Iranian Journal of Pediatric Hematology and Oncology
Volume:1 Issue: 4, Autumn 2011

Background Leukemia is one of the most common tumors in children and it is divided up into two main groups; acute and chronic leukemia. The acute leukemia is more prevalent than chronic in children. Generally acute type is included acute lymphoid leukemia (ALL) and acute myeloid leukemia (AML). In this study, patients with leukemia who were admitted in Talghani hospital of Gorgan were examined for immune markers.Materials and MethodsForty one patients (34 persons with ALL and 7 persons with AML) were examined. Bone marrow aspiration samples were obtained in tubes containing EDTA and were sent to pathology center of Baghiatallah hospital, Tehran. Immunophenotyping was conducted by Flow cytometry and results were recorded in profiles of patients. ResultsThe mean age of ALL and AML patients was 5.64±3.43 and 7.45±5.68 years respectively. It was determined that ALL risk in males is 1.086 times more than females. Mann-Whitney test did not show significant difference between mean age of AML and ALL groups (p=0.5). Highest markers in ALL were CD19 (90.2%), CD10 (84.36%), I3 (HLA-DR) (70.58%), and in AML CD45 (81.8%), I3 (HLA-DR) (63.64%) and CD34 (54.5%).ConclusionThe prevalence of markers in ALL and AML patients is different, and some of them are common. These results could be used for differentiation of ALM from ALL. Further study was recommended on bigger sample-size to achieve a definite conclusion.

BackgroundCerebral neoplasm arises from brain, spinal cord and meningeal cells. Not only malignant cerebral neoplasm also benign tumor could lead to death due to mass effect on vital structures. Access to these tumors is difficult, and MRI and CT scan could be helpful in determining anatomical location of tumors and distinction of malignant from benign.ObjectiveFor better and earlier diagnosis and treatment, present study determined the accuracy of MRI and CT scan in compare with pathological findings.Materials and MethodsThis experimental case-series study compare the results of tumor imaging (MRI and CT scan) with biopsy in patients who came with brain mass between April 2004 and April 2010. Demographic characteristic and medical history were recorded. The results of CT scan, MRI and biopsy reports were recorded for patients, and all data compared and analyzed by SPSS software version 15. ResultsResults of 218 patients were analyzed. 189 patients had definite diagnosis using CT scan, which 13 (7.2%) were diagnosed benign and 159 (92.4%) malignant. Sensitivity, specificity, positive predictive value and negative predictive value of CT scan in comparison with biopsy were 83%, 10%, 93% and 3% respectively. The accuracy of this method was 78%. Fifty four patients (24.4%) were evaluated by MRI. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRI were 92%, 25%, 93%, 2% and 87% respectively.ConclusionAccording to the results, positive results by MRI and CT scan are valuable and have diagnostic value, but negative reports need more evaluation and no roll out malignant tumor. So remarkable specificity, but low sensitivity were achieved for CT scan and MRI. They accepted as easier and more accessible methods to approach brain tumors.

BackgroundKetofol is usually using as a sedative drug during painful procedures now. That Provides sedation, analgesia and rapid recovery. The aim of this study was to compare the efficacy, respiratory and hemodynamic profiles, and side effects of two various combination of ketamine and propofol in patients undergoing bone marrow aspiration (BMA) and lumbar puncture (LP).Materials and MethodsThis randomized, double blinded study was designed to compare the quality of analgesia and side effects of intravenous ketofol in sixty boys and girls. In this study Patients received a slow bolus injection of a solution containing combination of equal amount of propofol and ketamine (1:1) (Group I) or two parts of propofol plus one part of ketamine (2:1) (Group II). Subsequent slow bolus injects to a predetermined sedation level using Ramsay Sedation Scale. Vital signs, oxygen saturation (SpO2) and incidence of any side effects were recorded.ResultsKetofol was used in 49 surgical procedures in children with a median age of 5 years (1 to 10 years old). In this study there was an increase postoperative nausea, psychomimetic side effects, and increase recovery time with the largest ketamine dosage (Group I). (P-value<0.001)ConclusionThe adjunctive use of smaller dose of ketamine in ketofol combination minimizes the psychomimetic side effects and shortens the recovery time. A large number of patients are required to evaluate and validate these findings.

BackgroundPrevalence of hereditary blood diseases such as sickle cell anemia, sickle thalassemia and thalassemia major are high in Khuzestan province. Sickle cell anemia and beta-thalassemia are predominantly common in Iranian Arabs. Pulmonary complications account for a large proportion of morbidity and mortality in patients with and sickle cell disease. Periodic lung function assessment is recommended to provide a diagnostic clue criterion for physicians. ObjectiveThe purpose of this study is to assess the spirometry parameters in patients with sickle beta thalassemia and sickle cell disease in south west Iran.Materials and MethodsOver three months, a total of 35 patients participate in this cross sectional study. Spirometry test was performed on 21 patients with sickle cell disease (12 male, 9 female) and 14 patients with sickle beta thalassemia (7 male, 7 female) aged 6to35 years old. Normal people were matched according to age and sex and were tested as control.ResultsEighty six percent of sickle cell disease and 57 percent of sickle beta thalassemia had restrictive pattern of lung disease. Forced expiratory volume in 1 second (FEV1) and forced vital capacity (FVC) correlated positively with Hb F level and negatively with Hb S level (P-value<0.001) in sickle cell disease patients (P-value<0.001). Serum ferritin level had a negative effect on FEV1 and FVC in sickle beta thalassemia patients.ConclusionPeriodic lung function tests are a useful monitoring test to provide a clinical evaluation profile and have positive correlation with Hb F level.

