2022 CiteScore: 1.3
Ardeshir Ghavamzadeh, MD.
Vol 16, No 3 (2022)
Background: The prognostic significance of preoperative neutrophil to lymphocyte ratio (NLR), lymphocyte to monocyte ratio (LMR), and platelet to lymphocyte ratio (PLR) have been demonstrated in various tumors. This study aimed to evaluate the prognostic role of these ratios in pediatric medulloblastoma.
Materials and Methods: Forty-three pediatric patients with medulloblastoma were evaluated, retrospectively. Clinical, radiological, and laboratory data were extracted from the electronic medical records of the patients. Univariate and multivariate Cox proportional hazard models were used to evaluate the impact of suggested variables, including NLR, LMR, and PLR on progression-free survival (PFS) and overall survival (OS). Kaplan-Meier curves were plotted for the assessment of PFS and OS. The Log-rank test was used to assess differences between the PFS and OS in the related categories.
Results: There were 27 males (62.8%) and 16 females (37.2%) with a mean age of 7.4 ±3.3 years. The median OS and PFS were 62.8 ±17.2 months and 43.3 ±15.6 months. The multivariate Cox model showed the clinical risk group, NLR, and LMR as independent predictors of the PFS and the OS (p<0.05). The Log-rank test revealed that OS and PFS were higher in patients with NLR <4 and those with LMR ≥ 3.48 (p <0.05). There were no differences between patients with PLR>200 and PLR< 200 based on OS and PFS.
Conclusion: Our results suggest an elevated preoperative NLR and a lowered preoperative LMR as simple predictors of survival in pediatric medulloblastoma. These cost-effective and easily available ratios, along with previously established variables, could be valuable to predict survival in pediatrics with medulloblastoma.
Background: Therapeutic approaches for acute myeloid leukemia (AML) have remained largely unchanged for over 40 years and cytarabine and an anthracycline (e.g., daunorubicin) backbone is the main induction therapy for these patients. Resistance to chemotherapy is the major clinical challenge and contributes to short-term survival with a high rate of disease recurrence. Given the established efficacy of nanoparticles in cancer treatment, this study was designed to evaluate the anticancer property of our novel nanocomposite in the AML-derived KG1 cells.
Materials and Methods: To assess the anti-leukemic effects of our nanocomposite on AML cells, we used MTT and trypan blue assays. Flow cytometric analysis and q-RT-PCR were also applied to evaluate the impact of nanocomposite on cell cycle and apoptosis.
Results: Our results outlined that ZnO/CNT@Fe3O4 decreased viability and metabolic activity of KG1 cells through induction of G1 arrest by increasing the expression of p21 and p27 cyclin-dependent kinase inhibitors and decreasing c-Myc transcription. Moreover, ZnO/CNT@Fe3O4 markedly elevated the percentage of apoptotic cells which was coupled with a significant alteration of Bax and Bcl-2 expressions. Synergistic experiments showed that ZnO/CNT@Fe3O4 enhances the cytotoxic effects of Vincristine on KG1 cells.
Conclusion: In conclusion, this study sheds light on the potent anti-leukemic effects of ZnO/CNT@Fe3O4 and provides evidence for the application of this agent in the treatment of acute myeloid leukemia.
Background: A declining need for red blood cells coupled with strengthening demand for plasma-derived medicines has led to a strong focus on moving whole blood donors to plasmapheresis. The purpose of this study was to evaluate the four-year policies of the Iranian Blood Transfusion Organization (IBTO) in terms of plasmapheresis recruitment of first-time donors and its effect on plasmapheresis outcome.
Materials and Methods: Plasmapheresis data related to 16 centers from 2016 to 2019 was obtained from IBTO software. This information includes; (1) blood donation number, (2) plasmapheresis donation number, (3) number of plasmapheresis donors, (4) plasmapheresis donor demographic data, (5) plasmapheresis donor status, (6) frequency of plasma donation for each donor, (7) volume of plasma and (8) the prevalence of transfusion-transmissible infections (TTIs) in plasmapheresis donors.
Results: The result of this study demonstrated that plasmapheresis collection centers have recruited 85,515 (91%) first-time and 8,595(9%) regular and repeated donors from 2016 to 2019 years. Plasmapheresis to blood donation index was increased from 0.2% in 2016 to 4.9% in 2019. The mean donation number was 2 times per year. The trend of the yearly Whole Blood Donation (WBD) Index decreased from 26.69 to 24.11/1000 for the general population. The total volume of collected source plasma was 49,203 liters during this period. However, 46,000 liters of recovered plasma were decreased due to less WBD. Furthermore, the results indicated that the prevalence of HCV was significantly higher in first-time donors compared to repeated and regular donors (P = 0.000).
