Iranian Journal of Blood and Cancer
Volume:15 Issue: 4, Dec 2023

As we approach the year 2023, the global rise in cancer mortality remains a pressing concern. Recent studies have demonstrated the remarkable potential of bacteria in combating cancer by stimulating the immune system. Exciting evidence suggests that bacterial therapy can revolutionize both the treatment and diagnosis of tumors. To effectively classify and treat tumors, the introduction of obligate or optional anaerobic bacteria into solid tumors may be necessary. Notably, certain strains of Clostridium have proven to be particularly effective in cancer treatment. A fascinating natural phenomenon lies in the ability of Clostridium spores to infiltrate tumors and selectively germinate in hypoxic regions within dense tumors upon injection into a vein. This bacterial invasion directly eliminates tumor cells by enhancing the presence of tumor-specific antigens, enabling the immune system to recognize and attack cancerous cells. Although these bacteria do not directly destroy tumor cells, their activation of the immune system holds great promise for eradicating them. Currently, an extensive range of bacteria is employed for cancer treatment, designing bacteria-carrying pharmaceutical compounds, and facilitating radiotherapy or radiation therapy. Additionally, genetic manipulation techniques can enable bacteria to specifically target tumor tissue and inhibit angiogenesis. In this comprehensive review, we delve into the potential advantages of utilizing Clostridium bacteria in cancer medications. Specifically, we explore the abilities of Clostridium perfringens and Clostridium novi to induce angiogenesis, provoke immune responses, and operate within oxygen-deprived environments.

 Acute promyelocytic leukemia (APL) is a type of aggressive acute myeloid leukemia (AML), characterized by the presence of abnormal promyelocytes in the bone marrow and bloodstream. The abnormal promyelocytes found in APL can lead to severe complications such as bleeding and blood clot formation.

 A 7-year-old boy diagnosed with APL encountered a unique occurrence of isolated molecular relapse following a recent episode of SARS-CoV-2 infection while undergoing routine monitoring for treatment response. The relapse was confirmed by the detection of the PML/RARalpha gene abnormality in both the peripheral blood and bone marrow samples. Notably, during relapse, the boy displayed symptoms indicative of a cerebral ischemic stroke; however, effective management was achieved through the administration of low molecular weight heparin (LMWH) and corticosteroids. Subsequently, the patient underwent an allogenic bone marrow transplantation. Of note, throughout an 18-month period of close monitoring, no complications were reported.

 The detection of the PML-RARA transcript in peripheral blood can serve as a valuable tool for detecting isolated molecular relapse in pediatric APL. In cases where patients are undergoing immunosuppressive chemotherapy, the presence of neurological signs and symptoms may be the sole indicator of APL relapse, and it can be thoroughly investigated through the use of MRI with or without diffusion-weighted imaging (DWI). The administration of LMWH is a safe treatment strategy until D-dimer levels return to normal. It has been observed that COVID-19, as seen with other respiratory viruses, may potentially contribute to the relapse of pediatric APL, highlighting its significance in disease progression.

Beta thalassemia is an inherited genetic disorder that often leads to transfusion dependence. One of the significant issues that these patients face is increased iron accumulation in their bodies due to the nature of the disease and regular blood transfusions. Iron overload can cause hemosiderosis and tissue damage in various organs, including the heart, liver, and endocrine systems. Endocrine problems are one of the most common complications in transfusion-dependent thalassemia, and addressing these complications can significantly improve patients' health-related quality of life. The prevalence of endocrinopathy is high, especially in patients with poor compliance with therapy. The most common endocrine disorders include hypogonadism, growth disturbances, short stature, delayed puberty, acquired hypothyroidism and hypoparathyroidism, adrenal dysfunction, osteoporosis, diabetes, fertility issues, and complications during pregnancy. Timely diagnosis and treatment of endocrine disorders can improve patients' quality of life and reduce social problems. This article reviews the literature on the various endocrine complications encountered in thalassemia.

According to the latest WHO report, lung cancer ranks among the top cancer-associated mortalities. Moreover, it has been related to a high rate of metastasis, which indicates the importance of angiogenesis. Histologically, lung cancer is divided into NSCLC and SCLC, with NSCLC being the most common. Angiogenesis is essential for tumor development. Additionally, immune cells, soluble factors, and ECM play a crucial role in their formation. this study reviews the angiogenesis formation factors in previous studies as well as analyzes in silico angiogenesis-related genes in NSCLCs. It is reported that EPhB2, PIK3R2, HSPB1and Wnt7b were the most upregulated angiogenesis genes. Among them, Wnt7b is the most prevalent in NSCLC subtypes. Moreover, a decrease of 50% in overall survival in both low and high Wnt7b transcripts per million was observed. First, three high-throughput GEO data sets with 18 lung cancer and normal samples were adopted to achieve the study purpose. Then, the up-and-down-regulated genes with p-value <0.05 were isolated. Next, the genes were taken to the Enrichr and the KEGG databases. Lastly, our in-silico analysis confirmed the gene expression connection between angiogenesis and lung cancer invasion.

