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Shahsavani A, Haghpanah S, Zarei T, Bazrafshan A, Karimi M. Safety of Sinopharm vaccine in patients with congenital bleeding disorders under on-demand therapy: a preliminary report. Blood Coagul Fibrinolysis 2023; 34:423-424. [PMID: 37590169 DOI: 10.1097/mbc.0000000000001227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Affiliation(s)
- Amin Shahsavani
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Hosseini S, Sadeghi M, Zarei T. A combined density gradient theory with equation of state model for the study of surface tension of refrigerant fluids. J Mol Liq 2022. [DOI: 10.1016/j.molliq.2022.118629] [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: 10/19/2022]
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de Sanctis V, Soliman A, Tzoulis P, Daar S, Kattamis A, Delaporta P, Karimi M, Yassin MA, Zarei T, Saki F, Sapunarova K, Banchev A, Galati MC, Raiola G, Messina G, Campisi S, Kattamis C. The The use of oral glucose-lowering agents (GLAs) in β-thalassemia patients with diabetes: Preliminary data from a retrospective study of ICET-A Network. Acta Biomed 2022; 93:e2022162. [PMID: 35546014 PMCID: PMC9171892 DOI: 10.23750/abm.v93i2.12056] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/24/2021] [Accepted: 07/27/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The management of prediabetes and hyperglycemia is an increasingly important aspect of care in patients with thalassemia. In light of the limited evidence about the management of GD (glucose dysregulation) with glucose-lowering agents (GLAs), we have conducted a retrospective survey in TDT and NTDT patients with diabetes mellitus to collect more detailed information on GLA use in order to make preliminary recommendations. STUDY DESIGN AND METHOD A questionnaire was prepared and distributed to the tertiary thalassemia care Centers of ICET-A Network. RESULTS Eight thalassemia care Centers [Bulgaria, Greece, Iran, Italy (4 Centers) and Qatar], following 1.554 with transfusion-dependent thalassemia (TDT), 132 (8.4%) with diabetes and 687 with non-transfusion-dependent thalassemia (NTDT), 27 (3.9%) with diabetes, participated in the retrospective survey. The records of 117 TDT patients and 9 NTDT patients with diabetes treated with GLAs were analyzed. Metformin, a biguanide, was the most frequently used drug (47.6 %), followed by alpha-glucosidase inhibitors (5.5 %), incretins (4.7%) and insulin secretagogues (3.1%). In 68 (61.2) patients GLAs was prescribed as monotherapy, while the remaining 49 (38.8%), who had inadequate glucose control with metformin, were treated with combination treatment. Fifty-one patients of 126 (40.4%) initially treated with oral GLA, for a mean duration of 61.0 ± 35.6 months (range: 12- 120 months), required insulin therapy for better metabolic control. CONCLUSION This retrospective study covers an unexplored area of research in patients with thalassemia and GD. Oral GLAs appear to be safe and effective for the treatment of diabetes mellitus in patients with thalassemia, and can achieve adequate glycemic control for a substantial period of time.
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Affiliation(s)
- Vincenzo de Sanctis
- Coordinator of ICET-A Network (International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescence Medicine) and Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy
| | - Ashraf Soliman
- Department of Pediatrics, Division of Endocrinology, Hamad General Hospital, Doha, Qatar and Department of Pediatrics, Division of Endocrinology, Alexandria University Children’s Hospital, Alexandria, Egypt
| | - Ploutarchos Tzoulis
- Department of Diabetes and Endocrinology, Whittington Hospital, University College London, London, UK
| | - Shahina Daar
- Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman
| | - Antonis Kattamis
- Thalassemia Unit, Division of Pediatric Hematology-Oncology, First Department of Pediatrics, University of Athens, “Agia Sofia” Children’s Hospital, Athens, Greece
| | - Polyxeni Delaporta
- Thalassemia Unit, Division of Pediatric Hematology-Oncology, First Department of Pediatrics, University of Athens, “Agia Sofia” Children’s Hospital, Athens, Greece
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Mohamed A. Yassin
- National Center for Cancer Care and Research, Medical Oncology Hematology Section HMC, Doha, Qatar
| | - Tahereh Zarei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Forough Saki
- Shiraz Endocrinology and Metabolism Research Center, Shiraz, Iran
| | - Katia Sapunarova
- Department of Hematology, University Hospital “Sv Georgi”, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Atanas Banchev
- Pediatric Hematology-Oncology, University Hospital “Tzaritza Giovanna - ISUL”, Sofia, Bulgaria
