Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 17 4 2023 10 14 224 230 Ali Ghasemi Department of Biochemistry and Hematology, Faculty of Medicine, Semnan University of Medical Sciences, Semnan, Iran Kazem Ghaffari Department of Basic and Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran Fatemeh Hoseini Clinical Research Development Center of Amir Kabir Hospital, Arak University of Medical Sciences, Arak, Iran Aziz Eghbali Clinical Research Development Center of Aliasghar Hospital, Iran University of Medical Sciences, Tehran, Iran Nooshin Sajadei Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran Vahid Falahati Department of Basic and Laboratory Sciences, Khomein University of Medical Sciences, Khomein, Iran Yazdan Ghandi Department of Pediatrics, Arak University of Medical Sciences, Arak, Iran 2021 03 18 2021 12 07 Background: Given the association of hypomagnesemia with cardiac arrhythmia, the aim of this study was to investigate the relationship between serum magnesium levels with age and T2* magnetic resonance imaging (MRI) findings of the heart and liver in patients with thalassemia major (TM).  Materials and Methods: In a descriptive cross-sectional study, a total of 62 patients with β-thalassemia major aged 11-48 years were selected at the Amir-Kabir Hospital, Arak, Iran. Serum magnesium, ferritin, and iron levels of patients were measured, and the rate of cardiac and hepatic hemosiderosis of patients was extracted according to the routine T2*MRI method.  Results: The mean age of the patients at diagnosis was 32.6 years. The comparison of TM patients with and without hepatic/cardiac hemosiderosis demonstrated that mean levels of serum ferritin, serum iron, and age were significantly higher in TM patients with cardiac hemosiderosis than in hepatic/cardiac non-hemosiderosis (P < 0.05); however, there was no significant difference in mean levels of serum magnesium in TM patients with and without hepatic/cardiac hemosiderosis (P = 0.279). Interestingly, the correlation of age with serum magnesium levels in TM patients revealed a statistically significant and moderate inverse correlation (r = -0.56, P = 0.013). Conclusion: Hypomagnesemia may occur in a time-dependent manner. It is recommended that, in addition to cardiac and hepatic T2*MRI, serum magnesium levels be measured by using magnesium replacement if necessary.   https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1584 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1584/1007

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 17 4 2023 10 14 231 239 Atefe Derakhshan Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran Ava Mansouri Research Center for Rational Use of Drugs, Tehran University of Medical Sciences, Tehran, Iran Aarefeh Jafarzadeh Kohneloo Department of Statistics and Epidemiology, Faculty of Health, Tabriz University of Medical Sciences, Tabriz, Iran Molouk Hadjibabaie Department of Clinical Pharmacy, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran 2022 07 20 2023 08 19 Background: The level of adherence to drug therapy after allogeneic hematopoietic stem-cell transplantation (Allo-HSCT) can affect the patient’s outcome, and poor adherence is one of the factors in first-year mortality after HSCT. Material and Methods: This study assessed adherence to cyclosporine and prednisolone as the immunosuppressant regimen in 110 post-HSCT patients (> 18 years). Demographic characteristics, clinical information, and cyclosporine levels were obtained. A validated Persian medication adherence scale was used to assess adherence to cyclosporine and prednisolone. Results: For 110 patients, the calculated mean of the total score of cyclosporine and prednisolone was 7.73 ± 0.62 and 7.63 ± 0.73, respectively. Poor adherence to medication in this population was 27.7% and 22.7% to prednisolone and cyclosporine, respectively. A significant correlation was observed between adherence total score and cyclosporine levels at the third- and fourth-month post-transplant (r = 0.52, P < 0.001 and r = 0.60, P = 0.001). In the first, second, and third months, the mean of cyclosporine levels in the high adherence level was higher than the moderate and poor adherence levels. Additionally, there was an association between adherence score and the level of cyclosporine. One score increase in adherence scale on average increased cyclosporine level by 34.48 ng/ml. Conclusion: In this study, medication non-adherence was high, which indicates the need for more careful monitoring of post-HSCT patients’ medication use. This is even more crucial currently since it has been confirmed that adherence can affect cyclosporine levels as the most effective immunosuppressant agent in preventing graft-versus-host disease (GVHD).  https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1879 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1879/1008

