Publications by authors named "Shabnam Shokouhi"

5 Publications

  • Page 1 of 1

Effects of aGVHD and cGVHD on Survival Rate in Patients with Acute Myeloid Leukemia after Allogeneic Stem Cell Transplantation.

Int J Hematol Oncol Stem Cell Res 2015 Jul;9(3):112-21

Hematology-Oncology and Stem Cell Transplantation Research Center, Tehran University of Medical Sciences, Tehran, Iran.

Background: Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) is a curative treatment option for many patients with Acute Myeloid Leukemia (AML); however, it can lead to complications of Graft-Versus-Host-Disease (GVHD) which can affect the quality of life and overall survival. The aim of this study was to assess the effects of both acute and chronic GVHD on survival rate in patients with AML who received HSCT.

Subjects And Methods: In a longitudinal study, 587 patients with AML who underwent bone marrow transplantation in Tehran-Iran between1991 and 2011 were recruited. All patient records were analyzed for the occurrence of adverse events including acute and chronic GVHD and leukemia relapse. Data were analyzed using Log-rank, Kaplan-Meier, Univariate and Multivariate Cox Regression models.

Results: The five-year overall survival (OS) was found to be 71.9% (95% CI: 67.40-76.41). Also there was a significant relationship between cGVHD and OS (P=0.001, HR = 0.476, 95%). Hazard of death in these patients was less than those who did not experience an occurrence of cGVHD and aGVHD (HR= 0.629, P= 0.078). A significant relationship between cGVHD and relapse was observed (P< 0.001) indicating that patients who developed cGVHD experienced a better survival rate. A significant relationship was also found between overall survival and aGVHD grade (P< 0.001). Hazard of death (HD) for cGVHD and relapse variables were estimated to be 0.554 and 3.869.

Discussion: This study is one of the largest studies (regarding the number of participants) done to date in the Middle East with quite a long duration (20 years). cGVHD appears to have a positive influence on survival rate in patients with AML who received HSCT. It is recommended that further studies investigate the underlying reason or mechanisms behind this.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4529677PMC
July 2015

Association between PGC-1alpha gene polymorphisms and type 2 diabetes risk: a case-control study of an Iranian population.

Can J Diabetes 2015 Feb 1;39(1):65-72. Epub 2014 Oct 1.

Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran; Department of Clinical Biochemistry, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran. Electronic address:

Objective: The peroxisome proliferator-activated receptor gamma coactivator-1alpha (PGC-1alpha) gene could play a role in the onset of type 2 diabetes mellitus. The aim of this study was to explore the possible associations among polymorphisms Gly482Ser, Thr394Thr and Thr528Thr of the PGC-1alpha gene and the risk of type 2 diabetes in Kurdish-Iranians.

Methods: DNA specimens from all 173 type 2 diabetes subjects and 173 normoglycemic subjects were genotyped by the polymerase chain reaction-restriction fragment length polymorphism method. Genotypic and allelic frequencies were analyzed in each group. Serum lipids, fasting glucose, fasting serum insulin, homeostasis model assessment of insulin resistance and glycated hemoglobin levels were determined using the conventional methods. The data were analyzed using SPSS software.

Results: The GA genotype of Gly482Ser was associated with a significant susceptibility for type 2 diabetes (odds ratio 5.23, p<0.000). Furthermore, the GA genotype of Thr528Thr had a higher risk for type 2 diabetes (odds ratio 2.37, p<0.002). Normoglycemic persons carrying the GA+AA genotypes of Gly482Ser variation had significantly lower high-density lipoprotein cholesterol in comparison with persons having GG genotype. In comparison with GG genotype carriers, normoglycemic subjects carrying the GA+AA genotypes of Thr394Thr variation had significantly higher fasting blood sugar, fasting serum insulin and homeostasis model assessment of insulin resistance. Normoglycemic subjects with the GA+AA genotypes of Thr528Thr variation had significantly higher levels of low-density lipoprotein cholesterol compared with subjects having the GG genotype. Type 2 diabetes subjects carrying the GA+AA genotypes of this polymorphism had significantly higher waist-hip ratio in comparison with the GG genotype carriers. We also found that haplotype 394-GG/482-GA/528-GG of PGC-1alpha was significantly associated with higher risk of type 2 diabetes.

Conclusions: Our findings revealed significant associations between PGC-1alpha Gly482Ser and Thr528Thr polymorphisms and type 2 diabetes in Kurdish-Iranians.
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http://dx.doi.org/10.1016/j.jcjd.2014.05.003DOI Listing
February 2015

Association of rs7903146, rs12255372, and rs290487 polymorphisms in TCF7L2 gene with type 2 diabetes in an Iranian Kurdish ethnic group.

Clin Lab 2014 ;60(8):1269-76

Background: Single nucleotide polymorphisms (SNPs) within the transcription factor 7-like 2 (TCF7L2) gene are well known risk variants for type 2 diabetes mellitus (T2DM). The association between TCF7L2 SNPs and T2DM has been investigated in several studies, but the results are controversial. In this study, we investigated whether the rs7903146, rs12255372, and rs290487 polymorphisms of TCF7L2 are associated with T2DM per se or metabolic traits related to this disease in a Kurdish ethnic group of Iran.

Methods: In all, 173 patients with T2DM and 173 normoglycemic subjects were included in this study. All subjects were genotyped using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP). Genotypic and allelic frequencies were then analyzed in each group. Serum lipids, fasting glucose, fasting serum insulin, HOMA-IR, and HbA1c levels were determined by conventional methods.

