markers for ALL diagnoses.

Iron overload can adversely affect thyroid and parathyroid function in patients with transfusion-dependent thalassemia. Iron deposition in both glands or the pituitary gland, which controls thyroid function, can lead to their destruction and dysfunction. Hypothyroidism can cause symptoms such as fatigue, weight gain, and depression, while hypoparathyroidism can cause symptoms such as numbness and tingling in the hands and feet, muscle cramps, and seizures. Regular thyroid and parathyroid function monitoring is essential in thalassemia patients to detect any dysfunction early and provide appropriate treatment. Treatment may include medications to replace thyroid hormone or calcium and vitamin D supplements to manage hypoparathyroidism. A comprehensive approach to managing endocrine complications in thalassemia patients can improve outcomes and quality of life for these individuals. To provide professional healthcare members with clear and concise recommendations for diagnosing and treating hypothyroidism and hypoparathyroidism in transfusion dependent thalassemia patients, a practical national guideline should be developed.

Several studies have demonstrated the undeniable value of plasma as the source of myriads of proteins with numerous biological activities, many of which might not be discovered yet. Plasma fractionation is a process aiming at the production of plasma-derived medicinal products (PDMPs) such as gamma globulins (immunoglobulin [Ig]), hyperimmune serum globulins, albumin, and clotting and coagulation factors like Factor VIII (FVIII) and FIX. Despite several challenges in the evolution of the plasma industry, there is still worldwide increasing demand for PDMPs with the proof that the market size value of this industry is estimated at 28.69 billion dollars in 2021. In Iran, the plasma industry began its journey with the initial activities of the Iranian Blood Transfusion Organization (IBTO). Regarding the expense of establishing companies for plasma fractionation and elevating demands of PDMP in Iran’s health system, decision-makers implemented contract fractionation which not only supply the needs of the country but also cause significant savings in financial resources. Although the amount of collected plasma has been raised, more than 400,000 liters of collected plasma is still half of the required amount as Iran’s demand for FVIII and albumin is over the supply. Putting together these data that the clinical indications for PDMPs, particularly IVIg, are growing (as seen in COVID-19) and commercially purchasing products is not economically beneficial, it is necessary for Iran’s policymakers to invest in the plasma industry by establishing more plasmapheresis centers and raising people’s awareness to donate more amount of plasma in order to elevate the levels of plasma collection annually. Moreover, entering the industry of fractionation by localization of this science and construction of fractionation plants should be on the agenda.

Pediatric cancer biobanks play an important role in advancing cancer research efforts and developing effective treatments. However, the majority of these biobanks are located in developed countries, leaving a large portion of the world's population without access to these critical resources. This article focuses on the current dispersion of pediatric cancer biobanks in the Middle East.

PubMed and Google Scholar databases were searched using the terms ‘pediatric cancer biobank’ or ‘childhood cancer biobank’ or ‘children’s cancer biobank’, or ‘pediatric cancer biorepository’ or ‘childhood cancer biorepository’ or ‘children’s cancer biorepository’, along with ‘Jordan’, ‘the United Arab Emirates’, ‘Iran’, ‘Bahrain’, ‘Turkey’, ‘Syria’, ‘Iraq’, ‘Saudi Arabia’, ‘Oman’, ‘Qatar’, ‘Kuwait’, ‘Lebanon’, ‘Egypt’, ‘Yemen’, ‘Palestine’ with English language restriction.

Despite being a relatively recent development, some notable pediatric cancer biobanks have been established in the region, including the King Hussein Cancer Center Biobank in Jordan, the Children's Cancer Hospital Egypt Biorepository and Biospecimen Research Facility in Egypt, the Iranian Childhood Cancer Biobank in Iran, and national pediatric cancer biorepository in Qatar.

However, several challenges still hinder the establishment and maintenance of biobanks in the region, including insufficient funding, lack of infrastructure and resources, limited awareness, and regulatory hurdles. Overcoming these challenges will require targeted investments, building infrastructure and awareness, and efficient regulatory frameworks. Developing and maintaining high-quality pediatric cancer biobanks within the Middle East could lead to a better understanding of pediatric cancer patterns in the region, ultimately improving treatment outcomes and quality of life for pediatric cancer patients globally.

Oncolytic virotherapy has emerged as a promising approach for the treatment of various cancers. This review article aims to provide an overview of Vesicular Stomatitis Virus (VSV) as an emerging anti-cancer therapy.