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 17 4 2023 10 14 240 244 Ghazaleh Haghighat Hamadan University of Medical Sciences, Hamadan, Iran Ahmad Khajeh-Mehrizi Department of Hematology and Medical Oncology, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran Hossein Ranjbar Department of Internal Medicine, Hamadan University of Medical Sciences, Hamadan Iran 2023 10 11 2023 10 11 Background: It has been shown that increased serum levels of vitamin B12 may be associated with some malignancies. This study aimed to compare the serum levels of vitamin B12 in patients with colon and breast cancer and healthy individuals. Materials and Methods: In this case-control study, 140 patients with colon and breast cancer were compared with 140 healthy individuals matched in age, gender, and socioeconomic status. Serum levels of vitamin B12 were measured through the Electrochemiluminescence method in both groups. The normal serum level of vitamin B12 was between 200 and 800 pg/ml. Results: Among 280 enrolled subjects, 60 had serum vitamin B12 levels higher than 800 pg/ml. Forty-six (32.9%) patients had high serum vitamin B12 levels, compared to 14 (10.0%) subjects in the control group (P value = 0.001). The mean serum vitamin B12 level was significantly higher in the patients (380.4 ±540.2 pg/ml vs. 278.0 ±314.08 pg/ml, P value=0.001). There was no statistically significant difference in serum levels of vitamin B12 in patients with breast and colon tumors (P = 0.8). A significant positive correlation was observed between serum levels of vitamin B12 and tumor stage (P = 0.001, r = 0.49). Conclusion: The findings of this study showed that serum levels of vitamin B12 in patients with colon and breast cancer are higher than in healthy individuals and are positively associated with the stages of cancer.  https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/2096 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/2096/999

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 17 4 2023 10 14 245 256 EN Mohammad Hossein Derakhty Gonbad Department of Applied Cell Sciences, Tabriz University of Medical Sciences, Tabriz, Iran Ali Baradar Khoshfetrat Chemical Engineering Faculty, Sahand University of Technology, Tabriz, Iran Ali Akbar Movassaghpour 3Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Zohre Sanaat Hematology and Oncology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran Hojjatollah Nozad Charoudeh Drug Applied Research Center, Tabriz University of Medical Sciences, Tabriz, Iran 2022 08 04 2023 08 31 Background: Platelets play a key role in the treatment of thrombocytopenia. Nowadays, platelets (PLTs) are only obtained through blood donation. However, due to the limitations in their preparation and storage, they are produced in laboratories, especially through bioreactors that convert megakaryocytes from stem cells into large-scale injectable PLTs. Materials and Methods: In this study, the CD34 cells isolated from cord blood were differentiated into megakaryocytes. A 6-chamber bioreactor with a two-layer collagen scaffold, several ECM factors, and human cryoprecipitate were used to simulate the structure of the bone marrow. After the addition of megakaryocytes to the scaffold, PLTs were produced due to the flow pressure and the interaction between the scaffold structure and the ECM factors. Results: CD41 + cells were expanded 100 times as much as CD34 + cord blood stem cells. The mean PLT release from one megakaryocyte in the pure collagen scaffold was 17.42 PLTs. Once fibrin, fibronectin, hyaluronic acid, and cryoprecipitates were added to collagen, the mean PLT release was 21.4, 22.4, 23.9, and 27.37, respectively. With the simultaneous addition of three factors to collagen (CFFH) and then four factors (CFFHC), the number of PLTs reached 30.52 and then 34. Conclusion: Functional PLTs can be produced on a large scale with a multi-chamber bioreactor using a combination of ECM and cryoprecipitate with collagen scaffolding. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1892 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1892/1000

