فصلنامه خون
سال دوازدهم شماره 1 (پیاپی 47، بهار 1394)

The evaluation of the number، potential، and functional capacity of cord blood stem cells after long term storage is essential for their therapeutic uses in hematological malignancies and non-malignancies. Therefore، this study was aimed to assess the quality of cord blood units stored in Royan public cord blood bank، before and after cryopreservation. To check the quality of cryopreserverd cord blood units، the total number of cells، percentage of viable cells، colony-forming ability، the number of CD34+ cells before and after freezing were examined on 50 samples Our results determined that the mean value of the total nucleated cells in 50 cord blood samples was 7. 6 × 108 ± 1. 12 × 108. The number and viability of mononuclear cells as well as colony forming potential significantly decreased after cryopreservation; however، the count of viable CD34+ cells did not significant changes post thawing. There was no significant correlation between the numbers of nucleated cells and CD34+ cells. Increasing the storage time significantly reduces the number of nucleated cells and differentiation potential of hematopoietic stem cells rather than the number of CD34+ cells. Improved cryopreservation techniques are necessary to maintain the function of cord blood stem cells.

The allogeneic hematopoietic stem cell transplantation is used for the treatment of some hematological and non-hematological disorders, but the lack of suitable donors for many patients limits the use of this source therapy. Umbilical cord blood (UCB) is an alternative source of hematopoietic stem cell (HSC) transplantation. Despite all advantage lower cell doses is major obstacle in cord blood transplantation. Exvivo expansion of HSC is an alternative way to overcome this problem. In this experimental study, Polycaprolactone (PCL) scaffold coated with nano fibrous collagen compared to routine cell culture system is used for cell culture. Total cells, CD34 cell, CFC assay, and CXCR-4 expression was performed. Our findings demonstrated that the total cell expansion and CD34+ cells in 3 dimensional (3D) scaffold compared to routine culture system (2D) was higher (p< 0.05). Also total colony cells in 3D scaffold was higher than 2D cell culture system and statically significant (p< 0.05). Higher CXCR-4 expression in 3D compared to 2D showed better homing of cells cultured in 3D scaffold (p< 0.05). PCL scaffold coated with nano fibrous collagen was a proper cell culture system compared to 2D for cell expansion.

A common polymorphism at codon 72 in the p53 gene has been associated with the increased risk for lung, oral, prostate, breast and colorectal cancers. We studied this polymorphism in acute myeloid leukemia specimen from Alzahra Hospital in Isfahan city. In the present case-control study, 59 whole blood specimen from normal people and 59 acutemyeloid leukemia specimen were analyzed. p53 codon 72 genotypes were identified using allele-specificPCR. Chi-square test was used for the comparison of the frequency distribution of three genotypes of codon 72 in cases and control specimen. Resulting PCR products were either 177bp for proline allele or 141bp for arginine allele. The genotype distribution for p53 polymorphism showed 11.9%, 81.4%, and 6.8% for the Arg/Arg, Arg/Pro, and Pro/Pro genotypes in control samples and 33.9%, 61%, and 5.1% in acute myeloid leukemia specimen, respectively. The differences in the distribution of p53 codon 72 polymorphism between the cases and controls were statistically significant (p = 0.04). Deferasirox is relatively more effective than deferoxamine in reducing iron content of the liver and heart. Moreover, deferasirox is more effective in reducing cardiac iron content relative to liver iron content.

Von Willebrand Disease is an autosomal inherited coagulation disorder that is caused by quantitative or functional defects in vWF. In 2007, R2185Q was described as a vWD type 1 mutation in the Canadian population. Recent studies conducted on healthy people showed that the R2185Q variant can be present in normal individuals. The purpose of this study was to evaluate the frequency of vWF gene R2185Q variant ‎. In this descriptive study, 297 Iranian healthy individuals were evaluated. The subjects were interviewed for bleeding history and other relative symptoms. DNA was extracted by salting out methods from 5 ml of blood samples. Using PCR-RFLP, the samples were genotyped and the results were confirmed by sequencing. The study was performed on healthy individuals from both sex and different Iranian ethnic groups. Two individuals without any bleeding history were found to carry this allele in a heterozygote manner. The allele frequency was calculated 0.33% which was below 1% and thereby could not be considered as a polymorphism. vWF gene contains various mutation and polymorphisms which are population specific. To understand the Iranian pattern, more studies should be done to reveal this characteristic.

