Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 16 1 2022 01 02 1 8 Hiroto Kaneko Department of Hematology, Aiseikai Yamashina Hospital, 19-4 Takehana-Shichouno-cho, Yamashina-ku Kyoto 607-8086, Japan Kazuho Shimura Department of Hematology, Aiseikai Yamashina Hospital, 19-4 Takehana-Shichouno-cho, Yamashina-ku Kyoto 607-8086, Japan Mihoko Yoshida Department of Hematology, Aiseikai Yamashina Hospital, 19-4 Takehana-Shichouno-cho, Yamashina-ku Kyoto 607-8086, Japan Yosuke Matsumoto Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto 605-8601, Japan Tsutomu Kobayashi Department of Hematology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan Hitoji Uchiyama Department of Hematology, Japanese Red Cross Kyoto Daiichi Hospital, 15-749 Honmachi, Higashiyama-ku, Kyoto 605-8601, Japan Junya Kuroda Department of Hematology, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan Masafumi Taniwaki 1) Department of Hematology, Aiseikai Yamashina Hospital, 19-4 Takehana-Shichouno-cho, Yamashina-ku Kyoto 607-8086, Japan 2) Center for Molecular Diagnostics and Therapeutics, Kyoto Prefectural University of Medicine, 465 Kajii-cho, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan 2020 04 17 2020 12 03 Background: In the current Japanese aging society, a high number of very elderly patients (age ranged from 80 to 93) with diffuse large B-cell lymphoma (DLBCL, most frequent hematological malignancy), who require chemotherapy are encountered. However, standard chemotherapy can result in severe adverse effects in elderly patients. Although various scoring systems are available to assess frailty, they are too complicated to immediately make a therapeutic decision, and studies on indications for chemotherapy in elderly patients are few. Materials and Methods: In the present study, we retrospectively analyzed the clinical records of 56 patients with DLBCL aged 80 or older who received R-CHOP or similar chemotherapy. Association of various clinical parameters, including performance status, stage, B symptom(s), laboratory data and relative dose intensity and survival outcomes was examined. Results: Pretreatment serum albumin level was identified as the only factor that predicts overall and progression-free survivals. Conclusion: We have concluded that very elderly DLBCL patients aged 80 or older with hypoalbuminemia may be unfit for standard chemotherapy, regardless of other factors. Alternative or palliative therapy should be considered for those patients. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1316 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1316/895

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 16 1 2022 01 02 9 13 Mojgan Shaiegan Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Mostafa Moghaddam Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Mahtab Maghsudlu Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Azita Azarkeivan Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Sima Zolfaghari Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Ali-Akbar Pourfatollah Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Peyman Soleimanzadeh Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran Ehsan Shahverdi 1) Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran 2) Department of Cardiology, Angiology and Sleep Medicine, Bonifatius Hospital Lingen, Lingen, Germany 2020 04 18 2021 04 05 Background: An analysis of red blood cell alloimmunization in patients with thalassemia can help to devise specific strategies to decrease the alloimmunization rate. This study explored the frequency and specificity of alloantibodies and autoantibodies against red blood cell (RBC) antigens in patients with thalassemia referring to the Iranian Blood Transfusion Organization (IBTO) Immunohematology Reference Laboratory (IRL) in Tehran. Materials and Methods: This study first examined the laboratory records of 23,113 patients suffering from different diseases referring to IBTO’s IRL for pretransfusion testing in the 2008-2015 period. ABO and Rh(D) typing and antibody screening tests were performed for all 23,113 patient records and 685 (2.97%) beta-thalassemia patients with positive pre-transfusion test results (antibody screening and/or DAT) were selected for further investigation. Results: The antibody screening test was positive in 640 out of 685 thalassemic patients (93.4%). DAT was performed for 529 patients, 226 (33%) of which showed positive results. Meanwhile, 161 out of 685 beta-thalassemia patients (23.5%) had positive auto control test results, reflecting the possible presence of allo- and/or autoantibodies. The most common antigen-specific alloantibodies were directed against K and E RBC antigens with a frequency of 25% (Anti-K) and 11.91% (Anti-E), respectively. The development of two antibodies (double antibodies) in one patient was observed in 80 individuals (11.46%). Conclusion: Age, gender, history of pregnancy, and splenectomy were not contributing factors to the antibody presence in the patient population under study. Extended red blood cell phenotyping should be considered as an essential procedure for expected multi-transfused thalassemia patients before blood transfusion. Considering the high frequency of anti-K and anti-E observed in this study, it is recommended that thalassemia patients in Iran are tested through phenotyping of RBC units for K and E antigens before transfusion. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1321 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1321/896

