Scientific Journal of

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  Abstract

 Background and Objectives

 Malignant lymphoma may be very difficult to be diagnosed through routine histopathological methods because they may mimic reactive architecture or contain reactive infiltrates. Detection of the monoclonal lymphocyte population is one of the best methods of diagnosis since a monoclonal proliferation is strongly suggestive of neoplasia. By means of a PCR method it is possible to detect the immunoglobulin heavy chain (IgH) gene rearrangement and consequently the lymphocyte clonality.

 

 Materials and Methods

 We evaluated formalin-fixed, paraffin-embedded biopsies, and bone marrow aspiration of 12 cases with non definite or suspicious histopathological diagnosis of non Hodgkin B cell lymphoma. After DNA extraction and quality control, semi-nested PCR was performed using consensus primers for amplification of CDR-3 region. PCR products were analyzed after heteroduplex analysis using polyacrylamide gel electrophoresis and silver staining.

 

 Results

 75% and 16.6% of patients showed clonal and polyclonal patterns respectively. One case showed weak monoclonal band in smear background and remained suspicious after duplicate PCR.

 

 Conclusions

 Our findings are comparable with other international studies and support the concept that molecular techniques such as PCR provide a helpful approach in detection of monoclonal immunoglobulin rearrangements in malignant lymphoma. This is especially true for suspicious cases, but always in combination with clinical and histopathological information.

  

 Key words : B-cell Lymphoma, Immunoglobulin Heavy Chain, Gene rearrangement 

 

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Molecular diagnosis of B cell Non-Hodgkin Lymphoma by evaluation of immunoglobulin heavy chain gene rearrangement Yousefian A.1(MS ), Poopak B.2(PhD), Abolghasemi H.1,3(MD), Azarkeivan A.1(MD), Farhadi Langroudi M.1(MD), Sadeghipour A.4(MD), Jeyhonian M.4(MD),Pourkhayat M.J.4(MD), Zare K.5(MD), Farahani K.2(BS), Salahmand M.6(BS) 1Iranian Blood Transfusion Organization-Research Center-Iran 2Islamic Azad University-Medical Branch. Tehran- Iran 3Baghiyatalah University of Medical Sciences-Molecular Biology Research Center, Tehran-Iran 4IranUniversity of Medical Sciences, Iran 5Shahid Beheshti University of Medical Sciences,Iran 6Payvand Medical Laboratory, Iran Abstract Background and Objectives Rearrangement of V, D, and J segments of immunoglobulin heavy chain gene with inserted or deleted nucleotides within rearranged segments makes unique hypervariable regions (CDR-3). These regions can be used for evaluation of B cell clonality for the purpose of molecular diagnosis of Non-Hodgkin Lymphoma (NHL) and for confirmatory diagnosis in suspicious cases. Materials and Methods In this study, samples of 42 patients were collected from Taleghani, Baqhiyatalah, and Aliasghar hospitals out of this number, there were 22 patients with diagnosis of B cell NHL, 10 with reactive hyperplasia, and 10 with malignant lymphoma. After DNA extraction from formalin fixed paraffin embedded tissues, PCR was done using consensus primers for amplification of CDR-3 region. PCR products were analyzed after heteroduplex analysis using polyacrylamide gel electrophoresis and silver stain. Results Clonal patterns in group 1 (B cell NHL), 2 (reactive and follicular hyperplasia), and 3 (morphological diagnosis without immunohistochemistry) were observed in 77.2%, 0%, and 70% of patients, respectively. Conclusions Our findings are compatible with other international studies with minor differences. The diagnosis of B-cell lymphoid malignancy can frequently be substantiated by detecting clonal immunoglobulin heavy chain (IGH ) gene rearrangement. Key words: Gene rearrangement, Non-Hodgkin Lymphoma, Immunoglobulin SJIBTO 2008 5(3): 157-166 Received: 31 Aug 2007 Accepted: 8 Oct 2008 Correspondence: Poopak B., PhD of Hematology. Islamic Azad University- Tehran Medical Branch. P.O.Box: 19295-1495 , Tehran, Iran, Tel: (+9821) 22006660 Fax : (+9821) 22264145 E-mail: bpoopak@yahoo.com

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  Abstract

 Background and Objectives

 Somatic point mutation in JAK2 gene is characterized by G to T transversion at nucleotide 1849 in exon 12 in the JAK2 gene and results in autonomous activation of JAK2 protein. JAK2 mutation leads to independent cytokine signaling and clonal proliferation of hematopoietic cells in MPNs. Due to absence of any reports for JAK2 V617F mutation in Iranian MPNs patients and its important role in diagnosis, we decided to carry out this study.

 

 Materials and Methods

 In this experimental study, we evaluated JAK2 mutation in 100 MPNs patients with diagnosis of PV (n=44), PMF (n=31) and ET(n=25) by simple randomized sampling. After extraction of genomic DNA from whole blood buffy coat, detection of mutation was done using allele specific PCR. Agarose gel electrophoresis was used for observation of PCR products. For confirmation of results, PCR-RFLP using BsaXI was applied.

