Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 3 1 2009 03 15 1 6 Ardeshir Ghavamzadeh Hematology- Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Amir Ali Hamidieh Hematology- Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Mohammad Jahani Hematology- Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2015 10 01  Introduction: Allogeneic hematopoietic cell transplantation (HSCT) is the only therapeutic modality capable of correcting the hematologic manifestations of Fanconi Anemia (FA). The development  of well  tolerated,  immunosuppressive  conditioning  regimens  for FA patients  undergoing HSCT has proven to be a rather challenging task for hematologists. Methods: We analyzed the outcome of 30 FA patients (median age at HSCT was 9 years age range, 2-32 years) who underwent HSCT between 1992 and 2008 in Shariati Hospital Tehran, Iran. . Patients were transplanted from either an HLA-identical sibling or matched relative (n=29), or an HLA-partially matched relative(n=1). Four  different  conditioning  regimens  without  radiation  were  used  .Graft  versus  host  disease  (GVHD) prevention consisted of cyclosporine with methotrexate or cyclosporine alone. Results: The median follow-up duration for survivors was 2.7 years (ranged 1 month to 12 years). The median survival time was 8.5 months. The 5-year overall surviv l was 43.6% (SE=10.0%). All surviving patients had normal blood counts with full donor engraftment. The median survival rate for patients who did or did not receive fludarabine in preparation for the allograft was not statistically significant (p-value=1.0). Conclusion:  Our  study  demonstrates  that  none  of the  studied  variables  significantly  affected  the  survival, including  sex,  age,  radiation-free  conditioning  regimens,  corticosteroids  before  transplant,  pre-transplant transfusions, acute GVHD and congenital abnormalities. The availability of better diagnostic tools to predict clinical course of FA, and modification of the conditioning regimen should improve survival and long-term consequences of therapy for patients in the future. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/199 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/199/192

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 3 1 2009 03 15 7 10 Mohammad Ali Mashhadi Hematology- Oncology Department, Ali Ebne Abitaleb Hospital, Zahedan University of Medical Sciences, Zahedan, Iran 2015 10 01 Background:This study testing the effectiveness ,toxicity and tolereability of new chemotherapeutic regimen (consist of Irinotecan 5-FU and Leucovorin) in locally advanced and metastatic Gastric Cancer. Patients and Methods: Patients with locally advanced gstric cancer (atleast stage 3)or metastatic gastric cancer that no treated previously with chemotherapeutic agents entered onto this study. Treatment consist of 6-12 cycles (every 2 weeks) with Irinotecan(CPT-11)140mg/m2iv,Lecovorin100mg/m2iv ,followed by 5-FU 400mg/m2(in4hours)and then 5-FU 1200m2(ci in 48h),all cycles given every 2 weeks and repeated atleast for 6 cycles(6-12 cycles). Results: Ten(10) patients were enrolled and eligible patients received   this protocol therapy.The over all response rate was 60% and 10% complete response,and50% with partial response and 10% stable disease. Median survival was 13 months and median event free survival was 8 months. The major toxicity was Neutropenia (grade 4) in 3 cases(30%), that two cases died in neutropenic sepsis feature.Grade 4 anemia was observed in one case that needs to transfusion therapy. Other mild side effect and toxicity of this protocol therapy were: Grade 1 neutropenia(10%),mild thrombocytopenia(10%),mild diarrhea (40% )mild nausea and vomiting (60%)and lethargia and mucositis were not seen. Conclusion: This protocol consist of Irinotecan iv bolous that followed with Leucovorin and 5-FU in 4h and then 5-FU in 48h ci is very active in patients with locally advanced and metastatic Gastric Cancer. Diarrhea and mucositis were less than other reports. Future trials in large series need to documented effectiveness and tolereability and toxicity of this new protocol. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/200 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/200/193

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 3 1 2009 03 15 11 16 Ardeshir Ghavamzadeh Hematology- Oncology and Stem Cell Transplantation, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Atefeh Masnavi Hematology- Oncology and Stem Cell Transplantation, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Farnaz Khatami Hematology- Oncology and Stem Cell Transplantation, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Arash Jalali Hematology- Oncology and Stem Cell Transplantation, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Kamran Alimoghaddam Hematology- Oncology and Stem Cell Transplantation, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2015 10 01 Introduction: Acute Myelogenous Leukemia (AML) is a clonal  malignant disease of hematopoietic tissue. The early use of  Hematopoietic Stem Cell Transplantation (HSCT) for AML was for patients with advanced stages of disease, usually while in relapse, in second or subsequent remission, or with resistant disease. Patients and Methods: From March 1991 until February 2008, 356(65%) registered allogeneic transplantation and 192(35%) of  registered autologous transplantation had comprehensive data available for analysis and were included in this study and all patients have followed through January 2008. Result: In allogeneic and autologous groups, 263 (73.9%) and 160 (88.3%) patients were in first complete remission, respectively. The stem cells sources of transplantation in allogeneic recipients were Peripheral Blood (92.4%), Bone Marrow (7%), Bone Marrow combined Peripheral Blood (0.3%) and Cord Blood (0.3%). The source of stem cell transplantation for 157 (82.3%) autologous patients was Peripheral Blood, for 33(17.2%) patients was Bone marrow and there was one recipient (0.5%) with combined Peripheral Blood and Bone marrow. Totally, 279 (78.4%) allogeneic patients and 123 (64.1%) autologous patients were alive since the end of this study. Relapse was the most common cause of death in both groups. Five years Overall Survival (OS) and Disease Free Survival (DFS) in allogeneic patients were 70.6% and 62.3% (SE=3%) and in autologous patients were 53.6% and 46.8% (SE=5%, 4%). The median follow up time for this study was 1.5 years (19 months). Conclusion: According to this study and our experience, the acceptable treatment for Acute Myeloblastic Leukemia, especially in first complete remission is allogeneic Hematopoietic Stem Cell Transplantation. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/201 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/201/194

