Introduction: Evidence suggests that Lysosome associated protein transmembrane 4B (LAPTM4B) contributes to the risk of numerous cancers. The present study aimed to find out the impact of LAPTM4B polymorphism on the risk of childhood acute lymphoblastic leukemia (ALL) in the southeastern Iranian population. Materials and Methods: A total of 230 subjects including 110 children diagnosed with ALL and 120 healthy children enrolled in this case-control study. Genomic DNA was extracted from the whole blood by salting out method. Genotyping of LAPTM4B polymorphism was performed by polymerase chain reaction (PCR). Results: The results showed that LAPTM4B polymorphism significantly increased the risk of ALL in codominant (OR=1. 91, 95% CI =1. 08-3. 40, p=0. 025, 1/2 vs 1/1), dominant (OR=2, 95%CI=1. 14-3. 54, p=0. 014 1/2+2/2 vs 1/1), and allele (OR = 1. 74, 95% CI = 1. 10– 2. 75, p = 0. 017, 2 vs 1) genetic models Conclusion: Conclusively, our findings showed that LAPTM4B polymorphism is the risk factor of childhood ALL in our population. Further studies with larger sample sizes and different ethnicities are needed to confirm our findings.

Background & Aim: The aim of this study is to determine an association between lymphoblastic lymphoma and myasthenia gravis. A 23-year-old male patient with myasthenia gravis (MG) developed mediastinal precursor T-lymphoblastic lymphoma (LBL), 15 months after MG diagnosis and treatment, presented with classic symptoms and MG crisis as a sign of LBL. LBL subtype was determined by using an immunohistochemistry test for B or T cell differentiation. His LBL did not show any high risk factors. His reaction was very well to CHOP (Cyclophosphamide, Doxorubicin, Vincristine, Prednisolone) chemotherapy with significant reduction in his myasthenic symptoms. Discussion: Decrease in signs of disease can show a significant relation- ship between myasthenia gravis and mediastinal lymphoblastic lymphoma.

Background: As a new point, some very rare features can be revealed as initial diagnosis of acute lymphoblastic leukemia (ALL) without any evidence of lymphoma-like behavior which after initial recovery, presents with new evidence of lymphoma. Herein, a case of the immunophenotypes of blast cells in B-cell precursor acute lymphoblastic leukemia originated from MYC gene-related that was evidenced later by burkitt lymphoma feature. Case Presentation: Our case was initially diagnosed as a typical B-cell ALL cells with L1 morphology in peripheral blood smear and bone marrow aspiration that was not recovered and referred again that was finally featured as burkitt’, s lymphoma with L3 morphological feature. Conclusion: Thus, in the primary diagnosis of B-cell ALL and especially in cases with treatment failure, the final feature of burkitt’, s lymphoma should be potentially in mind.

Background: T and B acute lymphoblastic leukemia (T, B-ALL) has seen improved survival rates with intensified chemotherapy, but therapy-resistant or refractory ALL remains a significant clinical challenge. This study examined the inhibitory effects of Venetoclax drug on the apoptosis gene to explore its potential as a novel therapeutic approach for treating human T, B-ALL.Method: This was a preclinical experimental study. Firstly, samples were collected from a leukemia patient, followed by isolating blast cells that were injected into primary mice. The sample was obtained from mice in 1, 8 and 14 days; the CD45 human was quantified using flow cytometry to confirm the development of leukemia. Spleen cells from the primary mice were isolated and injected into the secondary mice. After 14 days, the Venetoclax drug was administered to the mouse models for 21 days. Subsequently, mouse spleen cells were gathered, and the expression of genes associated with apoptosis was assessed. A two-tailed t-test was performed to compare the expression of apoptotic genes between the control and Venetoclax-treated groups.Results: Our findings indicated a decrease in the expression of the B-cell lymphoma 2 (BCL-2) gene, while the expression of the BCL-2-interacting mediator (BIM) of cell death gene exhibited an augmentation. The level of expression of the MCL-1 (Myeloid leukemia 1) gene did not display any significant divergence compared with the control group.Conclusion: Venetoclax drug shows potential therapeutic potential in B and T-ALL, increasing BIM expression and decreasing BCL-2, but further investigation and clinical trial studies are needed.

