Vol 17, No 2 (2023)

Original Article(s)

  • XML | PDF | downloads: 134 | views: 220 | pages: 65-74

    Background: Breast cancer and cervix cancer are the prevalent and deadly types of solid tumors around the world. According to the importance of cancer, it is necessary to understand predisposing factors that affect cancer risk. In this regard, previous studies suggest that blood types particularly ABO and Rh-Hr Blood-Group System could play roles in the risk and different features of cancers. In the present study, we aimed to evaluate the potential of ABO and Rh blood groups as risk factors for breast cancer and cervix cancer.

    Materials and Methods: A retrospective study included 109 and 14 patients diagnosed with breast cancer and cervix cancer, respectively with known ABO and Rh blood types, between 2018 and 2020 in Khuzestan province, Iran. For compression of ABO blood groups distribution between the cancer patients group and the healthy population, we used data from a large-scale study that report the distribution of ABO blood groups in 29,922 blood donors in Khuzestan province.

    Results: Based on obtained results the most frequent blood group is O followed by B, A, and AB in breast cancer and followed by A, B, and AB in cervix cancer. Results showed no significant association between ABO and Rh and the risk of breast and cervix cancer. Moreover, there is no relationship between blood types and clinic pathological features of breast cancer.  

    Conclusion:  Based on our data, ABO and in this regard, previous studies suggest that blood types particularly ABO and Rh-Hr Blood-Group System could play roles in the risk and different features of cancers. In the present study, we aimed to evaluate the potential of ABO and Rh blood groups as risk factors for breast cancer and cervix cancer do have not any association with the risk of breast and cervix cancer and their characteristics.


  • XML | PDF | downloads: 81 | views: 236 | pages: 75-80

    Background: We aimed to investigate the association of body mass index (BMI) with treatment response in patients with DLBCL

    Material and Methods: Seventy-nine DLBCL subjects were included in this study. Data about patient age, sex, serum LDH level, presence of B symptoms, IPI score, ECOG performance score, disease stage, extranodal involvement, and BMI values at diagnosis were retrieved by retrospective patient record review. Patients were staged according to Ann Arbor classification using CT and/or PET/CT findings, and the presence of B symptoms. Body mass index was calculated by dividing weight in kilograms by height in meters squared (kg/m2). Patients were divided into groups according to their BMI as underweight (BMI≤ 18.5 kg/m2), normal weight (BMI 18.5-25 kg/m2), overweight (BMI 25-30 kg/m2), and obese (BMI≥ 30 kg/m2), as defined by the World Health Organization.

    Results: Patients were divided into four groups according to their BMIs, but because there was only one patient in the underweight group, comparisons were performed between normal-weight, overweight, and obese patients. There was no statistically significant difference between these groups in terms of age, sex, serum LDH level, disease stage, presence of B symptoms, extranodal involvement, ECOG performance score, IPI score, and treatment response (p= 0.070, 0.704, 0.325, 0.464, 0.254, 0.152, 0.658, 0.620, and 0.947, respectively)

    Conclusion: In our study, we showed that BMI has no significant impact on treatment response in patients with DLBCL.


  • XML | PDF | downloads: 67 | views: 111 | pages: 81-88

    Background: FAT atypical cadherin 1 (FAT1) is a member of the cadherin superfamily whose loss or gain is associated with the initiation and/or progression of different cancers. FAT1 overexpression has been reported in hematological malignancies. This research intended to investigate FAT1 gene expression in adult Iranian acute leukemia patients, compared to normal mobilized peripheral blood CD34+ cells.

    Materials and Methods: The peripheral blast (peripheral blood mononuclear cells) cells of 22 acute myeloid leukemia (AML), 14 acute lymphoid leukemia (ALL) patients, and mobilized peripheral blood CD34+ cells of 12 healthy volunteer stem cell donors were collected. Then, quantitative real-time polymerase chain reaction (qPCR) was used to compare FAT1 gene expression.

