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Bordbar M, Vahidifar M, Zarshenas MM, Haghpanah S, Zareifar S, Shahriari M, Zekavat OR, Karimi M, Fathpour G, Zargaran A, Shakibazad N. The efficacy of Allium ampeloprasum L. in reducing neutrophil recovery time in childhood cancer with febrile neutropenia: a randomized, double-blind, placebo-controlled trial. Am J Blood Res 2023; 13:143-151. [PMID: 38023416 PMCID: PMC10658031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 09/01/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION Febrile neutropenia is a serious complication of cancer chemotherapy that can result in delays in treatment. This study evaluates the efficacy of A. ampeloprasum L. at neutrophil recovery time in children with chemotherapy-associated febrile neutropenia. METHODS This single-center, parallel-group, double-blind, randomized clinical trial was conducted at an oncology hospital. Patients selected among childhood cancers with febrile neutropenia. Overall, 97 febrile neutropenic children were enrolled. The intervention group (n=49) was given A. ampeloprasum L. in capsules (500 mg twice daily) for seven days plus supportive care. The control group (n=48) was treated similarly with supportive care and placebo capsules. Total white blood cell (WBC) and absolute neutrophil counts (ANC) were checked daily and neutrophil recovery time in both groups was compared. RESULTS Patients in the intervention group experienced shorter neutrophil recovery compared to the control group (4.02 ± 2.32 days vs. 6.38 ± 2.80 days, respectively, P less than 0.001). The intervention group was discharged from the hospital earlier than the control group with a mean of two days, but it did not reach statistical significance (P=0.133). Mean WBC and ANC were not significantly different in the two groups. Herbal medicine was well tolerated, and no adverse effect was reported. CONCLUSIONS A fresh, lyophilized extract from deciduous leaves of A. ampeloprasum L. can effectively shorten the ANC recovery time leading to an earlier release from the hospital. The trial was registered in the Iranian Registry of Clinical Trials with registration No. IRCT2015051615666N2 (http://www.irct.ir/).
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Affiliation(s)
| | - Mehdi Vahidifar
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Shiraz University of Medical SciencesShiraz, Iran
| | | | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical SciencesShiraz, Iran
| | - Soheila Zareifar
- Hematology Research Center, Shiraz University of Medical SciencesShiraz, Iran
| | - Mahdi Shahriari
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Shiraz University of Medical SciencesShiraz, Iran
| | - Omid Reza Zekavat
- Hematology Research Center, Shiraz University of Medical SciencesShiraz, Iran
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical SciencesShiraz, Iran
| | - Gholamreza Fathpour
- Department of Pediatrics, Division of Pediatric Hematology and Oncology, Shiraz University of Medical SciencesShiraz, Iran
| | - Arman Zargaran
- Department of Phytopharmaceuticals (Traditional Pharmacy), School of Pharmacy, Tehran University of Medical SciencesTehran, Iran
| | - Nader Shakibazad
- Hematology Research Center, Shiraz University of Medical SciencesShiraz, Iran
- Department of Pediatric Hematology and Oncology, Bushehr University of Medical SciencesBushehr, Iran
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Rahimi K, Amoozgar H, Zareifar S, Shahriari M, Zekavat OR, Karimi M, Fathpour G, Saleh F, Shakibazad N, Bordbar S, Bordbar M. Cardioprotective effects of deferoxamine in acute and subacute cardiotoxicities of doxorubicin: a randomized clinical trial. Egypt Heart J 2023; 75:21. [PMID: 36961611 PMCID: PMC10039151 DOI: 10.1186/s43044-023-00347-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Accepted: 03/13/2023] [Indexed: 03/25/2023] Open
Abstract