Conclusion: It is concluded that during four years, the net volume of plasma did not increase and plasmapheresis led to reducing WBD in our country. Moreover, first-time plasmapheresis donors can be associated with challenges such as increasing screening costs and compromising the safety of plasma resources. Therefore IBTO decided to stop the project and focus on its main role to prepare safe and sufficient blood components through WB collection and also single donor platelet and concurrent plasma by plateletpheresis.
Background: Prostate cancer is the second most common cancer in the male that affects the health, social and economic life of person. Different compounds such as Wharton jelly, have been used to treat prostate cancer. Wharton jelly is a tissue rich in cells with mesenchymal morphology. Wharton jelly compound inhibited the growth of various cancer cells, including ovarian, osteosarcoma, breast, and prostate cancers, and also reduced the expression of CXCR4 and VLA-4 genes involved in the metastasis process.
Materials and Methods: To do this research, Wharton jelly stem cells and DU145 cancer cell line were cultured. After cell culture, the effect of Wharton jelly on this cell line was evaluated by scratching and MTT assay. The expression of CXCR4 and VLA-4 genes was also evaluated by Real-time PCR.
Results: The results of MTT and Scratching tests showed that Wharton jelly inhibited the growth of DU145 cancer cells and also decreased the expression level of CXCR4 and VLA-4 genes.
Conclusion: The results of this study showed that Wharton jelly can be considered as an effective compound for decreasing metastasis of prostate cancer.
The microbiota is directly involved in the host metabolic process, as well as in immune response modulation and recruitment of different cells typology in the inflammatory site. Human microbiota modification (dysbiosis) is a condition that could be correlated with various pathologies. The short-chain fatty acids produced by the metabolic process have an important role as immune mediators. In the hematology field, dysbiosis can represent a predisposing condition for triggering and/or conditioning both non-neoplastic (iron deficiency anemia, thrombosis, thrombocytosis, or thrombocytopenia) and neoplastic disorders (lymphomas, leukemias, myeloma). Dysbiosis may also interfere with therapy efficacy (iron supplementation, chemotherapy, immunotherapy, and hematopoietic stem cell transplantation), impacting on patient's outcome.
Beta-thalassemia is a hereditary blood disorder in which the synthesis of the hemoglobin beta chain is halted or severely diminished, chiefly due to genetic mutations. As of today, the province of Sistan and Baluchistan has the highest prevalence of this disease in the southeast of Iran, with about 3,000 thalassemia patients. Adrenal dysfunction has been reported to arise in patients with beta-thalassemia major due to iron deposition in adrenal glands. We aimed to determine the prevalence of adrenal insufficiency in children with β-thalassemia major, who had been referred to Ali Asghar Hospital, Zahedan, prior to the time of the study.
T-cell/natural killer cell lymphoproliferative disorders are rare, associated with poor overall survival, and have limited treatment options. We report a case of a patient who developed hydroa vacciniforme-like lymphoma (HVLL, an EBV-peripheral T-cell lymphoma), refractory to multiple lines of systemic therapy including methotrexate, mycophenolate mofetil, dapsone, thalidomide, prednisone, and romidepsin. We conducted morphoproteomic analysis of the patient’s tumor which provided important biological insights. Histopathology showed primarily lymphohistiocytic infiltrates strongly positive EBV expression with a Ki-67 of >50% in the pretreatment biopsy and approximately 90% in the post-treatment biopsy, strong expression of Enhancer of Zester Homolog 2 (EZH2), a constitutively active mTOR pathway, 50% cytoplasmic BCL-2 expression; largely negative PD-1 positive CD8 T-cells. Based on this morphoproteomic analysis and published literature, we postulated that novel agents including venetoclax, tazemetostat, and other agents may provide a targeted approach for treating HVLL. This case illustrates the use of morphoproteomic analysis to better understand the biology of tumors.
Multiple myeloma constitutes a wide spectrum of diseases ranging from slow-growing monoclonal gammopathy of undetermined significance to rapidly progressing plasma cell leukemia. It is a very rarely diagnosed hematological malignancy in those less than 30 years.
A 25-year-old male presented with complaints of fatigue, and low-grade fever. On investigations, he was found to have bicytopeina and features of tumor lysis syndrome. This was initially thought to be consistent with a diagnosis of acute leukemia. Upon further analysis with bone marrow biopsy, serum protein electrophoresis, and immunofixation, the rare diagnosis of IgG myeloma with plasmablastic morphology was confirmed. However, it rapidly progressed and peripheral smear started showing clusters of plasma cells. Despite aggressive treatment, the patient succumbed to aggressive plasma cell leukemia with an underlying plasmablastic morphology.
This case highlights the possibility of myeloma as one of the differentials in young patients especially the rare plasmablastic variant that can get misdiagnosed as acute leukemia. This aggressive morphology may also show rapid progression to plasma cell leukemia and has an adverse prognosis.
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