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 16 1 2022 01 02 14 21 Osman Yokus Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey Konul Jafarli Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey Fettah Sametoglu Department of Internal Medicine, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey Hasan Goze Department of Hematoloy, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey Istemi Serin Department of Hematology, University of Health Sciences, Istanbul Training and Research Hospital, Istanbul, Turkey 2020 05 26 2021 11 10 Background: Chronic lymphocytic leukemia (CLL) is one of the most common hematological malignancies. In patients with CLL, serum immunoglobulin levels decrease over time due to both the disease itself and the chemo-immunotherapeutic agents used. It was aimed to reveal the relationship between hypogammaglobulinemia and disease stage, and chemo-immunotherapies. Materials and Methods: Data were obtained by retrospectively examining 74 patients who were followed-up between 2008-2019. The relationship between all parameters (demographic characteristics, RAI stages or therapy subtypes) and serum IgG levels was analyzed. Results: Thirty-two of 74 patients received a therapy. Twenty-two patients were on combined therapy with rituximab or only rituximab and 10 were treated with chemotherapeutic agents only. The frequency of hypogammaglobulinemia was 5.4% at the diagnosis, this rate was 55% in patients receiving a therapy. Hypogammaglobulinemia was higher in advanced stages. In patients with rituximab, higher levels of IgG decrease were observed. Conclusion: Serum IgG level was significantly lower in patients with advanced-stage, received chemotherapy, especially rituximab. In addition to basal IgG, immunoglobulin levels should be checked during treatment, and follow-up period. Early replacement intravenous immunoglobulins will be important to reduce severe infection attacks due to secondary immunodeficiency. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1347 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1347/897

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 16 1 2022 01 02 22 33 Mohammad Vaezi Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran Amirhoushang Pourkhani Department of Hematology/Oncology, Golestan University of Medical Sciences, Gorgan, Iran Amir Kasaeian Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran Maryam Souri Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran Marjan Yaghmaie Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran Kamran Alimoghaddam Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran Ardeshir Ghavamzadeh Cancer & Cell Therapy Research Center, Tehran University of Medical Sciences, Tehran, Iran 2021 03 17 2021 07 06 Background: Current treatment options of acute lymphoblastic leukemia(ALL) include chemotherapy alone or hematopoietic stem cell transplantation (HSCT) following induction chemotherapy both along with CNS prophylaxis. The usual and standard induction regimens currently administered could have severe complications and mortality. Materials and Methods: To lessen induction regimen complications in ALL patients who undergo HSCT, we used a cytoreduction induction regimen including dexamethasone (8 mg, IV, three times a day, for 28 days) and vincristine(1.4 mg/m2, IV, on days 1,8,15 and 22) for 49 newly diagnosed adult ALL patients followed by an early sibling donor HSCT within two months. The results were matched with outcomes of HSCT in 172 ALL patients inducted by standard induction regimen. Results: Median follow-up time was 5.41 years in the standard group and 5.27 years in the other. All patients of the case group (100%) achieved complete remission. Landmark analyses were performed to scrutinize the effect of treatments on different time intervals: first two years and 2nd to end years. Type of treatment had no significant effect on the hazard of death in the first landmark (HR=0.87, P=0.64). Cytoreduction regimen amplified the hazard of death 3.43 times more than the standard regimen in the second landmark (HR=3.43 P=0.035). Multivariate analysis showed that the cytoreduction regimen reduced the hazard of relapse about 22%, but not statistically significant (HR=0.78, P-value=0.24). Conclusion: Overall, it seems despite achieving complete remission in induction therapy, depth of response is a critical predictor for long-term outcomes of HSCT in ALL patients, and the use of multiple agents may be necessary to decrease tumor cell burden and minimal residual disease(MRD). https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1582 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1582/898