BACKGROUND Cardiotoxicity is a major concern following doxorubicin (DOX) use in the treatment of malignancies. We aimed to investigate whether deferoxamine (DFO) can prevent acute cardiotoxicity in children with cancer who were treated with DOX as part of their chemotherapy. RESULTS Sixty-two newly-diagnosed pediatric cancer patients aged 2-18 years with DOX as part of their treatment regimens were assigned to three groups: group 1 (no intervention, n = 21), group II (Deferoxamine (DFO) 10 times DOX dose, n = 20), and group III (DFO 50 mg/kg, n = 21). Patients in the intervention groups were pretreated with DFO 8-h intravenous infusion in each chemotherapy course during and after completion of DOX infusion. Conventional and tissue Doppler echocardiography, serum concentrations of human brain natriuretic peptide (BNP), and cardiac troponin I (cTnI) were checked after the last course of chemotherapy. Sixty patients were analyzed. The level of cTnI was < 0.01 in all patients. Serum BNP was significantly lower in group 3 compared to control subjects (P = 0.036). No significant differences were observed in the parameters of Doppler echocardiography. Significant lower values of tissue Doppler late diastolic velocity at the lateral annulus of the tricuspid valve were noticed in group 3 in comparison with controls. By using Pearson analysis, tissue Doppler systolic velocity of the septum showed a marginally significant negative correlation with DOX dose (P = 0.05, r = - 0.308). No adverse effect was reported in the intervention groups. CONCLUSIONS High-dose DFO (50 mg/kg) may serve as a promising cardioprotective agent at least at the molecular level in cancer patients treated with DOX. Further multicenter trials with longer follow-ups are needed to investigate its protective role in delayed DOX-induced cardiac damage. Trial registration IRCT, IRCT2016080615666N5. Registered 6 September 2016, http://www.irct.ir/IRCT2016080615666N5 .
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Affiliation(s)
- Kosar Rahimi
- Department of Pediatrics, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Amoozgar
- Department of Pediatrics, and Divisions of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soheila Zareifar
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahdi Shahriari
- Department of Pediatrics, and Divisions of Pediatric Hematology and Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omid Reza Zekavat
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Gholamreza Fathpour
- Department of Pediatrics, and Divisions of Pediatric Hematology and Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fazl Saleh
- Department of Pediatrics, and Divisions of Pediatric Hematology and Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Shakibazad
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Bushehr University of Medical Sciences, Bushehr, Iran
| | - Shayan Bordbar
- Students Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammadreza Bordbar
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Honar N, Nezamabadipour N, Dehghani SM, Haghighat M, Imanieh MH, Ataollahi M, Shakibazad N, Javaherizadeh H. An evaluation of ascitic calprotectin for diagnosis of ascitic fluid infection in children with cirrhosis. BMC Pediatr 2022; 22:382. [PMID: 35773636 PMCID: PMC9245209 DOI: 10.1186/s12887-022-03433-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 06/21/2022] [Indexed: 11/10/2022] Open
Abstract
Background The most common infection in children with the hepatic disease with or without cirrhotic ascites is spontaneous bacterial peritonitis (SBP), which occurs in the absence of an evident intra-abdominal source of infection. The present study aims to assess the value of calprotectin in ascitic fluid in the diagnosis of ascitic fluid infection in children with liver cirrhosis. Materials and methods In this cross-section study, 80 children with underlying liver disease who attended the Hepatology and Emergency Department in Shiraz University Hospitals were studied. All the patients were evaluated by a thorough history, clinical examination, laboratory investigations, diagnostic paracentesis with PMNLs count, and Calprotectin, which was measured in 1 mL ascitic fluid by ELISA. Results Thirty-five patients (43.75%) were diagnosed with ascitic fluid infection. Of these children 6 cases had positive ascitic fluid culture (SBP). Calprotectin was high in AFI patients with a statistically significant difference in AFI patients compared to non-AFI patients. The cut-off levels were 91.55 mg /L and the area under the curve was 0.971. So it can serve as a sensitive and specific diagnostic test for detection of AFI in children with underlying liver disease. Conclusion Elevated ascitic calprotectin levels in cirrhotic patients are a diagnostic and reliable marker for the detection of AFI and are considered a surrogate marker for PMN.
