Iranian Pediatric Hematology and Oncology Society Iranian Journal of Blood and Cancer 2008-4595 12 3 2020 10 1 What We Know of the Prognostic Value of Lymphopenia in SARS-CoV-2 Infection 75 79 EN Atieh Pourbagheri-Sigaroodi Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Davood Bashash Department of Hematology and Blood Banking, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran Meysam Olfatifar Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran Sina Salari Department of Medical Oncology, Hematology and Bone Marrow Transplantation, Taleghani Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran Hassan Abolghasemi Pediatric Congenital Hematologic Disorders Research Center, Mofid Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Background: Although by comparing the number of deaths to the total number of cases one may conclude that most of the infected cases are recovering, taking a look at the increasing statistics of deaths shows that SARS-CoV-2 continues to take its toll. Since lymphocytes are the main immune cells battling with rapidly evolving viruses, it comes as no surprise to assume that a decreased number of these propitious soldiers may contribute to poor prognosis of the wide range of viral infections, including COVID-19.  Methods: To provide a better prospect representing the prognostic value of lymphopenia in COVID-19, we searched the national library of medicine Medline/PubMed and performed a meta-analysis of pertinent literature representing information on the lymphocyte count in COVID-19 patients.  Results: The results of our meta-analysis revealed that the number of lymphocytes retains a specific clinical and biological significance in this infection and lymphopenia is seemingly an important hematological abnormality that contributes to mirror the evolution toward an unfavorable outcome.  Conclusion: The rapidly evolving nature of COVID-19 together with relentless disclosure of novel findings denotes a major limitation to the current study, and further investigations in the field of prognostic biomarkers will definitively pave the way to better manage patients with severe COVID-19. 

Iranian Pediatric Hematology and Oncology Society Iranian Journal of Blood and Cancer 2008-4595 12 3 2020 10 1 Flow Cytometry in Chronic Myelogenous Leukemia Blast Crisis 80 83 EN Vindhyaprabha Hegde Department of Pathology Maulana Azad Medical College New Delhi Sarika Singh Department of Pathology, Maulana Azad Medical College, New Delhi, India Pallavi Sinha Department of Pathology Maulana Azad Medical college New Delhi Lity Dhar Department of Pathology Maulana Azad Medical college New Delhi Sunita Aggarwal Department of General medicine maulana Azad Medical college New delhi Dharam Pal Bhadoria Department of General Medicine Maulana Azad Medical college New Delhi M K Daga Department of General Medicine Maulana azad Medical college New Delhi Background: Chronic myelogenous leukemia (CML) is a myeloproliferative disorder due to BCR-ABL1 translocation. Patients showing transformation into blast crisis (BC) have poorer treatment response and prognosis.  Methods: A retrospective study was conducted in the department of Pathology, Maulana Azad Medical College, New Delhi, India, over a time period of 5 years (2014-2019) to evaluate the immunophenotypic features of the blast population. Twenty-one Cases of CML in BC were subjected for multiparametric flow cytometry. Data of the subjects in CML blast crisis was compiled and analyzed for the immunophenotypic categorization of the blast population.  Results: The mean age of the patients at presentation was 39.84 years. Male to female ratio was 1:1.3. Out of 21 cases, 5 (23.8%) showed blasts of myeloid lineage, 8 (38%) myelomonocytic, 6 (28.5%) B lymphoid and 2 (9.5%) showed mixed lineage blast population.  Conclusion: Blast lineage in blast crisis of CML is heterogeneous and may show antigens of more than one lineage. Hence, it is necessary to evaluate the immunophenotypic nature of the blasts for the best appropriate management of the patients accordingly.

