Invasive
carcinoma of the uterine cervix in
Authors :
Haghdel M ,
Ardakany MS,Zeighami B .
Department of
obstetrics Gynecology .
Fax :
98-71-301751
E.mail : ardl79@neda.net
Invasive
carcinoma of the uterne cervix in
Key work :
Invasive cervical carcinoma , diagnosis , radical husteredctomy , pelvic
radiotherapy .
Synopsis . A retrospective study on 204 newly diagnosed
consecutive cases of invasive cervical carcinoma treated at
Abstract :
Objective : To
reviw diagnostic aspects , treatment and
pathologic findings ihn patients diagnosed and treated for invasive cervical
carcinoma in Shiraz Unir University of Medical Sciences hospitals .
Method : The
hospital records of all patients admitted to the
Results : 204 nemly
diagnosed patients were admitted with invasive cervival carcinoma of which 61
(30% ) were in stage I (FIGO ) , 96 (47% ) in stage II , 34 (16.6% ) in stage
III and 13 (6% ) in stage IV of the
disease . Of these 204 , the given
treatments included surgery in 88 fptients , internal and external pelcic
radiotherapy in 141 , both hysterectomy and pelvic radiotherapy in 22 ,
chemotherapy in 8 and cryotherapy in one patient . We found significantly
positive relations with stage disease and chest Roentgenogram (p<0.02) ,
intravenous pyelogram (p< 0.0002) , sigmoidoscopy ( p<0.006) and
cytoscopy ( p <0.045 ) . Of the total
number of pathologic specimens < squmous cell carcinoma was reported in 88%
and adenocarcinoma in 11% . Recurrence rates of up to 15.5% for stage II and 5
% for stage I were calculated . Among the complications for which hospital
admission was required , genitourinary complications were the most frequent .
Conclusion : The
recurrence rate in stage I is lower than the estimated recurrence risk in
several other surdies whichg can be due to a real asvantage of thd center’s
practice . This may pose the question of
indispensability for the advanced and expensive diagnostic paraclinical work –
ups .
Immunotherrapy
in management of malignancies ; a review on
techniques and
applications .
By : Mohammad Haghdel
Under the supervision of
: Dr.Mahdi Shahriari MD.
Associate Professor
Paediatrics
Haematologist Oncologist
1996-1997
Axknowledgements
The author would like to
sincerely express his solomn gratitude fo all the medical sxientists and
practitioners who offer their best and have no rivalry but in finding the best
way to care for their patients .
Abstract :
Lmmunotherapy is a type
of cancer treatment disigned to use patients own immune system to fight
cacer . Immunouherapy can be used alone
of in conjunction with other conventional treatments such as surgery ,
radiation , and chemotherapy .
The excision of the
cancerous tissues and thd invoved organs in both prinitive and imefficient .
Surgeons , even in the
modern time are unable to reliably detect and destroy the involved tissues .
Both chemothrapy and
radiotherapy are highly non – specific in lilling the viable cell masses at
their height of growth . The unwwanted damage cased by radiation and
chemotherapeutic agents to the growing children and the immunodeficiency that
they produce is totally unacceptable .
Starategies for
immunotherapy of cancer can be divided into the active and pasive ummunotherapy
. More recent therapeutic modalities using cytokines have had the same aime as
the earlier attempts at active non – specific immunotherapy , such as the
injection of Bacillus Calmette Guerin (BCG) or Corynebacterium parvum , which
were given to patients with cancer in an attempt to augment immune responses in
a non – specific manner . Both these bacteria can activate macrophages which
are then capable of causing tumour cell destruction as a bystaner effect .
Immunization by tumour cells or their extracts is the ftom of acrive specific
immunotherapy . Monoclonal antibodies of tumour infiltrating lymphocytes induce
a fotm of adoptive or passive immunity against cancer cells .