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Affiliation(s)
- Naser Honar
- Neonatal Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Najmeh Nezamabadipour
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Seyed Mohsen Dehghani
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mahmood Haghighat
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Hadi Imanieh
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Maryam Ataollahi
- Gastroenterohepatology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Shakibazad
- Department of Pediatrics, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Hazhir Javaherizadeh
- Alimentary Tract Research Center, Clinical Sciences Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Zekavat O, Bozorgi H, Bordbar M, Shakibazad N, Ebrahimi V. Prognosis and Overall Survival of Thalassemia Patients using Semi-Parametric Mixture Cure-Rate Model: a 30-Year Retrospective Cohort Study. Clin Lab 2022; 68. [DOI: 10.7754/clin.lab.2021.211016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Assadi M, Rekabpour SJ, Jafari E, Divband G, Nikkholgh B, Amini H, Kamali H, Ebrahimi S, Shakibazad N, Jokar N, Nabipour I, Ahmadzadehfar H. Feasibility and Therapeutic Potential of 177Lu-Fibroblast Activation Protein Inhibitor-46 for Patients With Relapsed or Refractory Cancers: A Preliminary Study. Clin Nucl Med 2021; 46:e523-e530. [PMID: 34269729 DOI: 10.1097/rlu.0000000000003810] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Fibroblast activation protein (FAP) is a member of the serine protease family and has a high expression in the stroma of approximately 90% of epithelial malignancies. The present investigation aimed to assess the feasibility, safety, and dosimetry data of 177Lu-FAPI-46 in diverse malignancies. PATIENTS AND METHODS Patients with advanced cancers with nonoperable tumors, or tumors refractory to conventional therapies, were enrolled. Treatment included escalating doses of 177Lu-FAPI-46 (1.85-4.44 GBq) per cycle using a combination of clinical and statistical expertise design, and intervals of 4 to 6 weeks were considered between the cycles. Biodistribution and dosimetry were examined by whole-body scans. We applied the National Cancer Institute Common Terminology Criteria for Adverse Events version 4.03 to measure peptide-targeted radionuclide therapy (PTRT)-associated toxicity. RESULTS A total of 21 patients (11 females and 10 males) with a median age of 50 years (range, 6-79 years) were investigated. Of 21 participants, 18 cases were selected for PTRT. Overall, 36 PTRT cycles were performed. The median number of PTRT cycles and the median injected amount of activity in each cycle were 2 and 3.7 GBq, respectively. The dosimetric analysis revealed median absorbed doses of 0.026, 0.136, 0.886, and 0.02 with ranges of 0.023-0.034, 0.001-0.2, 0.076-1.39, and 0.002-0.2 mGy/MBq for the whole body, liver, kidneys, and spleen, respectively. The therapy was well tolerated in almost all patients. CONCLUSIONS The findings of this preliminary investigation might indicate the potential feasibility and safety of PTRT using 177Lu-FAPI-46 for different aggressive tumors. Moreover, the current study could be beneficial in determining the suitable amount of activity for a phase 2 study.
