فهرست مطالب

Iranian Journal of Pediatric Hematology and Oncology
Volume:8 Issue: 1, Winter 2018

  • تاریخ انتشار: 1396/10/05
  • تعداد عناوین: 8
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  • Soheila Zareifar Dr, Fatemeh Rowshani Dr, Sezaneh Haghpanah Dr, Mohammadreza Bordbar Dr Pages 1-11
    Background
    Reduced survival and impaired quality of life of the children affected by cancers is one of the most important health problems. In this study, 5-year survival of children affected with Central nervous system (CNS) tumors and its related factors were evaluated.
    Materials And Methods
    Participants in this historical cohort study consisted of 161children with mean age of diagnosis 72 ± 51 months (median:60 months, range from 1 month to 17 years) who were diagnosed with CNS tumors from 1999 to 2005. All patients had referred to Oncology hospitals of Shiraz University of Medical Sciences, Shiraz, Iran. Data were extracted by checklist from their medical records.
    Result
    Five-year overall survival (OS) and disease free survival (DFS) of the patients were 59% (standard error: 5%) and 51.7% (standard error: 5%). Moreover, 10- year OS was calculated as 47% (standard error: 7%). Based on tumor histology, OS was 70% for low grade tumors and 52% for high grade tumors (P=0.202). Based on the results, gender (girls had longer survival than boys), recurrence, neurologic deficit and age of diagnosis (60-119 months had longer survival), were determined as the influencing factors on OS rate (HR (95% CI) =0.48 (0.24-0.98), P=0.044, 0.48(0.25-0.93) P=0.031, 0.42 (0.18-0.95), P=0.039, and 0.32 (0.11-0.88), P=0.029, respectively). Moreover, tumor location in diencephalon was determined as poor prognostic factors ((HR (95% CI) =10 (1.9-57), P=0.007).
    Conclusion
    Aforementioned prognostic factors should be taken into account by oncologists to make better decisions in the management of the patients with CNS tumors. It seems that survival is a multifactorial event and besides these prognostic factors, it might be also related to different clinical settings, ethnicity and type of treatment. Further studies with more focus on different treatment modalities are suggested.
    Keywords: Cancer, Central nervous system neoplasm, Pediatric, Survival
  • Fraidoon Kavoosi, Masumeh Sanaei Pages 12-20
    Background
    Histone deacetylation of tumor suppressor genes such as estrogen receptor alpha (ERα) can induce cancer, which is reversible by epi-drugs such as valproic acid (VPA). The previous result indicated that tamoxifen (TAM) induced apoptosis in hepatocellular carcinoma (HCC). This study was designed to assess the apoptotic and antiproliferative effects of VPA and TAM and also the effect of VPA on ERα gene expression in HCC.
    Material and
    Methods
    The cells were treated with various doses of VPA and TAM and the MTT assay, Real-Time RT-PCR, and flow cytometry assay were done to determine viability, ERα gene expression, and apoptosis.
    Results
    Both agents inhibited viability and induced apoptosis. ERα gene expression was increased by VPA, which in turn increased the apoptotic effect of TAM. The half-maximum inhibitory concentration (IC50) value for VPA and TAM was 5 and 20 μM respectively. VPA inhibited cell growth by 88 % to 38 % at 24 h (P
    Conclusion
    VPA and TAM can significantly inhibit viability and induce apoptosis and also VPA play a significant role in ERα reactivation.
    Keywords: Hepatocellular Carcinoma, Tamoxifen, Valproic acid
  • Loay S. Ibrahim, Reema F. Tayyem Pages 21-36
    Background
    This study primarily aimed to investigate the possible association between the risk of suffering from Iron Deficiency (ID) and body weight status among a group of obese, overweight, and normal body weight children. The second aim of this study was to assess Serum Iron (SI), Serum Ferritin (SF), Total Iron Binding Capacity (TIBC), Hemoglobin (Hb), and Body Mass Index (BMI) among the recruited children.
    Materials And Methods
    In this case-control study, a total of 150 disease-free children aged between 6-59 months were recruited conveniently from Amman. Children were grouped as normal body weight, overweight, and obese. BMI and BMI Z-scores were determined and the intake of many macro- and micronutrients were estimated. Serum iron, SF, TIBC, and Hb were measured to detect the presence of ID.
