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Search Results: 1 - 10 of 138841 matches for " K. Alimoghaddam "
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Is There any Greater Possibility in Finding HLA-identical Unrelated Hematopoietic Stem Cell Donors among Thalassemia Families for Transplantation of Thalassemia Patients?
Mohyeddin M,Alijanipour P,Alimoghaddam K,Ghavamzadeh A
International Journal of Hematology-Oncology and Stem Cell Research , 2004,
Abstract: Thalassemia is probably the most common single gene disorder causing a major public health problem in the world. Currently, allogenic hematopoietic stem cell transplantation (HSCT) is the only curative therapy for thalassemia. One major limitation of HSCT is the lack of HLA-identical sibling donors, so attention has turned to finding phenotypically matched unrelated donors."nPatients and methods: From 1991 to 2002, 182 thalassemia patients referred to our center for HSCT. Donor selection was based on HLA class I and class II histocompatibility matching. The results of the serologically HLA class I typing of 549 subjects (patients and their families) and HLA class II typing of 182 patients were compared with HLA class I and II antigens of 100 healthy Iranians normal people. The comparisons between these two groups were tested in univariate analysis, using the Pearson chi-squared statistics."nResults: In comparing, thalassemic families (549 subjects) and healthy Iranians (100 subjects) for HLA class I antigens, significant differences for 11 antigens, including A9 (p= 0.029), A11 (p= 0.01), A19 (p= 0.000), B16 (p= 0.000), B17 (p= 0.029), B27 (p= 0.003), B41(p= 0.000), C2 (p= 0.015), C3(p= 0.012), C4 (p= 0.004), C7 (p= 0.000) were found. For HLA class II antigens, we found that only HLA-DR7 was significantly different (p= 0.002) between 182 thalas-semia patients and the healthy Iranian normal group."nConclusion: In this study, we found that thalassemia families showed significant differences, compared to the healthy Iranian group in several HLA antigens. Comparing HLA polymorphism and finding enough similarity in thalassemia families in the countries, located in the thalassemia belt, may provide benefits for establishing a common HLA bank of thalassemia families.
Frequency of BCR-ABL Fusion Transcript in Iranian Patients with Chronic Myeloid Leukemia
Yaghmaie M.,Ghaffari S.H.,Alimoghaddam K.,Ghavamzadeh A.
International Journal of Hematology-Oncology and Stem Cell Research , 2005,
Abstract: Introduction: Reverse transcriptase-polymerase chain reaction (RT-PCR) assay is a useful tool for the detection of fusion transcript resulting from specific chromosomal translocation of the leukemia cells. A specific chromosomal abnormality, the Philadelphia chromosome (Ph), is present in 90% to 95% of CML patients.The aberration results from a reciprocal translocation between chromosome 9 and 22, creating a BCR-ABL fusion gene.There are two major forms of the BCR/ABL fusion gene, involving ABL exon 2, but including different exons of BCR gene. The transcripts b2a2 or b3a2 code for a p210 protein. Another fusion gene leads to the expression of an e1a2 transcript, which codes for a p190 pro-tein. Another, less common fusion genes are b3a3 or b2a3 (p203) and e19a2 (p230). The incidence of one or other rearrangement in chronic myeloid leukemia (CML) patients varies in different reported se-ries. In general, fusion transcripts are determined individually, a process which is labor intensive in or-der to detect all major fusion transcripts. Methods: This study was designed to determine the frequency of different fusion genes in 75 iranian patients with CML. peripheral blood samples were analyzed by multiplex reverse transcriptase poly-merase chain reaction (RT-PCR) from adult patients to detect all types of BCR-ABL transcripts of the t (9:22) and found that all cases were positive for some type of BCR/ABL rearrangement. Results: Most of our patients showed b3a2 fusion gene (62%), while the remaining showed one of the transcripts of b2a2, b3a3, b2a3, e1a2 or coexpression of b3a2 and b2a2. The rate of coexpression of the b3a2 and b2a2 was 5%. Conclusion: In contrast to the other reports, we did not see any coexpression of p210/p190. This may reflect either the sensitivity of the detection techniques used or the possibility of genetic differences be-tween the populations studied. Coexpression may be due to alternative splicing or to phenotypic varia-tion, with clinical course different from classical CML.
