Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 2 2005 06 15 1 4 A Shahriariahmadi Department of Hematology–Oncology, Taleghani Hospital, Kermanshah University of Medical Science, Iran M Tahmasian Department of Hematology–Oncology, Taleghani Hospital, Kermanshah University of Medical Science, Iran 2015 10 01 Introduction: Idiopathic Thrombocytopenic Purpura is one of the most common causes of thrombocy-topenia with varius clinical courses and different responses to its treatment modalities. Therefore, we decided to evaluate the clinical course of this disease in our patients. Methods: In this case series study, from March 1998 to March 2004, we evaluated 121 patients. As a first line of treatment, all of those patients received prednisolone (1mg/kg/day) for 6 weeks. Those who didn't respond or were refractory to prednisolone were candidates for splenectomy, and those who re¬fused these modalities or didn't respond to them were treated with Azathioprine. Results: 99 patients (81.8%) were female and 22 (18.2%) were male, aged 11-73 years (mean; 28.6). Two patients had immune hemolytic anemia in addition to thrombocytopenia, 4 had systemic lupus erythematosus, and one was HIV positive. %44.6 of patients fully responded to prednisolone, 42 pa¬tients (%34.7) underwent splenectomy and %83.3 of them responsed to it.31 splenectomies were per¬formed in the first three months after diagnosis and 27 (87.1%) of them showed complete response, but 8 (72.7%) of the patients splenectomized after 3 months, had complete response. 14 patients were treated with Azathoprine, 2 of which (14.3%) platelet count normalized. Conclusion: ITP is more common in females than males. Prednisolone is preferred as a non-invasive treatment with suitable response in comparison to other modalition responses to splenectomy, indicat¬ing that this modality of treatment is useful and effective, especially when performaed in the first 3 months of the diseases. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/184 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/184/177

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 2 2005 06 15 5 9 P Vossough Professor of pediatric hematology and oncology, Iran University of Medical sciences, Aliasghar Children’s hospital M Faranoush Assisted professor of pediatric hematology and oncology, Semnan University of Medical sciences, Amir Al Momenin Children’s hospital Z Emami Master of Science Hematology, Iranian transfusion Organization Gh Bahoush Professor of pediatric hematology and oncology, Iran University of Medical sciences, Aliasghar Children’s hospital Kh Arjmandi Professor of pediatric hematology and oncology, Iran University of Medical sciences, Aliasghar Children’s hospital Sh Ansari Professor of pediatric hematology and oncology, Iran University of Medical sciences, Aliasghar Children’s hospital M Alebouyeh Professor of pediatric hematology and oncology, Iran University of Medical sciences, Aliasghar Children’s hospital E Shahgholi Assisted professor of pediatric hematology and oncology, Tehran University of Medical sciences, Bahrami Children’s hospital A.A Hedayatiasl Professor of pediatric hematology and oncology, Iran University of Medical sciences, Aliasghar Children’s hospital 2015 10 01 Background: Induction Chemotherapy for Acute Lymphoblastic Leukemia achieves complete remis¬sion in over 90% of children. It is apparent therefore that many patients in clinical remission and with¬out residual disease detectable by conventional light microscopy of peripheral blood or bone marrow films still harbor viable cells of the original disease MRD analysis does have a useful role to play in the risk directed treatment of childhood ALL and this is currently being investigated in large prospective studies. Methods: We have investigated MRD in bone marrow samples by three color flowcytometry approach in 63 pediatric B-precursor ALL patients treated according to BFM ALL 95 protocol. Bone marrow samples were collected from children at three different times including: Day 28th, At the beginning of intensified therapy and at the end of therapy .Cells with leukemia associated Immunophenotype were investigated by DNA analysis for evaluation of DNA content. Results: Among 63 children with diagnosis of B-lineage ALL and quantified for post induction residual disease study .We observed that the mean number of blast cells have significant differences among these groups. The mean number of Leukemic blasts counted on day 28 was 2.7± 0.4, at the beginning of intensified therapy 1.7±0.4, and at the end of treatment 0.5±.2. These patients were in complete re¬mission in light microscopy examination. Relapse of ALL was demonstrated in six of 63 children (9.5%) whose MRD were more than one blast in 10-2 cells .Comparing this to light microscopic exami¬nation dill of  these patients had 4-5% blasts vs. 1% for those who did not relapse. Conclusion: MRD analysis does have a useful role in the risk directed treatment of child hood ALL and the investigation of levels and the dynamics of MRD by sensitive and quantitative flowcytometry and PCR methods reduce false negative results. However a good morphology is also valuable. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/185 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/185/178