    Results
    The mean concentration of SI was significantly higher in normal body weight than in overweight and obese children. The mean concentration of TIBC was significantly lower in normal body weight children than that in overweight and obese children (P
    Conclusion
    This study supports the findings of the presence of an association between weight gain and ID despite that iron intake among obese children was higher than those with normal body weight.
    Keywords: Iron Deficiency, Obesity, Overweight, Macronutrients, Micronutrients
  • Majid Firouzi Dr, Rana Yazdanmehr, Hosein Eliasy, Mehdi Birjandi Dr, Amin Goudarzi, Mohammad Almasian, Ali Asghar Kiani Dr Pages 37-47
    Background
    ABO incompatibility is the most common cause of immune hemolytic disease of the newborn (HDN) and in most cases is not dangerous. The present study aimed to determine the prevalence of ABO-HDN and its effects on neonatal blood parameters in a population of patients referred to some training hospitals in Iran.
    Materials And Methods
    In This cross-sectional study, All newborns (a total of 765 infants) whose medical records showed that they suffered from anemia or jaundice and were hospitalized in the training hospitals of Khorramabad, Iran, were evaluated. The information recorded in their medical records included age, gender, blood group, hemoglobin and bilirubin levels, reticulocyte count, platelet count, and maternal age. Data were analyzed using SPSS and statistical tests, such as chi-squared, independent t-test, and the Mann-Whitney test.
    Results
    Out of 765 newborns with anemia or jaundice, 293 infants (38.3%) had HDN, 78 (10.2%) of whom suffered from non-immune HDN. The rest, i.e. 215 neonates (28.1%), suffered from immune HDN. Among the neonates with immune HDN, 29 infants (3.8%) had Rh-HDN, and 186 newborns (24.3%) had ABO-HDN. Among the 186 newborns with ABO-HDN, 95 cases (13%) had blood group A and 84 cases (11.5%) had blood group B. No significant relationship was found between A and B blood groups in the newborns with the occurrence of ABO-HDN (p=0.1). There was a significant difference between neonates with ABO and those without ABO in terms of bilirubin (p= 0.001), hemoglobin (p=0.003), and reticulocyte (p=0.036) counts. A significant relationship between platelet count and the occurrence of ABO-HDN was not found (p= 0.558).
    Conclusion
    The results showed that a large percentage of neonates are affected by ABO-HDN and provisions should be made to avoid possible complications.
    Keywords: ABO-HDN, hemolytic anemia, neonatal blood parameters
  • Sara Salarian Dr, Bahador Mirrahimi Dr, Bahar Taherkhanchi Dr, Bahador Bagheri Dr Pages 48-53
    Background
    Thromboembolism (TE) in pediatric population is rare but may be a fatal situation. There is a lack of clinical guidelines to help decision making for the use of prophylactic measures in pediatrics. This study was designed to evaluate current guidelines and risk factors for the prevention of venous thrombosis and pulmonary embolism (DVT/PE) in children.
    Materials And Methods
    This cross-sectional, prospective, and observational study was done between October 2014 and April 2017 in Mofid Children Hospital, Tehran, Iran. All children between 40 days to 8 years old admitted to the pediatric critical care unit (PICU) were evaluated for DVT/PE risk factors such as Glasgow coma score (GCS)
    Results
    For 3 years, 1080 children aged from 40 days to 8 years who hospitalized in PICU were studied. The mean duration of ICU stay was 6 ± 1.1 days. Three hundred and forty (31.5 %) patients had at least 4 risk factors for DVT/PE. Thirty nine (11%) patients with 4 or more risk factors had diagnosed DVT/PE. Among 39 patients with thromboembolic events, 11 (1%) children died. Congenital heart disease was the independent risk factor for DVT and PE. DVT was the most common type of thrombosis (69%).
    Conclusion
    This study suggested that TE is multi-factorial in children and anticoagulation therapy can be considered in hospitalized children with at least 4 risk factors. It seems that it is necessary to develop new strategies for thromboprophylaxis in PICU.
    Keywords: Critical care, Pediatrics, Pulmonary embolism, Venous thrombosis
  • Hossien Ayatollahi Dr, Aref Keshavarzi, Behnaz Shams, Mohyedin Barzegar, Mojgan Amirpour, Maryam Sheikhi, Nafise Amini, Mohammad Hadi Sadeghian Dr, Alireza Khiabani Pages 54-61
    Background
    Acute Myeloid Leukemia (AML) is a group of heterogeneous malignancies caused by defects in differentiation of hematopoietic cells. SRY-box containing gene 17(SOX17) is a transcription factor which plays an important role in several biological processes, including cardiogenesis, angiogenesis, and lymphopoiesis. Aberrant expression of SOX17 has been detected in solid tumors. This study was performed to investigate the alternations of SOX17 expression in AML patients.