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Affiliation(s)
- Majid Assadi
- From the The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences
| | | | - Esmail Jafari
- From the The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences
| | | | | | | | | | - Sakineh Ebrahimi
- Division of Oncology, Department of Internal Medicine, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran
| | - Nader Shakibazad
- Division of Hematology/Oncology, Department of Pediatrics, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences
| | - Narges Jokar
- From the The Persian Gulf Nuclear Medicine Research Center, Department of Molecular Imaging and Radionuclide Therapy, Bushehr Medical University Hospital, School of Medicine, Bushehr University of Medical Sciences
| | - Iraj Nabipour
- The Persian Gulf Tropical Medicine Research Center, The Persian Gulf Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
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Zekavat OR, Shakibazad N, Haghpanah S, Dehbozorgian J, Tavoosi H, Yousefi S, Arandi N, Karimi M. Study of the Serum Immunoglobulin and Cell-Mediated Immunity in Patients with Congenital Severe Hemophilia. Clin Lab 2021; 67. [PMID: 34383406 DOI: 10.7754/clin.lab.2021.201229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
BACKGROUND It has been shown that a close relationship exists between the immune system and coagulation cascade. Hemophilia A is an X-linked, recessive bleeding disorder caused by deficiency of functional plasma clotting factor VIII that is classically treated with factor VIII replacement therapy. Despite this, some patients produce inhibitors or antibodies against epitopes of infused factor VIII, indicating the activation of the adaptive immune system. The aim of this study was to evaluate the change in the T cell frequency and serum immunoglobulin level in patients with congenital hemophilia A, especially those who produce inhibitors against factor VIII. METHODS This is a cross-sectional, case-control study on congenital hemophilia A patients with severe factor VIII deficiency. Twenty-eight hemophilia A male patients were randomly selected along with twenty age-matched healthy males, as the control group. Serum immunoglobulin concentration was measured by nephelometry (for IgG, IgA and IgM) and enzyme-linked immunosorbent assay (ELISA) (for IgE) and the frequency of CD4+ and CD8+ T cells were calculated using a flow cytometry method. RESULTS Serum IgG was significantly higher in hemophilic patients compared to controls (14.35 ± 3.60, vs. 12.4 ± 1.72, p = 0.014). Among IgG subtypes, the IgG1 antibody was significantly higher in hemophilia patients than control group (p < 0.001). The frequency of CD4+ as well as CD8+ T cells did not significantly differ between patients and control group (p > 0.05). There was no significant difference between patients with and without inhibitors re-garding serum immunoglobulin level, different IgG subtypes, the frequency of CD4+ and CD8+ T cells as well as CD4/CD8 ratio (p > 0.05). CONCLUSIONS Patients with hemophilia A have high levels of serum immunoglobulin especially IgG1. Therefore, further larger studies along with close observation and evaluation of the presence of serum inhibitor is recommended every 3 months.
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Shahriari M, Shakibazad N, Haghpanah S, Ghasemi K. Extramedullary manifestations in acute lymphoblastic leukemia in children: a systematic review and guideline-based approach of treatment. Am J Blood Res 2020; 10:360-374. [PMID: 33489446 PMCID: PMC7811904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 12/04/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE Acute lymphoblastic leukemia (ALL) may present with signs and symptoms related to extramedullary involvement, therefore, leads to delayed diagnosis of ALL in children. This study aims to consider the extramedullary manifestations of ALL in children and their proper treatment. METHOD The databases were searched for all relevant subjects including "acute lymphoblastic leukemia", "clinical presentation", "unusual presentation", "childhood acute lymphoblastic leukemia", "presenting features of ALL", "extramedullary presentation", and "atypical presentation" from April 1968 to June 2020. The Inclusion criteria for this review study were all cases reported, case series, and studies about extramedullary presentations of ALL in pediatrics. Eighty-seven studies had inclusion criteria. All reported studies were analyzed given their extramedullary presentations, age, sex, treatment option, and prognostic factors. A two-sided P-value less than 0.05 was considered statistically significant. RESULT In this review study, the extramedullary initial signs and symptoms of ALL were related to musculoskeletal system 17 (19.5%) especially bony symptoms and hypercalcemia. The additional extramedullary presentations of ALL in order of frequency include; renal involvement, 17 (19.5%), hepatic symptom 12 (13.8%), orbital presentation 10 (11.5%), neurologic signs 8 (9%), dermatological manifestations 5 (5.8%), oral presentations 5 (5.8%), hypereosinophilia 5 (5.8%), abdominal manifestation 3 (3.5%), pericardial involvement 2 (2.3%), and the other miscellaneous presentations 3 (3.5%). CONCLUSION The clinicians must become familiar with these extramedullary presentations of ALL in pediatrics to avoid the delayed diagnosis of this disease and increase the probable chance of survival by early detection.