    Results: Overall, there were no significant differences in FAT1 expression between AML and ALL patients (p>0.2). Nonetheless, the mean expression level of FAT1 was significantly higher in leukemic patients (AML and ALL) than in normal CD34+ cells (p=0.029). Additionally, the FAT1 expression levels were significantly higher in both CD34+ and CD34- leukemic patients than in normal CD34+ cells (p=0.028).

    Conclusion: No significant differences were found between FAT1 expression in CD34+ and CD34- leukemic samples (p> 0.3). Thus, higher FAT1 expression was evident in ALL and AML leukemia cells but this appeared unrelated to CD34 expression. This suggests in a proportion of adult acute leukemias, FAT1 expression may prove to be a suitable target for therapeutic strategies.

  • XML | PDF | downloads: 83 | views: 126 | pages: 89-99

    Background: Since 2019, Coronavirus has been a highly contagious disease. The COVID-19 outbreak was declared a pandemic by the World Health Organization in March 2020. Variable laboratory findings are reported in COVID-19 patients, among which elevated levels of D-dimer, lactate dehydrogenase, as well as lymphopenia, have been reported to be associated with increased severity of disease symptoms requiring ventilator support, intensive care unit admission, and mortality.

    Materials and Methods: In the current study, inclusion criteria were: patient age above 18 years and hospitalization in the Imam Khomeini hospital with COVID-19 disease confirmed with nasopharyngeal swab polymerase chain reaction tests. Levels of white blood cells, neutrophils, lymphocytes, hemoglobin, platelets, D-dimer, C-reactive protein, LDH, and ferritin were measured and their correlation with the final patients’ outcome was evaluated.

    Results: A total of 208 patients were included in the present study. Higher neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte, LDH, platelet to lymphocyte ratio, ferritin, and D-dimer were significantly related to O2 dependency. Neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte and LDH were significantly related to higher rates of mortality. Higher Hb and lymphocyte count were significantly related to higher rates of survival.

    Conclusion: Hematological parameters including neutrophil to lymphocyte ratio, (WBC count excluding lymphocyte)/lymphocyte, LDH, platelet to lymphocyte ratio, ferritin, D-dimer, Hb, and lymphocyte count were significantly related to the prognosis of patients with COVID-19 disease. This could help decide which COVID-19 patients have priority for hospitalization and intensive medical care, particularly when the pandemic disease causes limitations in healthcare service.

  • XML | PDF | downloads: 78 | views: 96 | pages: 100-105

    Background: Breast cancer is the most common malignant tumor and cause of death in women. Factors that play role in tumor metastasis are lymph node involvement, lack of tumor differentiation and hormone receptor expression, high proliferation rate, and angiogenesis. In the present study, we tried to evaluate the microvessel density (MVD) using Immunohistochemistry for the CD34 marker to investigate the amount of angiogenesis in breast cancer and its relationship with other histopathological parameters and compare it with normal tissue.

    Materials and Methods: 58 paraffin-embedded samples of breast cancer were enrolled. All blocks were sectioned and stained for estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor 2(HER 2/neu), ki67, and CD34 by immunohistochemistry (IHC) method.

    Results: The mean age of patients in this study was 49.6 ± 10.6 years. Statistically, there was a

    significant relationship between the grade of the tumor (P = 0.01), absence of expression of estrogen receptor (P = 0.008), and progesterone receptor (P = 0.003) with MVD.

    Conclusion: Due to the association between MVD, tumor grade, and absence of ER and PR expression, this valuable marker can play an important role in the prediction of prognosis in breast cancer patients and can lead to new targeted therapy in the future.


  • XML | PDF | downloads: 94 | views: 134 | pages: 106-113


    Background: High-dose chemotherapy followed by Autologous SCT (stem cell transplantation) is a treatment of choice for relapsed and refractory lymphoma. Due to cost, toxicity, and shortage of Carmustine, we decided to conduct a phase 2 clinical trial to evaluate the safety and efficacy of Bendamustine instead of Carmustine in a previously used BEAM-like protocol.