IntroductionAnemia in preterm infants is identified as hemoglobin lower than 7-10g/dl around 1-3 months after birth. The aim of this study was to evaluate the effect of early subcutaneous administration of erythropoietin on hematopoiesis and weight gain velocity in preterm infants. Materials and MethodsThe present study was clinical trial carried out on 42 preterm infants. Those whose weight was lower than 1800 g at birth and gestational age of less than 34 weeks were included in the study. The subjects were randomly assigned into two groups. Intervention (IG) and control (CG). The IG received 500 IU/kg of subcutaneous erythropoietin twice a week while there was no intervention with the control group. Both groups received iron supplement, vitamin A, D, E and folate daily. Measuring ferritin as well as reticulocyte, hematocrit, and hemoglobin were accomplished in each group before and after the treatment. SPSS11 software was used to analyze the data.ResultsTotally there were 19 boys (51.4%) and 18 girls (48.6%) in this study. there was an increase in the number of reticulocytes in IG after the intervention (P=0.004). Weight gain was also higher in this group (P=0.005). The mean systolic blood pressure, however, was not significant in both groups after the intervention (P=0.36). Two infants needed transfusion of packed RBCs in the CG while for IG this was not happened.ConclusionEarly use of human recombinant erythropoietin results in erythropoiesis as well as weight gain in preterm infants.

BackgroundBeta-thalassemia is a common hereditary hemoglobinopathy, which is a reason of microcytic hypochromic anemia. Patients with major thalassemia require multiple blood transfusions. This study evaluated growth in thalassemic patient and relationship with ferritin level.Materials and MethodsThis is a cross sectional study on seventy patients (36 boys, 34girls) with transfusion dependent major thalassemia at the special diseases center of Yazd. Their age rang was 2 to 28 year. All of them received chelating therapy (Deferoxamine) every night. Weight, height, body mass index (BMI) and serum ferritin of patients were recorded.ResultsIn this study 46 (65.71%) of patients had height less than five percentile, and 24(34.29%) more than five percentile. Thirty eight patients (54.28%) had weight more than five percentile and 32(45.71%) less than five percentile. BMI of 13(18.6%) patients were low and 57(81.4%) patients had normal BMI. Mean serum ferritin in patients with height more than 5 percentile was 2252+/-1040 and with height less than 5 percentile was 2962+/-1606(P-value=0.072). mean serum ferritin in patient with weight more than 5 percentile was 2309+/-1284 and with weight less than 5 percentile was 3199+/-1545 (P-value=0.017). In patient with normal BMI, mean serum ferritin was 2679+/-1378 and it was 2596+/-1777 with low BMI.ConclusionHigh serum ferritin levels during puberty cause delay of growth retardation and development in transfusion dependent thalassemia patients.

IntroductionConnection of socioeconomic status measures (such as income and education and parental addiction) to childhood leukemia are likely to vary with place and time. The aim of this study was to assess the relation between socioeconomic status and childhood leukemia.Materials and Methodsa case- control study conducted on 86 case of acute lymphoblastic leukemia age 0-14 years in Shahid Sadoughi Hospital in Yazd and matched on age and sex to 188 healthy controls. Data was collected by interview using a questionnaire.Data analyzed by chi-square test. Odds ratio (Ors) and 95% confidence intervals were used to measure the risk of childhood A.L.L associated with parental smoking, alcohol drinking & addiction.ResultsThere was a significant difference in parental education level (P-value=0, P-value=0.001), income status (P-value =0.001), father's job (0.002) between two groups. The risk of childhood A.L.L was associated with paternal smoking (P-value =0.001, OR=2.6, CI 95%, 1.5-4.5), alcohol drinking (P-value=0.003, OR=3.33, CI 95%, 2.7-3.9), addiction (P-value =0, OR=42.7, CI95%, 5.56-328.34).ConclusionThe results suggest that socioeconomic factors and paternal smoking and alcohol drinking are related to risk of childhood leukemia. It should be considered for planning support.

Background Involvement of lacrimal apparatus by Non Hodgkin lymphoma as a first manifestation is extremely rare and only three cases have been reported in children. The purpose of this report is to determine the clinical characteristic of patient with primary involvement of lacrimal apparatus with lymphoma.Case presentationA 7-year-old girl with history of tearing, gradually progressive periorbital redness and painless swelling over right lacrimal apparatus for almost 40 days was referred for treatment in our clinic. Orbital computed tomography revealed lacrimal apparatus mass. Histopathological examination demonstrated B cell type NHL. Following three cycles of cyclophosphamide, doxorubicin hydrochloride, vincristine and prednisone (CHOP regimen) and radiotherapy, the patient was discharged with good condition.ConclusionAlthough, the primary lacrimal apparatus lymphoma is extremely rare in children but malignant lymphoma should be taken under consideration in acute dacriocystitis.