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Affiliation(s)
- Mahdi Shahriari
- Hematology Research Center, Shiraz University of Medical SciencesShiraz, Iran
| | - Nader Shakibazad
- Department of Pediatric Hematology and Oncology, Bushehr University of Medical SciencesBushehr, Iran
- Hematology Research Center, Shiraz University of Medical SciencesShiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical SciencesShiraz, Iran
| | - Khadijeh Ghasemi
- Department of Pediatric Nephrology, Bushehr University of Medical SciencesBushehr, Iran
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Shahriari M, Bazrafshan A, Karimi M, Shakibazad N. Case series of bloody sweating; a scary event for families. Acta Haematologica Polonica 2020; 51:258-260. [DOI: 10.2478/ahp-2020-0044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Affiliation(s)
- Mahdi Shahriari
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Asghar Bazrafshan
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Shakibazad
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
- Pediatric Hematology and Oncology, Bushehr University of Medical Sciences, Bushehr, Iran
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Zareifar S, Dastsooz H, Shahriari M, Faghihi MA, Shekarkhar G, Bordbar M, Zekavat OR, Shakibazad N. A novel frame-shift deletion in FANCF gene causing autosomal recessive Fanconi anemia: a case report. BMC Med Genet 2019; 20:122. [PMID: 31288759 PMCID: PMC6617641 DOI: 10.1186/s12881-019-0855-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/22/2018] [Accepted: 06/26/2019] [Indexed: 11/23/2022]
Abstract
Background Fanconi anemia (FA) is a heterogeneous genetic disorder characterized by congenital anomalies, early-onset bone marrow failure, and a high predisposition to cancers. Up to know, different genes involved in the DNA repair pathway, mainly FANCA genes, have been identified to be affected in patients with FA. Case presentation Here, we report clinical, laboratory and genetic findings in a 3.5-year-old Iranian female patient, a product of a consanguineous marriage, who was suspicious of FA, observed with short stature, microcephaly, skin hyperpigmentation, anemia, thrombocytopenia and hypo cellular bone marrow. Therefore, Next Generation Sequencing was performed to identify the genetic cause of the disease in this patient. Results revealed a novel, private, homozygous frameshift mutation in the FANCF gene (NM_022725: c. 534delG, p. G178 fs) which was confirmed by Sanger sequencing in the proband. Conclusion Such studies may help uncover the exact pathomechanisms of this disorder and establish the genotype-phenotype correlations by identification of more mutations in this gene. It is the first report of a mutation in the FANCF gene in Iranian patients with Fanconi anemia. This new mutation correlates with a hematological problem (pancytopenia), short stature, and microcephaly and skin hyperpigmentation. Until now, no evidence of malignancy was detected. Electronic supplementary material The online version of this article (10.1186/s12881-019-0855-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Soheila Zareifar
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hassan Dastsooz
- Italian Institute for Genomic Medicine (IIGM), University of Turin, Turin, Italy
| | - Mahdi Shahriari
- Division of Pediatric Hematology and Oncology, Department of Pediatric, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Ali Faghihi
- Center for Therapeutic Innovation, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, USA
| | - Golsa Shekarkhar
- Molecular Pathology Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Omid Reza Zekavat
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Shakibazad
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. .,Pediatric Hematology and Oncology, Bushehr University of Medical Sciences, Bushehr, Iran.
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Zareifar S, Shakibazad N, Zekavat OR, Bordbar M, Shahriari M. Successful treatment of refractory metastatic neuroblastoma with panobinostat in combination with chemotherapy agents and iodine-131-meta-iodobenzylguanidine therapy. J Oncol Pharm Pract 2019; 26:481-486. [PMID: 31156056 DOI: 10.1177/1078155219852670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Neuroblastoma commonly required multimodal therapy containing surgery, chemotherapy, radiotherapy, and immunotherapy. CASE REPORT In our case, who had refractory metastatic neuroblastoma, we use histone deacetylase inhibitor (panobinostat) in combination with chemotherapy agents and iodine-131-meta-iodobenzylguanidine (MIBG) therapy. MANAGEMENT AND OUTCOME This approach leads to successfully treat the patient. MIBG scan and bone marrow examination after therapy revealed no evidence of tumor. Now, she underwent autologous transplantation six months ago and free of tumor. CONCLUSION Panobinostat can cause apoptosis induction in refractory metastatic neuroblastoma in combination with MIBG therapy and chemotherapy.