Iranian Pediatric Hematology and Oncology Society Iranian Journal of Blood and Cancer 2008-4595 12 3 2020 10 1 Glutathione Peroxidase as an Oxidative Stress and Insulin Resistance Marker in a group of Egyptian Patients with Normoglycemic Sickle Cell Disease 84 88 EN Doaa M. Abdou Department of Clinical and Chemical Pathology, Kasr Al Ainy, Faculty of Medicine, Cairo University, Cairo, Egypt Mona M. Hamdy Department of Pediatrics Medicine; Kasr Al Ainy, Faculty of Medicine, Cairo University, Cairo, Egypt Neviene Salama Department of Pediatrics Medicine; Kasr Al Ainy, Faculty of Medicine, Cairo University, Cairo, Egypt Elgammal Department of Pediatrics Medicine; Kasr Al Ainy, Faculty of Medicine, Cairo University, Cairo, Egypt Yasmine M. Amrousy Department of Clinical and Chemical Pathology, Faculty of Medicine, Helwan University, Cairo, Egypt Background: Sickle cell disease (SCD) which is characterized by abnormal hemoglobin structure has a carrier rate of 9-20% in Egypt. Reactive oxygen species (ROC) in SCD cause multiple organ injuries, endocrine complications and metabolic alteration such as insulin resistance (IR) in children and young adults. We aimed to determine the presence of IR in normoglycemic SCD patients and also assessing the concentration of glutathione peroxidase (GPX) and its correlation with insulin resistance in patients with SCD. Methods: Sixty patients were enlisted from pediatric hematology outpatient clinic, Cairo university hospital together with 31 age and sex-matched healthy children not suffering SCD or other hematological disorders. Oral glucose tolerance test (OGTT) was checked at the beginning. Serum fasting insulin levels and glutathione peroxidase measurement was done using enzyme-linked immunosorbent assay (ELISA). Beta cell function and insulin resistance was calculated using the “Homeostasis Model of Assessment” according to the following equation (fasting insulin x fasting glucose)/22.5. Calculations are based on mmol/l for glucose and mU/ml for insulin considering values more than 1.4 as insulin resistance (IR) Results: There were no impaired glucose tolerance in both patients and control group. On calculating HOMA-IR, 34 (56.7%) had IR compared to the absence of IR in 26 (43.3%) and all the subjects in the control group (P<0.001). Patients with SCD had lower GPX concentration than the control group with negative correlation with serum insulin and insulin resistance. Conclusion: The correlation between oxidative stress markers represented by GPX and the development of insulin resistance despite normal serum glucose levels. 

Iranian Pediatric Hematology and Oncology Society Iranian Journal of Blood and Cancer 2008-4595 12 3 2020 10 1 Knowledge, Attitude and Practice followed by Indian Blood Donors 89 94 EN C. Vasantha Kalyani College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Kusum K Rohilla College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Bhawna Shokeen College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Diksha Chann College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Divya Katariya College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Divya Kaushal College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Divyanshu Watts College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Esther Chinneikim College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Geetanjali Gola College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Gloria Athary College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Gloria Vungbiakmawi College of Nursing, All India Institute of Medical Sciences, Rishikesh, India Background: The shortage of blood in the blood banks has always been a challenging issue. In India, there are lot are lot of myths, misconception and malpractices regarding blood donation. Therefore, we aimed to identify the knowledge level of laymen about blood donation practices, their attitude and practices followed by Indian donors, so that we can identify these factors to overcome problem of blood shortage in our blood bank in future.  Methods: The study was a cross-sectional descriptive study conducted on 200 healthy persons who were visiting various outpatient departments of All India Institute of Medical Sciences, Rishikesh. The sampling techniques used for the present study was non- probability purposive sampling.  Results: Most donors were men (66%) and aged 18-27 years (48.5%). Only 19% of subjects had adequate level of knowledge regarding blood donation. Only 0.5% agreed with blood donation which showed that people had a negative attitude towards it. Most (83%) had bad practice for blood donation and had not experienced it.  Conclusion: The general public had inadequate knowledge about blood donation. Participants from general population were strongly against blood donation and actually did not donate blood. This gap in knowledge, attitude and practice can be corrected by providing awareness for blood donation in the schools, colleges and mass media. 

Iranian Pediatric Hematology and Oncology Society Iranian Journal of Blood and Cancer 2008-4595 12 3 2020 10 1 In Silico Activity of AS1411 Aptamer Against Nucleolin of Cancer Cells 95 100 EN Zohreh Farahbakhsh NourDanesh Institute of Higher Education, Meymeh, Iran Mohammad Reza Zamani National Institute of Genetic Engineering and Biotechnology (NIGEB), Tehran, Iran Mohammad Rafienia Biosensor Research Center, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Oguz Gulseren Deaprtment of Physics, Bilkent University, Ankara, Mahmoud Mirzaei Biosensor Research Center, School of Advanced Technologies in Medicine, Isfahan University of Medical Sciences, Isfahan, Iran Background: It has been expected that AS1411 aptamer could work against the cancer cells. Although the general information is available, there is still lack of details for the purpose. Therefore, activity of AS1411 aptamer against the nucleolin (NCL) target of cancer cells has been investigated in current work at the molecular scale. In addition, the same features have been also investigated for examining the activity of AT11, one of AS1411 derivatives.  Methods: This work has been done employing in silico Molecular Docking simulations. Ten starting 3D configurations have been considered for each aptamer to be docked against the NCL target. Conformational search processes of ligands against the target indicated that the starting configuration of ligand could play an important role in determining the final complex formation in both of quantitative and qualitative aspects.  Results: A04 and B01 are those starting configurations of AS1411 and AT11 making the strongest complexes with the NCL target among other ligands. The analyses indicated that the complexes of AT11 are slightly stronger than those of AS1411, in which the NCL target structure is more involved in the chelated complexes with the AT11 in comparison with the AS1411.  Conclusion: AS1411 and AT11 are specified for targeting the NCL of cancer cells for the diagnosis and therapeutic purposes. They have reasonable binding affinity and could work as possible inhibitors of NCL.

