The risk of malignancies in patients receiving hematopoietic stem cell transplantation: a systematic review and meta-analysis

INTRODUCTION

Hematopoietic stem cell transplantation (HSCT) is widely used in the treatment of malignant and non-malignant diseases. Due to advances in the number of survivors of this treatment, the number of survivors is increasing, but the late complications of this therapeutic approach such as secondary cancers have been long term and have not been fully controlled.

METHODS

The present meta-analysis study was performed by considering English-language articles in the databases including Web of Science, Scopus and PubMed. This meta-analysis included cohort studies that reported an incidence of cancer following stem cell transplantation (SCT). Random/fixed effect size meta-analyses were used to standardize the incidence ratio for different cancers.

RESULTS

22 studies that evaluated patients receiving SCT (n = 270,063) were included in the study. The study found 9233 cases of cancer after transplantation. Meta-analysis showed that the risk of cancer after SCT was SIR = 1.66 (95% CI 1.47-1.86). The most common cancers observed in SCT recipients were bone tissue, head and neck cancers, and melanoma, with SIRs of 10.04 (3.48-16.61), 6.35 (4.76-7.93) and 3.52 (2.65-4.39), respectively.

CONCLUSION

The meta-analysis findings showed that the risk of secondary cancers after HSCT was significantly increased in most types of cancers. Consequently, diagnostic tests for common cancers should be included in the screening program of these patients for the prevention and early detection of high-risk cancers.

Gene susceptibility in Iranian asthmatic patients: a narrative review

As environmental factors are important in the development of asthma, genetic factors could have a critical role in the expression of the disease. Hence, we carried out a systematic review to assess the susceptible genes for asthma in Iranian population. We conducted a literature search by using the electronic database PubMed, Biological Abstracts Web of Science, Current Contents Connect, Cinahl, ScienceDirect, Scopus, IranMedex, and Scientific Information Database to identify articles that evaluated the association between genetic variants and the risk of asthma in Iranian population (until April 30, 2012). The search terms were used include: Asthma and gene in combination with Iran for international database. The following criteria were used for selecting literatures in this review: The study should evaluate the association between gene polymorphism and risk of asthma in Iranian population, and the study should be a case-control design with normal subject as ac control group that published in a journal. Finally, 14 case-control studies were extracted from local and international database. In this study, we reviewed 38 polymorphisms in 19 genes. Polymorphism in interleukin-13 (IL-13), IL-10, IL-1, IL-2, IL-12, E-Selectin, S128R and Exon 9 Vitamin D Receptor were susceptible for asthma and polymorphism in chemokine receptor 5, transforming growth factor-a (TGF-a), Intron 8 of the Vitamin D Receptor, angiotensin-converting enzyme gene, IL-6 and interferon-c were not susceptible for asthma in Iranian population. Polymorphism in IL-4, tumor necrosis factor-α and TGF-b had inconsistent findings. This systematic review indicated that three polymorphisms (IL-13, IL-10, and IL-1) are associated with risk of asthma in Iranian population.

Interferon-gamma low producer genotype +5644 over presented in patients with focal brucellosis

Genetic polymorphisms that affect production levels of certain cytokines may determine the risk, severity or protection in some infectious diseases like brucellosis. IFN-gamma plays a key role in the defense mechanism against brucella infection. This study aimed to determine the influence of the polymorphism within the +5644 position of IFN-gamma gene on the susceptibility to brucellosis. We investigated the allelic and genotypes distribution of A5644G polymorphism in IFN-gamma gene in an Iranian population comprising 259 patients with brucellosis and 238 healthy controls. The single nucleotide polymorphism was determined using the polymerase chain reaction in association with sequence-specific primers (PCR-SSP) incorporating mismatches at the 3'-end. Allelic and genotype frequencies of G5644A polymorphism of IFN-gamma gene were not significantly differed between patients with brucellosis and controls (p > 0.05). Stratification of patients to focal and non focal diseases revealed a significant increased of 5644A allele in patients with focal brucellosis (79.31% vs. 61.94%, p = 0.0005). Moreover, multivariate logistic regression models showed patients harboring the INF-y G5644A genotype were significantly more likely to develop focal infectious complications (OR = 3.45, p = 0.0004, 95% CI = 1.26-7.94). The present study suggests that the variant genotypes of G6544A of IFN-gamma might be associated with focal form of brucellosis and play as a genetic risk factor in brucellosis.

Association of human leukocyte antigen and esophageal cancer in North of Iran

Several risk factors including environmental factor, Genetic and nutritional deficiencies have been associated with Esophageal Cancer (EC) in high risk areas. In a case-control association study, the association of HLA class I and esophageal carcinoma has been investigated. A total number of 30 patients and 30 clinical healthy individuals matched for sex and age with the same ethnicity and residence status were enrolled. Five milliliter defibrinated blood taken from each individual and diluted 1:1 with Hanks balanced salt solution buffer. The diluted blood added to 3.0 mL separating medium (ficol hypaqe). Lymphocyte separated and HLA, A, B and C molecules were determined by using the Terrasaki Mirocytotoxicity test. Data were analyzed by Chi square and Fisher exact tests. Thirty patients (20 females and 10 males) with age 61 +/- 2.4 enrolled in this study. Only patients with definite diagnosis of Squamous Cell Carcinoma (SCC) included and Patients with other esophageal cancer (adenocarcinoma) excluded. The frequency of many HLA molecules were different in comparison of patients and control groups, but statistical analysis of the data revealed that only difference between frequency of HLA A11, B41 and Cw3 are significant (p<0.05). We concluded that HLA-A11, -B41 and -Cw3 molecules may be risk factors for esophageal cancer in northern part of Iran.