Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 15 3 2021 07 14 139 144 Farshad Abbasi Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Gholam Abbas Kaydani Department of Laboratory Sciences, Paramedical Faculty, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Zari Tahannejad Infectious and Tropical Diseases Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Mohsen Nakhaie Department of Virology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Ali Aminasnafi Thalassemia & Hemoglobinopathy Research Center, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Maryam Moradi Department of Biostatistics and Epidemiology, School of Public Health, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran 2019 12 24 2020 06 28 Background: Immune thrombocytopenic purpura (ITP) is defined as a bleeding disorder in which the number and production of platelets are reduced by the immune system; however, the destruction of peripheral blood platelets also occurs. Although its exact etiology and pathogenesis have not already known, several studies have shown that Epstein-Barr virus (EBV) and cytomegalovirus (CMV) are known as possible causative agents of ITP. This investigation aims to evaluate the presence of CMV and EBV in two groups of case and control by polymerase chain reaction (PCR). Materials and Methods: we considered the presence of CMV and EBV in 48 acute ITP patients and 48 healthy people. Study participants were recruited from Ahvaz Shafa Hospital between 2017 and 2018 and the presence of two viruses was investigated by (PCR). Results: Out of 48 acute ITP patients, the CMV DNA was detected from the blood of 12 (25%) patients and the EBV DNA from the blood of 2 (4.2%) other patients. Also, only one patient was (2.1%) co-infected with CMV and EBV. In contrast, in 48 healthy subjects, 3 (6.6%) had CMV and none of the control group was infected with EBV. Conclusion: Due to the presence of both EBV and CMV in the acute ITP patients in Ahvaz, they can be considered as factors in the progression of this disease. Therefore, consideration of the methods of elimination and treatment of these two viruses in these patients may be used as a treatment strategy in ITP patients in the future. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1234 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1234/878

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 15 3 2021 07 14 199 205 Ravindran Ankathil Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia Eva Foong Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia Ismail Siti-Mariam Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia Ramli Norhidayah Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia Mohd Yunus Nazihah Human Genome Centre, School of Medical Sciences, Universiti Sains Malaysia, Health Campus, Kubang Kerian, Kelantan, Malaysia Vijay Sangeetha Regional Cancer Centre, Medical College, Thiruvananthapuram, Kerala, India Sreedharan Hariharan Regional Cancer Centre, Medical College, Thiruvananthapuram, Kerala, India Husin Azlan Department of Internal Medicine and Clinical Hematology, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia 2019 11 28 2020 04 23 Hyperdiploid multiple myeloma (MM) is associated with better prognosis and non-hyperdiploid subtype is associated with variable to adverse prognosis based on the nature of karyotype abnormality.  Rarely exceptions to this hyperdiploid and non-hyperdiploid divisions do exist in a minority. We report an adult male MM patient who showed hyperdiploid karyotype with few novel complex abnormalities and who showed poor clinical outcome. Conventional cytogenetic analysis carried out in 22 GTG banded metaphases showed 53,Y,der(X)t(X;22)(q27;q11.2),+3,+5,+6,+9,+11,+15,der(17)ins(17;1;3)(q11.2;?;?),der(17)ins(17;1;3)(q11.2;?;?),+19,-22 karyotype pattern in 15 metaphases whereas 7 metaphases showed 46,XY karyotype  pattern.  Interphase FISH revealed biallelic del(13q14) and del(17p13) but no translocations involving the 14q32 region. Through Spectral karyotyping FISH, the origin of complex abnormalities involving der(17) chromosome,  translocation t(X;22), and marker chromosome could be clearly delineated. Although the present case showed hyperdiploid karyotype, he showed an adverse prognosis probably due to the co-existence of complex abnormalities and expired 5 months after initial diagnosis despite standard treatment given. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1212 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1212/885

