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Background: Leukemia is the most common type of cancer in children which its relapse decreases the patients’ survival rate. The aim of this study was to determine the risk factors involved in leukemia relapse in patients in Shahid Faghihi Hospital, Shiraz, during 2004-2009 years. Materials and Methods: In this retrospective cohort study, 280 patients with acute lymphoblastic leukemia and acute myeloid leukemia were included. Patient characteristics were analyzed with respect to their association with recurrence through Chi-square test, Fisher’s exact test, and logistic regression model using SPSS software version 16 (P-value<0.05). Results: Logistic regression model revealed a statistically significance relationship between age and recurrence of the disease (odds ratio (OR) = 0.35, 95% confidence interval (CI) = 0.15-0.82), odds ratio of relapse in the 5-10 years old age group was 0.35 times more than the 0-5 years old age group (p=0.01). Conclusion: Noticing the greater likelihood of relapse in 0-5 years old age group compared with the 5-10 years old age group, more attention and better follow-up for decreasing the side effects of the disease and enhancing the survival rate of the 0-5 y/o age group are recommended.

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Background: Osteopenia is a common and sometimes disabling consequence of the treatment of common neoplastic diseases, such as acute lymphoblastic leukemia (ALL) and lymphoma in children. The aim of the present study was to evaluate the preventing effects of alendronate on steroid-induced osteopenia in children with ALL and non- Hodgkin’s lymphoma (NHL).

Materials and Methods: In this clinical trial, 30 children with ALL and NHL were purposefully selected. All patients received the same induction chemotherapy protocol. Then they were randomly divided into two matched groups. All of them received equivalent supplement of 400 IU/d vitamin D and 30-40mg/kg/d calcium. The patients of the case group received 35mg/week alendronate for 6 months as well. Lumbar spine and whole body bone densitometry were performd before and after intervention and Z score was calculated for all patients.  

Results: The mean age of the studied population was 6.11(±3.36) years and 15 of the children (50%) were male. There was no statistically significant difference in lumbar spine and whole body bone densitometry and Z score before and after intervention between the two groups (p>0.05). The improvement of bone densitometry and Z score were seen in both groups after intervention which was more in the case group but it was not statistically significant (p>0.05).

Conclusion: Administration of 35 mg/week alendronate for 6 months does not cause significant improvements in bone densitometry variables in children with ALL and NHL.  

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Background: Multidrug resistance is the main reason for unsuccessful chemotherapy. The important reason of drug resistance is ATP dependent pumps shus as MDR1 that extrude drugs from the cell. MDR1 is high polymorphic. It seems that polymorphisms influent on gene expression and response to treatment. The aim of this study was investigation of C1236T polymorphism MDR1 gene and it’s association with response of treatment in childhood acute lymphoblastic leukemia.

Materials and Methods: In this descriptive study, C1236T polymorphism of MDR1 was investigated in 44 acute lymphoblastic leukemia childhood and 40 healthy individual by ARMS-PCR technique. Association of this polymorphism with response to treatment was also investigated. Data were analyzed using Chi-squre test and SPSS software. P values <0.05 were considered to be statistically significant.

Results: There was no significant difference in frequencies of C1236T polymorphism between patients and healthy group (p=0.876). Frequency of C1236T polymorphism of MDR1 between responder and non responder was not significant (p=0.304).

Conclusion: It seems that there is no correlation between C1236T polymorphism of MDR1 gene and response to treatment. So the role of C1236T polymorphism in gene expression MDR1 in childhood acute lymphoblastic leukemia and response to treatment is still controversial.

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Background: Doxorubicin is a chemotherapeutic agent still in widespread use in hematologic malignancies. A side effect of anthracyclines such as doxorubicin is the activation of nuclear factor-&kappaB (NF-&kappaB), a potent inducer of antiapoptotic genes, which may blunt the therapeutic efficacy of the drugs. In this study, the effect of indole -3-carbinol (I3C) on the activation NF-&kappaB and the anti-apoptotic genes whose expression is regulated by NF-&kappaB was assessed in NALM-6 cells.

Materials and Methods: NALM-6 cells were preincubated with various concentrations of I3C and then treated with doxorubicin. Cellular DNA content assay and Annexin V-FITC staining were performed by flowcytometry for evaluation of apoptosis. For assessing the effect of I3C on the expression of XIAP, survivin, and nuclear p65 proteins, NALM-6 cells were pretreated with I3C and then incubated with doxorubicin. Whole-cell and nuclear extracts were prepared for Western blot analysis. A paired t-test was conducted to evaluate the results.

Results: DNA histogram analysis of NALM-6 cells indicates a combination of I3C with doxorubicin significantly escalated the percentages of sub-G1 population cells compared with doxorubicin - only treated group (p<0.05). Annexin V-FITC staining also showed that cotreatment of NALM-6 cells with I3C and doxorubicin significantly increased the proportion of Annexin-V positive cells in comparison with the doxorubicin treated cells (p<0.05). The western blot analysis indicated I3C significantly inhibits both doxorubicin -induced nuclear translocation of p65 and the expression of doxorubicin-induced NF-&kappaB target.

Conclusion: Our results indicated that using natural non-toxic inhibitors of NF-&kappaB such as I3C in combination with anthracyclines might be a rational combination therapy for BCP-ALL cells in which NF-&kappaB is constitutively active.