    Materials and Methods:102 patients (median age,37) with Hodgkin(n=54) and non-Hodgkin lymphoma(n=48) were recruited and transplanted in two centers. After stem cell harvesting, a modified BeEAM regimen was administered to all the patients. Overall survival and disease-free survival (DFS) at two years were calculated as the study's primary endpoints.

    Results: Neutrophil and platelet recovery were observed after a median of 12 and 13 days, and all the patients were engrafted. Fever was observed in 25(24.5%) with only two documented infections. The only grade III toxicities were mucositis (20%) and nausea (15.6%). No transplant-related mortality (TRM) was observed after 100 days. After a median follow-up of 37(range 25-48) months, 68(66.6%) patients were in complete remission while 21 patients were in partial response, and 16 patients(15.6%) developed progressive disease, among which 13 (12.7%) had died. The OS at two years was (89 of 102, 87.3%), and the DFS rate was 68 of 102=66.7%.

    Conclusion: Our study showed that modified BeEAM is a safe, effective, and feasible conditioning regimen for ASCT in lymphoma instead of the BEAM regimen.

Review Article(s)

  • XML | PDF | downloads: 102 | views: 274 | pages: 114-125

    Background: The prevalence of breast cancer has increased and has currently become one of the most common cancers. Although the majority of the world’s population is infected with Epstein Barr Virus (EBV) during their lives, the severity of symptoms varies and not everyone infected with EBV is diagnosed with cancer. EBV might increase the risk for breast cancer either by activating the HER2/HER3 signaling cascades or by creating a state of prolonged immune stimulation.

    Materials and Methods: A systematic search of several electronic databases including PubMed, ScienceDirect, Cochrane, EBSCOhost, JSTOR, and Scopus, following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted. The primary outcome of this review was to assess the prevalence of people with breast cancer that had a prior EBV infection.  

    Results: For this review, 24 case-control studies were accepted. Our analyses included 1.989 breast cancer cases versus 1.034 control cases. EBV was found to be present in 27.9% of breast cancer cases versus 8.02% found in the normal breast tissue of controls. All affected people were women with a mean age was 48.19 years. The most common type of breast cancer found in EBV-infected tissues was invasive breast cancer. Cases were reported sporadically in a wide geographical distribution, and the prevalence varied from 4.6% - 64.1%.

    Conclusions: A previous EBV infection might be associated with a higher risk for breast malignancy. The most common type is invasive cancer. It mainly affects women and geographical variances are observed. More studies are necessary to elucidate the role of EBV in the mechanisms of breast cancer. Also, it is crucial to improve the prevention and treatment strategies.


Case Report(s)

  • XML | PDF | downloads: 108 | views: 93 | pages: 126-128

    Donor cell-derived leukemia is a rare but well-described complication of allogeneic hematopoietic stem cell transplant (HSCT). This clinical case report aims to highlight the importance of recognizing this unusual disorder and thus, ensuring its appropriate management. We herein describe a case of a 9-year-old male diagnosed with acute lymphoblastic leukemia (ALL) and relapsed after initial chemotherapy. Subsequently, the patient had an allogenic peripheral blood stem cell transplant (PBSCT) from an HLA-matched, unrelated donor. Unfortunately, the patient then developed progressive thrombocytopenia and following investigation, including bone marrow examination and cytogenetic analysis, he was diagnosed with donor cell-derived myelodysplastic syndrome. The literature review emphasizes the importance of considering it as a differential diagnosis of disease relapse following allogeneic HSCT.

  • XML | PDF | downloads: 98 | views: 130 | pages: 129-132

    Covid-19 infection has more relevant consequences in frail and comorbid patients but little is known about its course in patients with hematologic malignancies. In this report we would like to present the case of a patient with multiple myeloma treated with recent autologous bone marrow stem cell transplantation and affected by Covid-19 pneumonia, presenting with a possible reinfection or an extremely long viral shedding.