Non-Myeloablative Stem Cell Transplantation in Hematologic Malig nancies: An Experience from the Hematology-Oncology and BMT Re search Center
Keyhanian S,Ghavamzadeh A,Bahar B,Alimoghaddam K
International Journal of Hematology-Oncology and Stem Cell Research , 2004,
Abstract: : Myeloablative-allogeneic stem cell transplantation is a common way of treating various malignant and nonma-lignant diseases; but, it is associated with hazardous immediate and late complications. The majority of patients are not good candidates for high dose therapy because of old age, medical co-morbidities or previous heavy treatments. The donor stem cells can engraft in the recipient and induce mixed chimerism when we use a less intensive, but sufficiently immunosup-pressive, conditioning regimen, known as mini-transplantation or non-Myeloablative allogeneic Stem Cell Transplantation (NM-allo-SCT)."nMethods: The conditioning regimens were the combination of Fludarabine and Cyclophosphamide or Busulfan and ATG. Prophylaxis against graft versus host disease (GVHD) included Cyclosporine A (CSA) +/- Methotrexate. A multiplex-PCR using short tandem repeats (VNTR) was used for chimerism analysis."nResults: We report the results of NM-allo-SCT from the HLA-identical siblings in 20 patients with AML (N=7), CML (N=6), NHL (N=2), MDS (N=2), ALL (N=1) and Fanconi anemia (N=2). Fourteen males and 6 females with median age of 43 years (range 8-55) underwent NM-allo-SCT and were followed up 4-870 days (median 420 days). Typical side effect of conventional HSCT, such as severe mucositis, vomiting and VOD were absent. Most of the patients did not become se verely pancytopenic and had relatively short hospitalization. Hematological recovery was rapid, a median of 8.5 days. Acute GVHD (grade ≥II) and extensive chronic GVHD was observed in three patients. Most of the patients initially had mixed-chimerism, progressing to full-donor-chimerism in 11 patients, after the interruption of the CSA therapy, and, in one patient, after DLI. Nine patients died, six from relapse or disease progression and three from transplantation-related complications (GVHD, infection or secondary malignancy). 14 month overall survival and disease free survival of 55% and 50%, respec tively, was observed."nConclusion: Our results confirm that NM-allo-SCT is safe and minimally toxic and is a potential new approach for a safer treatment of a large variety of hematologic diseases, especially in patients with AML and CML in remission.
Evaluation of the Affect of Maternal and Neonatal Factors on Cord Blood Parameters?
Mohyeddin Bonab M,Goliaei Z,Alimoghaddam K,Ghavamzadeh A
International Journal of Hematology-Oncology and Stem Cell Research , 2004,
Abstract: Chronic graft versus host disease (cGVHD) is one of the most serious potential complications of"nallogeneic bone marrow transplantation."nStudy design and method: We analyzed the incidence of cGVHD and its associated risk factors in a group of 161"nIranian recipients of HLA-identical sibling transplants, with at least 90 days post-transplantation survival. In the"nmajority of cases (n=73), cGVHD occurred in the first year after the transplant (median 273 days). The actual"nprobability of cGVHD within 1 year was 45.3±7% (CI 95%)."nResults: In a univariate analysis, the most important risk factor was the type of transplant. Peripheral blood stem cell"ntransplants (PBSCT) showed a significant increase in cGVHD compared with bone marrow transplants (BMT)"n(RR=2.34, p<0.001). In addition, male recipients were at a greater risk than female recipients (RR=2.08, p=0.004)."nOther risk factors were the presence of prior acute GVHD (RR=2.37, p=0.04) and the previous acute GVHD grade"n(p=0.03); The probabilities of cGVHD in patients with grade 0, Ι, Ι , ΙΙΙ, ΙV acute GVHD were 24%, 44.7%, 42.6%,"n56.8%, 64.3%, respectively."nConclusion: In a multivariate analysis, the only independent predictive factors for the development of cGVHD were the type of transplant (PBSC>BM, p<0.001) and male recipient (p=0.005). The survival rate was 88.8% and there was no significant difference in the probability of survival between BPSCT vs BMT (93.8% vs 86.6%, p=0.5).