The cinical work on
immunotherapy got a new start by early seventies and the word “immunotherapy”
appeared in medical indices in 1972 . On an electronic search for the articles
related to imunotherapy and treatment of cancer more then ten thousand enteries
were found . Immunotherapy has literally been tried for “each and every” human
neoplastic disorders but well controlled clinical trials are scaece . In this
review , I have tried to offer a realistic survay of the curent progress in
immumotherapy of cacer .
Folow up 100
breast cancer with tumourmarkers
Anthors and insitution :
Eisa Baybordi
Shariati hospital
Absrtact :
Study the records of
these patients in cross section methods we recognized 33 relapse case after 10
yours follow up . Then we assessment the role of 2 tumors marker , CEA ,CA15-3
fir early detection of relpase . which were examined every 6 months . All the
patients were female . patients ages was between 20-75 years old . At the time
of diagnise none of thems were not checked for CEA and CA15-3 . We diagnosed
their relapse by physical exam CT scan and X ray , with paraclinical date like
this 2 tumourmarkers .
Result :
We find 3 relaps case with out any rissing in
level of CEA and CA15-3 Markers . Twenty
relapse had only rissing in CA15-3 level 10 patients only had elevated CEA . 30
patients showed rissing in level of CEA and CA15-3 .
We concluded that CA15-3
has 30% false negativeand CEA 50% false negative for early detections of
relapses . Tumour marker CA15-3 has more effective in breast cancer follow up .
Gastrointestinal
lymphoma
A report ftom Shariati
hospital
Authors :
Ghavamzadeh .
B.Bahar.M.Nasseri.P.Iravani.M.Baybordy.E
Department of
In a retrospective study
, 59 patients who were diagnosed & treated between 1992 to 1996 as GI
lymphoma were considered . The mean age was 3406 (SD:16.3) yr . Twenty two
patients were female and 37 were male . The most prevalent symptoms at
presentation were triad of abdominal pain anorexia and weight loss . physical
exam of abdomen revealed no abnormal finding in 66% , and abdominal mass in 22%
as the most pre valent finding 54 patients were undergone endoscopy , there was
mucosal thickening in 37% , intraluminal mass in 18% and ulcer in 18% of
patients . The sites of lymphoma were in stomach in 17 (30%) , small intestine
in 34 (61%) and large bowel in 5 (8.9% ) of patients . The sites were not
evaluable in 3 patients . Gastric lymphoma were in stomach in antrum and
pylorus and small intestine lymphoma involved deudenum and jujenum , as the
main sites of involvment . There were 20 (34% ) cases of IPSID , 20 (34 % )
cases of large cell lymphoma and 9 (15 % ) cases of small & lsrge cell
lymphoma , other types of lymphoma were
reported with loss frequency .
These patient were
treated by combination chemotherapy (CTX) alone . Surgery + CTX ,
CTX+radiotherapy , antibiotic with or without CTX in IPSID cases and surgery +
CTX+radiotherapy .Complete remission was achieved in 13 (77% ) cases of IPSID ,
13 (81.3% ) cases of gasteic lymphoma and 6 (50% ) cases of small intestine
lymphoma with a mean duration of disease free survival of 30 (SE=8.3) , 34
(SE=10) and 18 (SE=5.2) respectively .
IPSID and large
cell lymphoma were the most prevalent
pathology in this study in GI lymphoma . In an investigation for diseade free
survival by Kaplan-Meier methed , there was no advantage for combination of
surgery and chemotherapy over chemotherapy alone (P.O.18) .
Hepatitis C
virus and HIV infection in hemophilic patients ,
in fare
province ,
Author : Mahdi
Hepatitic C virus
infection is frequent among hemophilic patient with non-inactivated factor
concentrates . Both HCV genotype and viral load have been suggested to be
important progenostic markers of disease progression and treatment outcome .
In this way we studied
65 hemophilic patients received non virally inactivated factor- concentrates of
FEP for at least 5 years to find the prevalence of HCV and HIV infection among
them .
The results were as
follows :
1-The prevalence of HCV
infection in the study group was 40% (26 of 65 ) Vs 0.5% (366 of 69743 ) in
control group p<0.000001 .