Multiple sclerosis (MS) is an autoimmune neurodegenerative disease in which the body’s natural defense system attacks myelin on neuronal cells. One of the most important immune system cells involved in MS is Th17 which is one of the main cells involved in most of autoimmune diseases. Recently, microRNAs (miRNAs) have been remarkably used in treating many kinds of diseases. MicroRNAs are endogenous 22-25 nt RNAs playing an important regulatory roles in cellular and developmental processes. The goal of this article is to determine miRNAs which possibly have the most effect in the pathway of differentiation to Th17 cells by using miRWalk database and candidate microRNAs that can suppress this pathway and limit the disease’s symptoms. Our in-silico studies identified the possible role of several miRNAs in differentiation of naïve CD4+ cells to Th17 cells. miR-93,miR-20a/b are probably applicable to inhibit the differentiation of naïve T cells into Th17 cells to reduce the progress of MS and also to be used as markers of diagnosis of MS in early stages. According to our results miR-20a/b&miR-93 can possibly be the key miRNAs, inhibiting the progression of MS by preventing the differentiation to Th17 cells.

Gelatinases are a subgroup of matrix metalloproteinases (MMPs) and have an important role in tumor growth and angiogenesis. In this regard, MMP-2 (gelatinase A) and MMP-9 (gelatinase B) have particular value. Isosorbide dinitrate (a nitric oxide donor) has been broadly used in treatment of cardiac diseases and its inhibitory effect on angiogenesis and tumor growth have been reported in vivo. In this study, the effect of isosorbide dinitrate on gelatinase-A and gelatinase B activity in leukemic cell lines has been assessed in vitro. MOLT-4, JURKAT and U937 leukemic cells were cultured in complete RPMI medium and then incubated with different concentrations of isosorbide (4 × 10-7, 4 × 10-6, 4 × 10-5, 4 × 10-4 M) in the presence of phorbol myristate acetate (PMA) (25 ng/mL), as a gelatinase inducer, for 24 hours. Afterwards, the gelatinase A and B activity in the cell culture medium was evaluated by gelatin zymography. The gelatinase A and B activity of MOLT-4, JURKAT and U937 leukemic cells treated with isosorbide did not show any significant difference with control. The gelatinase A activity was 1 ± 0.0 and 1.04 ± 0.06 in the control and 4 × 10-4 M concentration of the isosorbide in MOLT-4 cell line, respectively. In this study, isosorbide did not show any significant effect on gelatinase A and B activity in leukemic cells. The anti-tumoral and anti- angiogenic effect of isosorbide was reported by others to be possibly due to non-gelatinase activity mediated mechanism.

Blood transfusion causes many complications in major β thalassemia patients. In this study, the heart and liver iron deposition stata measured by MRI T2* technique in patients that are being treated by two iron chelation drugs of “deferoxamine and deferasirox” are compared. In an Experimental Study, 52 β-thalassemia patients treated with deferoxamine or deferasirox at least two years before the study were evaluated. In all patients, the liver and heart MRI T2* was taken and then the heart and liver iron deposition status was compared. The collected data were analyzed by SPSS software and statistical Mann–Whitney U test and Spearman's rank correlation coefficient. 23 female and 29 male were evaluated. The mean age in deferoxamine and deferasirox group were 17.7 (± 7.1) and 16.5 (± 7.3) years, respectively (p= 0.593). Mean of ferritin level in deferoxamine group was 2857.57 (± 2037.63) and in deferasirox group was 2067.42 (± 1789.18) ng/mL (p= 0.207). Mean of received packed cell was 150-180 cc/kg. The mean of liver MRI T2* relaxation time in deferoxamine group was 3.29 (± 2.07) msec and in deferasirox group was 3.37 (± 10.39) msec (p= 0.359). The mean of cardiac MRI T2* relaxation time in deferoxamine and deferasirox groups were 25.67 (± 10.73) and 29.1 (± 10.27) msec, respectively (p= 0.470). Deferasirox is relatively more effective than deferoxamine in reducing iron content of the liver and heart. Moreover, deferasirox is more effective in reducing cardiac iron content relative to liver iron content.