| | - Maria Concetta Galati
- Department of Pediatric Haematoncology, Thalassaemia and Prenatal Diagnosis Regional Center, Pugliese-Ciaccio Hospital, Catanzaro, Italy
| | - Giuseppe Raiola
- Department of Paediatrics, Pugliese-Ciaccio Hospital,Catanzaro, Italy
| | - Giuseppe Messina
- UOSD Microcitemie, Grande Ospedale Metropolitano “Bianchi- Melacrino- Morelli”, Reggio Calabria, Italy
| | | | - Christos Kattamis
- First Department of Pediatrics, National Kapodistrian University of Athens, Greece
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Bordbar M, Sarfaraz A, Haghpanah S, Zekavat O, Zareifar S, Zarei T. The Outcome of Children With Malignant Bone Tumors: A Single-Center Experience. Glob Pediatr Health 2021; 8:2333794X211042238. [PMID: 34471652 PMCID: PMC8404661 DOI: 10.1177/2333794x211042238] [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] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 08/07/2021] [Indexed: 11/24/2022] Open
Abstract
Malignant bone tumors (MBT) account for 3% to 5% of cancers in children younger than 15 years. We aimed to report the outcome of children with MBT in 10 years in Southern Iran. During the study period, 100 patients (57 Osteosarcoma, 43 Ewing sarcoma) with an M/F ratio of 1.56 and a median age of 13.8 years (3.8-17.9) were diagnosed. Metastasis occurred in 27% of patients, mostly in the first 3 months of diagnosis. The mean survival time of MBT altogether was 94.1 months (95% CI: 86.5-101.7). The 5-year overall survival and event-free survivals were 85.2% (95% CI: 74%-91.8%) and 69.2% (95% CI: 56%-79%), respectively. Metastasis was the only independent risk factor of death in our study cohort (Hazard ratio 36.7, 95% CI: 4.8-282.6, P = .001) MBT in children mostly occur in adolescent boys. About one-third of them become metastatic, which is significantly associated with poor outcomes.
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Affiliation(s)
| | - Ali Sarfaraz
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Omidreza Zekavat
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Soheila Zareifar
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Zarei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
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Ramzi M, Iravani Saadi M, Zarei T, Yaghobi R, Arandi N. Association Between Cytotoxic T-Lymphocyte Antigen 4 Gene Polymorphisms and Torque Teno Virus Infection After Hematopoietic Stem Cell Transplantation. EXP CLIN TRANSPLANT 2021; 19:259-263. [DOI: 10.6002/ect.2017.0105] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Karimi M, Bozorgi H, Zarei T, Bordbar M, Amanati A, Safaei A, De Sanctis V. Antithrombotic prophylaxis in children and adolescents' patients with SARS-CoV-2 (COVID-19) infection: A practical guidance for clinicians. Acta Biomed 2020; 91:e2020170. [PMID: 33525215 PMCID: PMC7927562 DOI: 10.23750/abm.v91i4.10720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 10/01/2020] [Indexed: 01/10/2023]
Abstract
Severe coronavirus disease 2019 (COVID-19) is often associated with features of the hypercoagulable state which can manifest as venous thromboembolism (VTE) and/or microthrombosis. Given the high risk of VTE in critically ill COVID-19 patients, appropriate VTE prophylaxis seems to be an important part of managing these patients. Although many protocols regarding venous thromboembolism (VTE) prophylaxis or therapeutic (full-dose) anticoagulation have been conducted worldwide, primarily in hospitalised adult patients, details on paediatric patients, if included, are limited or incomplete. The current evidence suggests that anticoagulation therapy with low molecular weight heparins (LMWH) appears to be associated with better prognosis in patients with moderate to severe COVID-19 induced coagulopathies or elevated D-dimer levels. Our recommendations are intended to offer guidance for anticoagulation prophylaxis and treatment in COVID-19 children and adolescent patients and not intend to supersede the clinician’s judgment. We are also conscious that several clinical questions deserve further studies and clarifications because this area is rapidly evolving. (www.actabiomedica.it)
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Affiliation(s)
- Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz .
| | - Haleh Bozorgi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz .
| | - Tahereh Zarei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz .
| | | | - Ali Amanati
- Professor Alborzi Clinical Microbiology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Arash Safaei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz .
| | - Vincenzo De Sanctis
- Coordinator of the International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescence Medicine (ICET-A), Ferrara, Italy.
