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 2015 06 15 95 103 Sushilkumar Ramdasi Regenerative Medicine Group, Reliance Life Sciences Pvt. Ltd. Dhirubhai Ambani Life Sciences Centre, R-282, TTC Area of MIDC, Thane-Belapur Road, Rabale, Navi Mumbai - 400701. India. Shabari Sarang Regenerative Medicine Group, Reliance Life Sciences Pvt. Ltd. Dhirubhai Ambani Life Sciences Centre, R-282, TTC Area of MIDC, Thane-Belapur Road, Rabale, Navi Mumbai - 400701. India. Chandra Viswanathan Regenerative Medicine Group, Reliance Life Sciences Pvt. Ltd. Dhirubhai Ambani Life Sciences Centre, R-282, TTC Area of MIDC, Thane-Belapur Road, Rabale, Navi Mumbai - 400701. India. 2015 10 14 Stem cell based treatments are being increasingly explored for their possible potential to treat various cancers. Mesenchymal stem cells believed to possess anti-tumor potential and are preferred for their properties like immune privileged nature, ability to migrate to the site of tumor and capability for multilineage differentiation. This tumor tropism property of MSCs could be utilized to deliver anti-tumor biological agents to the site of tumor. In a tumor micro-environment, MSCs are believed to play both, a pro-tumorigenic and an anti-tumorigenic role. However, this is dependent on a host of factors like, types of MSCs, its source, type of cancer cell line under investigation, in vivo or in vitro conditions, factors secreted by MSCs and interactions between MSCs, host’s immune cells and cancer cells. Among several cytokines secreted by MSCs, TRAIL (Tumor necrosis factor related apoptosis inducing ligand) is reported to be pro-apoptotic for tumor cells. The MSCs from bone marrow and adipose tissue have been studied quite extensively. Deriving MSCs from sources such as umbilical cord blood and umbilical cord tissue is relatively easier. Umbilical cord tissue preferred for MSC derivation due to their abundant availability. These MSCs believed to up regulate TRAIL expression in MSC-cancer cell co-culture system resulting in induction of apoptosis in cancer cells. However, umbilical cord tissue derived MSCs needs to be studied for expression pattern of TRAIL in a co-culture system. We present a review article on different studies reporting both, pro-tumorigenic and anti-tumorigenic properties of MSCs. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/388 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/388/429

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 9 2 2015 06 15 104 106 Kourosh Goudarzipour Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti Medical University, Tehran, Iran. Shahin Shamsian Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti Medical University, Tehran, Iran. Samin Alavi Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti Medical University, Tehran, Iran. Kazem Nourbakhsh Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti Medical University, Tehran, Iran. Roxana Aghakhani Department of Pathology, Shahid Beheshti Medical University, Tehran, Iran. Zahra Eydian Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti Medical University, Tehran, Iran. Mohammad Taghi Arzanian Pediatric Congenital Hematologic Disorders Research Center, Shahid Beheshti Medical University, Tehran, Iran. 2015 10 14 Introduction: Ewing’s sarcoma is the second most common primary malignant tumor of bone found in children after Osteosarcoma. It accounts for 4–9% of primary malignant bone tumors and it affects bones of the skull or face in only 1–4% of cases. Hence it rarely affects the head and neck. Subject and Method: In this case report, we describe a case of primary Ewing's sarcoma occurring in the temporal bone. The tumor was surgically excised, and the patient underwent chemotherapy for ten months. Results: Neither recurrence nor distant metastasis was noted in these 10 months after surgery but about 18 months after surgery our patient was expired. Conclusion: Although the prognosis of Ewing's sarcoma is generally poor because of early metastasis to the lungs and to other bones, a review of the article suggested that Ewing’s sarcoma occurring in the skull can often be successfully managed by intensive therapy with radical excision and chemotherapy. This result was supported by the case reported here. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/387 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/387/430