Imipenem/Cilastatin versus Cefepime as Empiric Monotherapy for Fever in Neutropenic Patients after ematopoietic Stem Cell Transplan tation
Kani C.,Mousavi A.,Iravani M,Alimoghaddam K
International Journal of Hematology-Oncology and Stem Cell Research , 2005,
Abstract: Objective: To evaluate the potential advantages of imipenem/cilastatin in control of fever in neutro-penic HSCT recipients.Patients and Method: In this single-center study, 111 consecutive febrile episodes in 104 neutropenic HSCT recipients with a mean age of 26 years were randomized to treatment either with Imipenem/cilastatin 1 g, IV, q8h or cefepime (our standard regimen) 2 g, IV, q8h. If fever persisted, se quential antibiotics were added in 72-hour intervals: vancomycin, amikacin and amphotericin-B. The study population was at serious risk of a poor outcome, since 73.5% of febrile episodes occurred after allogeneic and 26.5% of febrile events occurred after autologous hematopoietic stem cell transplanta tion."nResults: The median total duration of neutropenia was 10 days, and the median leukocyte count at study inclusion was 0.16 × 109/l. The two patient groups were comparable in terms of Age, gender, un derlying disease, conditioning regimen, clinical and bacterial documentation, severity and duration of neutropenia and mucositis, GI decontamination and G-CSF administration. Bacteremia was found in 20.6%, other microscopically documented infections in 9.8%, clinically documented infections in 20.6% and fever of unknown origin in 49% of the febrile episodes. Most (102) febrile episodes were evaluable for response. No significant difference was found between imipenem/cilastatin and cefepime in terms of success rate (73.1% versus 62%), empirical addition of vancomycin (38% versus 26.2%) or median duration of antibiotic therapy (7 days in both).The difference between imipenem/cilastatin and cefepime was statistically significant for median duration of fever (1.5 versus 2 days) and median time of resolution of neutropenia (12 versus 14 days). The overall response rates to initial monotherapy was significantly higher for HSCT recipients with thalassemia, MM, lymphoma, AA, than recipients with ALL, AML, CML, CLL (P<0.001) and for episodes of fever of unknown origin than episodes of clini cally documented infections (87.8% versus 12.2%). In episodes of success without modification, the median duration of neutropenia before entry was longer than episodes when vancomycin was added (P<0.027).No patient died from the infection. Both antibiotic regimens were well tolerated. The study treatment being stopped only in 1 patient because of toxicity (cutaneous allergy to imipenem/cilastatin). Conclusions: Imipenem/cilastatin and cefepime are effective and well tolerated when used as initial empirical treatment for HSCT recipient with prolonged neutropenia. But imip
Quantitative Analysis of Epstein-Barr Virus DNA Load in Bone Marrow Transplant Recipients By Using Real-Time PCR
Sabri SH.,Ghaffari H.,Sadeghizadeh M.,Alimoghaddam K.
