Showing 14 results for Malignancy
E Rahimi , R Behrozian , A Eishi ,
Volume 1, Issue 1 (9-2008)
Abstract
Background: the Iron deficiency anemia (IDA) is a common cause of referral to medical departments. Chronic gastrointestinal (GI) blood loss is important cause of IDA and also an alarming sign of serious underlying disease. The information concerning ideal evaluation of the gastrointestinal tract in patients with the IDA is scant. We designed a prospective study to determine the frequency of GI tract lesions in patients with the IDA. Methodology: This cross - sectional study was conducted since January 2006 to January 2008 at Imam Hospital, Urmia in the west of Iran. The study population was comprised of 227 patients including men over 40 years and post menopausal women with probable IDA. After identification of patients, we extracted detailed data via medical records, history taking, physical examination and laboratory. Data was analyzed by the chi square and student’s t-test.
Results: the patients totally underwent 478 in : 214 upper GI endoscopies, 179 colonoscopies, and 85 bariumenema. The mean age of subjects was 61 years (SD±15), and 55% were women. Upper GI lesions (esophagitis, gastritis, peptic ulcer and gastric cancer) accounted 32.1 (73 case) percent of cases. Colonoscopy findings include: polyps of colon were found in 10 (4.4%) of cases and colon cancer in 15 (6.6%). Etiology of IDA was not detected in 126 (55.5%) of our patients.
Conclusion: We concluded despite relatively low rate of malignant gastrointestinal lesions that were found in our study, GI tract assessment is necessary in iron deficiency anemia, chiefly in the patients with symptoms related to upper or lower gastrointestinal tract.
Volume 2, Issue 1 (10-2009)
Abstract
Background: NT-proBNP is a marker that is released from ventricles in response to pressure and volume overload. Raised plasma level of NT-proBNP is seen in ventricular dysfunction, ventricular muscular mass reduction or ventricular ischemia. Anthracyclines are widely used in treatment of pediatric cancer but their use is associated with cardiotoxicity which increases mortality and morbidity.
We measured the plasma levels of NT-proBNP to determine whether it might serve as a simple prognostic indicator of anthracycline-induced cardiotoxicity and to estimate the toxic levels of anthracyclines in children with malignancy treated with anthracycline containing regimens in
Tehran’s Mofid hospital.
Materials and Methods: This study was performed as a before and after clinical trial. Twenty-nine pediatric patients less than fifteen years old with newly diagnosed cancer were enrolled in this study. All patients received anthracycline-containing chemotherapy with 120 to 150 mg/m² in accumulative dose. Serial measurements of plasma NT-proBNP levels and echocardiographies were taken before onset of chemotherapy, simultaneous with accumulative dose of 120 to 150 mg/m² and two weeks after that dose.
Results: Plasma levels of NT-proBNP were within normal limits before treatment and increased significantly after the mentioned accumulative dose (P=0.002) in 26 patients out of 29. All patients had normal echocardiograms and none developed heart failure during the two-year period of the study.
Conclusion: NT-proBNP levels increases significantly after 120 to 150 mg/m² as accumulative dose in a subset of pediatric cancer patients. This increase is not associated with echocardiographic or clinical evidence of cardiac dysfunction. Longer follow-up of these patients is necessary to determine whether NT-proBNP can be used as an early and prognostic marker for anthracycline-induced cardiotoxicity and whether 120 to 150 mg/m² as accumulative dose of anthracycline is a safe dose or not.
S Ansari, A Kiumarsi, T Rostami, E Shirzadi,
Volume 6, Issue 4 (7-2014)
Abstract
As the data on the epidemiology and outcome of fungal infections in children with hematologic cancer are limited especially in Iran, this study was aimed to delineate the epidemiologic features and outcome of fungal infections in this population.
The medical records of all children with hematologic malignancies diagnosed with a fungal infection from 2005 to 2010 at a tertiary pediatric hospital (Ali Asghar Children’s Hospital, Tehran, Iran) were reviewed. The results indicated that out of 617 children hospitalized in the hematology/oncology department during the study period, 115 (18.6%) were diagnosed with a fungal infection. Between 87 patients with fungal infection whose records were complete, Candida species caused the majority (73.6%) of fungal infections. Aspergillus species were found in 14.9% and Mucor species in 11.5% of patients. The mortality rate significantly correlated with the organism causing the infection (P< 0.0001) and was especially high in patients with Aspergillus infections (61.5%). Improved prevention, early detection, and advanced treatment strategies are needed to improve the outcome.