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 16 1 2022 01 02 34 46 EN Nishit Gupta Department of Haematology, BLK Superspeciality Hospital, Delhi, India, 110005 Aditi Mittal Department of Haematology, BLK Superspeciality Hospital, Delhi, India, 110005 Tina Dadu Department of Haematology, BLK Superspeciality Hospital, Delhi, India, 110005 Dharma Choudhary Department of Hemato-oncology and Bone marrow transplant, BLK Superspeciality Hospital, Delhi, India, 110005 Anil Handoo Department of Haematology, BLK Superspeciality Hospital, Delhi, India, 110005 2020 05 14 2020 12 16 Background: FxCycleTM Violet (FCV) based flow cytometric (FCM) DNA ploidy analysis is a rapid and simple tool that can substantiate in characterizing the biological behaviour across the spectrum of haematological malignancies and correlates with cytogenetic studies. Materials and Methods: In this prospective study, we performed simultaneous immunophenotyping with FCV based on  ploidy analysis in n=132 consecutive new samples, comprising n=110 samples of haemato-lymphoid neoplasms, including acute leukemias (n=67, 60.9%), CML with myeloid blast crisis (n=1, 0.9%), MDS with excess blasts (n=2, 1.8%), mature B cell/ T cell neoplasms (n=37, 33.7%), multiple myeloma (n=3, 2.7%) along with n=22 normal samples. The FCM DNA data was compared with corresponding conventional karyotyping results, wherever available. Results: In FCM ploidy analysis (n=110), the overall DNA index (DI) ranged from 0.81 to 2.17 and S-Phase fraction (SPF) from 0.1-31.6%. Diploidy was seen in n = 90 (81.8%), low-hyperdiploidy in n = 10 (9.1%), high-hyperdiploidy in n = 7 (6.4%) with one case each (0.9% each) having near-tetraploidy, high-hypodiploidy and low-hypodiploidy. The DI of all viable cell populations in normal samples ranged from 0.96-1.05. Conventional karyotyping was performed in n=76/110 cases (70%) with n= 11/76 (15%) culture failures. The modal chromosome number ranged from 45 to 63. A concordance of 95.4% (n=62/65) was noted with corresponding FCM DI. Conclusion: FCV-based ploidy is a sensitive technique that provides complementary information and ascertains a strong correlation with conventional cytogenetics across all haemato-lymphoid neoplasms. It can detect aneuploidy in all B-ALL and myeloma cases, even in hemodiluted samples with cytogenetic culture failure; supplement the diagnoses of erythroleukemia, and provide a useful screen for a higher grade lymph node disease in lymphoma cases with SPF > 3%. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1340 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1340/904

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 16 1 2022 01 02 47 54 Vanusa Souza Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil Rayne Marques Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil José Luiz Rocha 1) Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil 2) Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil Glenda Petarli University Hospital Cassiano Antonio Moraes, Vitoria, Espirito Santo, Brazil Valdete Guandalini 1) Department of Integrated Health Education, Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil 2) Federal University of Espirito Santo, Vitoria, Espirito Santo, Brazil 2021 02 28 2022 01 17 Background: Hematological cancer patients are prone to the development of sarcopenia and impaired nutritional and functional status. SARC-CalF is a screening tool for the risk of sarcopenia that has shown good results in this population. This study aimed to identify the risk of sarcopenia by SARC-CalF and to verify its association with nutritional status and Hand Grip Strength (HGS) in patients with hematological cancer. Materials and Methods: Adult patients, of both sexes, with hematological cancer, and in outpatient care participated in the study. We measured the Hand Grip Strength of the Dominant Hand (HGSD) and the Adductor Pollicis Muscle Thickness of the Dominant Hand (APMTD). Moreover, we applied the Patient-Generated Subjective Global Assessment (PG-SGA) and SARC-CalF. Data were analyzed with SPSS® software, 22.0, with a significance level of 5.0%. Results: Fifty-one patients aged an average of 60.4 ± 15.1 years were evaluated. Of those, 58.8% were elderly, 51% female, and 80.4% declared themselves non-white. The predominant diagnosis was Mature B Lymphoid Cell Neoplasia (37.7%), and 60.8% of the patients had a diagnosis time of ≤ 3 years. PG-SGA revealed that 35.3% of the patients were malnourished; APMTD and HGSD revealed that 60.8% and 25.5% had reduced muscle strength, respectively. SARC-CalF exposed that 39.2% of the patients were at risk for sarcopenia. Significant associations were found between SARC-CalF and diagnosis time ≤ 3 years (p = 0.039), PG-SGA (p = 0.020), APMTD (p = 0.039) and HGSD (p = 0.002). After binary logistic regression adjusted for age and sex, the reduced HGSD remained associated with the risk of sarcopenia. Conclusion: SARC-CalF identified a risk of sarcopenia in 39.2% of patients. The reduced HGSD was associated with the risk of sarcopenia. https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1557 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1557/1027