2-The prevalence of HIV
infection in study group was 0 .
3-The prevalence of HBV
infection in study group was 3% (2 of 65) Vs 0.3% (242 of 69743 ) in control
group p<0.021 .
4-There was no
difference between blood groups of Rh of hemophilic patients and mormal
population .
5-There was no
difference between blood groups of Rh of HCV-positive hemophilic patients and
mormal population .
It’s obvious that the prevalence
of HCV and HIV infection in hemophilic patients of Fars is less than the
prevalence of these infections among hemophiliacs in western world and Japan (1,4)
which ranges from 98-100% and 22-40% for HCV and HIV respectively , which is mainly due to good
selection of blood donation volunteers by Iranian Blood transfusion
organization in Shiraz , Althought it may be due to low sensitivity of Elisa
generation 2 for detection of HCV Ab so we are conducting a PCR method for
detection of HCV Antigen .
Refrences :
1-Lee CA:Hepatitis virus
and hemophilia Hemophilia 1:8;1995
2-Lam NP:Dose dependent
acute clearance of hepatitis C genotype 1 virus with interferon alfa .
Hepatology 26:226;1997 .
3-Philips A : The
epidemiology of HIV deseas in men with hemophilia in the Uk Hemophilia 1 (
suppl 2):6;1995 .
4-Yanago Y ,One O and
Shirahata A : Counselling for HIV positive hemophiliacs in
Antilymphocyte
Globulin Therapy In Childhood Aplastic Anemia
Author :Mahdi Shariari
M.D
Department of Pediatrics
, Division of Pediatric Hematology Oncology
Immunosuppressive
therapy is a successful method in the threatment of aplastic anemia . The use
of Antilymphocyte globulin (ALG) had been recently recognized as an effective
therapy in many aquired cases and the results obtained were comparable with or
superior to Bone marrow transplantation .1-4
During last 3 years (
from September 1996 – September 1999) 20 cases with bone marrow biopsy proven
diagnosis of aplastic anemia ; either aquired or costitutional , who had minimal or transient response to
androgen therapy were hospitalized and were treated with A.L.G 15 mg/kg/day for
five days . Followed by 1 mg/kg prednisolon with show taper off over 6 months
and Danazal 100-200 mg/day ,for 6-12 mo .
Patient included in the
study were 11 male and 9 remale , with mean age of 11 years ; 12 patients had
sever aplastic anemia was defined as absolute neutrophil count (ANC) of
<500/mm3 , corrected retic count <1% , platelet count
<20000/mm3 ( presence of at least two of these factors ) and very
hypocellular marrow . Moderate aplastic anemia was present in 8 patients and
was defined as ANC<1500/mm3 , corrected retic count <1%
platelet count <100000/mm3 ( presence of at least two factors )
and hypocellular marrow . Eight patients ( out of 20 ) had constitutional (
Fanconi) aplastic anemia proven with features of Fanconi and chromosomal
brekage in Mitomycin enriched lymphocyteculture in metaphase arrest .
All of the patient were
followed by CBC and LFT evera 2 wks for 3 months then monthly till complete
response , then every other months ( mean follw up , 18 months , range 12 – 36
mo )
The following results were obtained : Ten
patients (50% ) including 3 cases of Fanconi anemia had complete response . 8
patient (40%) including 4 cases of Fanconi anemia ) had partial reponse , so
overall 90% of patient had a response to A.L.G which is superior to previous
puplished B.M. transplantation or ALG therapy . Only two patient ( including 1
case of Fanconi anemia ) had no reponse . No second that apart B.M.
transplantation , ALG terapy is a good alternative method in the treatment of
aplastic anemia and should be considered specialy when there is no HLA matched
donor for B.M. transplantation .
Refrences :
1-Bacigalupo A , Chaple
M , Hepws J , et al : Treatment of aplastic anemia with antilymphocyte globulm
and methyl prednisolone with or without androgens . Br J Hematol 183:145;1993 .