International Journal of Hematology-Oncology and Stem Cell Research , 2005,
Abstract: Introduction: Quantification of Epstein - Barr virus (EBV) in peripheral blood mononuclear cells (PBMNC) of allogenic bone marrow transplant (BMT) recipients is important because EBV-associated posttransplant Lymphoproliferative disease (PTLD) can occur after transplantation due to immunosup-pression therapy. Methods: To this end we chose Real-Time PCR using TaqMan probe. For the standard curve, we cloned BALF5 gene of EBV into a plasmid vector. After purification of the EBV-clone and calculation of plasmid copy number, the standard curve was constructed by using serial dilution of the plasmid clone. Results: We were able to detect from 2 to 107 copies per 2×105 PBMNC with wide linear range. The mean EBV DNA copy number was 103.7 copies per 2×105 PBMNC. In this study, No patient of 35 BMT recipients (275 PBMNC samples) developed PTLD during five months follow up post transplant. EBV copy numbers in 22 samples (3 patients) out of 35 BMT recipients were higher than cut off value with symptoms like fever and pulomonary noddes (9%). The virus load in one patient in the last sample obtained was 72400 copies. We detected low levels of EBV DNA in 20 BMT patients (57/1%). Conclusion: Real-Time PCR is useful to measure virus load in PBMNC. Detection of EBV in PBMNC samples may be valuable predictive marker to prognosis PTLD. Further studies need to determine ac-curate viral cut off value for treatment patients at risk for PTLD.
In Search of Mesenchymal Stem Cells: Bone Marrow, Cord Blood, or Peripheral Blood
Mohyeddin Bonab M,Alimoghaddam K,Talebian F,Ghaffari SH
International Journal of Hematology-Oncology and Stem Cell Research , 2005,
Abstract: Objective: Mesenchymal stem cells (MSC) are capable of self-renewal and differentiation into various connective tissue lineages. Therefore, they have attracted a lot of attention from investigators in the context of stem cell therapies. In our study, we have evaluated the frequency, phenotype and differen tiation potential of MSC in bone marrow (BM) cord blood (CB) and mobilized peripheral blood (mPB). methods: Sixteen CB, 11 BM and 19 mPB were obtained from normal donors. Mononuclear cells sus pended in culture medium and seeded in culture flasks. Flasks were incubated in a CO2 incubator with a change of culture medium every 4 days and passaged when fibroblast like cells reached confluence. For every other passage, MSC were examined for CD13, CD44,CD34 by flow cytometry and induced to differentiate into adipocytes and osteocytes."nResults: All BM samples produced MSC that survived multiple passages in mesenchymal culture me dium over 4 months. CB and mPB samples produced a non-confluent adherent layer of heterogeneous cells, and did not proliferate beyond the first passage. Immunophenotype of BM-derived MSC in every other passage were CD34-, CD13+ and CD44+, the adipogenic and osteogenic differentiation were con firmed by Oil-red O and Von Kossas staining, respectively."nThe mentioned evaluation for mPB and CB were not attempted because these were not confluent even in the first passage."nConclusion: In our study, only human BM cells produced MSC. These cells are positive for MSC sur face proteins and differentiate into MSC lineages.
Chronic Graft versus Host Disease after Allogeneic Bone Marrow Transplantation; An Analysis of Incidence and Risk Factors.
Ghavamzadeh A,Alimoghaddam K,Bahar B,Foroughi F
International Journal of Hematology-Oncology and Stem Cell Research , 2004,
Abstract: Chronic graft versus host disease (cGVHD) is one of the most serious potential complications of"nallogeneic bone marrow transplantation."nStudy design and method: We analyzed the incidence of cGVHD and its associated risk factors in a group of 161"nIranian recipients of HLA-identical sibling transplants, with at least 90 days post-transplantation survival. In the"nmajority of cases (n=73), cGVHD occurred in the first year after the transplant (median 273 days). The actual"nprobability of cGVHD within 1 year was 45.3±7% (CI 95%)."nResults: In a univariate analysis, the most important risk factor was the type of transplant. Peripheral blood stem cell"ntransplants (PBSCT) showed a significant increase in cGVHD compared with bone marrow transplants (BMT)"n(RR=2.34, p<0.001). In addition, male recipients were at a greater risk than female recipients (RR=2.08, p=0.004)."nOther risk factors were the presence of prior acute GVHD (RR=2.37, p=0.04) and the previous acute GVHD grade"n(p=0.03); The probabilities of cGVHD in patients with grade 0, Ι, Ι , ΙΙΙ, ΙV acute GVHD were 24%, 44.7%, 42.6%,"n56.8%, 64.3%, respectively."nConclusion: In a multivariate analysis, the only independent predictive factors for the development of cGVHD were the type of transplant (PBSC>BM, p<0.001) and male recipient (p=0.005). The survival rate was 88.8% and there was no significant difference in the probability of survival between BPSCT vs BMT (93.8% vs 86.6%, p=0.5).