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 17 4 2023 10 14 257 266 Shiva Mosadegh Manshadi Department of Hematology and Blood Banking, School of Allied Medical Sciences, Tehran University of Medical Sciences, Tehran, Iran Mohammad Reza Shams Ardekani Department of Pharmacognosy and Medicinal Plants Research Center, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran 2021 04 22 2021 09 25 Background: Ziziphus jujube Mill. belongs to the Rhamnaceae family. It has been reported to have a variety of biological activities such as antitumor, antioxidant, and anti-inflammatory effects. This study investigates the antiproliferative effect of Ziziphus jujube on KG-1 and NALM-6 acute leukemia cell lines. Materials and Methods: In this experimental study, the aqueous, ethyl acetate, and hydroalcoholic extracts of the Ziziphus jujube were prepared. Total phenolic and flavonoid components were detected because the presence of these compounds is associated with antioxidant and anticancer effects. Different concentrations of extracts were prepared, and KG-1 and NALM-6 cell lines were treated with them at 12, 24, 36, and 48 hours. Cell viability and IC50 values of the extracts were calculated using MTT assays. BD Cycle TEST PLUS DNA Kit was used for cell cycle progression analysis. Bcl2, Bax, and caspase-3 mRNA expressions were also assessed. Results: Cell viability decreased in a concentration-dependent manner. The best efficacy belonged to the ethyl acetate extract. Investigation of cell cycle progression demonstrated that the number of G0/G1 cells enhanced and the number of G2/M cells decreased when the ethyl acetate extract was applied in its IC50 concentration. A considerable increase in Caspase-3 and Bax and a decrease in Bcl2 gene expression were detected in molecular examination. Conclusion: According to our research, Ziziphus jujube ethyl acetate extract has antitumor properties on KG-1 and NALM-6 cell lines, possibly through induction of apoptosis and cell cycle regulation.   https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1610 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1610/1001

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 17 4 2023 10 14 267 274 Laleh Vahedi Department of Pathology, Mazandaran University of Medical Sciences, Sari, Iran Somayeh Sheidaei Department of Pathology, Mazandaran University of Medical Sciences, Sari, Iran Maryam Ghasemi Immunogenetic Research Center, Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran Kolsumeh Ebrahimi Department of Pathology, Mazandaran University of Medical Sciences, Sari, Iran Jamshid Yazdani Cherati Faculty of Medicine, Mazandaran University of Medical Sciences, Sari, Iran 2021 04 25 2021 06 23 Background: This study investigates the CCR7 chemokine receptor’s prognostic value in gastric cancer and its relationship to metastasis. Materials and Methods: Normal and adjacent tumor cells in 70 patients with gastric cancer were evaluated for CCR7 expression using immunohistochemical staining. The prognostic values of high and low levels of expression of CCR7 were also evaluated by multivariate and univariate analyses. Results: Analysis indicated high expression of CCR7 in 52.9% of tumor tissue. Moreover, high expression of CCR7 was significantly related to metastasis of lymph nodes (p = 0.00). In addition, high expression of CCR7 had a positive correlation to the disease stage (p = 0.00), age of ≥50 years (p = 0.019), male gender (p = 0.024), vascular involvement (p = 0.009), histology of tumor adenocarcinoma (p = 0.00), and poor tumor differentiation (p = 0.00). However, the high expression of the CCR7 marker was not related to the tumor size. Conclusion: Based on our results, CCR7 expression in gastric cancer can be considered a clinical prognostic indicator in patients with gastric cancer. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1619 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1619/1009

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 17 4 2023 10 14 275 280 Hosein Jodat 1) Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2)Department of Laboratory Sciences, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Javad Jodat 1)Student Research Committee, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2)Department of Laboratory Sciences, School of Allied Medical Sciences, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Ali Khodadadi 1) Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1965 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1965/1038

