Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 9 2 2015 06 15 55 59 Ardeshir Ghavamzadeh Professor of Medicine, Hematology, Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran. Mehrzad Mirzania Hematologist and Medical Oncologist, Cancer Research Center, Cancer Institute, Tehran University of medical Sciences, Tehran, Iran. Naser Kamalian Professor of Medicine, Tehran University of Medical Sciences, Tehran, Iran. Nahid Sedighi Associate Professor of Medicine, Advanced Diagnostic and Interventional Radiology, MSK research group, Tehran University of Medical Sciences, Tehran, Iran. Parisima Azimi Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Currently, hematopoietic stem cell transplantation (HSCT) is the only curative option for patients with beta-thalassemia major, but liver iron overload in these patients will not decrease and hepatic fibrosis may still progress despite successful HSCT. Liver biopsy samples were taken from 14 patients (Out of 25 patients) who underwent HSCT. All patients met three criteria: negative HCV antibody, liver fibrosis in samples before HSCT and lack of regular treatment for iron overload after HSCT (Because patients did not consent to phlebotomy or they had not regular follow-up). We evaluated liver fibrosis and liver iron overload by a semi quantitative method, Perls' Prussian blue staining, before and after HSCT. HSCT was successful in all the patients. Liver iron overload did not change after transplant (P=0.61), but hepatic fibrosis progressed after transplant (P=0.01). In patients with beta thalassemia major who previously had some degree of liver fibrosis, HSCT alone cannot reduce liver iron overload and liver fibrosis will increase. We recommend that regardless of the amount of iron overload in patients with beta thalassemia major that have shown some degree of fibrosis in their liver biopsy before transplantation, appropriate steps should be taken to reduce iron overload as soon as possible after successful transplantation. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/394 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/394/423

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 9 2 2015 06 15 60 66 Adel A Hagag Pediatrics and Clinical Pathology Departments, Faculty of Medicine, Tanta University, Egypt Mohamed S El-Farargy Departments, Faculty of Medicine, Tanta University, Egypt Amany M Abo El-Enein Departments, Faculty of Medicine, Tanta University, Egypt. 2015 10 14 Background: Sickle-cell anemia is characterized by defective hemoglobin synthesis with production of sickle hemoglobin. Sickle red blood cells become deformed and rigid with difficulty to pass through narrow capillaries and frequent clotting and thrombosis leading to repetitive vascular occlusions and progressive organ damage. We conducted this work to study some adrenal functions using ACTH stimulation test in Egyptian children with sickle cell anemia in correlation with iron overload. Methods: This study was conducted on 60 children with sickle cell anemia who were attendants of Hematology unit, Pediatric department, Tanta university hospital in the period from April 2012 to May 2014 including 34 males and 26 females with their age ranging from 5-17 years and main age value of 13±2.9 in comparison with 30 healthy children matched for age and sex as a control group. For all patients the following were done: Complete blood count, Hb electrophoresis, serum ferritin, iron, iron binding capacity, sodium and potassium, random blood glucose, thyroid functions , morning basal cortisol levels and adrenocorticotrophic hormone stimulation test. Results : There was significantly lower basal morning cortisol in patients than controls (mean value in patients were 8.78±3.53 ug/dl compared with 11.79±2.32 ug/dl in control group with p value of 0.021). No significant differences in adrenocorticotrophic hormone stimulation test between patients and controls were detected. (Mean value in patients were 23.078±3.709 ug/dl compared with 24.492±5.006 ug/dl in control group with p value of 0.389). Significant negative correlation was found between serum cortisol and ferritin in patients group (r= 0.625 and p value =0.003) Conclusion: There was significantly lower basal morning cortisol in sickle-cell anemia patients with significant negative correlation with iron overload so regular follow up to adrenal functions to detect any adrenal impairment, as SCD patients are vulnerable to adrenal hypo function, is recommended. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/393 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/393/424

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 9 2 2015 06 15 67 71 Zeinab Hemati PhD Candidate of Nursing, School of Nursing and Midwifery, Isfahan University of Medical Sciences, Isfahan, Iran. Davood Kiani BSc of Nursing, Shahrekord University of Medical Sciences, Shahrekord, Iran. 2015 10 14 Mental stress and daily crises comprise a part of physical and mental threats. Perceived stress is a physical and mental threat, as well. Perceived stress is a psychological process during which the individual considers his/ her physical and psychological welfare as being threatened. Since idiopathic thrombocytopenic purpura (ITP) is one of the chronic diseases being able to affect patients' perceived stress, this study was conducted to compare perceived stress in ITP patients and healthy people.This is a descriptive-comparative study with control and case groups. In this study, 64 ITP patients referring Seyed Al-Shohada Hospital and the same number of healthy individuals from the patients' neighborhood, as the control group, were selected randomly and compared. The Kohen Perceived Stress Standard Questionnaire was used to collect the data. The data were analyzed by SPSS and Student's independent t-test, chi-square, and Mann-Whitney test. Results : 64.1%, 59.4% and 53.1% of participants in case group were older than 35 years old, female and had elementary education. 78.1% of case group had severe perceived stress. 70.3% of participants in control group experienced mild perceived stress. Mann-Whitney test showed significant difference between two groups in level of stress (p<0.001).In ITP patients, perceived stress was considerable. Planning interventional measures to determine stress-making agents and subside or at least control them is very essential. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/392 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/392/425