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Karimi M, Haghpanah S, Zarei T, Azarkeivan A, Shirkavand A, Matin S, Tavakoli MA, Zahedi Z, De Sanctis V. Prevalence and severity of Coronavirus disease 2019 (COVID-19) in Transfusion Dependent and Non-Transfusion Dependent β-thalassemia patients and effects of associated comorbidities: an Iranian nationwide study. Acta Biomed 2020; 91:e2020007. [PMID: 32921705 PMCID: PMC7716961 DOI: 10.23750/abm.v91i3.10155] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Coronavirus disease 2019 (COVID-19) outbreak is a global and challenging disease that is accompany with mortality and morbidity. AIM OF STUDY We evaluated the prevalence and the impact of comorbidities in thalassemia Iranian patients affected by COVID-19. Methods: A multicenter, retrospective, cross-sectional study was conducted across all comprehensive thalassemia centers in Iran, from January to June 15th, 2020. RESULTS Forty-three confirmed COVID-19 thalassemia patients (32 TDT, and 11 NTDT) were detected. The mean age of patients was 35.3 ± 11.5 years (range 9 - 67); 21 females and 22 males. Overall, 78.1% of TDT and 90.9% of NTDT patients were complicated with at least one comorbidity (P: 0.656). The overall mortality rate of thalassemia patients with COVID-19 was 18.6% while 27.3% was in NTDT patients compared to 15.6% in TDT patients (P:0.401). The dead group had a non-significant higher frequency of endocrinopathies compared to the recovered group (62.5% versus 45.7% P:0.457). Ten female thalassemia patients with positive COVID-19 had hypogonadism, six patients were receiving hormone replacement therapy and all of them recovered (zero death) compared to two deaths from 4 patients who were not receiving hormone replacement therapy (P:0.133). Furthermore, the prevalence of COVID-19 in NTDT patients was significantly higher than the general population (45 per 10,000 versus 22.29 per 10,000 respectively, P:0.018) while the prevalence of TDT was almost similar to the normal population (P:0.539). The mortality rate of COVID-19 was 4.71% in the normal Iranian population compared to 18.6% in β-thalassemias (P: <0.001) at the same date. CONCLUSIONS It is important to acknowledge that β-thalassemia patients, especially young adults/adults, have a chronic condition which may contribute to increase susceptibility to SARS-CoV-2 infection. A higher susceptibility to the infection was observed in patients with NTDT and in untreated hypogonadal female thalassemic patients. However, to confirm these data, more accurate designed studies are needed.
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Affiliation(s)
- Mehran Karimi
- Hematology research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Sezaneh Haghpanah
- Hematology research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Tahereh Zarei
- Hematology research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Azita Azarkeivan
- Zafar Adult Thalassemia Clinic, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran.
| | - Afshan Shirkavand
- Medical Physicist, Pardis Noor Medical Imaging Center, Tehran, Iran.
| | - Sara Matin
- Pediatric Department, Jahrom University of Medical Sciences, Jahrom, Iran.
| | | | - Zohre Zahedi
- Hematology research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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De Sanctis V, Canatan D, Corrons JLV, Karimi M, Daar S, Kattamis C, Soliman AT, Wali Y, Alkindi S, Huseynov V, Nasibova A, Tiryaki TO, Sezgin Evim M, Gunes AM, Karakas Z, Christou S, Yassin MA, Galati MC, Campisi S, Zarei T, Khater D, Oymak Y, Kaleva V, Stoyanova D, Banchev A, Skafida M, Kilinc Y. A comprehensive update of ICET-A Network on COVID-19 in thalassemias: what we know and where we stand. Acta Biomed 2020; 91:e2020026. [PMID: 32921722 PMCID: PMC7716954 DOI: 10.23750/abm.v91i3.10063] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 06/18/2020] [Indexed: 01/10/2023]
Abstract
A review of the literature on COVID-19 pandemic in patients with thalassemias is presented. Globally, the prevalence of COVID-19 among β-thalassemia patients seems to be lower than in general population; associated co-morbidities aggravated the severity of COVID- 19, leading to a poorer prognosis, irrespective of age. A multicenter registry will enhance the understanding of COVID-19 in these patients and will lead to more evidence-based management recommendations.
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Affiliation(s)
| | - Duran Canatan
- Antalya Genetic Diseases Diagnostic Center, Antalya,Turkey.
| | - Joan Lluis Vives Corrons
- Red Blood Cell and Haematopoietic Disorders Unit, Institute for Leukaemia Research Josep Carreras (IJC) and University of Barcelona, Catalonia, Spain. ENERCA Coordinator.
