Table of contents 2 0 0 2015/03/2 1393/12/11 2015/03/2 1393/12/11 ## ##

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Determining Serum Zinc Level in Children with Cancer before and 3 Months after Chemotherapy in Kerman Province, Iran 2 2 Introduction: Cancer and chemotherapy could decrease serum Zinc level. In this study, serum Zinc level was investigated at the beginning of cancer diagnosis and 3 months after chemotherapy in children with all types of cancer. Method: In this cross sectional study forty-five 1-15 year old children who were newly diagnosed cancer cases (leukemia, lymphoma and solid tumor) were evaluated. Patients with previous chronic disease were excluded from the study. Serum Zinc level was measured before and 3 months after chemotherapy by an atomic absorption spectrophotometer. The relationship between serum Zn level and malnutrition was also evaluated in both steps. Results: The mean serum Zn level was 37.26±45.02 μg/dl at the beginning of cancer diagnosis and 11.96±24.59 μg/ dl 3 months after chemotherapy (p-value=0.002), which showed a significant statistical reduction. There was no significant statistical difference in Zinc level between groups in regard to age, gender, place of resident and type of cancer. Conclusion: This study indicated that Zinc level was lower than normal before chemotherapy and further decrease was seen after chemotherapy in all types of cancer among participating patients. Therefore, it is recommended to add Zinc supplement to chemotherapy protocols especially for malnourished patients. Keywords: Children, cancer, Zinc, chemotherapy, malnutrition. 87 91 2015/03/22015/03/22012/11/24 1391/9/4 2015/03/22015/03/22013/02/11 1391/11/23 Naderi Naderi Farahmandinia Farahmandinia Shahraki Ghadimi Shahraki Ghadimi Doustan Doustan Shahraki Ghadimi Shahraki Ghadimi Madahian Madahian Hayat Bakhsh Abbasi Hayat Bakhsh Abbasi Children, cancer, Zinc, chemotherapy, malnutrition. ## ##

Cluster of Differentiation 45: An Adjunct to Flowcytometric Diagnosis of Leukemias 2 2 Background: This Cross sectional comparative study was performed to compare the mean fluorescence intensity of cluster of differentiation 45 between healthy individuals and patients with acute lymphoblastic leukemia. Patients and methods: Thirty three healthy individuals (mean age 11 years) and 41 patients with B cell acute lymphoblastic leukemia (mean age 7 years) were enrolled in the study in department of Immunology, Armed Forces Institute of Pathology, Rawalpindi, from Jan 2009 to April 2011, after ethics committee approval and obtaining informed consent. For immunophenotyping analysis, blood was stained with monoclonal antibodies using lyse wash procedure. For each subject, panel for staining consisted of cluster of differentiation 3, cluster of differentiation 5, cluster of differentiation 7, cluster of differentiation 10, cluster of differentiation 19, cluster of differentiation 20, , cluster of differentiation 13, cluster of differentiation 34, cluster of differentiation 1314, cluster of differentiation 1333, cluster of differentiation 45, HLA-DR, and intracytoplasmic myeloperoxidase as well as terminal deoxynucleotidyl transferase . Cells were then analyzed on Becton Dickinson FACSCalibur flow cytometer using Cell Quest Pro software. For each subject, mean fluorescence intensity was calculated in software along with geometric mean and standard deviation. Results: Mean of geometric means of cluster of differentiation 45 expression on blasts of patient population was considerably low (145) as compared to lymphocytes of healthy population (764), being statistically significant (p<0.0001). Conclusion: cluster of differentiation 45 is useful in differentiating mature lymphocytes from blasts in ALL cases. Keywords: Flow cytometry, acute lymphoblastic leukemia, cluster of differentiation 45, mean fluorescence intensity. 93 97 2015/03/22015/03/22012/11/242012/10/8 1391/7/17 2015/03/22015/03/22013/02/112013/01/13 1391/10/24 Tipu Tipu Flow cytometry, acute lymphoblastic leukemia, cluster of differentiation 45, mean fluorescence intensity ## ##