Bhat Sh, Manzoor F, Bashir N, Bashir Y, Geelani S, Rasool J,
Volume 7, Issue 1 (11-2014)
Abstract
Background: Acute Myeloid Leukemia (AML) with translocation (3,3) is a form of AML that may present de novo or may arise from a previous myelodysplastic syndrome. It is often associated with normal or elevated peripheral blood platelet count and increased bone marrow megakaryocytes with associated multi lineage dysplasia. A subset of patients present with hepatosplenomegaly while a few cases have less than twenty percent blasts at the time of diagnosis, including cases with features of chronic myelomonocytic leukemia (CMML). Here we present a rare case presenting initially with features of CMML who eventually turned out to be a case of AML with translocation (3, 3).
Key words: Acute myeloid leukemia, translocation, malignancy.
Samin Alavi, Maryam Ebadi, Sadaf Esteghamati, Mohammad Kaji Yazdi,
Volume 8, Issue 2 (6-2016)
Abstract
Background: Tumor lysis syndrome (TLS) is a major metabolic complication in patients with malignancy after initiation of chemotherapy or spontaneously without treatment. The role of Rasburicase (a recombinant urate-oxidase enzyme) in prevention and treatment of TLS has been demonstrated in recent years. We aimed to investigate the efficacy of a single dose of rasburicase in reducing the risk of TLS in children at high risk.
Methods: we conducted a retrospective analysis of 560 children with various malignancies in a single referral center. On the basis of the reference values previously established in our center hyperuricemia and TLS were defined. Tumor lysis syndrome development was the primary outcome. 48 children with a mean age of 7.1 years (range: 3 months to 15.8 years) developed tumor lysis syndrome. The most common malignancies were B-precursor acute lymphoblastic leukemia (ALL) (45%) followed by non-Hodgkin lymphoma (NHL) and Wilms’ tumor (each 10.4%), respectively. They received normal saline intravenously at a rate of 4-5 L/m2/day in 24-48 hours prior to initiating chemotherapy. Plasma samples were drawn to detect uric acid, calcium, phosphate, potassium, creatinine and blood urea nitrogen (BUN) 4 hours before administering a single dose of IV rasburicase (0.2 mg/kg over 30 minute). Laboratory markers were evaluated again 4 and 24 hours after administering rasburicase.
Results: All patients with diagnosis of TLS had significantly decreased uric acid levels following single dose of rasburicase except 1 patient (2.1%) (P<0.001). Mean plasma uric acid concentration before treatment was 10.0±4.2 mg/dL and 4 hours after treatment declined to 2.2±5.5 (P<0.001). Hyperphosphatemia was also detected in 43.7% of these 48 cases which significantly decreased to 16.7% (P=0.012). Plasma uric acid levels remained low one day after treatment. No side effects were detected.
Conclusion: Rasburicase is a safe and highly effective drug in children with hyperuricemia in the setting of malignancy at risk of developing TLS.
Geetha Narayanan, T Manohar Anoop, Lakshmi Haridas, Lali V Soman,
Volume 9, Issue 1 (3-2017)
Abstract
Survival of patients with multiple myeloma has improved substantially because of availability of new therapies including autotransplants, immunomodulating drugs and proteasome-inhibitors. Second primary cancers have emerged as an important determinant of morbidity and mortality among cancer survivors. Even though there is an increased risk of new cancers of the lymphoreticular and haematopoetic system, it is very rare for Hodgkin’s lymphoma to occur as a second malignancy following autologous peripheral blood stem cell transplantation (APBSCT) for myeloma. We report a case of a female with plasma cell leukemia treated with autologous peripheral blood stem cell transplantation and lenalidamide maintenance. She developed cervical lymphadenopathy 4.5 years after the APBSCT, biopsy confirmed the diagnosis of classical Hodgkin’s lymphoma, nodular sclerosis type. Since she developed allergic reaction to ABVD, she was given 6 cycles of COPP chemotherapy and is in complete remission now.
Mazaher Ramezani, Maryam Mirzaie, Masoud Sadeghi,
Volume 9, Issue 4 (12-2017)
Abstract
Gastric carcinosarcoma is a rare cancer of adults with poor prognosis compared with other gastric malignancies. To the best of our knowledge, the present report is the first case of gastric carcinosarcoma with chondroblastic differentiation in Iran. A 63-year-old man with epigastric pain was admitted to the surgery department. Abdominopelvic CT-scan showed a hypodense mass lesion in distal gastric lesser curvature measuring 5.7 x 4.0 cm with decreased enhancement after contrast injection. Microscopic examination revealed coexistence of carcinomatous and sarcomatous components, presence of vascular and perineural invasion and involvement of the adjacent lymph nodes. This is a report of a rare case of gastric carcinosarcoma with chondroblastic differentiation.