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Shahina Daar
- Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman.
| | - Christos Kattamis
- First Department of Paediatrics, National Kapodistrian University of Athens, Athens, Greece.
| | - Ashraf T Soliman
- Pediatrics and Endocrinology Department of Pediatrics, Hamad Medical Center, Doha, Qatar and Department of Pediatrics, University of Alexandria, Alexandria, Egypt.
| | - Yasser Wali
- Paediatric Hematology Unit, Child Health Department, College of Medicine, Sultan Qaboos University Oman and Department of Paediatrics, Faculty of Medicine, Alexandria University, Egypt.
| | - Salam Alkindi
- Department of Haematology, College of Medicine and Health Sciences, Sultan Qaboos University, Sultanate of Oman.
| | | | | | - Tarık Onur Tiryaki
- 10 İstanbul University, Faculty of Medicine, Department of Hematology, İstanbul,Turkey.
| | - Melike Sezgin Evim
- Uludag University, Medical Faculty, Dept. of Pediatric Hematology, Bursa, Turkey.
| | - Adalet Meral Gunes
- Uludag University, Medical Faculty, Dept. of Pediatric Hematology, Bursa, Turkey.
| | - Zeynep Karakas
- Istanbul University, Istanbul Faculty of Medicine, Pediatric Hematology / Oncology, Istanbul, Turkey.
| | - Soteroula Christou
- Archibishop Makarios III Hospital, Thalassaemia Clinic, Nicosia, Cyprus.
| | - Mohamed A Yassin
- Hematology Section, National Center for Cancer Care and Research, Hamad Medical Corporation, (HMC), Doha, Qatar.
| | | | | | - Tahereh Zarei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
| | - Doaa Khater
- Department of Pediatric Endocrinology Alexandria University, Egypt and Department of Pediatrics, Sultan Qaboos University, Oman, Qatar.
| | - Yesim Oymak
- Dr. Behcet Uz Children's Hospital, Izmir, Turkey.
| | - Valeriya Kaleva
- Expert Center for Coagulopathies and Rare Anemias, Varna, Bulgaria.
| | - Denka Stoyanova
- Pediatric Hematoncology, University Hospital "Tzaritza Giovanna - ISUL", Sofia, Bulgaria.
| | - Atanas Banchev
- Pediatric Hematoncology, University Hospital "Tzaritza Giovanna - ISUL", Sofia, Bulgaria.
| | - Myrto Skafida
- First Department of Paediatrics, National Kapodistrian University of Athens, Athens, Greece.
| | - Yurdanur Kilinc
- Pediatric Hematology Department, Çukurova University, Adana, Turkey.
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Haghpanah S, Pishdad P, Zarei T, Shahsavani A, Amirmoezi F, Ilkhanipoor H, Ilkhanipoor H, Safaei S, Setoodegan F, De Sanctis V, Karimi M. Frequency of thyroid nodules in patients with β-thalassemias in Southern Iran. Acta Endocrinol (Buchar) 2020; 16:68-73. [PMID: 32685041 DOI: 10.4183/aeb.2020.68] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Background Although thyroid nodules are a common finding in the general population, determining the clinically important nodules is essential. We investigated thyroid nodules or cysts by thyroid ultrasonography (US) in patients with β-thalassemia major (β-TM) and intermedia (β-TI). We also report a β-TI patient who was diagnosed with thyroid cancer six months before our screening. Methods In this cross-sectional study, 178 patients with β-thalassemias referred to the Thalassemia Clinic in a tertiary hospital affiliated to Shiraz University of Medical Sciences were investigated, from January to June 2016, by US. Results Thyroid nodules or cysts were detected in 11 patients [total: 6.17 %; 8 patients with β-TM (8.2%) and 3 patients with β-TI (3.7%)]. All nodules were < 1 cm in diameter and were not suspicious of malignancy. All patients, after 1 year of thyroid US follow-up, did not show any significant change in favor of malignancy. Conclusion Based on our results, the frequency of thyroid nodules was similar to what was reported in the general population. However, a long-term follow-up of these patients is recommended because of the potential carcinogenic effects of iron and hepatitis C infection (HCV). To achieve more precise information, collaborative multicenter studies should be considered.