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 15 3 2021 07 14 145 151 Aulia Rahmani Universitas Padjadjaran Nur Melani Sari Departement of Pediatrics, Hematology & Oncology Division, Faculty of Medicine, Universitas Padjadjaran/Dr. Hasan Sadikin Hospital, Bandung, Indonesia Vita Indriasari Departement of Pediatric Surgery, Faculty of Medicine, Universitas Padjadjaran/ Dr. Hasan Sadikin General Hospital, Bandung, Indonesia 2019 12 29 2020 12 14 Background: Overall five-year survival rate of Wilm’s Tumor (WT) in developing countries is still poor. Delayed diagnosis is one of the contributing factors, whereas early diagnosis is an important thing for the outcome. It is caused by the WT burden in developing countries that was not comparable with the number of facilities for diagnosis and treatment. Ultrasonography (USG) is the mandatory first-line imaging modality in children with a suspected abdominal mass and an overall sensitivity of76%. Additionally, it can be found in many health facilities at a lower cost, quick, non-invasive, and carries no risk of radiation.   Therefore, the relationship between USG and histopathology should be measured. Materials and Methods: A cross-sectional study with an analytical approach was performed in pediatric (0 untill 18 year of age)  renal malignancy and neuroblastoma that admitted to Dr. Hasan Sadikin Hospital, Bandung between 2015-2018. Data were collected from medical records. Statistical analyses using Fisher exact test were done to determine the significance of the relationship between USG and histopathology. Results: Forty-three samples were obtained based on inclusion criteria, such as  WT (n=33), neuroblastoma (n=6), renal clear cell carcinoma (n=2), and no specific type of renal malignancy (n=2). Fisher exact test revealed the no-significant relationship between USG and histopathology with a p-value > 0.05 Conclusion: There is no significant relationship between USG and histopathology. Therefore, centralized unity for USG interpretation is recommended. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1237 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1237/879

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 15 3 2021 07 14 152 159 Fatemeh Zamani Department of Pathology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Mansoureh Shokripour Department of Pathology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran Maral Mokhtari Department of Pathology, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, Iran 2020 01 05 2020 04 21 Background: Multiple myeloma is a hematologic malignancy manifested by the secretion of abnormal immunoglobulin. Different methods have been described for diagnosis and patient response to management. Serum free light-chain assay is recently approved in the diagnosis of multiple myeloma patients. This study aimed to evaluate the diagnostic accuracy of serum free light-chain assay and its agreement to bone marrow findings. Materials and Methods: Forty-six patients with the diagnosis of multiple myeloma were enrolled in the study. The patients were grouped into newly diagnosed cases (22 patients,47.8%) and known cases who were under treatment (24 patients,52.2%). Bone marrow study was done and percentage and clonal status of plasma cells were evaluated by a combination of immunohistochemistry and flow cytometry. Free light-chain assay was done in all patients and sensitivity, specificity, positive predictive value, and negative predictive value were analyzed. Results: Thirty of 46 patients showed monoclonal plasma cell infiltration and 16 patients showed polyclonal plasma cell infiltration based on bone marrow findings. An abnormal κ/λ ratio was seen in 15(68.18%) of new cases and 16(66.6%) of known cases. Sensitivity, specificity, PPV and NPV for κ⁄λ ratio were 72.73%, 46.15%, 71%, and 50%, respectively. Conclusion: In conclusion, due to high false positive and false negative results, the presence of an abnormal serum FLC ratio was not equal to the presence of monoclonal gammopathy, and observation of a normal ratio does not exclude the presence of monoclonal gammopathy. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1251 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1251/880