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 2 2005 06 15 10 15 M Mohyeddin Bonab Hematology-Oncology & BMT Research Center S Yazdanbakhsh Department of Neurology, Shariati Hospital, Tehran Iran K Alimoghaddom Hematology-Oncology & BMT Research Center A Ghavamzadeh Hematology-Oncology & BMT Research Center F Hooshmand 3Iranian MS society, Tehran Iran J Lotfi Iranian MS society, Tehran Iran F Talebian Immunogenetics lab, Department of Immunology, Tehran University of Medical Sciences, Tehran, Iran B Nikbin Immunogenetics lab, Department of Immunology, Tehran University of Medical Sciences, Tehran, Iran 2015 10 01 Human mesenchymal stem cell (MSC) can be isolated from bone marrow (BM) and differentiated into multiple lineages. These properties make them promising tools in cell and gene therapy. Up to now, no definite therapeutic intervention for late stages of multiple sclerosis (MS) has been found. We decided to inject MS patients with autologous expanded MSC. Five patients participated in this ongoing study. Patients were injected intrathecally with the culture expanded BM MSCs. Patients were followed monthly for their clinical status and every 3 months re¬garding their magnetic resonance imaging. During 7 months follow up, one patient improved 1.5 EDSS, two patients improved by 1 and 2 scores, and two others remained unchanged till now. The first MRI findings of patients showed no change. We can claim that the injection of expanded MSC is a safe procedure. Three patients showed some de¬gree of improvement and the other two had no progression. Patients should be followed for at least one year and a larger sample is r quired in order to draw a definite conclusion. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/186 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/186/179

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 2 2005 06 15 16 20 T Azarm Saied-alshohada Medical Center; Isfahan University of Medical Siences; Islamic Republic of Iran M Jahani Hematology- Oncology and Bone Marrow Transplantation Research Center, Tehran University of Medical Sciences A.Gh Amini Saied-alshohada Medical Center; Isfahan University of Medical Siences; Islamic Republic of Iran M.R Saghfi Hematology- Oncology and Bone Marrow Transplantation Research Center, Tehran University of Medical Sciences 2015 10 01 From 1365 to 1382, 205 cases of Acute lymphoblastic leukemia (ALL) were refered to our Center. 160 cases achived complete remission and entered our clinical trial of CNS relapse which were under consideration. The patients included 98 men and 62 women with an average age of 32 years (range 4-61 years). 160 of 205 cases had complete remission with a rate about 78%.The latter group was entered into our clinical trial. The patients were followed for 30 months after starting maintenance therapy. All patients underwent CNS prophelaxy by CNS Irradiation with 14 GY and Intratechal Methotrexate in¬jection for 6 weeks. 24 cases had relapsed. The age of CNS relapsed patients were between 9 to 58 years (Mean 31y). Patient Sex: 11 male of 91, 13 female of 69. Results: 1 case showed CNS relapse after 4 months of starting maitenance therapy. 19 cases relapsed in the duration of 6-18 months after starting maintenance therapy. 2 cases relapsed within 24 & 28 months after starting maintenance therapy. The Statistic analysis are summarized as follows: 1-CNS relapse of ALLin the Females are more than Males (p=0.001). 2-CNS relapse of ALL in the age groupe older than 12 years were higher. 3-CNS relapse of ALL in those patients with bone marrow failure in responding to first period of treatment were higher (p=0.002). 4-CNS relapse of ALL in those patients with Leukocytosis more than 40.000/ul were higher (p=0.003). 5-The first Symptom of CNS relapse was severe headache (100%). 6-CNS relapse of ALL were in 18 months period of strating maintenance therapy. 7-CNS relapse of ALL in those patients with Type II ALL were more than Type I, with a rate of 18.7 % and 4.7% respectively. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/187 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/187/180