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Affiliation(s)
- S Haghpanah
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - P Pishdad
- Shiraz University of Medical Sciences, Medical Imaging Research Center - Shiraz, Iran
| | - T Zarei
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - A Shahsavani
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - F Amirmoezi
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - H Ilkhanipoor
- Shiraz University of Medical Sciences, Pediatric Endocrinologist, Shiraz, Iran
| | - H Ilkhanipoor
- Shiraz University of Medical Sciences, Medical Imaging Research Center - Shiraz, Iran
| | - S Safaei
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - F Setoodegan
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
| | - V De Sanctis
- Quisisana Hospital, Pediatric and Adolescent Outpatient Clinics, Ferrara, Italy
| | - M Karimi
- Shiraz University of Medical Sciences, Hematology Research Center - Shiraz, Iran
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Karimi M, Zarei T, Haghpanah S, Azarkeivan A, Kattamis C, Ladis V, Kattamis A, Kilinc Y, Daar S, Alyaarubi S, Khater D, Wali Y, Elshinawy M, Almadhani A, Yassin M, Soliman AT, Canatan D, Obiedat M, Al-Rimawi H, Mariannis D, Christodoulides C, Christou S, Tzoulis P, Campisi S, Di Maio S, De Sanctis V. Evaluation of endocrine complications in beta-thalassemia intermedia (β-TI): a cross-sectional multicenter study. Endocrine 2020; 69:220-227. [PMID: 31853840 DOI: 10.1007/s12020-019-02159-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2019] [Accepted: 12/09/2019] [Indexed: 11/26/2022]
Abstract
BACKGROUND Data on the prevalence and type of endocrine disorders in β-thalassemia intermedia (β-TI) patients are scarce. This multicenter study was designed to determine the prevalence of endocrine complications and the associated risk factors in a large group of β-TI patients. METHODS In this cross-sectional multicenter study, 726 β-TI patients, aged 2.5-80 years, registered at 12 thalassemic centers, from nine countries, were enrolled during 2017. In a subgroup of 522 patients (mean age 30.8 ± 12.1; range: 2.5-80 years) from Qatar, Iran, Oman, Cyprus, and Jordan detailed data were available. RESULTS Overall, the most prevalent complications were osteopenia/osteoporosis (22.3%), hypogonadism (10.1%), and primary hypothyroidism (5.3%). In the subgroup multivariate analysis, older age was a risk factor for osteoporosis (Odds ratio: 7.870, 95% CI: 4.729-13.099, P < 0.001), hypogonadism (Odds ratio: 6.310, 95% CI: 2.944-13.521, P < 0.001), and non-insulin-dependent diabetes mellitus (NIDDM; Odds ratio: 17.67, 95% CI: 2.217-140.968, P = 0.007). Splenectomy was a risk factor for osteoporosis (Odds ratio: 1.736, 95% CI: 1.012-2.977, P = 0.045). Hydroxyurea was identified as a "protective factor" for NIDDM (Odds ratio: 0.259, 95% CI: 0.074-0.902, P = 0.034). CONCLUSIONS To the best of our knowledge, this is the largest cohort of β-TI patients with endocrine disorders evaluated in extremely heterogenic thalassemic populations for age, clinical, hematological, and molecular composition. The study demonstrates that endocrine complications are less common in patients with β-TI compared with β-TM patients. However, regular monitoring with timely diagnosis and proper management is crucial to prevent endocrine complications in β-TI patients.