Results: T-allele and genotype frequencies of rs7903146, rs12255372, and rs290487 were significantly different between T2DM and control subjects. The CT genotype (OR = 1.98, p = 0.008), TT genotype (OR = 3.54, p = 0.024), and the dominant model (OR = 2.16, p = 0.002) of rs7903146 were associated with T2DM. The GT genotype (OR = 2.23, p = 0.005), TT genotype (OR = 4.25, p = 0.046), and the dominant model (OR = 2.2, p = 0.001) of rs12255372 gave a higher risk for T2DM. The carriers of CT genotype of rs290487 showed a significantly increased risk for T2DM (OR = 2.24, p = 0.003). Similarly, the dominant model of this SNP was found to be significantly associated with T2DM (OR = 2.25, p = 0.002). The control subjects carrying the T-allele of rs7903146 had higher levels of total cholesterol (CC; 4.52 +/- 1.03 vs. CT + TT; 5.00 +/- 1.2 mmol/L, p = 0.009) than those with CC genotype. Normoglycemic subjects carrying GT + TT genotypes of rs12255372 had a significantly higher WHR (GG; 0.90 +/- 0.059 vs. GT + TT; 0.93 +/- 0.07, p = 0.038) as compared with those with the GG genotype.

Conclusions: The T-allele of rs12255372, rs7903146, and rs290487 polymorphisms of TCF7L2 confer susceptibility to T2DM in the Kurdish population of Iran.
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http://dx.doi.org/10.7754/clin.lab.2013.130809DOI Listing
October 2014

A case-control study on the association of common variants of CAPN10 gene and the risk of type 2 diabetes in an Iranian population.

Clin Lab 2014 ;60(4):663-70

Background: Calpain-10 is a ubiquitously expressed protease that serves as an intracellular calcium-dependent cysteine protease and is regarded to be one of the candidate genes for type 2 diabetes mellitus (T2DM). We aimed to identify the association of the common variants of this gene and the risk of T2DM in the Kurdish ethnic group of Iran.

Methods: Study groups included 173 T2DM and 173 normoglycemic subjects. Genotyping was determined by PCR-RFLP. Genotypic and allelic frequencies were then evaluated. Data was analyzed using SPSS software.

Results: The allelic frequency of the A-allele of SNP-43 variant was significantly different (p = 0.01) between case and control groups (18% vs. 11%). The genotype frequencies for SNP-43 did not show any significant difference between case and control individuals. However, the dominant model of SNP-43 was found to be significantly associated with T2DM (OR = 1.75, 95% CI = 1.06 - 2.89, p < 0.029). The distribution and allele frequency of other SNPs (SNP-19 and -63) did not show any significant difference between the study groups. For SNP-43, fasting serum insulin (p = 0.043) and HOMA-IR (p = 0.026) were higher in the control subjects with the GA+AA genotype when compared with the GG genotype. Among the T2DM subjects, there was no significant difference in any of the clinical or biochemical parameters between the GG and GA+AA genotypes of SNP-43. Normoglycemic subjects carrying the 2R/3R+3R/3R genotypes of SNP-19 had significantly lower HDL-C (p = 0.034) as compared with those with the 2R/2R genotype. In T2DM subjects, no significant difference was found in any of the clinical or biochemical parameters between 2R/2R and 2R/3R+3R/3R genotypes. T2DM subjects carrying the CT+TT genotypes of SNP-63 variation had significantly higher LDL-C (p = 0.015) as compared with those with the CC genotype. In normoglycemic subjects, no significant difference was found in any of the clinical or biochemical parameters between CC and CT+TT genotypes.

Conclusions: Our findings revealed that there is an association between the SNP-43, but not SNP-19 and -63, and T2DM in the Kurdish ethnic group of West Iran.
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http://dx.doi.org/10.7754/clin.lab.2013.130630DOI Listing
May 2014

Effects of aGVHD and cGVHD according to relapse status on survival rate in patients with acute lymphocytic leukemia.

Hematology 2014 Dec 23;19(8):441-7. Epub 2014 Jan 23.

Objectives: Graft-versus-host disease (GVHD) is an exaggerated and dysregulated response of the normal immune system to tissue damage that is intrinsic to transplantation. The aim of this study was to assess the effects of acute GVHD (aGVHD) and chronic GVHD (cGVHD) according to relapse status on the survival rate in patients with acute lymphocytic leukemia (ALL).

Methods: Patients with ALL (n = 425) between 1991 and 2011, who underwent bone marrow transplantation and stem cell transplantation in Tehran (Iran), were recruited into a longitudinal study. All patient records were screened for the occurrence of adverse events including GVHD and relapse. Data were assessed using SPSS software with log-rank, univariate, and multivariate Cox regression analyses.

Results: Five-year survival rate based on a Kaplan-Meier curve was 60.2% overall (95% confidence interval (CI): 54.32-66.08) and 66.6% (95% CI: 59.35-73.86) for individuals in their first complete remission (CR1) disease stage. A significantly higher survival rate was observed for patients who developed cGVHD in comparison with those who did not develop it, with a 2.7 fold increased risk of mortality for the latter group (P < 0.001). A significant Cox proportional hazard ratio of 2.3 was observed for mortality following adjustments for age and gender. The presence of cGVHD, reduced the risk of mortality for all individuals, which was observed to be significant for those patients without relapse (P = 0.004).

Conclusion: This study is one of the largest studies (regarding the number of participants) done to date in the Middle East with quite a long duration (20 years). Findings suggest that cGVHD has a positive influence on the survival rates for ALL patients, which subsequently may assist physicians to make optimal treatment decisions. Additional research is now needed to determine the mechanisms around this increased survival and its influence on patients' survival.
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http://dx.doi.org/10.1179/1607845414Y.0000000151DOI Listing
December 2014