1 2008-4595 Iranian Pediatric Hematology and Oncology Society 748 Pediatric Hematology & Oncology Complete Content of this Issue and Cover Content 1 6 2017 9 2 0 0 02 07 2017 02 07 2017
722 Adults Hematology & Oncology The Role of Adiponectin in Prostate Cancer: A Narrative Review Sheikhpour Robab b b Hematology and Oncology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 1 6 2017 9 2 31 36 01 05 2017 19 06 2017 Prostate cancer (PCa) is the most common type of cancer among men over 60 years old. The aggressiveness and mortality of PCa can be correlated with obesity. Adipose tissue-derived cytokines such as adiponectin may explain the correlation between PCa and obesity. Since the correlation between adiponectin and aggressive PCa is still not fully evaluated, we aimed to investigate the probable role of adiponectin in PCa. Adiponectin is considered as a link between obesity, insulin resistance and diabetes. On the other hand, adiponectin is a key mediator of systemic insulin sensitivity and glucose homeostasis. Moreover, low level of adiponectin is associated with inflammation and angiogenesis. These processes could promote tumor growth. Special effects of adiponectin are mediated via adenosine monophosphate-activated protein kinase (AMPK). AMPK activation inhibits growth of androgen-independent and androgen-sensitive PCa cell lines. Moreover, c-Jun N-terminal protein kinase (JNK) and Signal transducer and activator of transcription 3 (STAT3) signaling pathway are known as adiponectin’s mediators on the metabolic syndrome and cancer. Furthermore, adiponectin acts as a tumor suppressor gene via inhibition of Epithelial-to-mesenchymal Transition (EMT) of PCa cells, but it is down regulated through hypermethylation of promoter gene in PCa cells. Therefore, according to the results of these studies, decreased concentration of adiponectin was associated with increased risk of PCa. It seems that hypoadiponectinemia may act as a promising biomarker for detection and diagnosis of PCa.  704 Pediatric Hematology & Oncology Brain MRI Findings in Children with Acute Lymphoblastic Leukemia Kamali Karmella c Taghavinasab Reza d Haghpanah Sezaneh e Bordbar Mohammadreza f Kamalipour Parsa g c Assistant professor of Radiology, Radiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran d Resident of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran e Assistant professor of Community Medicine, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran f Associate professor of Pediatric Hematology-Oncology, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran g Medical student, Shiraz University of Medical Sciences, Shiraz, Iran 1 6 2017 9 2 37 43 27 12 2016 13 04 2017 Background: Patients with leukemia are facing more complications in order to achieve longer survival. We aimed to evaluate the frequency of central nervous system abnormalities (CNS) on MRI of children with acute lymphoblastic leukemia (ALL). Methods: Sixty-six children with diagnosis of ALL aged 2-18 years were recruited. Non-contrast sequences of brain MRI in addition to diffusion weighted imaging of brain were obtained with 1.5 T (Siemens medical system) scanners in their maintenance phase of treatment. The age of onset, type of leukemia, protocol of treatment, and elapsed time from diagnosis were recorded. Chi-square test was used to compare the groups and t-test was used to evaluate the effect of not normally distributed variables. Results: 19 (28.8%) had abnormal CNS findings identified on MRI images including: nonspecific white matter high signal intensity in flair images with normal DWI, white matter ischemia proved on DWI, generalized brain atrophy, isolated mild enlargement of lateral ventricle and extracerebral complications including sinus thrombosis and sinusitis. Brain abnormalities were correlated with leukemia type, chemotherapy protocol and radiotherapy (P=0.006, 0.036, and 0.01, respectively).   