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 18 2 2024 04 16 156 164 Mohammad Soltani Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mohammad Sharifi Division of Laboratory Hematology and Blood Banking, Department of Medical Laboratory Sciences, School of Paramedical Sciences, Shiraz University of Medical Sciences, Shiraz, Iran Parvin Khalilian Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mehran Sharifi Department of Internal Medicine, School of Medicine, cancer Prevention Research Center, Seyyed Al-Shohada Hospital, Isfahan University of Medical Sciences, Isfahan, Iran Pardis Nematollahi Department of Pathology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Hooriyeh Shapourian Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Mazdak Ganjalikhani Hakemi 1) Department of Immunology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran 2) Regenerative and Restorative Medicine Research Center (REMER), Research Institute of Health Sciences and Technology (SABITA), Istanbul Medipol University, Istanbul, Turkey 2022 10 31 2023 08 06 Background: Myelodysplastic syndromes (MDS) are determined by ineffective hematopoiesis and bone marrow cytological dysplasia with somatic gene mutations and chromosomal abnormalities. Accumulating evidence has revealed the pivotal role of NLRP3 inflammasome activation and pyroptotic cell death in the pathogenesis of MDS. Although MDS can be diagnosed with a variety of morphologic and cytogenetic tests, most of these tests have limitations or problems in practice. Materials and Methods: In the present study, we evaluated the expression of genes that form the inflammasome (NLRP3, ASC, and CASP1) in bone marrow specimens of MDS patients and compared the results with those of other leukemias to evaluate their diagnostic value for MDS. Primary samples of this observational cohort study were collected from aspiration samples of patients with myelodysplastic syndromes (27 cases) and patients with non-myelodysplastic syndrome hematological cancers (45 cases). After RNA extraction and c.DNA synthesis, candidate transcripts and housekeeping transcripts were measured by real-time PCR method (SYBER Green assay). Using Kruskal-Wallis the relative gene expressions were compared and differences with p value less than 0.05 were considered as significant. Discrimination capability, cut-off, and area under curve (AUC) of all markers were analyzed with recessive operation curve (ROC) analysis. Results:  We found that Caspase-1 and ASC genes expressed at more levels in MDS specimens compared to non-MDS hematological malignancies. A relative average expression of 10.22 with a p-value of 0.001 and 1.86 with p=0.019 was detected for Caspase-1 and ASC, respectively. ROC curve analysis shows an AUC of 0.739 with p=0.0001 for Caspase-1 and an AUC of 0.665 with p=0.0139 for ASC to MDS discrimination. Conclusion: Our results show that Caspase-1 and ASC gene expression levels can be used as potential biomarkers for MDS diagnosis. Prospective studies with large sample numbers are suggested.   https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/view/1925 https://ijhoscr.tums.ac.ir/index.php/ijhoscr/article/download/1925/1028

Tehran University of Medical Sciences International Journal of Hematology-Oncology and Stem Cell Research 2008-2207 18 2 2024 04 16 165 173 EN Zohreh Ehsani Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Ebrahim Salehifar Pharmaceutical Sciences Research Center, Hemoglobinopathy Institute, Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran Emran Habibi Pharmaceutical Sciences Research Center, Hemoglobinopathy Institute, Department of Clinical Pharmacy, Faculty of Pharmacy, Mazandaran University of Medical Sciences, Sari, Iran Reza Alizadeh-Navaei Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Mahmoud Moosazadeh Gastrointestinal Cancer Research Center, Non-Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Nasim Tabrizi Department of Neurology, Faculty of Medicine, Mazandaran University of Medical