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Affiliation(s)
- Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Zarei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Azarkeivan
- Pediatric Hematology-Oncology, Adult Thalassemia Clinic, Tehran, Iran
| | - Christos Kattamis
- Thalassemia Unit, Division of Pediatric Hematology-Oncology, First Department of Pediatrics, University of Athens "Agia Sofia" Children's Hospital, Athens, Greece
| | - Vassilis Ladis
- Thalassemia Unit, Division of Pediatric Hematology-Oncology, First Department of Pediatrics, University of Athens "Agia Sofia" Children's Hospital, Athens, Greece
| | - Antonios Kattamis
- Thalassemia Unit, Division of Pediatric Hematology-Oncology, First Department of Pediatrics, University of Athens "Agia Sofia" Children's Hospital, Athens, Greece
| | - Yurdanur Kilinc
- Department of Pediatric Hematology, Medical Faculty, Çukurova University, Adana, Turkey
| | - Shahina Daar
- Department of Hematology, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Saif Alyaarubi
- Department of Hematology, College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Doaa Khater
- Department of Hematology, College of Medicine & Health Sciences, Sultan Qaboos University and Muscat, Sultanate of Oman Pediatric Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Yasser Wali
- Department of Hematology, College of Medicine & Health Sciences, Sultan Qaboos University and Muscat, Sultanate of Oman Pediatric Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Mohamed Elshinawy
- Department of Hematology, College of Medicine & Health Sciences, Sultan Qaboos University and Muscat, Sultanate of Oman Pediatric Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt
| | - Ali Almadhani
- Department of General Medicine, Sohar Hospital, Sohar, Oman
| | - Mohamed Yassin
- Department of Pediatrics, Division of Endocrinology, Hamad General Hospital Doha, Qatar and Department of Pediatrics, Division of Endocrinology, Alexandria University Children's Hospital, Alexandria, Egypt
| | - Ashraf T Soliman
- Department of Pediatrics, Division of Endocrinology, Hamad General Hospital Doha, Qatar and Department of Pediatrics, Division of Endocrinology, Alexandria University Children's Hospital, Alexandria, Egypt
| | - Duran Canatan
- Thalassemia Diagnosis Center of Mediterranean Blood Diseases Foundation, Antalya, Turkey
| | - Maha Obiedat
- King Abdullah University Hospital, Princess Rahma Teaching hospital, Irbid, Jordan
| | - Hala Al-Rimawi
- King Abdullah University Hospital, Princess Rahma Teaching hospital, Irbid, Jordan
| | | | | | | | - Ploutarchos Tzoulis
- Department of Endocrinology, Whittington Hospital, University College London, London, UK
| | | | | | - Vincenzo De Sanctis
- Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy.
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Karimi M, Haghpanah S, Azarkeivan A, Zahedi Z, Zarei T, Akhavan Tavakoli M, Bazrafshan A, Shirkavand A, De Sanctis V. Prevalence and mortality in β-thalassaemias due to outbreak of novel coronavirus disease (COVID-19): the nationwide Iranian experience. Br J Haematol 2020; 190:e137-e140. [PMID: 32484906 PMCID: PMC7300954 DOI: 10.1111/bjh.16911] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Accepted: 05/31/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Azita Azarkeivan
- Zafar Adult Thalassemia Clinic, Blood Transfusion Research Center, High Institute for Research and Education in Transfusion Medicine, Tehran, Iran
| | - Zohreh Zahedi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Zarei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Asghar Bazrafshan
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Vincezo De Sanctis
- Pediatric and Adolescent Outpatient Clinic, Quisisana Hospital, Ferrara, Italy
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Haghpanah S, Zarei T, Eshghi P, Zekavat O, Bordbar M, Hoormand M, Karimi M. Efficacy and safety of resveratrol, an oral hemoglobin F-augmenting agent, in patients with beta-thalassemia intermedia. Ann Hematol 2018; 97:1919-1924. [PMID: 29926158 DOI: 10.1007/s00277-018-3392-8] [Citation(s) in RCA: 7] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2018] [Accepted: 06/04/2018] [Indexed: 11/24/2022]
Abstract
Recently, resveratrol showed induction of γ-globin mRNA synthesis in human erythroid precursors and reducing oxidative stress in red cells of thalassemia patients in many in vitro studies. We aimed to investigate the efficacy and safety of resveratrol, for the first time, in non-transfusion-dependent beta-thalassemia intermedia (B-TI) in Southern Iran. In this double-blind randomized clinical trial, 54 patients with B-TI were investigated during 6 months between October 2016 and March 2017. Patients were randomly allocated into three groups by simple randomization method. Group 1 (hydroxyurea (HU) and placebo, 18 patients), group 2 (resveratrol/piperine and placebo, 16 patients), and group 3(HU and resveratrol/piperine, 20 patients). Primary end point was considered as change in hemoglobin (Hb) levels and need for blood transfusion. Drug safety was considered as a secondary end point. Mean age of the patients was 28.2 ± 5.6 (18-42) years. Response rate was not significantly different among the three groups (P > 0.05). Higher percentages of adverse events were detected in groups 2 (31.3%) and 3 (25%) compared to group 1 (5.6%). However, the difference was not statistically significant (P > 0.05). All reported adverse events were gastrointestinal symptoms. Resveratrol showed a similar efficacy with HU in the small population of non-transfusion B-TI patients during a 6-month follow-up. Complications, mostly gastrointestinal, were observed more frequently in resveratrol groups compared to the HU group. Although it was not statistically significant, more attention should be given to safety and efficacy of resveratrol as an oral HbF-augmenting agent.
