2023 CiteScore: 1.3
pISSN: 2008-3009
eISSN: 2008-2207
Editor-in-Chief:
Ardeshir Ghavamzadeh, MD.
This journal is a member of, and subscribes to the principles of, the Committee on Publication Ethics (COPE).
Vol 2, No 1 (2005)
Articles
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Introduction: Arsenic Trioxide is effective and approved for treatment of relapsed or refractory APL cases to ATRA but its effects in new cases of APL is not clear and needs long term follow up to dis¬close the role of this drug in treatment of APL in combination with chemotherapy/ATRA or alone.
Material and methods: we studied 111cases of APL (94 new case and 17 relapsed) diagnosed by mor¬phological criteria and confirmed by cytogenetic and/or RT-PCR for the presence of PML/RARA fu¬sion gene. Arsenic Trioxide was infused as 0.15mg/kg/day doses, until complete remission by morphological cri¬teria or till 60 days. In case of complete remission, after 28 days do rest, 0.15mg/kg/days Arsenic Tri-oxide was infused for an additional 28 days as consolidation. Also, we studied minimal residual disease by semi-sensitive RT- PCR on peripheral blood samples up to a year after complete remission.
Results: Complete remission was observed in 95 patients (85.6%) and median time to complete remis¬sion was 30 days. There was no significant difference between remission rate in new and relapsed cases. During the induction phase, the most common cause of toxicity and mortality was APL differentiation syndrome (23 cases or 20.7%). Other toxicities were serosistis (7.2%) and hepatotoxicity (19.8%). With a median follow up of 16.5(1-57) months for patients in complete remission, one and two year disease free survival (DFS) was 88.3% and 63.7%, respectively. We observed 24 relapses and 19 of them achieved second complete remission, again by Arsenic Trioxide. Median time to relapse was 17 months (4-33) and median time of second DFS after re-treatment with Arsenic Trioxide was 18 months. We observed a third and fourth remission for some patients, who relapsed, again by Arsenic Trioxide. For patients in complete remission, one and three years survival was 95.5% and 87.6%, respectively. Minimal residual disease was positive in 4 (8.3%) out of 48 cases up to a year after remission induction and 3 of these patients clinically relapsed.
Conclusion: Arsenic Trioxide is effective as a first line treatment of APL. Results of Arsenic Trioxide combination with chemotherapy/ATRA needs further study. Also it seems that Arsenic Trioxide is ap¬plicable for relapsed patients again and drug resistance is an unusual event -
The prevalence of Helicobacter pylori infection and the effect of its eradication on platelet count in 95 Iranian patients with chronic refractory autoimmune thrombocytopenic purpura (CRITP) was investigated. 69 of 95 patients were infected with H.pylori (72.6%). H.pylori eradication was obtained in 69 infected CRITP pa¬tients who were not in remission and had platelet count below 100×109 at the time of infection assessment. 4 pa¬tients failed to eradicate of H.pylori. During follow-up (median 22.5 months). 3 of 33 of responsive patients re¬lapsed after 14 months of eradication. 30 of 65 H.pylori-eradicated patients (46%) showed a significant increase in platelet count accompanied by a significant decrease of platelet-associated immunoglobulin G (IgG). In forteen patients without H.pylori infection, platelet counts did not significantly increase with the same treatment. On the other hand, eradication therapy did not affect platelet counts in 6 patients with gastric ulcer. This re¬sponse was maintained in all responding patients throughout the follow up period.
The assessment of H.pylori infection and its eradication shoud be attempted in CRITP as this approach could be an effective strategy, at least for some of these patients -
Objective: Mesenchymal stem cells (MSC) are capable of self-renewal and differentiation into various connective tissue lineages. Therefore, they have attracted a lot of attention from investigators in the context of stem cell therapies. In our study, we have evaluated the frequency, phenotype and differen¬tiation potential of MSC in bone marrow (BM) cord blood (CB) and mobilized peripheral blood (mPB).
methods: Sixteen CB, 11 BM and 19 mPB were obtained from normal donors. Mononuclear cells sus¬pended in culture medium and seeded in culture flasks. Flasks were incubated in a CO2 incubator with a change of culture medium every 4 days and passaged when fibroblast like cells reached confluence. For every other passage, MSC were examined for CD13, CD44,CD34 by flow cytometry and induced to differentiate into adipocytes and osteocytes.
Results: All BM samples produced MSC that survived multiple passages in mesenchymal culture me¬dium over 4 months. CB and mPB samples produced a non-confluent adherent layer of heterogeneous cells, and did not proliferate beyond the first passage. Immunophenotype of BM-derived MSC in every other passage were CD34-, CD13+ and CD44+, the adipogenic and osteogenic differentiation were con¬firmed by Oil-red O and Von Kossas staining, respectively. The mentioned evaluation for mPB and CB were not attempted because these were not confluent even in the first passage.
Conclusion: In our study, only human BM cells produced MSC. These cells are positive for MSC sur¬face proteins and differentiate into MSC lineages. -
Background: The hemoglobin disorders constitute the most prevalent group of monogenic disease A findings consis¬tent with this is a hemoglobin/G variant indicating that the patient has HbD/G trait. Hb D/G traits are clinically benign. In this study, the epidemiology of HbD/G was reviewed in a single institution in Iran.
