Effect of Epoetin Alfa and Sodium Valproate in Patients with Myelodysplastic Syndrome

Background: Myelodysplastic syndrome (MDS) is an important precancerous disease leading to blood malignancies. Prompt diagnosis and treatment would result in better outcome in patients. Purpose of the study was to determine the effect of Epoetin Alfa and Sodium Valproate in patients with MDS. Materials and Methods: In this interventional quasi-experimental study, 50 consecutive patients with MDS from Taleghani Hospital (Tehran, Iran) in 2016-2017 were enrolled. They underwent treatment for eight months with 10000 units per month from Epoetin Alfa plus 200 mg TDS from Sodium Valproate. The hematological response was determined according to the hemoglobin, platelet, and neutrophil. Results: Hematological response was present in 68%. The packed cell treatment were decreased significantly (P=0.040) and 56% of patients had no receipt of packed cells after treatment. Conclusion: It is concluded that Epoetin Alfa plus Sodium Valproate was effective in treatment of patients with Myelodysplastic syndrome and use of this combination therapy is recommended

Effects of low level laser therapy on mucositis in patients under chemotherapy and bone marrow transplantation

Background: Oral mucositis is among the most important adverse effects of chemotherapy and bone marrow transplantation and prevention from this side effect is important to improve the situations in patients. Hence, in this study the main aim was to determine the effects of low-level laser therapy on mucositis in patients under chemotherapy and bone marrow transplantation. Materials and Methods: In this randomized controlled clinical trial, 60 consecutive patients under chemotherapy and bone marrow transplantation in a training hospital in 2018 were enrolled and randomly assigned to receive either low-level laser therapy (630 and 780 nm) or off-laser. Finally, the frequency rate and severity of mucositis (grades 0 to 4 according to WHO severity index) were determined and compared across the groups. Results: Mucositis was present in 30% and 56.7% in laser and control groups, respectively with statistically significant difference (p=0.037). The severity of mucositis was same across the laser and control groups (p=0.785). Conclusion: Low-level laser therapy is an effective modality for preventing from mucositis in patients treated by chemotherapy and bone marrow transplantation. Accordingly, utilization of this safe and effective therapeutic method is recommended

Assessment of Effectiveness and Adverse Effect of New Combination Chemotherapy (irinotecan, cisplatin, and dexamethasone) in Relapse and Refractory Hodgkin Lymphoma

Background: Chemotherapy with adriamycin, bleomycin, vinblastine, and dacarbazine (ABVD regimen) cannot cure all patients with Hodgkin lymphoma. In this study, we evaluated the efficacy and adverse effect of a new regimen consist irinotecan, cisplatin, and dexamethasone (ICD) in relapsed and refractory Hodgkin lymphoma as the second to fifth line of treatment. Materials and Methods: We performed a retrospective study in 26 relapsed or refractory patients with Hodgkin lymphoma receiving at least the first-line chemotherapy regimen (ABVD) and (ICD) as salvage therapy in Thaleghany Hospital from 2012 to 2018. This regimen consisted of irinotecan 65mg/m2 D1, D8, cisplatin 30mg/m2 D1, D8, and dexamethasone 40mg D1, 2, 8, and 9 was administered every 3 weeks for 6 cycles.  Treatment was discontinued in cases of disease progression or severe toxicity. Response to treatment was evaluated after two cycles. Patients with complete and partial remission were candidate high dose chemotherapy and autologous stem cell transplantation. Twenty-four patients were enrolled in the study. The mean age of 22 patients was 31.5 (19-67) years. Seven patients (29.1%) were in the first recurrence, and 17 (70.8%) were in the second or subsequent recurrence. Results: According to this study, three patients (12.5%) had complete response, 13 (45%) had partial response, four (16.6%) had stable disease, and four (16.6%) had progressive disease. Nine patients (37.5%) received high-dose chemotherapy and autologous stem cell support after ICD regimen. None of the cycles of chemotherapy were delayed due to treatment-related adverse event. Overall survival after six months in all patients was 91%, and mortality rate was 8.3% at the end of the study. Conclusion: The goal of salvage chemotherapy in relapsed or refractory Hodgkin Lymphoma is achieving CR or PR preparation patients for stabilization with BMT. Thus, we recommend ICD as one of the most effective protocols with overall response rate of 66% in this population.