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 15 3 2021 07 14 160 169 Nazanin Jalilian Department of Clinical Biochemistry, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran Yosra Maleki Department of Clinical Biochemistry, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran Ebrahim Shakiba Department of Clinical Biochemistry, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran Mozafar Aznab Department of Internal Medicine, Medical School, Kermanshah University of Medical Sciences, Kermanshah, Iran Ziba Rahimi Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran Mehdi salimi Department of Internal Medicine, Kermanshah University of Medical Sciences, Kermanshah, Iran Zohreh Rahimi Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran 2020 01 19 2021 01 16 Background: Chronic lymphocytic leukemia (CLL) is the most common leukemia in adults. The MDM2 and p53 are interacting proteins that play crucial roles in cell biology. Genetic variations of p53 and MDM2 (p53 codon 72 and MDM2 SNP30) have been identified in many cancers including CLL. Materials and Methods: In this study, we sought to find the impact of two SNPs of p53 and MDM2 in the pathogenesis of CLL. A total of 100 CLL patients and 102 healthy controls were recruited. Genomic DNA was extracted, and genotyping was performed using the PCR-RFLP method. The allele and genotype associations were analyzed using the χ2 test. The gene-gene interaction analysis was studied using GMDR v0.9. Results: Our study found the absence of a significant difference between CLL patients and controls related to the allelic frequencies or genotypic distributions for both MDM2 SNP309 and p53 codon72. A significantly higher frequency of p53 C allele was found in patients with a disease duration of more than 36 compared to those less than 36 months. However, GMDR analysis suggests genetic interaction between the genes under study. Conclusion: Our findings indicated each polymorphism of p53 codon72 and MDM2 (SNP309) was not a risk factor for CLL but the p53 C allele could be associated with the disease duration. Besides, the interaction between p53/MDM2 genotypes may confer susceptibility to CLL. Our study could be useful in genetic association studies of CLL and the role of gene-gene interactions in the susceptibility to the disease.   https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1256 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1256/881

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 15 3 2021 07 14 170 177 EN Kiran PK HealthCare Global (HCG) Hospital, Bengaluru, India Vinu Sarathy P HealthCare Global (HCG) Hospital, Bengaluru, India Srinivas BJ HealthCare Global (HCG) Hospital, Bengaluru, India Girish Badarkhe HealthCare Global (HCG) Hospital, Nashik, India Rajesh KS Department of Translational Medicine & Therapeutics, HealthCare Global (HCG) Hospital, Bengaluru, India Thianeshwaran S HealthCare Global (HCG) Hospital, Bengaluru, India Nitin Bayas HealthCare Global (HCG) Hospital, Bengaluru, India Suhail Mufti Department of Translational Medicine & Therapeutics, HealthCare Global (HCG) Hospital, Bengaluru, India Hrishi V Department of Translational Medicine & Therapeutics, HealthCare Global (HCG) Hospital, Bengaluru, India Radheshyam Naik Department of Translational Medicine & Therapeutics, HealthCare Global (HCG) Hospital, Bengaluru, India 2020 01 24 2020 12 13 Background: Autologous HCT in multiple myeloma is done as upfront treatment in newly diagnosed transplant eligible patients after induction chemotherapy. In addition, it is standard for relapsed, aggressive non-Hodg Marziyeh Asadizaker Nursing Care Research Center in Chronic Diseases, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran Mojtaba Jahanifar Shahid Chamran University of Ahvaz, Ahvaz, Iran 2019 12 06 2020 03 01 Background: Uncertainty leads to a stressful situation in patients with thalassemia major that can dramatically affect their psychosocial coping ability, treatment process and disease outcomes, and reduce patients' quality of life. As one of the important factors affecting the health of thalassemia patients, understanding the concept of uncertainty is of major importance to health care providers especially nurses as the first line of exposure to these patients. The present study aimed to explore the experiences of uncertainty in patients with thalassemia major. Materials and Methods: The present qualitative study was conducted through in-depth face-to-face semi-structured interviews held with 18 patients with major thalassemia selected through purposive sampling. Interviews continued until saturation of data. All interviews were recorded, transcribed and analyzed with conventional content analysis method of Landman and Graneheim using MAXQDA10 software. Results: Two main themes, including 'living in the shadow of anxiety' and 'coping with uncertainty' emerged from patients’ experiences of illness uncertainty of thalassemia. 'Living in the shadow of anxiety' included four categories of 'fear of complications', 'contradictory views on treatment', 'unknown future' and 'stigma'. 'Coping with uncertainty' included three categories of 'spiritual coping', 'psychosocial coping' and 'knowledge acquisition'. Conclusion: According to the results of this study, uncertainty is a major psychological stress in patients with thalassemia major. Healthcare providers should therefore consider the challenges and concerns faced by patients and, through utilizing appropriate training and communicational practices, plan interventions and strategies to empower patients for coping with uncertainty.   https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1219 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1219/865