Conclusion: The wide spectrum of CNS abnormalities that were observed in children with ALL showed correlation with treatment methods and type of leukemia in this study. Combination of radiation therapy and chemotherapy increased CNS complications. Among extracerebral complications, dural sinus thrombosis proved by MRV was seen more frequently in T-cell leukemia patients treated with multiple high doses of the chemotherapy agent “L-asparaginase”. Since some neurological complications of leukemia are treatable, early diagnosis sounds essential. 709 Adults Hematology & Oncology The Difference in Initial Leukocyte Count, Bone Marrow Blast Cell Count and CD 34 Expression in Patients with Acute Myeloid Leukemia with and without NPM1 gene Mutation Notopuro Paulus h Notopuro Harianto i Budiwijono Imam j AdiPireno Purwanto k h Faculty of Medicine Airlangga University i Faculty of Medicine Airlangga University j Faculty of Medicine Diponegoro University k Faculty of Medicine Diponegoro University 1 6 2017 9 2 44 47 08 02 2017 14 05 2017 Background: Mutation in NPM1 gene has been reported to be the most common genetic mutation in de novo acute myeloid leukemia (AML). AML with NPM1 gene mutation usually presents with higher initial leukocyte and blast cell counts and negative CD34 expression. We aimed to investigate the difference of initial leukocyte counts, bone marrow blast cell counts and expression of CD34 among patients with AML with and without NPM1 mutation. Methods: In this study, 25 de novo patients with AML were investigated for NPM1 exon 12 gene mutation using ASO-RT-PCR. Initial leukocyte counts, bone marrow blast cell counts and expression of CD34 on blasts were examined in all patients. Results: 13 of 25 de novo patients with AML (52%) had NPM1 gene mutation. Initial leukocyte counts in AML patients with NPM1 gene mutation was not significantly higher than patients without this mutation (23.400 /µL versus 16.000 /µL, P=0.53). Blast cell counts were not significantly higher in AML patients with NPM1 gene mutation than patients without mutation. (41% versus 19%, P=0,18). Expression of CD34 was not significantly different between AML patients with and without NPM1 gene mutation (P=0.48). Conclusion: There were no difference in initial leukocyte count, blast cell count and CD34 expression among patients with AML with and without NPM1 exon 12 type A gene mutation. 719 Immunology Assessment of Cytotoxicity of Dimethyl Sulfoxide in Human Hematopoietic Tumor Cell Lines Hajighasemi Fatemeh l Tajic Shaghayegh m l Department of Immunology, Faculty of Medicine, Shahed University, Tehran, Iran. m Immunology, Asthma and Allergy Research Institute, Tehran University of Medical 1 6 2017 9 2 48 53 23 04 2017 24 05 2017 Background: Dimethyl Sulfoxide (DMSO) is a solvent most broadly used as a cryopreservative agent. Antitumor effects of DMSO is a recently recognized phenomenon. In this study, cytotoxic effects of DMSO on human monocytes and T leukemic cell lines has been investigated in vitro. Methods: Human leukemic T cells (Molt-4 and Jurkat) and monocytes (U937 and THP1) were cultured in complete RPMI mediums. The cells at different logarithmic growth phases were incubated with different concentrations of DMSO (0.1, 0.2, 0.5, 1, 2 and 5%). Then viability and proliferative response of leukemic cell lines was assessed by trypan blue dye exclusion (TB test) and MTT assays, respectively. Results: DMSO has a cytotoxic effect on the leukemic cells used in this study; dose and time-dependently. This cytotoxicity for all of these leukemic cells was shown at ≥ 2% concentrations of the DMSO after 24, 48 and 72 hours’ incubation time. Moreover, there was not any significant difference between DMSO cytotoxicity in these different leukemic cell lines. Conclusion: All of the used leukemic cells showed sensitivity to DMSO at ≥2% concentrations time dependently. This sensitivity significantly increased with time. DMSO might be a cytotoxic agent for leukemic cells. It might be a useful candidate in design of chemotherapeutic protocols for leukemia as well as other cancers.  