Dr Bijan Keikhaei, Dr Homayoun Yousefi, Dr Arash Alghasi, Dr Asaad Sharhani, Dr Roya Khazaei,
Volume 13, Issue 4 (10-2023)
Abstract
Background: The mainstay of managing severe β-thalassemia remains lifelong blood transfusion. Mismatched red blood cell phenotypes between donors and recipients in multiple blood transfusions can result in the development of alloimmunization in recipients. The aim of this study was to determine the frequency of major and subgroup antigens and their phenotypes in thalassemia major patients.
Materials and Methods: This cross-sectional descriptive study was performed on 105 patients with thalassemia major who referred to Baghaei Hospital in Ahvaz in 2021. Their alloimmunization to erythrocyte antigens was determined with standard tubular antibody search kits.
Results: Among the thalassemia major patients participating in the study, 51 were female (48.45%). The mean age of the participants was 21.10 ± 5.8 years. Out of the 105 patients studied, 26 had detectable alloantibodies in the serum (24.7%). The two groups of patients with positive and negative alloantibodies were significantly different in terms of Rh and C blood groups (P-values of 0.03 and 0.05, respectively). There was no significant association between the existence alloantibody and age, gender, spleen condition and the time of first transfusion (P > 0.05).
Conclusion: It was concluded that red blood cell matching, at least for Rh and C groups, is necessary to prevent alloimmunization in thalassemia major patients.
Dr Homayoun Yousefi, Dr Bijan Keikhaei, Dr Arash Alghasi, Dr Kaveh Jaseb, Dr Ghorban Mohammadzadeh, Dr Maria Cheraghi, Dr Najmeh Namehgoshay Fard,
Volume 14, Issue 1 (1-2024)
Abstract
Background: Idiopathic thrombocytopenic purpura (ITP) is a rare and autoimmune disorder determined by an abnormal reduction in the number of platelets. The current study aims to evaluate the oxidative stress status of children with ITP in two treatment methods using methylprednisolone and methylprednisolone with intravenous immunoglobulin (IVIG).
Materials and Methods: This retrospective study was conducted on 60 children with ITP who referred to Baghaei Hospital in Ahvaz in 2021. All the ITP children were equally divided into two groups, 30 receiving methylprednisolone and 30 receiving methylprednisolone and IVIG. The sampling of the patients’ blood was done in two stages before and after the start of treatment. Then, malondialdehyde (MDA), superoxide dismutase (SOD), total antioxidant status (TAS), total oxidative status (TOS), catalase (CAT) and glutathione were measured according to the instructions in the commercial kit. The analyses were performed using SPSS software version 23. P value < 0.05 was significant.
Results: The number of platelets after treatment in methylprednisolone and methylprednisolone+ IVIG groups was 133.44 ± 18.93 and 158.76 ± 34.76 (×103/µL), respectively. Itas significantly increased compared to that before the treatment (P = 0.04). The amount of TAC in the group receiving methylprednisolone + IVIG and the methylprednisolone group was 1.64 ± 0.18 and 1.26 ± 0.53 nm, respectively; there was a remarkable difference between the two groups (P = 0.001). Also, SOD, CAT and glutathione in the methylprednisolone + IVIG group were remarkably higher than those in the methylprednisolone group (P < 0.05). Finally, the levels of TOS were lower in the methylprednisolone + IVIG group (19.74 ± 9.93 μmol) than in the methylprednisolone group (26.65 ± 10.64 μmol) (P = 0.01).
Conclusion: A combination of IVIG and methylprednisolone was found to have a greater effect on improving antioxidant status and decreasing the oxidative stress indices of ITP children.
Dr Arash Alghasi, Dr Roozbeh Moghaddar, Dr Roya Salehi Kahyesh, Dr Babak Najibi, Dr Bijan Keikhaei, Dr Saeid Bitaraf,
Volume 15, Issue 1 (1-2025)
Abstract
Background: Acute lymphoblastic leukemia (ALL) is the most prevalent malignancy in pediatrics. ALL blood cancer causes excessive production of immature white blood cells called lymphoblasts or leukemic blasts. Therefore, the present study evaluates the effect of chemotherapy on echocardiography, uric acid (UA) and lactate dehydrogenase (LDH) in ALL children.
Materials and Methods: A quasi-experimental study was designed for 53 ALL patients who referred to Shahid Beqaei 2 in Ahvaz from 2022 to 2023. The inclusion criteria for the studied ALL children aged 2 to 16 years were the maintenance phase of chemotherapy and lack of symptoms of cardiomyopathy. The levels of LDH, UA and echocardiographic parameters were compared before and after chemotherapy through paired sample t-tests. P-values<0.05 were considered significant.
Results: The mean age of the ALL patients was 6.28 ± 4.13 years. Of all the patients, 64% were male. The mean levels of LDH before and after chemotherapy were 1443.36 ± 1373.26 and 534.51 ± 236.61 U/L, and the LDH levels decreased significantly after chemotherapy (P < 0.001). The mean U.A levels before and after chemotherapy were 6.67 ± 6.80 and 5.30 ± 6.15 mg/dl, respectively (P = 0.30). Abnormal echocardiography before and after chemotherapy was observed in 3.76% and 22.64% of the patients, respectively, but the difference was not markedly significant (P = 0.44). The relative risk was estimated to be 0.16, suggesting that the probability of cardiac dysfunction after chemotherapy reduced to approximately 16% of the baseline risk observed before chemotherapy.
Conclusion: The initial evaluation of serum LDH can be beneficial in knowing the response to chemotherapy. So, it is of importance to determine the prognostic value of this biological marker. On the other hand, chemotherapy does not seem to have a significant effect on the mean values of echocardiographic parameters and the level of uric acid.