Acute myeloid leukemia (AML) is a malignant disorder characterized by a poor prognosis. Current therapeutic approaches include chemotherapy, steroids administration, and blood transfusion. Previous studies have highlighted the potential anticancer property of 9-hydroxyoctadecadienoic acid (9S-HOD). This molecular computational research aims to investigate the intricate molecular mechanism underlying the effects of 9S-HOD on leukemia cells.

Utilizing proteomic data and the optimum numbers of the first neighbors from the STRING database, Cytoscape 3.9.1 along with its applications, NetworkAnalyzer and ClueGO+CuePedia were employed to analyze the constructed protein-protein interaction (PPI) network, its centrality and enrichments.

The analysis identified five proteins namely ACTB, HSP90AA1, GAPDH, TP53, and HSP90AB1 as potential central nodes within the PPI network. Furthermore, gene ontology analysis revealed “Response to salt stress” and “Positive regulation of type 1 interferon production” as enriched biological processes associated with these key elements of the PPI network. HSPA8, MYC, and KAT5 were identified as seed proteins within the sub-networks.

The findings suggest that the effect of 9S-HOD on the leukemia cells primarily involves the regulation of ACTB, HSP90AA1, HSP90AB1, GAPDH, and TP53.  additionally, HSPA8, MYC, and KAT5 emerged as important proteins influenced by 9S-HOD.

Lupus anticoagulant (LAC) is an acquired IgG or IgM autoimmune antibody against platelet membrane phospholipids. LAC is an important cause of aPTT prolongation in children. We determined the prevalence of LA-positive results in ≤ 18 years patients referred to the Iranian Blood Transfusion Organization (IBTO) special reference coagulation laboratory.

During a period of 27 months all patients ≤ 18 years old who were referred to IBTO and had results of aPTT and LAC were evaluated. LAC test panel included screening tests (aPTT-LA and DRVVT screen) and the mixing test and confirmatory tests (Hexagonal assay and/or DRVVT confirm) all performed by STAGO reagents and instruments. In cases with positive LAC, their follow-up refers to IBTO coagulation lab were evaluated after 12 weeks.

Our data revealed a LAC prevalence of 2.4% in the referred patients ≤ 18 years who had aPTT test result and 31% in those whom the LAC test was performed for them. In more than half of the LA-positive patients, the main reason for referring was an incidental finding of aPTT prolongation noticed before surgery or during hospitalization. Interestingly only 21.6% of the patients with positive LAC results were requested by the physician.

LAC is not infrequent in children and adolescents however in most cases it is a transient problem without any significant clinical findings. Most of the cases (78.4%) were not suspected of LAC by their physicians so it may be frequently missed in children clinically.

Gastric cancer (GC) is the most frequent destructive polyp allied to the GIT. It is reported as the foremost oncological complication with a prevalence ranks fifth and mortality ranks fourth worldwide with a survival rate of <25% in five years. In GC, men were observed as 2-3 times more susceptible to incidence and mortality than women. The GC patients experienced a burden of symptoms with multiple co-occurring symptoms including pain, weight loss, depression, fatigue, dysphagia, nausea, vomiting, etc. The risk factors of GC include infection of H. pylori, smoking, obesity, hereditary, high salt, radiation, and the frequent use of medications, etc. The role of genes, long-coding RNAs, metabolomics, machine learning, plant extracts, and nanoparticles has been studied for the progression, diagnosis, and treatment of GC. Due to the progressive stage diagnosis and lack of competent therapy, an imperative requirement is the identification of sensitive and accurate biomarkers towards the initial prognosis and the development of innovative therapeutic approaches. Microorganisms execute a momentous role in human health by contributing to immune system development and accomplishing an extensive range of metabolic functions. The disturbance in the stability of the microbes may stimulate various diseases including cancer. This review focuses on the role of microorganisms in the development, prognosis, and therapy of GC.

Thalassemia major hemoglobinopathy requires regular blood transfusions, often leading to iron overload due to repeated transfusions and increased intestinal iron absorption. The association between thalassemia major and metabolic complications, including diabetes and metabolic syndrome, has been recognized due to iron overload, insulin secretion impairment, insulin resistance, hepatic dysfunction, and other endocrine complications. These hormonal imbalances can also influence glucose metabolism and contribute to the development of metabolic syndrome. It's essential for individuals with thalassemia major to undergo regular monitoring of their glucose metabolism, including periodic assessments of fasting blood glucose, oral glucose tolerance tests, and measurement of Fructosamine. Early detection and management of diabetes and metabolic syndrome in thalassemia major patients are crucial to minimize complications and optimize overall health. Medical management may involve a combination of regular blood transfusions, iron chelation therapy to reduce iron overload, lifestyle modifications such as a healthy diet and physical activity, and, if needed, pharmacological interventions for glycemic control. Close collaboration between hematologists and endocrinologists is often necessary to provide comprehensive care for individuals with thalassemia major and metabolic complications.