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 3 1 2009 03 15 17 20 Ardeshir Ghavamzadeh Hematology- Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Kamran Alimoghaddam Hematology- Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Ali Naderi Department of Pediatrics, Kerman Medical University, Kerman, Iran Amir Ali Hamidieh Hematology- Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Babak Bahar Hematology- Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Seyed Asad-o-allah Mousavi Hematology- Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran Masoud Iravani Hematology- Oncology and Stem Cell Transplantation Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran 2015 10 01 Introduction:In 1989, the first successful umbilical cord blood transplantations (UCBTs) was reported in a boy with fanconi's anemia, using umbilical cord (UCB) of his HLA matched sister. Cord blood transplantation is a good substitute for bone marrow or peripheral blood transplantation especially for children and small body size adults. Methods: Between 1998 and 2007 ,14 children(10 boys and 4 girls ) with non-malignant(9 Beta-Thalassemia Major ,3 SCID,1 Hurler) and malignant(1 AML) diseases were given  an allogenic CB transplant from sibling (10 cases) or unrelated(4 cases). In the majority of cases, busulfan and cyclophosphamide were given in various dosage in conditioning regimen GVHD prophylaxis consisted mainly of (CsA) alone(  in 9 cases), the combination of CsA and methoterxate  (in 4 cases)and methotrexate alone (in 1 case). Results: In thalassemic patients 89% are alive but 55% with disease. Graft failure occurred in 4 thalassemic and 1 AML patients. Only 2 cases experienced GVHD (1 acute GVHD grade2 and 1limited chronic GVHD). All three cases of SCID that transplanted very late after many infectious complications are dead. Conclusion: This study demonstrated that CBT is curative in   some thalassemic patients but in future, we can improve results of CBT with use of ATG, Alemtuzumab, Thiotepa, G-CSF, double cord, TNC dose of 4×107/kg and elimination of methotrexate  for GVHD prophylaxis in HLA- match sibling. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/202 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/202/195

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 3 1 2009 03 15 21 26 Kourosh Sayemiri Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Iran. AND Department of social medicine, School of medicine, Ilam University of Medical Sciences, Iran MR Eshraghian Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Iran Kazem Mohammad Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Iran Kamran Alimoghaddam epartment of nutrition and biochemistry, School of Public Health, Tehran University of Medical Sciences, Iran A Rahimi Foroushani Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Iran H Zeraati Department of Biostatistics, School of Public Health, Tehran University of Medical Sciences, Iran Ahmad Reza Shamshiri Hematology- Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Iran K Djafarian Department of nutrition and biochemistry, School of Public Health, Tehran University of Medical Sciences, Iran Ardeshir Ghavamzadeh Department of nutrition and biochemistry, School of Public Health, Tehran University of Medical Sciences, Iran 2015 10 01 Introduction: This paper used Generalized Gamma (GG) distribution to find the predictive factors of overall survival (OS) after haematopoietic stem cell transplant (HSCT) in acute myeloid  leukemia patients. Methods: Discrimination among the exponential, Weibull, GG, log-logistic, and lognormal distributions was done using maximum likelihood and Akaike information criteria. Results: The 5-year OS in 301 patients was 65% (95%CI: 60.7-69.3). Peak mortality hazard occurred at months 6-7 after HSCT then, it was U Shape. The data was fitted by GG distribution better than other distributions. Univariate analysis using GG distribution showed a positive association between OS with dose of infused WBC (P=0.018), CD3 (p=0.001), no relapse (P<0.001), cGVHD (P<0.001), and platelet recovery (P<0.001). Multivariate analysis indicated that, OS has relationship with relapse (P<0.001), platelet recovery (P=0.004), disease status at transplant (P=0.036) and aGVHD (P=0.036). Conclusion: We showed that GG distribution can be a useful tool for recognizing prognostic factors of OS in AML patients. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/203 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/203/196

