Efficacy and safety of Iranian made deferasirox [Osveral]in Iranian major thalassemic patients with transfusional iron overload: a one year prospective multicentric open-label non-comparative study

To determine the efficacy, adverse effects and safety of a new Iranian generic product of deferasirox [Osveral] in Iranian transfusion dependent major thalassemic [TD-MT] patients. In 9 main thalassemia treatment centers, all of TD-MT patients [aged >/= 2 yrs] with serum ferritin [SF] levels >/= 1000 ng/ml, or >100 ml/kg of RBC transfusion, who could not tolerate parental iron chelating were recruited regardless of their previous iron chelation therapy. Periodical clinical and laboratory evaluations were conducted for adverse effects [AEs]. Primary efficacy end point was Mean of Relative Change of Serum Ferritin [MRC-SF] from the baseline level during one year. Analysis of variance [ANOVA], t test, chi-square or Fisher exact test were used for statistic analysis appropriately [P values <0.05 were considered as statistical significant]. In 407 cases the male/female ratio was 0.98. Mean age was 11.5 +/- 7.4 [2-58] years. The mean of initiating dose of Osveral and mean usage dose during the study was 23.5 +/- 4.9 mg/kg and 24.9 +/- 4.9 mg/kg respectively. MRC-SF was -11.44% +/- 38.92 and it showed significant decline in SF [P value<0.001] one hundred and forty eight patients out of 407 patients experienced at least one. AE, the most common of them were transient increase in serum creatinin [97;24.1%] and > 5 time increase in transaminases [24;5.89%].The causes of discontinuation of treatment were non-satisfactory treatment [24; 5.8%], poor or non-compliance of patients [21;5.1%], and adverse effects [13; 3.1%]. A detailed comparison with similar studies on deferasirox [Exjade] shows a promising efficacy and safety for its Iranian generic product [Osveral]

[Evaluation of correlation between iron over load and the response of chronic hepatitis c in thalassemia major patients treat with alfa- interferon and ribavirin]

beta thalassemia is genetic disorders in beta globin chain production. There is either a complete absence of beta globin chain production or a partial reduction. In bone marrow, thalassemic mutations disrupt the maturation of red blood cells, resulting in ineffective erythropoiesis and disrupt of red blood cells in spleen causes severe hemolytic anemia in beta thalassemia major Patients. Transfusion therapy can lead to normal life expectancy but also exposes Patients to the risks of iron over load and transfusion - transmitted viruse. [Especially HCV] these Patients need for effective anti viral therapy in addition to regular iron chelation. Evaluation of correlation between iron over load and the response of chronic hepatitis C In thalassemia major Patients treat with alfa- interferon and ribavirin. We enrolled 30 Patients with beta thalassemia major and chronic hepatitis C who referred to clinic of hematology from December 1998 to April 2006. HIC was measured by atomic absorption spectroscopy before treatment. Hepatitis C virus, genotype, viral load, were analyzed. Multiple variables were analyzed by SPSS [15] Among the 30 Patients, 17 cases [56.7%] were male and 13 cases [43.3%] female. HIC was determined on a liver biopsy specimen. This study showed that HIC was not correlated to a therapeutic response [p =1]. Evaluation of correlation between viral load and therapeutic response showed that viral load was not correlated to a therapeutic response [p= 0.414]. Among the 30 Patients, 24 cases [80%] had genotype la and 6 cases [20%] had genotype 3a and genotyping was not correlated to a therapeutic response. [p<0.068]. Gender and HIC were not correlated to a therapeutic response. [Male p=0.226] and [female p= 0.199]. In this study HIC, genotyping, viral load and gender were not correlated to a therapeutic response and it does not need chelation therapy before anti viral therapy

[Epidemiologic evaluation of pediatric malignancies in 17 Shahrivar hospitals]

Introduction: although cancers occur rarely in children, they considered as the second cause of death in children underl4 years old. Cancers in children differ markedly from those in adults according their nature, distribution, and prognosis. Acute Lymphoblastic leukemia and lymphoma account about 40% , central nervous system tumors consist of 30% and embryonal malignancies and sarcoma account for about another 10% of all pediatric cancers

Objective: epidemiologic evaluation of pediatric causes of cancer who referred to 17 Shahrivar hospital in Rasht during 2001-2007

Materials and Methods: this descriptive cross- sectional study was carried out in 17 Shahrivar hospital in Rasht from 2001-2001 .All cases of pediatric cancers were included in this study. All information about the age, sex, type of cancers and residence of patients were collected from their medical records; 152 forms were completed and the data were analyzed by SPSS

Results: among 152 patients with different types of malignancy there were 89 male [58.6%] and 63 female [41.4%]. Ratio of male to female was 1.36 in acute lymphoblastic leukemia, 0.71 in AML 4 in non-hokin ulmphoma [NHL], 0.33 in sarcoma. 1.6 In Wihns Tumor, 2 in Hodgkin disease, 5 in neuroblastoma 0.25 in soil tissue srircoma mid 0.5 in medulloblnstoma. The peak incidence of cancer was in the ages between 3 to 4 years. [11.2%] and lowest was in the ages of 14 to 15 years [0.7%]. ALL was the most common cancer 47.6% and Langcrhanse hisliocytosis was the least common one [0.7%]. The prevalence of other malignancies were NHL 9.9% , Wilms Tumor 8.6% , AML 7.9% CNS TumorsS.9% . HD 5.9% . The majority of patients were inh11bitance Of Rasht [47.4%]. Hashtpar 7.2% . Rudsar 5.9% Langrood 5.3% and Fouman 4.6% consisted the next four cities with high rates of pediatric cancers. Amlash and Siahkal had the lowest prevalence of patients [0.7%]

Conclusion: in this study pediatric malignancies were more prevalent in males and the other epidemiological characteristics were quite different from the other studies, It need further evaluation