Blood transfusion rate for coronary artery bypass grafting (CABG) accounts for more than 10% of all blood consumption. Studies have showed that combination of blood conservation methodstogether with the multimodality programs can reduce blood transfusion during the cardiac surgery. The aim of this study was to perform an audit of blood transfusion, determine the predictors of transfusion in CABG operation, and compare the predicted and injeced rate of blood transfusion as a method of quality assurance. In this prospective observational study, 105 consecutive patients at Jamaran Heart Hospital from September 2012 to January 2013 were included. They were undergoing isolated, primary CABG by a single surgical team. The team were following a multimodality blood conservation strategy The predicted and injected blood rates were 24.1% and 13.3%, respectively. (OR = 0.48, CI = 0.26-1.4). Only 2% of patients required 2 units of packed cell and nobody received more than 2 units of blood. Low patient weight (p = 0.010) and female gender (p = 0.032) were determined as two significant predictors of blood consumption. Multimodality blood conservation program can reduce blood transfusion in the CABG operation. Thus, in the current era open heart surgery without blood transfusion is possible.

Confidential self-exclusion (CUE) system has been designed to enhance transfusion safety as an extra screening test to detect donors who donate their blood during window period. This study was designed to survey the efficacy of CUE option in Shiraz Blood Transfusion Center (southern Iran). The present retrospective study was conducted in Shiraz Blood Transfusion Center from 2009-2012. CUE is used for all individuals who refer for blood donation and prefer their blood not to be used if they have any doubt about their blood suitability for transfusion. The prevalence rates of HIV, HBV, and HCV were compared among blood donors who opted in and out of CUE. The data were analyzed using t-test and proportion test in Med Calc-8. From all donors, 4551 (1.13%) opted for CUE. Self exclusion was more frequent among male, single, low-grade education donors, and donors with the history of previous donation (p < 0.05). The prevalence rate of HBV and HCV was higher among donors who opted CUE option (p < 0.05). The prevalence rate of HIV was not higher among donors who opted CUE option (p > 0.05). The sensitivity and specificity of CUE were 4.4% and 98.8%, respectively. In our study, the prevalence rate of HBV and HCV was higher among donors who opted CUE option. There is a need to review the process of CUE option and make some changes to prevent unreasonable CUE option.

Excessive consumption of iron supplement during pregnancy may increase in Hb level and adverse pregnancy outcome. The aim of this study was to examine the effect of iron supplementation in pregnant women with high hemoglobin. In a randomized, double-blind, placebo-controlled trial, 83 healthy pregnant women who had a hemoglobin concentration more than 13.2 g/dL and a serum ferritin level higher than 15 μg/L between the 16th and 20th week of pregnancy took either one 50 mg tablet of ferrous sulfate daily or placebo during their pregnancies. Markers of iron status (Hb, ferritin) were measured at 37-39 weeks of pregnancy. The mean of maternal age and prepregnancy BMI were 26.11 ± 5.13 and 23.9 ± 2.32 kg/m2, respectively. After intervention, the mean levels of hemoglobin concentration were 12.05 ± 0.9 g/dL and 38.5 ± 9.3 µg/L in iron supplementation and 11.94 ± 0.65 g/dL in placebo groups and those of ferritin levels were and 27.22 ± 12.96, respectively. The differences were significant (p = 0.03) in both groups but the incidence of anemia did not show any differences. Not using iron supplementation did not increase the risk of anemia in women with hemoglobin concentration more than 13.2g/dL during pregnancy; thus, the intensive care and control of iron status markers are recommended for the groups without supplementation.

The use of vascular access devices (VADs) is an integral aspect of health care for neonates, children, and adults and has moved beyond the acute care setting to chronic, long-term care. VADs have a paramount role throughout the management of the oncology patient, as they are needed in the initial phases for surgery or chemotherapy, in the advanced stages for chronic treatment, and in the last stages for palliative measures. In patients with cancer, chemotherapeutic drugs can damage the wall of peripheral veins thereby rapidly putting an end to the peripheral access. Central venous lines (CVLs) were first described by Dudrick in 1968. In 1973, the first long-term central venous catheter (CVC) was used for parenteral nutrition. In 1979, the Hickman catheter, a long-term venous access device, was used for chemotherapy for the first time. The introduction of totally implantable port systems started in the early 1980s. In this article, we will review the use of port A Cath and its role in hematology-oncology patients based on the literature review. This article was provided based of review of many recent anf up-to-date articles in field of port A Cath uding and its role in hematology-oncology patients. Evaluation these articles showed the essential role of port A Cath and the best ways to deal with the possible complications. Review of articles revealed the essential role of port A Cath in hematology-oncology patients. Also it is necessary to be careful about using and care of port A Cath.