The article discusses the mechanism of action, preclinical and clinical studies, and challenges in the clinical translation of VSV. It also explores potential strategies to enhance the efficacy and safety of VSV-based oncolytic therapy, including combination therapies and genetic modifications

The mechanisms underlying VSV-mediated anti-cancer activity, such as induction of apoptosis, activation of immune responses, and disruption of tumor vasculature, are explored. Additionally, known methods for the preparation of oncolytic VSV, including genetic modifications and combination therapies, are discussed to optimize its anti-cancer effects.

Strategies to enhance VSV efficacy and overcome safety challenges are examined, including the use of VSV in combination with other therapies, such as chemotherapy or immunotherapy, as well as the development of novel viral vectors and engineering approaches to improve tumor-specific targeting and minimize off-target effects. In conclusion, this review highlights the potential of VSV as a novel therapeutic strategy for cancer treatment. Harnessing the unique characteristics of VSV, combined with ongoing research and technological advancements, may pave the way for the development of effective and safe VSV-based therapies in the future.

Non-melanoma skin cancer is a serious malignancy and white-skinned people are highly susceptible to this cancer. About 918 deaths occurred due to NMSC in the UK following the year 2018-2019. The incidence of NMSC is 18-20 times higher as compared to melanoma skin cancer. The tumor immune microenvironment of NMSC possesses a diversity of immune cells that exert pro-tumor and anti-tumor effects on the TIME. So by recognizing the tumor-promoting entities, the TIME can be remodeled. Immunotherapy provides such a treatment that activates the person’s immune system to fight against tumorigenic cells. Radiotherapy also causes the modulation of the immune system and increases the anti-tumor responses in patients. The use of immune checkpoint inhibitors after radiotherapy has produced significant survival rates in patients. Oncolytic virus therapy is a subtype of immunotherapy with a positive response in the treatment of cancer. The synthetic viral promoter is highly specific to tumor and the introduction of transgenes help them to inhibit the tumor-promoting cells and make the tumor susceptible to anti-tumor cells, thus helping the tumor to eliminate from the body. This characteristic of oncolytic virus converts the ‘‘cold TIME’’ to ‘‘hot TIME’’ which exerts a highly positive response when used ICIs. In this article, a literature review is conducted to study the role of TIME in the progression of cancer and various methods that remodel the TIME such as immunotherapy, radiotherapy, and oncolytic viruses that might help to treat NMSC.

Severe congenital neutropenias (SCNs) are the rare heterogenous group of preleukemia bone marrow failure syndromes characterized by impaired differentiation of neutrophilic granulocytes and, as a result, severe chronic neutropenia. Patients with SCN are predisposed to recurrent, often life-threatening bacterial and/or fungal infections beginning in the first months of life. Molecular abnormalities in 10 genes have been identified that are responsible for SCNs. The pathophysiological mechanisms of SCNs are the subject of extensive investigation and are not fully known. The current review aims to summarize the studies exploring the biological role of SCN-associated genes and the effects of mutant genes in neutropenia pathogenesis. We mainly focus on the genetic mutations that lead to SCN1 to SCN9 and X-linked SCN (XSCN) to shed more light on the pathophysiology of these diseases.

Kaposi sarcoma is a low-grade vascular tumor with the uniform expression of latent nuclear antigen-1 of the human herpes virus 8 (HHV-8). Differentiation of Kaposi sarcoma from other benign and malignant vascular or non-vascular spindle cell lesions is sometimes a manner of challenge. Thus, the expression of human herpes virus 8 in a fixed specimen would be diagnostically useful. This study aimed at immunohistochemical detection of human herpes virus-8 in cutaneous vascular lesions.

This cross-sectional study was conducted on 46 cases of cutaneous vascular lesions including six cases of Kaposi Sarcoma, twenty-five cases of Pyogenic Granuloma, four cases of Angiolymphoid Hyperplasia with Eosinophilia, three cases of Masson Tumor, two cases of Arteriovenous Hemangioma, two cases of Sclerosing Hemangioma, three cases of Angiofibroma, and one case of Lymphangioma. After histologic confirmation, immunohistochemistry was done on sections of paraffin-embedded tissue with mouse anti-HHV-8 antibody.

Of 46 patients, 27 (58.7%) were male and 19 (41.3%) were female, and the mean age was 46.36±17.48 years. All 6 Kaposi sarcoma cases showed strong, nuclear staining for HHV-8 (100%). All 6 patients with HHV-8 positive results were older than 60 years.  Sarcoma cases included four (66.7%) resection specimens from the soft tissues of the leg and two (33.3%) resection specimens from the soft tissues of the hand.

The high sensitivity and specificity of the immunohistochemical method for detecting HHV-8 in skin lesions, especially Kaposi sarcoma, makes it a reliable and cost-effective tool to differentiate Kaposi sarcoma from other vascular and non-vascular spindle cell lesions.