Afshin Karami, Mehrdad Payandeh, Noorodin Karami, Amir Yami,
Volume 10, Issue 2 (6-2018)
Abstract
Alireza Rezvani, Sima Kiani Salmi, Ehsan Taherifard, Mohammad Ali Davarpanah, Erfan Taherifard,
Volume 11, Issue 1 (3-2019)
Abstract
Background: Infection is one of the most serious complications and leading cause of morbidity and mortality in patients with hematological-oncological disorders. We aimed to assess distribution of pathogens and their antibiotic resistance pattern in patients admitted to hematology-oncology department of Namazi Hospital, Shiraz from April 2016 to March 2017.
Methods: The current cross-sectional study found out 234 patients with positive culture from different sites. Patients with all kind of malignancies were included in the study. Isolation of the pathogens and antibiotic resistance pattern was conducted using disc diffusion Method.
Results: Among 234 subjects with positive culture, gram negative and gram positive bacteria, and fungi comprised 45.3%, 32.4%, and 22.2% of the cases, respectively. The most common pathogens were E. coli (20.9 %) and Non-albicans Candida (20.9 %). Data analysis found E. coli, Acinetobacter, Enterococci, and catheter-related coagulase-negative Staphylococci highly resistant to fluoroquinolones, imipenem, vancomycin and ceftazidime, respectively.
Conclusion: New strategies in prescribing antibiotics are demanded due to altered pathogenic sensitivity to the conventional antibiotics. Meanwhile, measures such as standard precautions and transmission-based precautions (i.e., contact, droplet, and airborne precautions) should be taken more seriously to decrease the emergence of bacterial and fungal infections.
Majid Sanatkhani, Javid Rasekhi, Zohreh Dalirsani, Narges Ghazi,
Volume 11, Issue 4 (12-2019)
Abstract
Pregnancy is a physiological period in a woman’s life. It is well known that some pathological changes have been reported to be more common in pregnancy than other stages of the life. It seems that primary tumors have a tendency to progress more rapidly in pregnancy due to hormonal alterations or increased expression of some growth factors. The exact relationship between pregnancy and malignancy has not been established. There are different kinds of malignancies occurring during pregnancy. Herein, we report malignant tumors of the jaws in two pregnant patients. Histopathological diagnosis was compatible with chondroblastic variant of osteosarcoma and squamous cell carcinoma, respectively.
The clinical practitioners and dentists must be able to differentiate between the inflammatory and neoplastic conditions, especially during pregnancy to avoid unnecessary treatments which could lead to harmful effects on pregnant woman or her fetus.
Leila Khajavi, Hamid Farhangi, Sara Movahhed, Fatemeh Nejati Salehkhani, Abdolreza Norouzy,
Volume 12, Issue 1 (3-2020)
Abstract
Background: As children have a higher metabolic rate and higher calorie needs for growth, they are more susceptible to nutritional depletion than adults. We aimed to assess the nutritional status of children with cancer who were referred to the outpatient clinic of hematology and oncology clinic at Sheikh Children Hospital, Mashhad, Iran.
Methods: The nutritional status of the children with cancer was assessed by anthropometric indices and nutritional risk screening tool. We used BMI-for-age (BMIFA), height-for-age (HFA) and weight-for-height (WFH) to define malnutrition. The anthropometric indices (BMIFA, HFA, and WFH) were categorized according to z-scores. STRONGkids tool was applied for screening risk of malnutrition.
Results: 61 pediatric patients with cancer were assessed. Of the studied patients, 77% were boys (47 patients) with a mean age of 8.4 years (6 months to18 years). Acute lymphoblastic leukemia (ALL) was the most prevalent cancer (64%). 26.2% of the patients had malnutrition according to BMI for age z-score index (underweight), 24.5% according to weight for height (WFH) index (wasting) and 21.3% according to HFA index (stunting). The STRONGkids classified 34.4% of patients as high risk, and 65.6% as moderate risk of malnutrition. Conclusions: Malnutrition was prevalent among pediatric cancer patients in this study, so appropriate nutritional screening and management should be implemented for improving the nutritional status of children with cancer.