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Affiliation(s)
- Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Tahereh Zarei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Peyman Eshghi
- Pediatric Congenital Hematologic Disorders Research Center, Shaheed Beheshti University of Medical Sciences, Tehran, Iran
| | - Omidreza Zekavat
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | | | - Mahmood Hoormand
- Department of Pharmacology, Iran University of Medical Sciences, Tehran, Iran
| | - Mehran Karimi
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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13
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Saki F, Haghpanah S, Zarei T, Dabbaghmanesh MH, Omrani GR, Bordbar M. Investigating the bone mineral density in children with solid tumors in southern Iran: a case-control study. Arch Osteoporos 2018; 13:8. [PMID: 29374326 DOI: 10.1007/s11657-018-0416-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2017] [Accepted: 12/21/2017] [Indexed: 02/03/2023]
Abstract
UNLABELLED Along with increasing childhood cancer survival, there is increasing concern about its chronic complications. We showed that 20.5 and 45.9% of children with solid tumors in southern Iran had low bone mass for chronological age in lumbar and femoral area, which was associated with serum ferritin and hemoglobin. 52.4% of these children had vitamin D deficiency, as well. PURPOSE/INTRODUCTION Along with increasing the childhood cancer survival, there is increasing concern about the chronic complications of the disease and the related therapies. This study aims to compare the vitamin D status and bone mineral apparent density (BMAD) of these children with healthy ones and assess some possible associated factors. METHOD This case-control study enrolled 50 children with solid tumors and their age- and sex-matched controls. Dual-energy X-ray absorptiometry was used to assess bone mineral density. Body mass index, puberty, physical activity, sun exposure, and biochemical data were assessed. RESULTS 52.4% of children with solid tumors had vitamin D deficiency, and there was no significant difference between the prevalence of vitamin D deficiency in patients and controls (P = 0.285). The prevalence of low bone mass for chronological age in lumbar area was 20.5 and 12.5% in patients and controls, respectively (P = 0.399). Lumbar spine BMD was associated with hemoglobin level (r = 0.468, P = 0.049), while low bone mass in femoral neck was associated with serum ferritin (859 ± 1037 in low bone mass vs. 178 ± 264 in without low bone mass, P = 0.039). CONCLUSION Vitamin D deficiency and low bone mass are prevalent among Iranian children with solid tumors. Future studies are warranted to investigate the best strategies to prevent and treat vitamin D deficiency and low bone mass in children surviving cancer.
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Affiliation(s)
- Forough Saki
- Shiraz Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR, Iran
| | - Tahereh Zarei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR, Iran
| | | | | | - Mohammadreza Bordbar
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR, Iran.
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Bordbar MR, Haghpanah S, Zarei T, Dabbaghmanesh MH, Omrani GR, Saki F. Evaluation of bone mineral density in children with sickle-cell anemia and its associated factors in the south of Iran: a case-control study. Arch Osteoporos 2017; 12:70. [PMID: 28779437 DOI: 10.1007/s11657-017-0364-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 07/25/2017] [Indexed: 02/03/2023]
Abstract
Sickle-cell anemia is a hereditary hemoglobin disorder among children. We showed that the low bone mass is prevalent among these children, and it has a negative association with hemoglobin. In spite of using supplementary 200 IU/day vitamin D, 59.6% of children with sickle-cell anemia are vitamin D deficient. We suggest that early diagnosis and treatment of this problem could improve the bone health in them.
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Affiliation(s)
| | - Sezaneh Haghpanah
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR, Iran
| | - Tahereh Zarei
- Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, IR, Iran
| | | | - Gholamhossein Ranjbar Omrani
- Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, P.O. Box: 71345-1744, Shiraz, Iran
| | - Forough Saki
- Endocrinology and Metabolism Research Center, Shiraz University of Medical Sciences, P.O. Box: 71345-1744, Shiraz, Iran.