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 14 4 2020 10 07 248 256 EN Aysun Senturk Yikilmaz Department of Hematology, Yıldırım Beyazıt University, Ankara 06010, Turkey Sema Akinci Department of Hematology, Ataturk Training And Research Hospital, Ankara 06010, Turkey Sule Bakanay Department of Hematology, Yıldırım Beyazıt University, Ankara 06010, Turkey İmdat Dilek Department of Hematology, Yıldırım Beyazıt University, Ankara 06010, Turkey 2019 12 01 2020 02 25 Background: Complete response (CR) and very good partial response (VGPR) are targeted with pre-ASCT induction regimens in patients by diagnosed multiple myeloma (MM), who are candidates for ASCT. In this study, it was aimed to compare the response and survival evaluations of cases who underwent induction treatment by vincristine-doxorubicin-dexamethasone (VAD) protocol versus bortezomib containing regimens. Materials and Methods: The data of 96 ASCT eligible patients, retrospectively analyzed. P value> 0.05 was considered statistically significant. Results: While 66 cases had received bortezomib containing regimens as induction regimen, 30 cases had received VAD protocol. The total survival was 91.3 (st.s 6) months and 43 (st.s 7.9) months, respectively, when we compared the cases without ASCT and with ASCT (p = 0.001). The OS of patients who underwent ASCT after reaching at least VGPR was longer than the underwent ASCT without reaching VGPR (p=0.019).  Post-ASCT PFS (p=0.717) and OS (p = 0.126) analyzes were performed in 74 cases undergoing ASCT treatment, there was no significant statistical difference when patients with treated by VAD protochol and treated by bortezomib containing regimens as pre-ASCT induction regimens was compared to each other. Conclusion: Whatever the type of induction regimen is, the level of response achieved before ASCT is important. The survival of the myeloma patients are much more influenced with HDT-ASCT as well as post-transplantation strategies to keep the patients in remission. Even though it is outdated, we think that the VAD protocol may be an option in patients who are not responding with the new generation of agents in the following days. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1216 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1216/866

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 14 4 2020 10 07 257 264 Amirhosein Maali 1) Infection Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran 2) Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran 3) Student Research Committee, Babol University of Medical Sciences, Babol, Iran Elaheh Ferdosi-Shahandashti 1) Infection Diseases and Tropical Medicine Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran 2) Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran 3) Department of Medical Biotechnology, School of Medicine, Babol University of Medical Sciences, Babol, Iran Farzin Sadeghi Cellular and Molecular Biology Research Center, Health Research Institute, Babol University of Medical Sciences, Babol, Iran Ehsan Aali Department of Pharmacology, School of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran 2019 10 25 2020 03 01 Background: Adult T-cell leukemia/lymphoma (ATLL) is a poor prognostic Hematopoietic malignancy with various therapeutic challenges, which had been classified as non-Hodgkin lymphoma.  The Drug switching, as a novel, innovative and promising approach, is an opportunity to overcoming on therapeutic challenges of hard-treating disease, e.g. ATLL. Our aim is evaluating the antiproliferative and apoptotic effect of Mebendazole (MBZ) on ATLL cancer cells in in-vitro conditions. Materials and Methods: We used Jurkat cell-line as ATLL cancer cells. After treatment of MBZ in different concentrations on jurkat cells, the cell viabilities were determined by MTT assay. After IC50 value determination, the 24-, 48- and 72-h treatments had been performed in IC50 concentration and control to evaluating the quantitative apoptosis rate by Annexin/PI Flowcytometry and qualitative apoptosis by DAPI Nuclear staining. Also, Glucose spectrophotometry were performed to evaluate the reduced amount of glucose uptake through MBZ treatment. Results: MBZ inhibits proliferation of jurkat cells and IC50 value had been estimated 10 μM (P< 0.01). According to the flowcytometric results, increasing in drug concentration is associated with decrease cell viability and the percentage of full-apoptosis. However, it inversely correlates with percentage of early-apoptosis rate. Also, the microscopic captures of DAPI Nuclear staining confirms the flowcytometry results in qualitative manner. In addition, it was found that inhibition of glucose uptake was inversely correlated with increased MBZ concentration (P< 0.05). Conclusion: MBZ potentially inhibits the proliferation of ATLL cancer cells in in-vitro condition. MBZ inhibits the growth of Jurkat cells by inducing apoptosis. Also, we