 

 Results

 Using allele specific PCR and PCR-RFLP, frequency of JAK2 V617F mutation was evaluated to be 89%, 61%, and 56% in PV, PMF and ET, respectively.

 

 Conclusions

 Frequency of JAK2 mutation in our study is compatible with previous reports. According to WHO criteria, allele specific PCR can be applied for detection of JAK2 mutation in Iranian patients with diagnosis of MPNs.

 

 Key words : JAK2, Protein Tyrosine Kinase, Polymerase Chain Reaction, Mutation, Neoplasms

 

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  Abstract

 Background and Objectives

 Thalassemia is the most common hereditary anemia in Iran. Despite improved hematologic care, multi endocrine dysfunction is a common complication in these patients. The main objective of this study was to estimate the prevalence of thyroid dysfunction in patients including both thalassemia major and thalassemia intermedia.

 

 Materials and Methods

 In this descriptive cross sectional study, a questionnaire was designed for 195 patients who were reffered to Iranian Blood Transfusion Organization Clinical Laboratory of Tehran from Thalassemia Clinic in Winter 2007. The following items were brought up in the questionnaire: sex, age, height, weight, splenectomy time, amount of transfused blood, blood transfusion interval, desferoxamine dosage, type of thalassemia (major or intermedia), serum thyroid hormones, and ferritin levels. Then, the correlation of thyroid functional status with age, serum ferritin level, type of thalassemia, splenectomy and desferoxamine dosage was evaluated in both β thalassemia major and thalassemia intermedia groups.

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 Results

 We had 178(91.3%) β thalassemia major (50.6% male, 49.4% female with the mean age of 17.2 ± 8 years) and 17(8.7%) thalassemia intermedia (23.5% male, 76.5% female with the mean age of 23.2 ± 8.8 years). One hundred sixty two (83.1%) patients were euthyroid, 27 (13.8%) had subclinical hypothyroidism (CI 95%= 9-18.6), and 6(3.1%) were primary hypothyroid (CI 95%_�= 0.7-5.5). Mean ferritin levels for euthyroid group were 1923 ± 1470 ng/ml, for subclinical hypothyroidism group 1723 ± 1346 ng/ml, and for primary hypothyroidism 1569 ± 734 ng/ml, respectively. No significant correlation was found between abnormal thyroid function (subclinical and primary hypothyroidism) and serum ferritin levels (p=0.55), age (p=0.11) , type of thalassemia (p=0.68), splenectomy (p=0.62) and desferoxamine dosage (p=0.33).

 

 Conclusions

 Based on our results, thalassemia patients present a sort of thyroid dysfunction such as hypothyroidism. So, more effective treatment with desferoxamine and regular follow up of patients for evaluation of thyroid function satus are recommended.

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  Key words : Thalassemia, Thyroid Gland, Hypothyroidism

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  Abstract

 Background and Objectives

 Nurses play an important role in safe use of blood and blood products. Blood safety and effectiveness of transfusion somehow pertain to the knowledge and skills of the nurses who are responsible for. The purpose of this study was to evaluate nurses' knowledge and practice of blood transfusion in hospitals of Arak in 2010.

 

 Materials and Methods

 In this descriptive cross-sectional study, all nurses in hospitals of Arak participated. Information was collected through questionnaires. Scores of knowledge and practice were arranged to three levels of weak, average and good after recoded in terms of accepted scores. Data were analyzed by statistics-descriptive analysis using SPSS16, Chi Square correlation test and Spearman correlation coefficient.

 

 Results

 Most people were women (92.9%) and had bachelor degree (99.3%). Average and standard deviation of age and work history were 29.79 ± 5.14 and 6.15 ± 4.76, respectively. Knowledge measurement showed that 50.9% of participants are at good level, 33.5% at the intermediate and 15.6% at the weak level. Self-evaluation of nurses about their practice showed that the majority of subjects (63.9%) have good practice and the rest are at average. There was a significant correlation between knowledge and practice of the nurses (p< 0.001).

 

 Conclusions

 In this study the majority of nurses' knowledge and performance is satisfactory but there is still the need for more learning about the complications of blood transfusion and care improvement. Therefore, holding educational programs and monitoring managers seem to be necessary.

  

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Abstract Background and Objectives For people with Bombay phenotype due to the expression of strong IgM Anti H in their sera, transfusion with ABO group O blood will cause acute hemolytic reactions. Therefore, it is important to detect them. Case Following O blood type transfusion to a blood group O Rh positive patient with multiple trauma, acute hemolytic transfusion reaction happened. The reaction was recognized by the trained nurse in the haemovigilance system. In serologic studies, a high level of anti-H, anti-A, and anti-B was detected in the patient blood. Conclusions This case increased the number of Bombay phenotypes in Iran to 16. Therefore, using antibody screening test and existence of trained nurses and physicians with haemovigilance system in order exact management of transfusion reactions should be considered necessary.