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Karimi M, Zarei T, Haghpanah S, Zahedi Z. Evaluation of Knowledge of Patients with Hemophilia Regarding Their Diseases and Treatment in Iran. Turk J Haematol 2016; 33:355-356. [PMID: 27312959 PMCID: PMC5204196 DOI: 10.4274/tjh.2016.0041] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Mehran Karimi
- Shiraz University of Medical Sciences, Hematology Research Center, Shiraz, Iran, Phone: 00987136473239, E-mail:
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Zarei T, Dehbozorgian J, Imanifard J, Setoodegan F, Karimi M. A Number of Cases in Iran Presenting with Coinheritance of Hemoglobin-H Disease and Beta-Thalassemia Minor. Hemoglobin 2016; 40:316-318. [PMID: 27535574 DOI: 10.1080/03630269.2016.1220953] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 10/21/2022]
Abstract
Thalassemias are a group of inherited hematological disorders caused by defects in the synthesis of one or more of the hemoglobin (Hb) chains. The β- and α-thalassemias are widespread throughout the Mediterranean region, the Middle East, and Southeast Asia including Iran. In this study, we report five patients known to carry a coinheritance of Hb H (β4) disease and β-thalassemia (β-thal) minor. There is a high prevalence of consanguineous marriages in our population and the high rate of thalassemia determinants can cause coinheritance of α- and β-thal. Therefore, it is of special interest to report coinheritance of Hb H disease and β-thal minor which could lead to misdiagnosis.
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Affiliation(s)
- Tahereh Zarei
- a Hematology Research Center, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Javad Dehbozorgian
- b Hematology Research Center, Dastgheib Hospital, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Jaber Imanifard
- b Hematology Research Center, Dastgheib Hospital, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Fatemehsadat Setoodegan
- b Hematology Research Center, Dastgheib Hospital, Shiraz University of Medical Sciences , Shiraz , Iran
| | - Mehran Karimi
- a Hematology Research Center, Shiraz University of Medical Sciences , Shiraz , Iran
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Zarei T, Haghpanah S, Parand S, Moravej H, Dabbaghmanesh MH, Omrani GR, Karimi M. Evaluation of bone mineral density in patients with hemoglobin H disease. Ann Hematol 2016; 95:1329-32. [DOI: 10.1007/s00277-016-2708-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 05/23/2016] [Indexed: 01/19/2023]
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18
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Arandi N, Haghpanah S, Safaei S, Zahedi Z, Ashrafi A, Eatemadfar P, Zarei T, Radwan AH, Taher AT, Karimi M. Combination therapy - deferasirox and deferoxamine - in thalassemia major patients in emerging countries with limited resources. Transfus Med 2015; 25:8-12. [DOI: 10.1111/tme.12188] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2014] [Revised: 01/11/2015] [Accepted: 03/07/2015] [Indexed: 01/19/2023]
Affiliation(s)
- N. Arandi
- Hematology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - S. Haghpanah
- Hematology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - S. Safaei
- Hematology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - Z. Zahedi
- Hematology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - A. Ashrafi
- Hematology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - P. Eatemadfar
- Hematology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - T. Zarei
- Hematology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
| | - A. H Radwan
- Department of Internal Medicine; American University of Beirut Medical Center; Beirut Lebanon
| | - A. T Taher
- Department of Internal Medicine; American University of Beirut Medical Center; Beirut Lebanon
| | - M. Karimi
- Hematology Research Center; Shiraz University of Medical Sciences; Shiraz Iran
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Haghpanah S, Zarei T, Zahedi Z, Karimi M. Compliance and satisfaction with deferasirox (Exjade®) compared with deferoxamine in patients with transfusion-dependent beta-thalassemia. ACTA ACUST UNITED AC 2013; 19:187-91. [PMID: 24074344 DOI: 10.1179/1607845413y.0000000121] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
OBJECTIVE The current standard option for iron chelation therapy (ICT) in transfusion-dependent patients with beta-thalassemia is deferoxamine (DFO). We aimed to compare the compliance with DFO vs. deferasirox (Exjade®), a novel oral iron chelator, in patients with transfusion-dependent beta-thalassemia. METHODS In this cross-sectional study, 220 patients from Southern Iran who were receiving DFO or Exjade® for the last 2 years were investigated in 2012. Satisfaction, compliance, convenience, and life disturbances of the patients with ICT were evaluated. Assessments were performed at four different occasions during 1 year. RESULTS According to the results, 114 patients received treatment with DFO and 106 patients were treated with Exjade®. In comparison with the patients who were treated with DFO, those receiving Exjade® reported a significantly higher rate of compliance and convenience (P < 0.05). However, no significant difference was observed between the two groups regarding their satisfaction (P > 0.05). In the DFO group, 44.9% of the patients reported irritation and pain at the injection site. CONCLUSIONS Considering higher rate of compliance and convenience with Exjade® and the comparable efficacy of these two modalities of ICT documented in previous studies, Exjade® can be used as a preferable choice of ICT in iron-overload patients with beta-thalassemia.
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