2-Frickhofen N , Kalt
wasser JP : Treatment of aplastic anemia with antilymphocyte globuline and
methyl prednisolone with of without cyclosporine .
3-Matloob YH ,Bostrom
B,Golembe B ,et al : Antilymphocyte globulin , cyclosporine and prednisolone
for the treatment of sever aplastic anemia in children . Am J pediatr Hematol
16:104;1994 .
4-Park CW , Han CH , Kim
CC , etal : Immunomodulation therapy for sever aplastic J Inter Med
Impact of
prognostic Indicators on Survival Indices in Patients with Acute Lymphoblastic
Leukemia diagnosed between 1372/1993 and 1379/1997 at the
A Ghavamzadeh ; M
Khodabandeh ; M Iravani; AR Vassigh
Department of
Haematology,
Abstract : It has long
been astablished that certain clinical and laboratory features in patients with
ALL come to exert an influence on survival indices . The number and
significance of these prognostic indicators very from study to study . we
perfotmed a cross-sectional retrospective study to evaluate the impact of a
number of prognostic indicators on survival indices in 54 patients diagnosed
with ALL at the Shariati Hospital between 1372/1993 and 1376/1997 . Following a
comprehensive litrature search , we developed a list of established and
putative prognostic indicators , and then proceeded to evaluate their influence
on the three survival indices of time taken to achieve complete remission (CR)
, disease –free survival (DFS) , and overall survival (OS ) . Univariate
analysis showed a significant correlation between white cell count (WCC) and
both DFS [p=0.01] and OS [p=0.02] . Among female patients , there was a
significant correlation between age and CR [p=0.0042] . Multivariate analysis
demonstrated only one significant correlation [between WCC and OS ; p=0.055] .
Our result confirm the prognostic influence of admission WCC on outcome in
parent with ALL. We recommend larger prospective studies that may elucidate
further prognostic variables .
The effect of
long term & short term miniconsolidation on survival in patient with Acute
myelogeneous leukemia
P.Nasseri/ A.Ghavamzadeh
/ M.Keyhani/ M.Iravani / F.Elahi / RA.Sharirian/J.Natighi / K.Alimoghadam/
MR.Mortazavizadeh / M.Abasi / MR.Eshragian
Department of
Hematology-Oncology /
Summary :
Pupose : To investigate
the value of three post remission methods of treatment , a retrospective study
was done on 130 patients with acute myelogenous leukemia (AML) who were treated
in SHARIATI and
Patients and methods :
ALL patients were in complete remission (CR) and had been treated by ARA- C (300 mg/m2/day
continuos’ infusion for 5 days ) and Daunarubicine (45 mg/m2/days
for 3 days ) as induction and early consolidation therapy . Forty patients were
treated by an additional similar chemotherapy as second consolidation and no
futher treatment was Offered (glroup I) . Fifty patients were treated by ARA-C
(120 mg/m2subcutaneously for 5 days ) and Etoposide (120 mg /m2 on day one )
and Mitoxantrone ( 12 mg/m2 on day one ) on each of successive months as short
term miniconsolidations ( group II) .
Forty parient were
treated similar to group II until reapse , as for up to 2 years as long term
miniconsolidations (group III) .
Resulte : There was no
difference regarence regarding mean age and other prognostic facrors between
these groups ; treatment related mortality & morbidity was similar also .
Median duration of
diseadse free survival (DFS) were 36 month ( 3.5 –68 with 95% CI ) ,
17(12.5-21.5) and 19 (14.7-23.3 ) months respectively in these three groups .
In a median observation of 14 months three was no difference in DFS &
overall survival (OS) between these three groups (p=0.7)
Conclusion :We concluded
that short of long term miniconsolidation chemotherapy would not improve DFS
& OS in patients with AML comparing to standard treatment .
Key word : Acute
myelogeneous , Consoidati on , Maintenance treatment Correspondence : Massoud Iravani M.D ,
Hematology-Oncology ward , Shariati Hospital , Tehran 14114 , Iran .
Fax no : 0098218004140