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 9 2 2015 06 15 72 79 Seyed Hadi Mousavi PhD student of Hematology, Department of Hematology and Blood Banking, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Saeid Abroun Associated Professor of Hematology, Department of Hematology and Blood Banking, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Masoud Soleimani Associated Professor of Hematology, Department of Hematology and Blood Banking, Faculty of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Seyed Javad Mowla Associated Professor of Genetic, Department of Molecular Genetics, Faculty of Biological Sciences, Tarbiat Modares University, Tehran, Iran. 2015 10 14 Allogeneic hematopoietic stem cell transplantation is used in the treatment of patients suffering from hematologic and non-hematologic disorders, but the application is limited by the identification of a suitable donor. Umbilical cord blood (UCB) is an alternative source of hematopoietic stem cell (HSC) transplantation. Despite all advantages, the limited cell dose is one of the  major obstacles. Ex-vivo expansion of HSC is an alternative way to overcome this problem.In this study, polycaprolactone (PCL) scaffold coated with fibronectin (3D) is compared to routine cell culture system (two dimensional, 2D) used for cell culture.1×10(4) cord blood CD34+ cells isolated by MACS were seeded on PCL scaffold and allowed to expand for 10  days. Before and after this period, total cells, CD34(+) cells, CFC assay and CXCR4 expression were evaluated.Our findings demonstrated that 3D scaffold produced a 58-fold expansion of total cells compared to 2D cultures (38-fold expansion). Also CD34+ cells in 3D compare to 2D cell culture was 40-fold and 2.66 fold increased, respectively; this difference was statistically significant (p<0.05). Moreover, total number of colonies in the 3D scaffold was higher than those of 2D cell culture system, but no statistically significant difference was observed. Higher expression of CXCR4 in 3D compared to 2D showed better homing of cells that were cultured in 3D scaffold (p<0.05).PCL scaffold coated with fibronectin had higher number of total cells and CD34+cells than 2D routine culture system. Findings revealed that 3D is a proper cell culture system for hematopoietic stem cell expansion, compared to 2D. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/391 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/391/426

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 9 2 2015 06 15 80 87 Maria Tavakoli-Ardakani Department of Clinical Pharmacy, School of pharmacy and Pharmaceutical Sciences Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Maryam Mehrpooya School of Pharmacy, Hamedan University of Medical Sciences, Hamedan, Iran. Mahshid Mehdizadeh Taleghani Bone Marrow Transplantation Center, Taleghani Hospital and Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti University of Medical Sciences ,Tehran, Iran. Abbas Hajifathali Taleghani Bone Marrow Transplantation Center, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Alireza Abdolahi Vali-Asr Hospital, Tehran University of Medical Sciences, Tehran, Iran. 2015 10 14 Background: The release of pro-inflammatory cytokines is responsible for the variety of behavioral, neuroendocrine and neuro-chemical alterations in psychiatric condition. In this study we evaluate relation between depression and IL-6 and IL-10 in patients undergoing hematopoietic stem cell transplantation (HSCT). Materials and Methods: 66 patients in this cross-sectional study from July 2013 until August 2014 for HSCT interred the study and were assessed for depression using Hospital Anxiety and Depression Scale (HADS). Serum interleukin (IL)-6, (IL)-10 and high sensitive C-reactive protein (hs-CRP) were assessed on the same time. Association between these biomarkers with depression was evaluated using SPSS version 20.  Results: A total of 66 patients with the mean age of 41.18+13.92 and 41.95+12.35 years old in non depressed and depressed group respectively were enrolled in this study. Patients with depression showed significantly higher levels of serum IL-6 and the IL-6-to-IL-10 ratio compared to patients without depression (p<0.001).There was no statistically significant association between IL-10 and hs-CRP with depression in this group of the patients.  Conclusions: High IL-6 level has significant association with depression in patients undergoing HSCT. In conclusion, since IL-6 can affect the outcomes after HSCT and depression was associated with increased serum IL-6 level, early identification of depression can be beneficial in these patients. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/390 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/390/427