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 18 3 2024 07 18 249 253 Mohammad Jafar Sharifi 1)Division of Laboratory Hematology and Blood Banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran 2)Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Negar Gheibi Department of Information Technology , Aliasghar Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Fatemeh Panahi Division of Laboratory Hematology and Blood Banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Sedigheh Sharifzadeh 1) Division of Laboratory Hematology and Blood Banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran 2) Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Nahid Nasiri 1) Division of Laboratory Hematology and Blood Banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran 2)Diagnostic Laboratory Sciences and Technology Research Center, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran 2024 02 05 2024 05 12 Background: Hematological abnormalities in COVID-19 infection included quantitative and qualitative changes and should be further characterized. Evaluation for myelodysplastic syndromes (MDS) is usually prompted by abnormal hematologic findings and the presence of dysplastic morphologies. Viral infections are considered to be the cause of dysplastic morphologies and should be considered by morphologists. There are few reports of dysplastic abnormal morphologies in patients with COVID-19 infection. However, such correlations still have to be clarified. Materials and Methods: In the present study, we examined the granulocyte lineage morphological abnormalities in symptomatic RT-PCR-confirmed COVID patients. Peripheral blood samples were collected from 82 patients with symptomatic COVID-19. Blood smears were prepared according to the standard Wright-Giemsa staining procedure. The morphological examination was carried out by two laboratory experts. Results: Blood smear examination revealed common myelodysplastic syndrome (MDS) type abnormalities including but not limited to pseudo-pelger nuclear lobulation (4.8%), hypogranulation (7.3%), Howell-Jolly-like bodies or detached nuclear segments (6.0%) and elongated and thin nuclear filaments (6.0%). One case of abnormal immature granulocyte and ring form nucleus is also evident. Conclusion: Our results accounted for the possibility of active COVID-19 infection in all subjects with granulocyte dysplasia. These results are of practical importance for patients suspected of having myelodysplastic syndromes or disease processes associated with myeloid malignancies.   https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/2169 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/2169/1039

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 18 3 2024 07 18 254 261 Thu Nguyen Stem Cell Transplantation Department, Blood Transfusion Hematology Hospital, Ho Chi Minh City, Vietnam Huu Than Huynh Stem Cell Transplantation Department, Blood Transfusion Hematology Hospital, Ho Chi Minh City, Vietnam Hung Tran Stem Cell Transplantation Department, Blood Transfusion Hematology Hospital, Ho Chi Minh City, Vietnam Quang Nguyen Stem Cell Transplantation Department, Blood Transfusion Hematology Hospital, Ho Chi Minh City, Vietnam Phu Huynh Stem Cell Transplantation Department, Blood Transfusion Hematology Hospital, Ho Chi Minh City, Vietnam Nam Hoang Stem Cell Transplantation Department, Blood Transfusion Hematology Hospital, Ho Chi Minh City, Vietnam Tuan Ma Stem Cell Transplantation Department, Blood Transfusion Hematology Hospital, Ho Chi Minh City, Vietnam Duong Do Stem Cell Transplantation Department, Blood Transfusion Hematology Hospital, Ho Chi Minh City, Vietnam Dung Phu Stem Cell Transplantation Department, Blood Transfusion Hematology Hospital, Ho Chi Minh City, Vietnam Man Huynh Stem Cell Transplantation Department, Blood Transfusion Hematology Hospital, Ho Chi Minh City, Vietnam 2022 11 17 2023 08 15 Background: Busulfan plus cyclophosphamide (Bu/Cy) is considered one of the classical myeloablative conditioning regimens. However, its toxicity can significantly increase mortality rates. To reduce both acute and long-term complications after hematopoietic stem cell transplantation (HSCT), newer conditioning regimens are being investigated. The purposes of this study were to assess the efficacy and safety of busulfan plus cyclophosphamide (Bu/Cy) and busulfan plus fludarabine (Bu/Flu) conditioning regimen for allogeneic HSCT (allo-HSCT) in acute myelogenous leukemia (AML). Materials and Methods: We conducted a single-center, retrospective analysis of AML, both adults and children, who underwent either Bu/Cy or Bu/Flu conditioning regimen for allo-HSCT and received peripheral blood stem cell transplants from HLA-matched donors. Results: From 2005 – 2019, 49 AML patients receiving Bu/Cy and 21 receiving Bu/Flu were identified, meeting inclusion criteria. The two groups showed no significant differences in age, gender, disease status pre-transplant, the median time to neutrophil and platelet engraftment. Bu/Flu patients had a shorter duration of neutropenia (median 7 days vs 10 days, p = 0.001) and shorter duration of thrombocytopenia (median 10 days vs 15 days, p = 0.016) than Bu/Cy.  No difference was observed in disease-free survival (DFS) and overall survival (OS) between the two groups. Both univariate and multivariate analyses showed that age, disease status pre-transplant, and chronic graft-versus-host disease (GvHD) are related to worse DFS and OS. Conclusion: With similar efficacy to Bu/Cy but faster neutrophil and platelet recovery time, Bu/Flu is suitable as a pre-HSCT conditioning regimen for patients with AML. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1937 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1937/1040