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Affiliation(s)
- Soheila Zareifar
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Shakibazad
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.,Pediatric Hematology and Oncology, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Omid Reza Zekavat
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mahdi Shahriari
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Shahriari M, Ghasemi K, Bordbar M, Shakibazad N. Gynecomastia as a late complication of childhood cancer and its treatment that can affect the quality of life of male survivors. Semin Oncol 2019; 46:155-159. [PMID: 31128839 DOI: 10.1053/j.seminoncol.2019.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/07/2019] [Accepted: 04/24/2019] [Indexed: 11/11/2022]
Abstract
Childhood cancer is relatively rare, and nowadays it is curable in more than 80% of children. Childhood cancer therapy is directed not only at improving survival but recently, we also concentrate on reducing late effects. We want children who have a diagnosis of cancer to survive and have an excellent quality of life. Gynecomastia and fertility outcome of the survivors of childhood malignancies should be considered in the follow-up of teen agers and young adults and should be approached in an accurate manner and managed in comprehensive teams.
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Affiliation(s)
- Mahdi Shahriari
- Division of Pediatric Hematology and Oncology, Department of Pediatric, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Khadijeh Ghasemi
- Department of Pediatric Nephrology, Bushehr University of Medical Sciences, Bushehr, Iran
| | | | - Nader Shakibazad
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran; Department of Pediatric Hematology and Oncology, Bushehr University of Medical Sciences, Bushehr, Iran.
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Zekavat OR, Sahraian A, Esmaili S, Haghpanah S, Rabie S, Alipour F, Bahrami R, Shakibazad N. The Relationship of Birth Weight, Feeding and Gestational Age with Serum Copper and Zinc in Premature Neonates. J Clin Diagn Res 2019. [DOI: 10.7860/jcdr/2019/40236.12846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bordbar M, Shakibazad N, Fattahi M, Haghpanah S, Honar N. Effect of ursodeoxycholic acid and vitamin E in the prevention of liver injury from methotrexate in pediatric leukemia. Turk J Gastroenterol 2018; 29:203-209. [PMID: 29749328 DOI: 10.5152/tjg.2018.17521] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND/AIMS Ursodeoxycholic acid (UDCA) and antioxidants such as vitamin E are considered to have a protective role in preventing chemotherapy-induced liver damage. The aim of this study was to assess the efficacy of these agents for hepatoprotection in pediatric patients with B-cell acute lymphoblastic leukemia (ALL), who were treated with methotrexate in their maintenance phase of treatment. MATERIALS AND METHODS Eighty children with B-cell ALL were randomly divided into four groups. Group 1 was administered oral vitamin E (400 mg/day); group 2 was administered oral UDCA (15 mg/kg/day); group 3 was administered a combination of the two drugs; and group 4 served as a control group and was administered no drug except their chemotherapy drugs. Complete blood count, liver function test, liver ultrasonography, and liver fibroscan were requested, and the results were compared. RESULTS Group 1 showed a slight increase in total bilirubin levels compared to baseline levels during the study (P=0.036). Group 2 showed a decline in aspartate aminotransferase and alanine aminotransferase levels during the study and at 6 months after discontinuing the drug; however, these differences were not statistically significant (P=0.051 and 0.083, respectively). None of the patients showed the evidence of significant fibrosis on liver fibroscan. Eight patients showed some evidence of mild-to-moderate fibrosis (F1, F2), but the results were not different between the groups as well as between pre- and post-study periods in each group. CONCLUSION Low-dose methotrexate does not cause significant liver fibrosis in pediatric leukemia. UDCA and vitamin E have minimal roles in hepatoprotection among pediatric patients with ALL.