Background: Transcription factors (TFs) play a key role in the development, therapy, and relapse of B-cell malignancies, such as B-cell precursor acute lymphoblastic leukemia (BCP-ALL). Given the essential function of Forkhead box protein P1 (FOXP1) transcription factor in the early development of B-cells, this study was designed to evaluate FOXP1 gene expression levels in pediatric BCP-ALL patients and NALM6 cell-line. Materials and Methods: This case-control study was done on the NALM6 cell-line and bone marrow specimens of 23 pediatric BCP-ALL patients (median age: 7. 5 years; range: 2. 0 – 15. 0 years) at different clinical stages including new diagnosis, 15th day after the treatment, and relapse. Also, 10 healthy children were included as the control group. FOXP1 gene expression was analyzed by quantitative real-time polymerase chain reaction (qRTPCR). The correlation analysis was performed between the FOXP1 gene expression and patients’ demographic and laboratory characteristics. Results: The results showed that FOXP1 gene expression was significantly downregulated in the NALM-6 cellline (median=0. 05, P<0. 001) and patients at new diagnosis (median=0. 06, p<0. 0001), and relapse (median=0. 001, p<0. 0001) phases, compared to the control group (median=0. 08). FOXP1 gene expression on the 15th day of the treatment was significantly higher than its level at the new diagnosis stage (p<0. 001). Moreover, FOXP1 gene was significantly downregulated in the relapse phase compared to the new diagnosis. Patients whose number of bone marrow blasts on the 15th day of the treatment was below 5% had higher FOXP1 gene expression at the diagnosis phase (Spearman’ s correlation, P<0. 05, r=-0. 485) and higher ratio of diagnosis/day 15 (p<0. 001, Mann-Whitney U test). Conclusions: FOXP1 levels could be a potential biomarker of therapy response in remission induction therapy for pediatric BCP-ALL patients.

Background: Acute lymphoblastic leukemia (ALL) is the most common neoplasm in pediatric and adolescent populations. Overall survival has improved in recent decades. This study aimed to assess the overall survival of patients with pediatric ALL in a Latin American hospital. Materials and Methods: A longitudinal and retrospective analytical study was conducted on 31 patients less than 16 years of age diagnosed with ALL at the hematology department of a Peruvian hospital during the period 2015-2016. Overall survival at 5 years was determined using the Kaplan-Meier curve with parametric log-rank tests, and the Cox regression model was employed to ascertain the hazard ratios of significant variables. Results: The average age was 6 years, and 21 (67. 7%) were female. The 5-year overall survival rate was 35%, with a median survival of 33 months (95% CI = 34. 078-66. 861). Being 10 years or older was associated with lower survival (p = 0. 002). No significant association with B-cell acute lymphoblastic leukemia was found (p = 0. 057). Conclusion: The overall survival rate obtained was similar to that reported in other local studies, however, several international studies have reported better survival rates compared to our findings. Age was identified as a significant factor affecting survival.

Background: Acute lymphoblastic leukemia (ALL) is the most common cancer among children. The prognostic significance of the cluster of differentiation 34 (CD34) markers in children with B-cell acute lymphoblastic leukemia (B-ALL) is not yet fully understood. Materials and Methods: This study is a case-control trial based on the clinical data of 40 children with B-ALL who referred to a pediatric oncology center in the city of Sari, Iran. The data were derived from the demographic findings, laboratory test results at diagnosis, immunophenotyping, transfusion of blood products including packed red blood cells and platelet concentrates, and the frequency and duration of hospitalization due to febrile infection. Results: Of the participants, 42.5% were CD34-negative and 57.5% were CD34-positive. The mean age of the patients at diagnosis was 3.1 ± 3.3 years (Range:0.1-13.3 years). Also, 60.9% of the CD34-positive children and 47.1% of the CD34-negative ones were boys (P = 0.38). According to the calculated Cohen's d, the relationship of CD34 positivity with transfused packed red blood cell and platelet concentrates was mild -0.15 (95% CI -0.78 to 0.47) (P = 0.55) and moderate 0.49 (95% CI -0.15 to 1.12) (P = 0.29), respectively, which was significant in neither case. Moreover, the relationship of CD34 positivity with the hospitalization frequency of -0.51 (95% CI -1.14 to 0.13) (P = 0.22) and the hospitalization duration of -0.52 (95% CI -1.16 to 0.12) (P = 0.27) due to febrile infection was moderate to strong. Conclusion: The CD34-positive children with B-ALL experienced less blood products transfusion (except packed red blood cells) and febrile infection in terms of both the frequency and duration of hospitalization during chemotherapy. Therefore, CD34 expression in the B-ALL children was associated with better prognosis.