Iranian Journal of Blood and Cancer
Volume:3 Issue: 4, Summer 2011

Chronic Idiopathic Thrombocytopenic Purpura (ITP) is an autoimmune disorder characterized by a low platelet count due to reduced production and higher destruction of the platelets. Therapy is aimed at increasing the patient’s platelet count to safe levels and includes a wide variety of treatments, which has a large impact on the patient’s quality of life. Health Related Quality of Life (HRQoL) is one of the most important factors to evaluate the efficacy of the treatment. This study was conducted to compare the effect of the various types of treatment on HRQoL in ITP patients. Ninety under 25 year-old patients were included in this cross-sectional study. All patients had active disease with platelet count of less than 120,000/mm3. The patients were divided into 3 treatment groups: 1- Intravenous immunoglobulin (IVIg) treatment, 2- various corticosteroids treatments and 3- Immunosuppressive treatments, and filled-out a validated “quality of life” questionnaire.The HRQoL was calculated according to the collected information such as well-physical activity, gynecologic problems, bleeding disorders, response to treatment, side effects and social interactions. Ninety patients were enrolled, consisting of 38 male and 52 females. The mean age of the patients was 19.73±4.02 years. The mean total score of HRQoL was 21.8±9.1. We did not find any significant difference in HRQoL total score among treatment groups (p=0.129). HLQoL did not differ among treatment protocols and it seems that other factors are more important in influencing quality of life among ITP patients.

Hemoglobin S arises is the result of a point mutation (A-T) in the sixth codon on the -globin gene on chromosome 11 causing sickle cell anemia. The presence of fetal hemoglobin in infancy plays a relatively protective role for vaso-occlusive symptoms that are the major contributor for the morbidity and mortality among patients with sickle cell anemia. hydroxyurea, an s-phase-specific and non-DNA-hypomethylating chemotherapeutic agent is capable of inducing HbF synthesis. We reviewed the records of 28 sickle cell anemia patients, aged 4-52 years, treated with hydroxyurea to study the drug’s side effects. In our study, the most common adverse effect was dermatologic complication which occurred in 15 patients (53.5%). The gastrointestinal side effects were nausea, vomiting, abdominal pain and anorexia occurring in 3 patients 10.7%. The neurologic adverse effects were uncommon and occurred in 4 patients (14.3%). Side effects of hydroxyurea were common but mild to moderate, benign and transient. Starting a low dose of hydroxyurea (10 mg/kg per day) and increasing the dose slowly in pediatric and adult patients with sickle cell anemia can be tolerated well, without serious side effects.

Human leukocyte antigens (HLA) are polymorphic cell surface proteins. Distribution of HLA alleles vary among different racial and ethnic populations in unrelated stem cell registries. Determination of HLA allele frequencies in different ethnic groups is useful for population genetic analyses. Based on data available from the Iranian Stem Cell Donor Registry, HLA-A, B, DRB1 allele frequencies were evaluated from 244 individuals who were recruited as unrelated volunteer donors by PCR-SSP method from Fars people living in Tehran, Iran.The most frequent alleles found were HLA-A*02(19.8%), HLA-A*03(13%), HLA-A*11 and -24 (12.5%), HLA-B*35(17.7%) HLA-B*51(13.2%), HLA-DRB1*11(20.8%), whereas HLA-A*34 and HLA-A*44 (0.2%), HLA-B*47, B*54, B*56, B*73(0.2%), and HLA-DRB1*09 (0.4%) were the least frequent alleles.Identifying HLA allele frequencies in different ethnic groups, helps in designing a better plan for development of donor centers in different provinces of a country, and a more precise prediction of donor size in the registry, in addition to finding suitable donors for patients in need of hematopoietic stem cell transplantation.

Blood transfusion has an important role in public health and the blood safety remains a main concern. HBV has been considered as one of the most prevalent blood borne infections. It is estimated that chronic HBV affects 350-400 million people worldwide, with a mortality rate of 500,000 to 1.2 million deaths per year. Comprehensive knowledge about HBV is more important in blood safety in our country due to high number of blood dependent patients in Iran. In this article we review 138 research articles from Iran and worldwide. We discuss the prevalence, and the role of genotype, HBV-HCV co infection, HIV-HBV co infection and HBV in blood transfusion and blood safety. Iran is in Intermediate endemicity region and studeis indicate that between 10–60% of the Iranian population has the evidence of infection, and 2-7% are chronic carriers. In blood donors the rate of infection is lower than general population. The occult hepatitis B infection is the main concern in blood safety due to transmission of HBV via seronegative blood components. Iranian researchers have found a 1-2% prevalence of occult hepatitis B infection among Iranian blood donors. Considering the moderate HBV and occult hepatitis B prevalence in Iran, the new molecular methods to detect this infection among blood donors might increase the blood safety.

The aim of the present study was to assess the mean corpuscular volume (MCV) as a surrogate marker for detecting early iron deficiency prior to definitive investigation and treatment. This study was done on one hundred students in Swada Preparatory School – Sharkia Governorate from 2010 to 2011. They were subdivided into three groups: Group (A): comprised of 31 anemic children. Group (B): comprised of 19 microcytic children. Group (C): comprised the control group of 50 apparently healthy children with normal CBC. All subjects were subjected to: full history taking, thorough clinical examination and iron studies including: serum iron, total iron binding capacity, serum ferritin and transferrin saturation. There was a significant difference among studied subjects in height, presence of anorexia and pallor. Moreover, there was a significant difference among studied subjects in Hb, RBCs count, MCH, RDW (p < 0.001) and WBCs count (p= 0.004). We noticed a significant positive correlation between MCV (fl) and serum iron (mg/dl) in anemic subjects. Also there was a significant positive correlation between MCV (fl) and TIBC (μg/dl) in anemic subjects as well as a significant positive correlation between MCV (fl) and serum ferritin (μg/dl). In microcytic subjects, we found a significant positive correlation between MCV (fl) and iron (mg/dl) and a significant positive correlation between MCV (fl) and ferritin (μg/dl). Every child with clinical manifestations of anemia proved by CBC who have microcytosis and low MCV should undergo iron studies (serum iron, serum ferritin, total iron binding capacity and transferrin saturation).