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Affiliation(s)
| | - Nader Shakibazad
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammadreza Fattahi
- Gastroenterology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Naser Honar
- Department of Gastroenterology, Shiraz University of Medical Sciences, Shiraz, Iran
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14
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Ajami G, Alvasabi F, Edraki MR, Amoozgar H, Amirghofran AA, Parnian Rad A, Shakibazad N, Bordbar M. Generalized lymphatic anomaly presenting as rhinorrhea and chylous pericardial effusion. Pediatr Blood Cancer 2018; 65:e27021. [PMID: 29469185 DOI: 10.1002/pbc.27021] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2017] [Revised: 01/26/2018] [Accepted: 01/29/2018] [Indexed: 12/24/2022]
Affiliation(s)
- Gholamhossein Ajami
- Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fathi Alvasabi
- Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohammad Reza Edraki
- Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hamid Amoozgar
- Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ahmad Ali Amirghofran
- Department of Cardiovascular Surgery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ayeh Parnian Rad
- Department of Pediatrics, Division of Pediatric Cardiology, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Nader Shakibazad
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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15
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Zekavat OR, Fathpour G, Bordbar M, Haghpanah S, Shakibazad N. Buparvaquone Intoxication: Report of a Life-Threatening Thrombocytopenia in a Child and Review of Literature. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/31088.11192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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16
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Zekavat OR, Abdolkarimi B, Pouladfar G, Fathpour G, Mokhtari M, Shakibazad N. Colonic basidiobolomycosis with liver involvement masquerading as gastrointestinal lymphoma: a case report and literature review. Rev Soc Bras Med Trop 2017; 50:712-714. [DOI: 10.1590/0037-8682-0057-2017] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Accepted: 06/20/2017] [Indexed: 11/21/2022] Open
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17
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Shakibazad N, Kamali K, Honar N, Bordbar M, Mohazabieh E. Rigler Sign in a Child With Posttransplant Lymphoproliferative Disease: A Sign That Should Not Be Missed. EXP CLIN TRANSPLANT 2016; 16:352-354. [PMID: 27765006 DOI: 10.6002/ect.2016.0006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Rigler sign is a double wall sign suggesting pneumoperitoneum and intestinal perforation, and it needs emergency surgical treatment. Early diagnosis of intestinal perforation by clinical symptoms, presence of Rigler sign in abdominal radiography, and then early surgical treatment can reduce mortality. Here, we report a patient with Crigler-Najjar syndrome who underwent liver transplant and then developed posttransplant lymphoproliferative disease and received chemotherapy with cyclophosphamide, doxorubicin, vincristine, and prednisone plus rituximab. She was referred to the emergency department due to abdominal distension with positive Rigler sign in abdominal radiography; intraoperative findings revealed intestinal perforation. Pediatricians and surgeons should be aware of Rigler sign so that it is diagnosed early and emergency surgical treatment can be performed.
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Affiliation(s)
- Nader Shakibazad
- >From the Department of Pediatric Hematology and Oncology, Shiraz University of Medical Sciences, Shiraz, Iran
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18
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Karamifar H, Shakibazad N, Saki F, Saki N, Kardeh S. Skin manifestation of methylmalonic acidemia: case report and review of the literature. GIORN ITAL DERMAT V 2015; 150:741-744. [PMID: 25058035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Skin manifestations, including scalded skin, desquamation, and chronic periorificial dermatitis, are rare clinical signs in patients with methylmalonic acidemia. This condition may be due to enzyme deficiency or multi-nutrient deficiency because of nutritional restriction. Bullous skin lesion is very rare in these patients and consequently, this type of skin lesion can be the presenting sign of methylmalonic acidemia.