721 Pediatric Hematology & Oncology Association between Red Cell Distribution Width and Mortality in Pediatric Patients Admitted to Intensive Care Units Hashemi Seyedeh Masumeh Khanbabaee Ghamartaj Salarian Sara Fariborzi Mohammadreza Kiumarsi Azadeh 1 6 2017 9 2 54 58 26 04 2017 28 05 2017 Background: Red cell distribution width (RDW) is a routine laboratory measure that could be used as a predictor of mortality in critically ill patients. Identification of patients at risk for mortality early in the course of PICU admission is an important step in improving the outcome. We aimed to assess the use of RDW as an early biomarker for outcome in pediatric critical illnesses. Methods: A retrospective study by extracting administrative and laboratory data from patients admitted to PICU of an academic pediatric teaching hospital was accomplished. After exclusion of 64 patients according to our exclusion criteria, 304 pediatric patients with PICU admissions over the 6 months of study period were included in the study.  Results: The mean RDW for all patients was 14.9%±2.5%. PICU mortality was 13.3%. The rate of mortality in the quartile of RDW>15.7% was 20.1%. Elevated RDW was associated with longer duration of PICU admission (P<0.001). Tracheal intubation and ventilator support was needed in 34.2% of the patients. This was also correlated with elevated RDW (P=0.043).  Conclusion: We observed that higher RDW was strongly linked to higher mortality risk in pediatric patients admitted in PICU. Higher RDW was associated with longer duration of PICU admission.  725 Immunology Association between Percentage of TCD4 and TCD8 Lymphocytes with Iron Status in Female Adolescents Rafieemehr Hassan Rafiee Mohammad Mahmoodi Marzieh hamadam medical sciences university hamadam medical sciences university Bushehr University of Medical Sciences 1 6 2017 9 2 59 63 06 05 2017 24 05 2017 Background: Iron deficiency impairs the proliferation and function of T lymphocytes. This study was conducted to assess the relationship between serum iron with percentage of TCD4 and TCD8 lymphocytes in peripheral blood of female high school students in Hamadan.  Methods: In this cross-sectional study, 355 female high school students with an age range of 15-18 years were enrolled from January 2016 to March 2017. After approval by the ethics committee of Hamadan University of Medical Sciences, taking written consent of parents, and completion of a questionnaire involving demographic information, serum iron profile, the percentage of TCD4 and TCD8 cells, and TCD4/TCD8 ratio were measured using standard methods. The results were analyzed by SPSS software, version 13.  Results: The prevalence of iron deficiency anemia was 16.1% in 355 female high school students of Hamadan. There was no correlation between transferrin saturation with percentage of TCD4 lymphocytes and TCD4/TCD8 ratio in the two groups of students with and without iron deficiency (P>0.05). However, a significant correlation was found between Tfs with percentage of TCD8 lymphocytes in the group of patients with iron deficiency anemia (P<0.05). Conclusion: This study indicated an increased percentage of TCD8 lymphocytes with reduced Tfs in patients with iron deficiency anemia. In addition to reduced Tfs, other factors may be associated with the alterations in percentage of TCD4 and TCD8 lymphocytes and TCD4/TCD8 ratio. 712 Adults Hematology & Oncology Multiple Myeloma Presenting as Respiratory Stridor Narayanan Geetha Rajan Varun TR Preethy Soman Lali V Regional Cancer Centre, Trivandrum, India Regional Cancer Centre, Trivandrum, India Regional Cancer Centre, Trivandrum, India Regional Cancer Centre, Trivandrum, India 1 6 2017 9 2 64 66 26 02 2017 07 05 2017 Extramedullary plasmacytoma occurs in 18% of patients with multiple myeloma. Laryngeal involvement in multiple myeloma is rare, and only a few cases have been reported. We present a case of a 44-year-old women with multiple myeloma who presented with stridor due to a mass involving the larynx which was initially proven to be plasmacytoma on biopsy. She had evidence of multiple myeloma of IgA lambda subtype. She was treated with bortezomib containing chemotherapy followed by lenalidomide as maintenance therapy. She attained complete remission and is alive in remission at 3 years of treatment. 745 Adults Hematology & Oncology Rhabdomyosarcoma of the Lower Eye Fornix and Conjunctiva in a Child Alavi Samin 1 6 2017 9 2 67 68 28 06 2017 28 06 2017