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 9 2 2015 06 15 88 94 Mehdi Azad Department of Medical laboratory sciences, Faculty of Allied Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. Ramin Bakhshi Biniaz Department of Medical laboratory sciences, Faculty of Allied Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. Mehdi Goudarzi Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Science, Tehran, Iran. Naser Mobarra Department of Biochemistry, Metabolic Disorders Research Center, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. Shaban Alizadeh Department of Hematology, Allied Medical School, Tehran University of Medical Sciences, Tehran, Iran. Hajar Nasiri Hematology-Oncology and Stem cell Transplantation Research Center, Tehran university of Medical Science, Tehran, Iran. Ali Dehghani Fard Sarem Cell Research Center, Sarem Women's Hospital, Tehran, Iran. Saeid Kaviani Department of Hematology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Mohamad Hossein Moghadasi Department of Hematology, School of Medical Sciences, Tarbiat Modares University, Tehran, Iran. Mohammad Reza Sarookhani Department of Medical laboratory sciences, Faculty of Allied Medicine, Qazvin University of Medical Sciences, Qazvin, Iran. Mousa Vatanmakan Department of Hematology, Allied Medical School, Tehran University of Medical Sciences, Tehran, Iran. Mehdi Sahmani Department of Clinical Biochemistry, Cellular and Molecular Research Center, Qazvin University of Medical Sciences, Qazvin, Iran. 2015 10 14 Background: Early diagnosis and treatment of leukemia patients remains a fundamental aim in clinical oncology, especially in developing country. Present study highlights the basic requirements of these patients in Iran. Better understanding of these issues may lead to improve the healthcare standards toward leukemia diagnosis and treatment. Methods: This descriptive study included 101 specialists in hematology-oncology and pathology serving in oncology centers. The participants were then asked to fill out a standard questionnaire on the issues around diagnosis and treatment of blood malignancies. Results: According to specialists, unfair distribution of facilities across the country, delayed diagnosis of disease, absence of psychological support for patients, and insufficient financial support were the main reasons of inappropriate diagnosis and treatment in leukemia patients. Conclusions: Our results show that making an amendment to health policies by preparing well-equipped medical centers in all provinces, improving the morale of patients through consultation during the process of treatment, and above all, subsiding leukemia patients' financial problems will promote the health standard regarding the leukemia diagnosis and treatment in Iran. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/389 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/389/428

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 9 2 2014 06 15 33 37 Mehrdad Payandeh Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Zohreh Rahimi Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Mohammad Erfan Zare Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. AND Nosocomial Infection Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. Atefeh Nasir Kansestani Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran. AND Student Research Committee, Kermanshah University of Medical Sciences, Kermanshah, Iran. Farzad Gohardehi Student Research Committee, Mazandaran University of Medical Sciences, Mazandaran, Iran. Amir Hossein Hashemian Department of Biostatistics, Faculty of Public Health, Kermanshah University of Medical Science, Kermanshah, Iran. 2015 10 14 Hemoglobinopathies are the most common single gene disorders worldwide with a considerable frequency in certain area particularly Mediterranean and Middle Eastern countries. Hemoglobinopathies include structural variants of hemoglobin (Hb S, Hb C, HbE,…) and thalassaemias which are inherited defects in the globin chains synthesis. The present study was conducted to determine the prevalence of hemoglobinopathies in western Iranian patients. A total of 344 patients (151 males and 193 females) with abnormal CBC and/or hemoglobin electrophoresis were enrolled in the present study. Cellulose acetate gel electrophoresis was performed for all patients and abnormal bands were identified by citrate agar gel electrophoresis and PCR based methods. Iron deficiency anemia (IDA) was present in 156 (45.3%) individuals. Thirty four (9.8%) patients had both iron deficiency anemia and α-thalassemia trait trait, 41(11.9%) patients were with both iron deficiency anemia and minor β-thalassemia. There were 31(9%) patients with α-thalassemia trait and 5 (2.2%) patients with Hb H disease. Fifty six (16.2%) patients had minor β-thalassemia. Also, there were 10 (2.9%) individuals homozygous for hemoglobin D-Punjab and one patient with hemoglobin G (0.3%). There was one sample with hemoglobin C. Further, we found 3 patients (0.9%) with sickle cell trait and more 3 patients (0.8%) with S/ β +-thalassemia. Our results indicated that the most frequent cause of hypochromic and/or microcytic anemia in our population was IDA and the minor β-thalassemia was the second cause that needs to more attention in screening programs. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/422 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/422/375

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 8 2 2014 06 15 38 40 Gholamreza Bahoush Assistant professor of pediatric hematology-oncology, Oncopathology research center, Ali Asghar children's hospital, Iran University of medical sciences, Tehran, Iran. Ghasem Miri-Aliabad Assistant professor of pediatric hematology-oncology, Children and Adolescent Health Research Center, Zahedan University of Medical Sciences, Zahedan, Iran. 2015 10 14 Hypercalcemia in children is a medical emergency and often manifests as nonspecific symptoms such as nausea, vomiting, weight loss, and anorexia. Severe hypercalcemia is a rare complication of malignancy in children, while it can be seen in various types of malignant tumors. It is usually associated with significant morbidity and may be severe enough to threaten life. Incidence of hypercalcemia in hematopoietic malignancies including acute lymphoblastic leukemia (ALL) is very rare and unusual, especially as the initial manifestation of the disease. In this paper a 6-year-old boy who had severe hypercalcemia and gastrointestinal symptoms before the onset of common and usual manifestations of ALL is introduced. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/421 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/421/376

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research