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 18 3 2024 07 18 262 273 Kien Do National Cancer Hospital, Hanoi, Vietnam Tu Do National Cancer Hospital, Hanoi, Vietnam Tai Nguyen National Cancer Hospital, Hanoi, Vietnam Duc Le National Cancer Hospital, Hanoi, Vietnam Linh Phan National Cancer Hospital, Hanoi, Vietnam Chu Nguyen 1) National Cancer Hospital, Hanoi, Vietnam 2) Hanoi Medical University, Hanoi, Vietnam 2022 10 31 2023 07 23 Extranodal natural killer (NK)/T-cell lymphoma, nasal type is a rare, aggressive, and poor prognostic subtype. The concurrent chemoradiotherapy followed by chemotherapy showed a relatively high response rate and the toxicity due to the treatment is acceptable. The study attempted to report the clinicopathological features, the survival outcome, and response rates of stages I-II, nasal type ENKTL patients treated with CCRT followed by adjuvant VIPD chemotherapy in Vietnam. Materials and Methods: The current study was conducted on 31 stage I or II NK/T cell lymphoma, nasal-type patients received by CCRT, followed by adjuvant VIPD chemotherapy. Information on patient demographics, disease stage, clinical symptoms, tumor, and paraclinical characteristics were collected. The primary endpoints of this study were OS and response rates. Results: After CCRT, 26 out of 31 (83.9%) patients had stable disease or response. Overall response rate (ORR) was observed in 80.6% of patients with a complete response rate of 67.7%. Low-risk PINK patients had a higher response rate than the intermediate- risk group(p=0.038). Mean disease-free survival was 44.3±4.5 months (95% CI, 35.4-53.1 months). Mean overall survival was 46.8±4.5 months (95% CI, 37.99-55.8 months). The intermediate-risk PINK patients had a significantly lower OS rate than low-risk patients. Conclusion: Concurrent chemoradiotherapy followed by adjuvant VIPD chemotherapy showed a high response rate and survival benefit in stages I-II, nasal type, and extranodal natural killer (NK)/T-cell lymphoma Vietnamese patients.   https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1926 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1926/1041

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 18 3 2024 07 18 274 284 Ayda Baghery Saghchy Khorasani Department of Hematology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran Mina Soufizomorrod Department of Applied Cell Sciences, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran Davood Bashash Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran 2022 10 18 2023 08 29 Background: Multiple myeloma (MM) is a malignancy of plasma cells, terminally differentiated B cells, with complications like hypercalcemia, renal failure, anemia, and bone disease, which are also known as CRAB criteria. MM develops from monoclonal gammopathy of unknown significance (MGUS), a pre-malignant plasma cell dyscrasia. Over some time, MGUS has the potential to progress into smoldering multiple myeloma (SMM), which can evolve into MM. MM rarely progresses into plasma cell leukemia (PCL), a condition in which malignant plasma cells no longer stay in the bone marrow niche and circulate in the peripheral blood. In MM, various soluble factors play important roles, and  interleukin-6 has different vital roles.  Interleukin-6, an inflammatory cytokine, has significant roles in the growth, survival, angiog