Methods and Materials: We conducted the epidemiological study at Aliasghar children's hospital and all patients with HbD/G were entered to this study. The hematological values, hemoglobin electrophoresis, peripheral blood smear and clinical findings were collected in the data special form.
Results: Among 11825 hemoglobin analysis performed, we detected 101 cases of hemoglobin D/G. There were 55.4% male and 44.6% female, median age 9±13.36 yrs. Homozygous of D/G was found in seven pa¬tients with splenomegaly, jaundice, mild anemia and Reticulocytosis. Heterozygote patients were as¬ymptomatic. There wasn't any correlation between HbD/G with serum ferritin, MCV, Hb and sex.
Conclusion: In Iran HbD/G is relatively benign condition with mild anemia, Poikylocytosis and minimal hemolysis. -
Arsenic trioxide (ATO) has been reported to induce apoptosis in Leukemic cells of Acute Promyelo-cytic Leukemia (APL) patients through different pathways. However, the exact mechanism of ATO-induced apoptosis is not yet clear. Co stimulation of death receptors CD30 and tumor necrosis factor receptor type one (TNFR-I) is one of the postulated mechanisms.In the present study we aimed to evaluate their involvement in fresh Promyelocytic cells separated from bone marrow of APL patients. Immunomagnetic separated cells were treated up to 48 hr at clinically tolerable concentrations of ATO (0.5-2.0 µmol/l) and expression of TNFR-I and CD30 were evaluated within the apoptotic and live populations using a sensitive triple color flow cytometric method for measuring apoptosis in combina¬tion with dual color immunofluorescence. Our results suggest that the expression of TNFR-I and CD30 might not be related to ATO-induced apoptotic cell death.
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Rapid and complete cyst resolution in a case of craniopharyngioma following Gamma knife radiosurgery
A case of cystic craniopharyngioma is presented in which multiple micro-surgeries failed to result in cyst resolution and significant enhancement in patients symptoms. Tumor irradiation using Leksell Gamma knife resulted in complete absorption of the remained cystic parts of the tumor and dramatic improvement in patients symptoms three months after the radiosurgery .Possible mechanisms are dis¬cussed.
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Primary adrenal lymphoma is extremely rare. We report a case with primary bilateral adrenal lym-phoma in a young male patient. He presented with abdominal pain and weight loss. Pathologic study revealed malignant lymphoma, diffuse large cell type (T- cell origin). Patient recieved combination chemotherapy and radiation therapy but 22 months after diagnosis died because of progression of dis¬ease
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Objectives: The Iranian Cancer Network was established in May 2003. Our aim was to coordinate re¬search and treatment programs in all cancer centers in Iran in order to save time and money and enable patients, wherever they live, to receive a uniformly high-standard treatment and care. Methods: After signing a mutual contract with fellow (collaborator) university and holding some shared sessions, the project was planned on the basis of the network missions. Network structure guide¬lines and the responsibility of the sections and staff in the network were being defined. Cancer teams include physicians, epidemiologists, pathologists, basic scientists, and executive authorities related to cancer management.
Results: The Iranian Cancer Network has started its work as a preliminary study between two centers. Then some other cancer centers in the country joined it and it is developing gradually. Several common research projects and clinical trials have been started in this network. Genomic DNA bank for patients with hematopoetic malignancies is being constructed. Data bank for all cancers referring to these cen¬ters is being constructed and its result will be published later.
Conclusion: Cancer networks make a systematic connection between all cancer centers around a coun¬try (or abroad) to ensure delivery of new information, interventions, and best practices and help others to share their research and laboratory facilities. -
Mediastinal neoplasms are uncommon tumors that can occur at any age but are most common through the fifth decades of life.
A wide variety of systemic disorders are associated with 71% of thymomas. The symptoms of these as¬sociated disorders often lead to the original discovery of the mediastinal tumor. A 35-year-old female with petechia and purpura was admitted to Sina hospital of the city of Hamadan in 5/6/2000. the serum platelet count was 4000/microliter. After the primary evaluations Idiopathic Thrombocytopenic Purpura (ITP) was diagnosed and after corticosteroid therapy serum platelet count increased. After 2 month she was admitted to the neurology ward of our hospital with diagnosis of cerebro vascular accident (CVA). In brain computed tomography (CT) scan a hyperdense lesion was reported that reveald hemorrhage in the temporoparietal region. The platelet count was 154000/microliter at this time which suggests the idea that some suppressive antibodies in the serum might lead to platelet disfunction. Two years later she was admitted to Shariati hospital with fatigue, left lid ptosis, speech disorder, bifacial weakness, diplopia and muscle force = 4/5. Myasthenia gravis was diagnosed and in the chest CT scan a density associated with thymus was reported. Thymectomy was performed for the patient and report of the pathologist was thymoma. After adjuvant radiotherapy serum platelet count increased and myasthenia gravis was improved and all of the patient's signs and symptoms resolved. ITP must be considered as one of the paraneoplastic symptoms of thymoma.