Arsenic Trioxide Selectively Induces Apoptosis within the Leukemic Cells of APL Patients with t(15;17) Translocation Possibly through the Fas Pathway
Ardjmand. A.R,Alimoghaddam. K,Zaker F,Ghavamzadeh A
International Journal of Hematology-Oncology and Stem Cell Research , 2004,
Abstract: Acute Promyelocytic Leukemia is a sub-type of acute myelogenous leukemia that occurs in about 10-15% of patients with AML. Approximately 20%-30% of these patients, who are treated with the current standard All Trans Retinoic Acid (ATRA) and Anthracyclin-based chemotherapy regimen, suffer relapse in less than a year. Arsenic trioxide (ATO) as a single agent can induce complete remission even in refractory and relapsed patients with few adverse effects. The investiga tors efforts regarding elucidation of the mechanisms of action underlying these clinical responses has shown that Arsenic apparently affects numerous intracellular signal transduction pathways and causes many alterations in cellular function, among which the most prominent ones are the induction of differentiation & apoptosis with low & high doses of arsenic, respectively."nPurposes: In vivo apoptosis on these patients has not been evaluated yet and despite previous In vitro studies, which mostly reveal Fas/Apo1 is not expressed during ATO treatment, its in vivo expression has not been evaluated yet. Materials & methodes: In order to study the apoptotic pattern in leukemic cells of APL patients, we conducted a single-laser, triple-color flowcytometric experiment, to detect leukemic apoptotic cells in a heterogeneous population of bone mar row samples with the Annexin V & 7AAD technique. The Fas expression was also evaluated in promyelocyte population cells in a dual color panel."nResults & Conclusion: A substantial Apoptosis was selectively detected in Promyelocytic cells during the early and middle stages of treatment and the concurrent Fas expression indicates its involvent in Apoptosis induced by Arsenic Trioxide.
RESULTS OF HEMATOPOIETIC CELL TRANSPLANTATION IN PEDIATRIC LEUKEMIA
A. Mousavi,L. Nedaeifard,M. Iravani,K. Alimoghaddam
Acta Medica Iranica , 2008,
Abstract: Hematopoietic cell transplantation (HCT) is an accepted treatment for acute myeloid leukemia (AML) in first remission, the treatment of choice for chronic myeloid leukemia (CML) and high risk groups of ALL who relapse with conventional chemotherapy. We assessed results of HCT for pediatric leukemia in our center. A total of 92 children, 63 with diagnose of AML, 23 with ALL and 6 with CML received allogeneic transplantation from HLA full matched siblings (57.6%) and autologous transplantation (42.4%). Source of hematopoietic cells were peripheral blood 83.7%, bone marrow 15.2% and cord blood 1.6%. The median transplanted nucleated cells were 6.4 ± 4.7 ×108 /Kg (body weight of patients) and mononuclear cells were 5.5 ± 2.9×108/Kg. The most common conditioning regimens were cyclophosphamide + busulfan. Prophylaxis regimen for GVHD was cyclosporin ± methotrexate. GVHD occurred in 50 (54.3%) patients. Eighty five of children had engraftment, 26 (28.6%) relapsed and 57 (62%) are alive. The most common cause of death was relapse (68.6%). Five years overall survival of patients with AML and ALL were 49% and 44% respectively and disease free survival of them were 52% and 49%. One year overall survival and disease free survival of CML was 57%. Overall survival increased with increasing age of patients at transplantation time (P = 0.06). Longer survival significantly related to earlier WBC and platelet recovery (P < 0.0001 and P = 0.006 respectively). Considering acceptable overall and disease free survival of patients after HCT, we concluded that is a good modality in treatment of leukemia of children.
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