Iranian Journal of Blood and Cancer
Volume:9 Issue: 3, Sep 2017

Children with hemophilia are prone to a variety of psychological problems due to some limitations associated with the disease. We aimed to compare the cognitive, emotional, and behavioral problems of children with hemophilia to healthy children.
This study was performed on 65 children with hemophilia and 65 healthy individuals as the control group who were between the ages of 7 and 12 years in Children’s Hospital. The Child Behavior Checklist (CBCL) was used to identify emotional/behavioral problems and Wisconsin Card Sorting Test (WCST) to evaluate cognitive problems.
The results showed that children with hemophilia obtained lower scores in activity, academic performance, and overall competence variables. Children with hemophilia in comparison to healthy children showed more internalizing and externalizing problems and emotional and behavioral deficits. Also they demonstrated more impairment in executive functions than healthy children.
The bio-psycho-social factors such as factors associated with the disease (e.g. anemia and bleeding), and the treatment (e.g. side effects of the drugs) and environmental and social factors are among underlying causes of some psychological problems in children with hemophilia.

Glial fibrillaryacidic protein (GFAP), an intermediate filament protein, is mainly expressed by astrocytes, but some other cells like enteric glia and non-myelinating Schwann cells can also express GFAP. GFAP elevation has been reported in some types of meningioma and malignant brain tumors. In the present study, we analyzed the association between serum levels of GFAP with meningioma.
Sixty-eight newly diagnosed patients with meningioma and 28 healthy individuals (control group) were included. Serum levels of GFAP were measured by ELISA.
There was no significant difference in GFAP serum levels between the two groups. Subdivision of the patients also revealed no significant association between GFAP and meningioma.
We studied serum levels of GFAP in meningioma in Iranian patients for the first time. We did not observe a significant association between meningioma and GFAP. A larger study including a larger number of different subtypes of meningioma patients may discover a weakly significant difference if it exists.

Bone marrow is the site of many malignant disorders and it is one of the common places for solid tumors to metastasize. Examination of the bone marrow aspirate and biopsy is a routine procedure performed for assessment of various conditions such as cytopenias, hematologic neoplasms, nonmalignant disorders and metastatic neoplasms.
The patients were referred to the Hematology Department at Tishreen University Hospital. 236 patients enrolled the study. Both bone marrow aspiration and biopsy were performed for all patients. Bone marrow aspirate was interpreted by the hematologist and the biopsy was examined by a Histopathologist. Moreover, we used immunohistochemical staining of some bone marrow biopsy specimens in cases where more information for diagnosis is required.
Bone marrow metastases was diagnosed in 35 (14.83%) samples. Prostate, breast, stomach, lung and neuromuscular cancers were metastasized to bone marrow in 11, 9, 7, 6 and 2 cases, respectively. Bone marrow biopsy could discover the metastasis in 100% of the involved cases, while only 40% of the cases with bone marrow involvement were diagnosed by bone marrow aspiration. The degree of sensitivity of bone marrow biopsy for diagnosis of bone marrow metastases in comparison to aspiration was statistically significant (P=0.001).
Bone marrow Metastases were diagnosed in 14.83% of the patients with malignant tumors. Prostate and breast cancer were the most common. Bone marrow biopsy could diagnose the metastases in all the cases compared to 40% by bone marrow aspiration.

Oral mucositis afflicts more than 3/4 of patients with cancer under chemotherapy. In acute cases it could lead to brain damage caused by hypoxia and even death due to airway obstruction and reduction of chemotherapy drug dose. We aimed to compare the effects of topical mouth rinse and chamomile mouthwash in prevention of oral mucositis caused by chemotherapy in children with cancer.
The study was a randomized double-blind clinical trial on 62 children aged 6-15 years with acute lymphoblastic leukemia under chemotherapy. The participants were divided randomly into two groups. The first group used topical mouth rinse and the second group started to use chamomile mouthwash a day before chemotherapy through 14 days. Mucous membrane status was assessed before starting the treatment (one day before chemotherapy), 7th and 14th day and it was reviewed based on WHO oral mucositis check list assessment and then registered by the researcher.
The results showed that the frequency of severity of oral mucositis in both groups did not have any significant difference 7 days after chemotherapy (P=0.46). The severity of oral mucositis in those who had used chamomile mouthwash 14 days after chemotherapy was significantly lower than those who used topical mouth rinse (Z=3.23, P=0.001).
In short term, using chamomile mouthwash and topical mouth rinse to prevent oral mucositis is effective in children with cancer.

Hemoglobinopathies are the commonest single gene disorder in human that affect hemoglobin production and function that occur when mutations alter the amino acid sequence of globin chains. The purpose of the present study was to evaluate the prevalence of hemoglobninopathies detected by capillary electrophoresis method in individuals referred to Masjed-Soleiman health centers by capillary electrophoresis method.
This study was carried out on 394 individuals referred to Masjed-Soleiman health centers during 2015-2016. Blood samples were collected in EDTA vacutainer tubes, then CBC including blood indexes (MCV, MCH), level of Hemoglobin A, Hb F, Hb A2 and other hemoglobins were evaluated by Sebia minicap (France) and also genetic tests applied for them to confirm results that were aqcuired by capillary electrophoresis method.
77 (19.5%) subjects had HbA2 ≥3.5%, thus were classified as beta thalassemia carrier and 3.3%, 2.5%, 1.5% and 0.5% of the individuals were heterozygote for Hb S, Hb D, Hb C and Hb Bart, respectively. Results of the genetic analysis showed the mutations in these subjects; cd36-37(-T) was the most frequent mutation in beta thalassemia carriers in this geographic region.
This study showed high frequency of beta thalassemia mutations in the geographic region of Masjed-Soleiman (19.5), and 7.85% of the individuals had hemoglobin variants including Hb S, Hb D and Hb C detected by capillary electrophoresis. Capillary electrophoresis could be a considerable method for detection of hemoglobinopathies.

Macrophage activation syndrome (MAS) is a rare feature of rheumatic disorders in children and adolescence and its presentation as the first symptom of rheumatic disorders is very infrequent.
A 9-year-old girl, in whom MAS developed, was admitted to our Hospital in Tehran, Iran. She suffered from high grade fever and rash followed by multiple joint swelling months afterwards. Bone marrow aspiration and biopsy showed normocellular marrow with a cellularity of 90%. Benign-looking macrophages were remarkably increased; many of them showed hemophagocytic features. According to the presentation of long-standing fever and observation of “hemophagocytic macrophage” in bone marrow, MAS was diagnosed for the patient. Additionally, due to recurrent joint swelling in following months, she was diagnosed to be affected by “Juvenile Idiopathic Arhtritis” complicated by MAS.
MAS is a rare complication of rheumatic disorders which should be considered as the first presentation of rheumatic disorders in children specifically in those presenting with high fever, hepatosplenomegaly, lymphadenopathy and severe cytopenia.