Iranian Journal of Blood and Cancer
Volume:5 Issue: 2, Winter 2013

Determining the prevalence and risk factors of thrombocytopenia among neonates enables us to prevent the inevitable and sometimes irreversible complications. In this study we aimed to survey the frequency of thrombocytopenia and its demographic features and risk factors. In this cross sectional study the platelet counts of 364 neonates admitted to neonatal intensive care unit of Aliasghar children’s hospital, Tehran, Iran, were assessed. Maternal and neonatal medical conditions, risk factors and drug history were also recorded. Patients were divided into 4 groups according to the severity of thrombocytopenia: mild (100-149 × 109/L), moderate (50-99 × 109/L), severe (30-49 × 109/L) and very severe (< 30 × 109/L).They were also grouped as presenting early (less than 72 hours after birth) and late (more than 72 hours after birth) thrombocytopenia. Demographic data and hemorrhagic manifestations were also recorded. Sixty two (17.9%) of neonates were thrombocytopenic. The average gestational age at birth for the thrombocytopenic neonates was significantly lower than the non thrombocytopenic neonates (32.2 ±2.5 weeks versus 34.9± 2.5, P=0.0001), and also the average birth weight was significantly lower among the thrombocytopenic neonates (1979±517gr versus 2371±480 gr, P=0.0001). Neonatal sepsis was significantly associated with thrombocytopenia (24.1% versus 5.9%, P=0.0001). Our study indicated a high prevalence of thrombocytopenia among neonates admitted to NICU and its association with low birth weight, prematurity, and neonatal sepsis. Regarding the importance of life threatening events among the thrombocytopenic newborns, it is best to keep the risk factors in mind to prevent the future complications.

The aim of this study was to investigate the efficacy and safety of metronomic capecitabine chemotherapy in pretreated elderly patients with advanced gastric carsonoma. Patients and Eligible patients were treated with capecitabine at a fixed dose of 1000mg daily until disease progression or toxicity. Endpoints were overall response rate, safety, progression-free survival and overall survival. Thirty eight patients were enrolled (June 2004 to October 2011) with a median age of 69 years. Two patients refused continuation due to deterioration of general condition; consequently, 36 out of 38 patients were assessed for response. No complete response was observed while 6 patients out of 36 patients (16.7%) achieved partial response, 13 (36.1%) showed stable disease and 17 (47.2%) showed progression of disease. The disease control rate (response rate + stability rate) was 52.8%. The most common hematologic adverse effects were neutropenia in 3 (8.3%), followed by mucositis in 2 (5.6%) patients. There was one reported case of neutropenic fever. The reported hand-foot syndrome cases were all lower than grade 3. There were no treatment-related deaths and treatment delays were observed in 8 patients. Symptomatic improvement was evident in 18 patients (50 %). Median follow-up period was 6.5 months. Median time to progression was 3 months (range: 0 to7 months), while the median overall survival was 7 months (range: 3 to15 months). Metronomic capecitabine may be considered an effective and tolerable treatment option in elderly patients with pretreated advanced gastric cancer after the failure of previous lines of chemotherapy.

Blood transfusion plays a great role in public health and the blood safety still has remained 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. Comprehensive knowledge about HBV has high importance in Iran due to high number of blood dependent patients. The data used in this research are derived from articles obtained by searching keywords like occult hepatitis B infection, thalassemia, hemophilia, hemodialysis, co-infection and blood transfusion in databases including PubMed, Google Scholar and Scopus. The prevalence, genotypes, HBV-HCV co-infection, HIV-HBV coinfection and their role in blood transfusion and blood safety are discussed in this review article. Iran is in intermediate endemicity region and studies have reported that between 10–60% of the Iranian population has the evidence of HBV infection, with 2-7% being 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 the HBV via seronegative blood components. Iranian researches have reported a 1-2% prevalence of occult hepatitis B infection among Iranian blood donors. Based on our review findings the prevalence of HBV and occult hepatitis B infection in Iran is moderate, which shows the importance of taking necessary steps to reduce the transfer of infection via blood and its components.

Treating a chronic disease such as hemophilia is to improve the symptoms and quality of life (QOL) of the patients. This study aimed to study the quality of life among hemophilic children and compare the quality of life between patients receiving prophylactic or on demand treatments. In this descriptive-comparative study, we enrolled 60 patients from three main hemophilia care centers in Tehran. All patients were 4-7 year old. Half of the patients were receiving prophylactic and half were receiving on-demand treatment. The assessment tool was Heamo-QoL questionnaire which assesses the quality of life in different dimensions (physical, feeling, family, friends, others, attitude, treatment and behavior). In this instrument, higher points correspond to lower quality of life. The mean quality of life in each dimension and also the total score were determined. Quality of life was compared between prophylactic and on demand treatments. The mean quality of life in groups receiving prophylactic and on-demand treatments were 2.6±0.3 and 3.33±0.4 respectively (P<0.001). All dimensions except “treatment” and “feeling” were different between groups. The highest impairments among patients, regardless of their treatment regimen, were in family and physical dimensions. It is necessary to pay more attention to prophylactic treatment in hemophilic children as it seems to provide a higher quality of life among patients.

Non Hodgkin Lymphomas (NHL) are nodal or extra nodal monoclonal infiltrations by malignant lymphoid cells (B Lymphocytes in 80% of cases), which are distinguished as indolent or aggressive forms. According to the heterogeneity of lymphoid cells and their ubiquitous anatomical distribution, these disorders can develop in any organ and have very heterogeneous clinical expressions, but they are usually expressed by tumor development in the lymphoid tissue (lymph nodes, Waldeyer ring, spleen, bone marrow and sometimes blood). We report a patient referred to the department of hematology and bone marrow transplantation with an unusual localization for this type of pathology: eye localized phenotype B lymphoma in its aggressive form, occurring in a 88 years old man. Clinical remission was obtained by using rituximab, cyclophosphamide, hydroxydaunorubicin, oncovin, prednisone protocol combined with radiotherapy.