Fariba Binesh, Alireza Jenabzadeh, Mohammad Ali Dideban, Najmeh Beheshti, Fatemeh Khaleghi, Seyed Hossein Shahcheraghi,
Volume 13, Issue 4 (12-2021)
Abstract
Acute lymphoblastic leukemia/lymphomas are tumors made of the precursor B or T cells. Precursor B cell type presents as acute leukemia, and most cases of pediatric leukemia are of this type. Malignancies originated from T cells are less common and are often manifested as lymphoma in adolescents. Terminal deoxynucleotidyl tranferase (TdT) is a DNA polymerase that is present in immature pre-B and pre-T cells. TdT enzyme is a sign of cell immaturity and is used to differentiate the dominant types of lymphoblastic lymphoma from mature lymphoma/leukemia cells. TdT is expressed in 90%–95% of lymphoblastic lymphoma cells. Childhood TdT negative lymphoblastic leukemia/lymphoma is very infrequent and its prognostic significance remains challenging. It is suggested that TdT negative lymphoblastic leukemia/lymphoma shows poor response to chemotherapy and has a more disastrous course. Here, we report a case of TdT negative T-cell lymphoblastic lymphoma in a 10-year-old boy who presented with respiratory distress.
Maryam Panahi, Leyli Mohajerzadeh, Mohsen Rouzrokh, Parastou Molai Tavana, Fatemeh Abdollah Gorji, Javad Ghoroubi, Ahmad Khalegh Nejad Tabari,
Volume 14, Issue 1 (3-2022)
Abstract
Background: Long-term central venous access is used in children for various reasons specially for delivering chemotherapy. Since vessels in children have smaller diameters, they are more prone to injury and complications such as thrombosis. Different methods are used for implantation of port-a-cath in children. We aimed to compare the complications of insertion of central venous access ports between two methods of open and ultrasound (US) guided.
Methods: All children who were referred to pediatric surgery department of a children hospital from April 2018 to March 2020 for implantation of port-a-cath were included. Right jugular vein was the target vein and patients were randomly divided between two methods of insertion of open lateral neck exploration and ultrasound real-time guided percutaneous insertion and the reservoir was fixed in subpectoral fascia pouch. All open cases in which jugular vein was ligated proximally were excluded. Patients were followed up for early and late complications two days and one week later by the surgical team, then monthly by a trained nurse and were referred to the surgeon if any complication or malfunction had occurred for at least 6 months.
Results: We included 76 patients (21 girls and 55 boys) less than 18 years of age: 24 patients with ultrasound guided method (1-13 years, median 3 years) and 52 patients with open exploration method (4 months-17 years, median 6 years). We observed no statistically significant difference between two groups with respect to sex, underlying disease, and complications. Most patients had hematological malignancies including ALL (52.9%), AML (19.1%) and the rest had solid organ malignancies. Early complications were observed in 2 (3.8%) in the open and 1 (4.2%) in the US- guided group (P=1). Late complications were observed in 9 (17.3%) patients in the open group and 1 (4.2%) in the US guided group. Infection was observed in 9.6% and malfunction in 5.8% of the open group leading to earlier removal of the catheter. There was not any complication indicative of infection in the US-guided group.
Conclusion: US-guided method can be suggested for routine use as a safe method of insertion of port venous access in children.
Setare Kheyrandish, Shiva Shadani, Aziz Eghbali, Behzad Poopak, Davood Bashash,
Volume 16, Issue 2 (6-2024)
Abstract
CD4+/CD8+ double-positive (DP) thymocytes are normal cells within the thymus. However, the presence of mature DP T cells is indicative of cancer and abnormality in peripheral blood. Philadelphia+ (Ph+) T-ALL is extremely rare, but it holds significant therapeutic and prognostic implications. The incidence and outcomes of BCR-ABL+ T-ALL remain uncertain, and distinguishing it from T-cell lymphoblastic crises of CML can be challenging. The current document discussed a rare case of CD4+/CD8+ BCR-ABL+ T-ALL in an 11-year-old Iranian male, detailing his medical conditions, laboratory findings, and treatment. The patient presented with enlarged lymph nodes, splenomegaly, anemia, leukocytosis, and severe thrombocytopenia. The blood smear was nearly filled with irregular/convoluted and cleaved nuclear blasts with fine chromatin. The patient received imatinib with induction chemotherapy. After two months, the patient achieved complete remission with undetectable Minimal/Measurable Residual Disease (MRD). By detailing the patient's characteristics and the required tests, the manuscript contributes to a deeper understanding of this complex disease subtype. Furthermore, by examining and comparing the current case with other available cases, the study lays the groundwork for better characterizing the disease and developing more effective therapeutic strategies.