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Affiliation(s)
- H Karamifar
- Pediatric Department, Shiraz University of Medical Sciences, Shiraz, Iran -
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19
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Shakibazad N, Honar N, Dehghani SM, Alborzi A. Epstein-Barr viral load before a liver transplant in children with chronic liver disease. Exp Clin Transplant 2014. [PMID: 25489804 DOI: 10.6002/ect.2013.0100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVES Many children with chronic liver disease require a liver transplant. These patients are prone to various infections, including Epstein-Barr virus infection. This study sought to measure the Epstein-Barr viral load by polymerase chain reaction before a liver transplant. MATERIALS AND METHODS This cross-sectional study was done at the Shiraz University of Medical Sciences, Shiraz, Iran, in 2011. All patients were aged younger than 18 years with chronic liver disease and were candidates for a liver transplant at the Shiraz Nemazee Hospital Organ Transplant Center. They had been investigated regarding their demographic characteristics, underlying disease, laboratory findings, and Epstein-Barr viral load by real-time TaqMan polymerase chain reaction. RESULTS Ninety-eight patients were studied and the mean age was 6.5 ± 5.9 years. Cryptogenic cirrhosis was the most-prevalent reason for liver transplant, and the death rate before a transplant was 15%. Among the study subjects, 6 had measurable Epstein-Barr viral load by polymerase chain reaction before the transplant, and 4 of them had considerably higher Epstein-Barr viral loads (more than 1000 copies/mL). CONCLUSIONS With respect to the close prevalence of posttransplant lymphoproliferative disease (6%) and the high Epstein-Barr viral load in the patients before a transplant (4%), high pretransplant Epstein-Barr viral load can be considered a risk factor for posttransplant lymphoproliferative disorder.
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Affiliation(s)
- Nader Shakibazad
- From the Department of Pediatrics, Shiraz University of Medical Sciences, School of Medicine, Nemazee Teaching Hospital, Shiraz, Iran
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20
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Firuzi O, Shakibazad N, Amoozgar H, Borzoee M, Abtahi S, Ajami G, Ardi P, Miri R. Effects of omega-3 polyunsaturated Fatty acids on heart function and oxidative stress biomarkers in pediatric patients with dilated cardiomyopathy. Int Cardiovasc Res J 2013; 7:8-14. [PMID: 24757612 PMCID: PMC3987424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Revised: 01/05/2013] [Accepted: 02/13/2013] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Dilated cardiomyopathy is the most prevalent type of cardiomyopathy in children, which results in congestive heart failure and causes significant morbidity and mortality. This study, aims to investigate the effect of supplementation with omega-3 polyunsaturated fatty acids (n-3 PUFA) on heart function and oxidative stress biomarkers in these patients. METHODS The present research was a case-control study on pediatric patients with dilated cardiomyopathy, who received n-3 PUFA and anti-failure therapy for 6 months (group 1, n = 6), or anti-failure therapy alone for 6 months (group 2, n = 6), as well as age matched normal individuals (group 3, n = 6), and evaluated the cardiac function and biomarkers of oxidative stress. RESULTS Echocardiographic parameters, such as left ventricular ejection fraction, shortening fraction, tissue Doppler Ea and Aa waves of lateral annulus of tricuspid valve, and Ea and S wave of septum, were significantly improved in group 1 after n-3 PUFA compared to pre- treatment status, while they were not changed after treatment in group 2. Antioxidant enzymes, including catalase and glutathione peroxidase activities in erythrocytes were slightly decreased, while plasma 8-iso-prostaglandin F2α concentrations were somewhat increased in group 1 compared to groups 2 and 3, however these changes were not statistically significant. Total antioxidant capacity of plasma was similar in all 3 groups. CONCLUSIONS The results indicate that some echocardiographic parameters were significantly improved in patients receiving omega-3 fish oil. However, omega-3 had no significant effect on oxidative stress biomarkers.
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Affiliation(s)
- Omidreza Firuzi
- Medicinal and Natural Products Chemistry Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Nader Shakibazad
- Division of Pediatric Cardiology, Department of pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Hamid Amoozgar
- Division of Pediatric Cardiology, Department of pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran,Cardiovascular Research Center, Shiraz University of Medical Science, Shiraz, IR Iran,Corresponding author: Hamid Amoozgar, Cardiovascular Research Center, Shahid Faghihi Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran, 71937-11351, Tel/Fax: +98-7116474298, E-mail:
| | - Mohammad Borzoee
- Division of Pediatric Cardiology, Department of pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Saeed Abtahi
- Division of Pediatric Cardiology, Department of pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Gholamhossein Ajami
- Division of Pediatric Cardiology, Department of pediatrics, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Pegah Ardi
- Medicinal and Natural Products Chemistry Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
| | - Ramin Miri
- Medicinal and Natural Products Chemistry Research Center, Shiraz University of Medical Sciences, Shiraz, IR Iran
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