Short-term Chelating Efficacy of Deferoxamine in Iron Overloaded Rat Hepatocytes 2 2 Abstract Background: Iron overload is a clinical consequence of repeated blood transfusions and causes significant organ damage, morbidity, and mortality in the absence of proper treatment. The primary targets of Iron chelators used for treating transfusional Iron overload are the prevention of Iron ingress into tissues and its intracellular scavenging. The present study was aimed at elucidating the capacity of clinically important Iron chelator, deferoxamine to gain access to intracellular Iron pools of key Iron accumulating cells (hepatocytes). Material and methods: The study was conducted as an in vivo investigation. Iron-rich chow fed rats and regular chow fed rats were given deferoxamine and hepatic Iron concentration was measured using atomic absorption spectroscopy. Results: In Iron-loaded rats, the results showed that deferoxamine did not alter hepatocyte Iron levels compared with the control group but increased urinary excretion. Conclusion: We conclude that short term deferoxamine treatment is ineffective in Iron removal from rat hepatocytes. Key words: Deferoxamine, Iron overload, hepatocytes. 99 105 2015/03/22015/03/22012/11/242012/10/82012/07/7 1391/4/17 2015/03/22015/03/22013/02/112013/01/132012/10/14 1391/7/23 Somaye Kalanaky Somaye Kalanaky Alireza Farsinejad Alireza Farsinejad Saeede Fakharzade Saeede Fakharzade Mohammad Ali Karbasian Mohammad Ali Karbasian Morteza Keshavarz Morteza Keshavarz Azim Mehrvar Azim Mehrvar Narjes Mehrvar Narjes Mehrvar Maryam Rahbar Maryam Rahbar Mohammad Faranoush Mohammad Faranoush Deferoxamine Iron overload hepatocytes ## ##

How to Care for Implanted Ports 2 2 Implantable ports are used for intravenous infusion therapy and play an important role in management of oncology patients. These ports are best suited for patients requiring long-term therapy (>4 weeks). Implanted ports provide reliable venous access protect peripheral access increase patients’ comfort through reducing repeated and difficult vein punctures allow for safe and comfortable administration of concentrated solutions, vesicants or irritants with minimal risk of extravasations and chemical phlebitis help patients avoid anxiety related to repeated vein puncture and provide a better quality of life. Implanted port systems and their needles are from a variety of types and materials. They are inserted with a surgical technique through an incision into subcutaneous tissue commonly in the upper chest wall. Implanted ports need some care including: flushing, locking, dressing, change of needle and minimizing the risk of contamination by scrubbing the access port with an appropriate antiseptic. The aim of this review is to provide evidence on managing port systems in order to improve practice, boost patient outcomes and reduce complications and health care costs. Keyword: Implanted port, care, chemotherapy. 107 114 2015/03/22015/03/22012/11/242012/10/82012/07/72013/01/12 1391/10/23 2015/03/22015/03/22013/02/112013/01/132012/10/142013/04/16 1392/1/27 Mohammad Kazem Nourbakhsh Mohammad Kazem Nourbakhsh Afsaneh Nekoee Afsaneh Nekoee Shahnaz Nemati Shahnaz Nemati Mahin Gheibizadeh Mahin Gheibizadeh Implanted port care chemotherapy ## ##

Treatment of a Child with Refractory Acute Myeloid Leukemia with Humanized Anti-CD33 Monoclonal Antibody: A Case Report and Review of Drug Development 2 2 Background: The induction chemotherapy regimen for acute myeloid leukemia has evolved as once induction is completed patients progress through the consolidation phase and achieve remission in 76% of cases. For patients with relapsed or refractory disease, alternative chemotherapy agents are available. Monoclonal antibody therapy with biological agents, such as the immunotoxin gemtuzumab ozogamicin has been used to induce remission in relapsed patients. Report of the case: Here, we report the first Iranian child, an 8-year-old boy, with refractory acute myeloid who was treated with gemtuzumab ozogamicin. Unfortunately, remission was not achieved and the patient died of neutropenia and septic shock. Conclusion: Gemtuzumab ozogamicin therapy in our case was not successful in achieving remission. It could be due to longstanding chemotherapy and its detrimental effects on bone marrow of the patient. Further controlled studies are necessary to learn more about efficacy and safety of this new treatment. Keywords: Childhood acute myeloid leukemia, refractory, treatment, gemtuzumab ozogamicin 115 120 2015/03/22015/03/22012/11/242012/10/82012/07/72013/01/122012/10/10 1391/7/19 2015/03/22015/03/22013/02/112013/01/132012/10/142013/04/162013/01/16 1391/10/27 Samin Alavi Samin Alavi Mohammad Taghi Arzanian Mohammad Taghi Arzanian Childhood acute myeloid leukemia refractory treatment gemtuzumab ozogamicin ## ##

Obituary 2 120 120 2015/03/22015/03/22012/11/242012/10/82012/07/72013/01/122012/10/102013/10/6 1392/7/14 2015/03/22015/03/22013/02/112013/01/132012/10/142013/04/162013/01/162015/01/3 1393/10/13 M M ## ##