Iranian Pediatric Hematology and Oncology Society Iranian Journal of Blood and Cancer 2008-4595 12 3 2020 10 1 Carcinosarcoma of the Maxillary Sinus: A Case Report 101 103 EN Sethu Thakachy Subha Department of Surgery/ENT Universiti Putra Malaysia (UPM), Serdang, 43400, Selangor, Malaysia Mohamad Doi Department of ENT, Hospital Serdang , Ministry of Health Malaysia, Serdang, Selangor,43400,Malaysia Nor Yatizah Mohd Yatim Department of Pathology, Hospital Serdang, Ministry of Health Malaysia, Serdang, Selangor, 43400, Malaysia Carcinosarcoma is a highly malignant tumour exhibiting histological components of both carcinomatous and sarcomatoid elements. Carcinosarcoma is extremely rare in the sinonasal cavity. Due to the rarity and clinical diversity, these neoplasms are often misdiagnosed and pose a challenge in their management. Here we report a 44-year-old man with epistaxis and progressive symptoms of nasal obstruction. Nasal endoscopy revealed a polypoid mass in right middle meatus extending into the nasal cavity. Polypectomy through endoscopic sinus surgery was performed. Carcinosarcoma was diagnosed based on histopathology and immunohistochemical studies. The patient underwent total maxillectomy followed by radiotherapy for the residual tumor. Unfortunately, the patient suffered from multiple recurrences during 20 months following primary resection. This report is to emphasize the need for early diagnosis and radical multimodality intervention for this rare malignancy with an ominous prognosis.

Iranian Pediatric Hematology and Oncology Society Iranian Journal of Blood and Cancer 2008-4595 12 3 2020 10 1 Submandibular Hemangioma with Cardiorespiratory Arrest in an Infant 104 107 EN Jose Arriola-Montenegro Sociedad Nacional de Capacitación, Lima - Peru Pedro Guerra Canchari Facultad de Medicina de San Fernando, Universidad Nacional Mayor de San Marcos. Sociedad Científica de San Fernando, Lima - Perú Patricia Cabanillas-Lozada Universidad Nacional de Trujillo, Trujillo - Peru Pamela Contreras-Chavez Advocate Illinois Masonic Medical Center, Illinois – USA Liliana Arriola-Montenegro Universidad Peruana de Ciencias Aplicadas, Lima - Peru Karina Ordaya-Gonzales Policlinico Naval de San Borja, Lima - Peru Marilin Sabogal-Deza Universidad Nacional de Trujillo, Trujillo - Peru Hemangiomas are defined as soft tissue lesions in the maxillofacial or oral region. Hemangiomas of salivary glands constitute 30% of the non-epithelial tumors in major salivary glands.  Benign tumors in salivary glands are located 85% in parotid gland and 13% in submandibular gland. We present a case of submandibular hemangioma in an infant patient that had some complications and a challenging diagnosis. A 3- month-old female patient presented a giant hemangioma located in the submandibular, preauricular and right malar region with purplish color that during hospitalization had a cardiorespiratory arrest as a severe complication of the disease.

Iranian Pediatric Hematology and Oncology Society Iranian Journal of Blood and Cancer 2008-4595 12 3 2020 10 1 C-ANCA Positive Vasculitis in a Case of Amyloidosis 108 109 EN Nasim Valizadeh Department of Internal Medicine, Faculty of Medicine, Tehran Medical Sciences, Islamic Azad University, Amir-Al Momenin Hospital, Tehran, Iran