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 3 1 2009 03 15 27 33 Ardeshir Ghavamzadeh Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran Kamran Alimoghaddam Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran Mohammad Jahani Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran Seyed Asad-o-allah Mousavi Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran Masoud Iravani Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran Babak Bahar Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran Ali Khodabandeh Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran Farnaz Khatami Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran Arash Jalali Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Shariati Hospital, Tehran, Iran 2015 10 01 Hematology- Oncology and Stem Cell Transplantation Research Center related to Tehran University of Medical Sciences located in Shariati Hospital. These center activities have started in 1991 in order to help needful patients and augment new data to reach new aspects of therapeutic trials. Also it is one of the greatest Stem Cell Transplantation centers in world and is the second center in the world based on the transplanted Thalassemia patients. Since 1991, 2426 first Hematopoietic Stem Cell Transplantation (HSCT) The two patient groups were comparable in terms of Age, gender, un¬derlying disease, conditioning regimen, clinical and bacterial documentation, severity and duration of neutropenia and mucositis, GI decontamination and G-CSF administration. Bacteremia was found in 20.6%, other microscopically documented infections in 9.8%, clinically documented infections in 20.6% and fever of unknown origin in 49% of the febrile episodes. Most (102) febrile episodes were evaluable for response. No significant difference was found between imipenem/cilastatin and cefepime in terms of success rate (73.1% versus 62%), empirical addition of vancomycin (38% versus 26.2%) or median duration of antibiotic therapy (7 days in both).The difference between imipenem/cilastatin and cefepime was statistically significant for median duration of fever (1.5 versus 2 days) and median time of resolution of neutropenia (12 versus 14 days). The overall response rates to initial monotherapy was significantly higher for HSCT recipients with thalassemia, MM, lymphoma, AA, than recipients with ALL, AML, CML, CLL (P<0.001) and for episodes of fever of unknown origin than episodes of clini¬cally documented infections (87.8% versus 12.2%). In episodes of success without modification, the median duration of neutropenia before entry was longer than episodes when vancomycin was added (P<0.027).No patient died from the infection. Both antibiotic regimens were well tolerated. The study treatment being stopped only in 1 patient because of toxicity (cutaneous allergy to imipenem/cilastatin). Conclusions: Imipenem/cilastatin and cefepime are effective and well tolerated when used as initial empirical treatment for HSCT recipient with prolonged neutropenia. But imipenem/cilastatin may be more effective than cefepime, as evidenced by a significantly better response in two outcome measures and in one subgroup of patients (AML). https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/189 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/189/182

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 2 2005 06 15 36 41 M Mohyeddin Bonab Hematology-Oncology & BMT Research Center, Shariati Hospital, Tehran University of Medical Sciences, Iran K Alimoghaddam Hematology-Oncology & BMT Research Center, Shariati Hospital, Tehran University of Medical Sciences, Iran F Talebian Hematology-Oncology & BMT Research Center, Shariati Hospital, Tehran University of Medical Sciences, Iran S.H Ghaffari Hematology-Oncology & BMT Research Center, Shariati Hospital, Tehran University of Medical Sciences, Iran A Ghavamzadeh Hematology-Oncology & BMT Research Center, Shariati Hospital, Tehran University of Medical Sciences, Iran B Nikbin Hematology-Oncology & BMT Research Center, Shariati Hospital, Tehran University of Medical Sciences, Iran 2015 10 01 Mesenchyml stem cell (MSC) are receiving much attention in treatment of various diseases. The low frequency of MSCs in bone marrow (BM) necessitates their in vitro expansion prior to clinical use. We evaluated the effect of long term culture on the senescence of these cells. BM cells were taken from 11 transplant donors with mean age of 25 years. In different passages, MSC were examined for different aging indicators including: telomere length assay, differentiation ability, immunophenotyping of CD13, CD44 and CD34 antigens, determination of cumulative population dou¬blings (CPDs), and study of morphological characteristics of MSC cultures. The mean long term culture was 118 day and the mean passage number was 9. The average number of PD decreased from 7.7 to 1.2 in the 10th passage. The mean telomere length decreased from 9.19 Kbp to 8.7 kbp in the 9th passage. Differentiation potential dropped from the 6th passage on. The culture's morphological abnormalities were typical of the Hayflick model of cellular aging. We believe that MSC enter senescence almost undetectably from the moment of in vitro culturing. Si¬multaneously these cells are losing their stem cell characteristics. Therefore, it is much better to con¬sider  them for cell and gene therapy early on. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/190 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/190/183

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 2 2 2005 06 15 42 45 M Iravani Assistant professor of hematology- oncology, Hematology- Oncology and BMT Research Center Shariati Hospital, Tehran University of Medical Sciences, Iran M Arshy General practitioner, Hematology- Oncology and BMT Research Center Shariati Hospital, Tehran University of Medical Sciences, Iran M