Objectives: The aim of this study was the evaluation of glycometabolic function, lipid profile, and liver function in patients with β thalassemia major (TM) and their relationship with serum iron and ferritin.Methods: Fasting serum glucose, insulin, cholesterol, triglyceride (TG), and liver enzymes were evaluated for 78 homozygous TM patients and 122 normal control subjects. Serum iron, ferritin, and insulin resistance index (IRI) were determined for them.Results: Fasting serum glucose, TG, aspartate transaminase (AST) levels, alanine transaminase (ALT) levels, and IRI were significantly higher in the homozygous TM patients than in the controls (P<0.0001 for all). Serum cholesterol was significantly lower in patients (P=0.003), and 5.1% of cases had diabetes mellitus.Conclusions: Impaired glucose and lipid metabolism, and also liver dysfunction were observed in about 18%, 30%, and 20% of the patients, respectively. Normoinsulinemia and a high IRI suggest beta cell failure. Better evaluation of iron toxicity can protect patients from complications associated with treatment.
Neuroblastoma is the most common extracranial solid tumor of children, accounting for an estimated 15% cancer-related deaths in this period. It has been hypothesized that drug resistance of cancer stem cells may be responsible for chemotherapy failure, sustained tumor growth, and recurrence in many solid tumors. In this study, we investigated the expression of Octamer-binding transcription factor 4 (Oct4) and Nanog, two stem cell markers, in 47 neuroblastic tumors by immunohistochemistry and correlated their expression by other prognostic factors especially with NMYC amplification using both fluorescent and chromogenic in situ hybridization methods. Twenty three cases (48.9%) showed Oct4 signals and eight cases (17%) showed Nanog expression. All Nanog positive tumors showed Oct4 expression. Seven cases (14.1%) had NMYC amplification. There was also no association between positive Oct4 and Nanog reactivity and tumor morphology, age, mitosis-karyorrhexis index, NMYC amplification, favorable or unfavorable histology, and risk groups (p > 0.05). Cancer stem cells hypothesis is a challenging issue and controversies exist about their significance. Although our study did not show strong association between prognostic factors and expression of stem cell markers, performing of further large-scale studies of various neuroblastic tumors with various stages is suggested.
Administration of one dosage of DTP/Td vaccine during maintenance therapy and after cessation of therapy could be recommended, while one dosage of MMR vaccine at least three months after completion of therapy could be safe and beneficial.
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