    Materials And Methods
    This case-control study included 54 AML patients who were referred to Molecular Pathology Cancer Research Center of Ghaem Hospital in North East of Iran from October 2011 to May 2016. Patients were classified according to French-American-British (FAB) and World Health Organization (WHO) criteria. RNA was extracted from peripheral blood. SOX17 gene expression was evaluated by real-time quantitative polymerase chain reaction (RQ-PCR).
    Results
    Over expression of SOX17 was observed in 34 (62.96%) AML patients. No relation was noticed between SOX17 expression and patient survival (p=0.493). In addition, no correlation among patient survival, Sex(p=0.322),hemoglobin(p=0.866) and white blood cell (WBC) (p=0.103).
    Conclusion
    Based on these results, SOX17 did not have any important role in AML pathogenesis. Thus, it can’t be used as a diagnostic and prognostic factor. However, more studies are required to fully elucidate the role of SOX17 in AML.
    Keywords: Acute myeloid leukemia, SOX17, Survival
  • Hadi Zare-Zardini, Mona Salehvarzi, Fatemeh Ghanizadeh, Zahra Sadri, Robab Sheikhpour Dr, Fatemeh Zare Bidoki, Fatemeh Shabani, Asghar Taheri Kafrani Dr Pages 62-70
    Application of chemotherapy in cancerous children leads to reduction of immune system efficiency. Therefore, these children are prone to various infectious diseases. The excessive use of antibiotics can bring about antibiotic resistant strains. Hence, it is essential to investigate new therapies for this problem. On the other hand, the emergence of resistance against multiple drugs is a major problem in treatments of infection and cancer. Lack of selectivity and negative side effects on normal cells is another associated problem for available drugs. Antimicrobial peptides are important agents that are made by the immune system in response to pathogens. This kind of immune response exists in all animal categories from prokaryotes to humans. Different types of antimicrobial peptides have been identified and isolated from various organisms. These peptides, along with antimicrobial effects, also contain other biological activities such as anticancer, spermicidal, anti-diabetic, growth stimulant, etc. Therefore, these natural compounds can be considered as new therapeutic goals in different areas, especially for the prevention of pediatric infectious disease. Because of anticancer activity, antimicrobial peptides can be used as an effective double functional drug: anti-infective and anti-cancer drugs. There are 2851 antimicrobial peptides from six kingdoms (303 bacteriocins/peptide antibiotics from bacteria, 4 from archaea, 8 from protists, 13 from fungi, 342 from plants, and 2181 from animals) with different activities in various recorded databases and 210 peptides with anticancer/antitumor activity. Most of these peptides are still in the early stages of the study, but in the future, these compounds will have a special place in the medicine basket as the most important and effective drug. In this review, the characteristics and applications of antimicrobial peptides were investigated and their anticancer effects were focused.
    Keywords: Anticancer, Antimicrobial peptides, Infectious diseases, Immune system, pathogen
  • Fariba Binesh Dr, Alireza Jenabzadeh Dr, Maryam Vagihinejad Dr, Mohammad Ali Dideban, Fatemeh Pourhosseini, Hadi Zare-Zardini Pages 71-74
    Malignant melanoma in children is rare. It can arise from congenital melanocytic nevi. In pediatric patients, diagnosis of melanoma is difficult and challenging because the physicians have a low index of suspicion. Marrow metastasis in malignant melanoma especially in children is extremely uncommon. Here, the authors reported a 5 year old girl who was presented with a 4 month history of pelvic and right lower limb pain and limping to the pediatric outpatient clinic in August 2016 at Shahid sadoughi Hospital,Yazd,Iran. She was febrile and had right cervical lymphadenopathy and scalp congenital nevus. The investigations confirmed the diagnosis of malignant melanoma with marrow and cervical lymph node metastases. The patient underwent multidisciplinary management and she was followed up closely.
    Metastatic malignant melanoma is a rare and dangerous disease with poor prognosis in children. It should be considered in differential diagnosis of children with congenital melanocytic nevi.
    Keywords: Malignant melanoma, Bone marrow, Metastasis, Child