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 2 2005 06 15 20 24 M Hoseinzadeh Mollayosefy Department of Hematology and oncology, Shariati Hospital, School of Medicine, Tehran university of medical Science, Tehran, Iran M Iravani Department of Hematology and oncology, Shariati Hospital, School of Medicine, Tehran university of medical Science, Tehran, Iran A Ghavamzadeh Department of Hematology and oncology, Shariati Hospital, School of Medicine, Tehran university of medical Science, Tehran, Iran Gh Toogheh Deparment of Hematology and oncology, Emam Khomeini (rah) Hospital, School of Medicine, Tehran University of medical Science, Tehran, Iran K Alimoghaddam Department of Hematology and oncology, Shariati Hospital, School of Medicine, Tehran university of medical Science, Tehran, Iran 2015 10 01 Background: Cisplatin-based chemotherapy is the standard treatment for advanced non-small cell lung cancer (NSCLC). Many novel drugs, including gemcitabine, vinorelbine, paclitaxel and docetaxel have been used in combination with cisplatin in this setting. Of these drugs, gemcitabine is reported to have a high response rate and acceptable toxicity. The aim of this study was to evaluate the efficacy and safety of gemcitabine & cisplatin combination. Methods: Twenty-three patients with NSCLC, who met inclusion criteria, were enrolled from January 2001 till September 2003. All of them were confirmed by histology and were in advanced stages, i.e. stage IIIB or stage IV. Cisplatin with a dose of 70mg/m2 was given every 21 days, in combination with gemcitabine at a dose of 1250mg/m2 administered on days 1and 8 of a 21-day cycle. Results: of the 23 patients, 1 showed complete remission, 5 achieved partial remission, 7 had stable disease and 2 patients showed progressive disease, while 8 patients were not evaluable for response. The overall response in 15 evaluable patients was 40% (95% CI), median survival was 13.5 months (95% CI, 3.5-27.4 months), and median progression free survival (PFS)was 11 months (95% CI, 1.04-20.9 months). Hematological toxicities included WHO grade 3, 4 anemia, neutropenia and thrombocytopenia 10%, 7% and 2% respectively. Non-Hematological toxicities included nausea/vomiting WHO grade 1,2 & peripheral neuropathy WHO grade 1,2. Skin rashes were mild.Six patients developed grade 2 toxicity. Renal impairment was mild. One case developed Acute Respiratory distress syndrome (ARDS) after first dose of chemotherapy, another case developed transient acute psychosis under therapy. Conclusions: The regimen of combined gemcitabine with cisplatin is safe and effective and well toler¬ated in patients. Some rare but important toxicity such as ARDS may occur occasionally. In this com¬bination, a lower dose of cisplatin seems to have an efficacy similar to that of in previous reports. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/188 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/188/181

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 2 2005 06 15 25 35 C Kani Hematology, Oncology and Bone Marrow Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran A Mousavi Hematology, Oncology and Bone Marrow Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran M Iravani Hematology, Oncology and Bone Marrow Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran K Alimoghaddam Hematology, Oncology and Bone Marrow Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran B Bahar Hematology, Oncology and Bone Marrow Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran M Jahani Hematology, Oncology and Bone Marrow Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran A Ghavamzadeh Hematology, Oncology and Bone Marrow Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2015 10 01 Objective: To evaluate the potential advantages of imipenem/cilastatin in control of fever in neutro-penic HSCT recipients.Patients and Method: In this single-center study, 111 consecutive febrile episodes in 104 neutropenic HSCT recipients with a mean age of 26 years were randomized to treatment either with Imipenem/cilastatin 1 g, IV, q8h or cefepime (our standard regimen) 2 g, IV, q8h. If fever persisted, se¬quential antibiotics were added in 72-hour intervals: vancomycin, amikacin and amphotericin-B. The study population was at serious risk of a poor outcome, since 73.5% of febrile episodes occurred after allogeneic and 26.5% of febrile events occurred after autologous hematopoietic stem cell transplanta¬tion. Results: The median total duration of neutropenia was 10 days, and the median leukocyte count at study inclusion was 0.16 × 109/l.dical sciences, Tehran, Iran Alireza Zahiri Iran’s Gamma knife center, Iran university of medical sciences, Tehran, Iran Soraia Salmanian Iran’s Gamma knife center, Iran university of medical sciences, Tehran, Iran 2015 10 01 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. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/180 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/180/173

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 1 2005 03 15 37 39 Ali Shahriariahmadi Department of Hematology and Oncology, Taleghani Hospital Kermanshah University of Medical Sciences; Kermanshah; Iran Nader Djangioskouie Department of Hematology and Oncology, Taleghani Hospital Kermanshah University of Medical Sciences; Kermanshah; Iran Shabnam Salimi Department of Hematology and Oncology, Taleghani Hospital Kermanshah University of Medical Sciences; Kermanshah; Iran Babak Izadi Department of Hematology and Oncology, Taleghani Hospital Kermanshah University of Medical Sciences; Kermanshah; Iran 2015 10 01 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 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/181 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/181/174

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 1 2005 03 15 41 44 Kamran Alimoghaddam Assistant Professor, Hematology- Oncology and BMT Research Center, Tehran University of Medical Sciences Forough Foroughi Research Assistant, Hematology- Oncology and BMT Research Center, Tehran University of Medical Sciences Ali Shahriari Ahmadi Assistant Professor, Kermanshah University of Medical Sciences Vahid Farnia Research Assistant, Kermanshah University of Medical Sciences Maryam Tavakkoli Research Assistant, Hematology- Oncology and BMT Research Center, Tehran University of Medical Sciences Ardeshir Ghavamzadeh Professor, Hematology- Oncology and BMT Research Center, Tehran University of Medical Sciences 2015 10 01 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. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/182 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/182/175

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 1 2005 03 15 45 48 M Abbasi Department of internal medicine, school of medicine, Hamadan university of medical sciences & Health services, Hamadan, Iran B Karimi Medical student, school of medicine, Hamadan university of medical sciences & health services, Hamadan, Iran 2015 10 01 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