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Bozkurt C, Hazar V, Malbora B, Küpesiz A, Aygüneş U, Fışgın T, Karakükçü M, Kuşkonmaz B, Kılıç SÇ, Bayırlı D, Arman Bilir Ö, Yalçın K, Gözmen S, Uygun V, Elli M, Sarbay H, Küpesiz FT, Şaşmaz Hİ, Aksoy BA, Yılmaz E, Okur FV, Tekkeşin F, Yenigürbüz FD, Özek G, Atay AA, Bozkaya İO, Çelen S, Öztürkmen S, Güneş AM, Gürsel O, Güler E, Özcan A, Çetinkaya DU, Aydoğdu S, Özbek NY, Karasu G, Sezgin G, Doğru Ö, Albayrak D, Öztürk G, Aksoylar S, Daloğlu H, Odaman Al I, Evim MS, Akbayram S, Öncül Y, Zengin E, Albayrak C, Timur Ç, Kar YD, Çakmaklı HF, Tüfekçi Ö, Töret E, Antmen B. COVID-19 disease in children and adolescents following allogeneic hematopoietic stem cell transplantation: A report from the Turkish pediatric bone marrow transplantation study group. Pediatr Transplant 2024; 28:e14758. [PMID: 38659218 DOI: 10.1111/petr.14758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 02/27/2024] [Accepted: 04/01/2024] [Indexed: 04/26/2024]
Abstract
BACKGROUND Data on the risk factors and outcomes for pediatric patients with SARS-CoV-2 infection (COVID-19) following hematopoietic stem cell transplantation (HSCT) are limited. OBJECTIVES The study aimed to analyze the clinical signs, risk factors, and outcomes for ICU admission and mortality in a large pediatric cohort who underwent allogeneic HSCT prior to COVID-19 infection. METHOD In this nationwide study, we retrospectively reviewed the data of 184 pediatric HSCT recipients who had COVID-19 between March 2020 and August 2022. RESULTS The median time from HSCT to COVID-19 infection was 209.0 days (IQR, 111.7-340.8; range, 0-3845 days). The most common clinical manifestation was fever (58.7%). While most patients (78.8%) had asymptomatic/mild disease, the disease severity was moderate in 9.2% and severe and critical in 4.4% and 7.6%, respectively. The overall mortality was 10.9% (n: 20). Deaths were attributable to COVID-19 in nine (4.9%) patients. Multivariate analysis revealed that lower respiratory tract disease (LRTD) (OR, 23.20, p: .001) and lymphopenia at diagnosis (OR, 5.21, p: .006) were risk factors for ICU admission and that HSCT from a mismatched donor (OR, 54.04, p: .028), multisystem inflammatory syndrome in children (MIS-C) (OR, 31.07, p: .003), and LRTD (OR, 10.11, p: .035) were associated with a higher risk for COVID-19-related mortality. CONCLUSION While COVID-19 is mostly asymptomatic or mild in pediatric transplant recipients, it can cause ICU admission in those with LRTD or lymphopenia at diagnosis and may be more fatal in those who are transplanted from a mismatched donor and those who develop MIS-C or LRTD.
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Affiliation(s)
- Ceyhun Bozkurt
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Istinye University School of Medicine, Bahçelievler Medicalpark Hospital, Istanbul, Turkey
| | - Volkan Hazar
- Department of Pediatric Hematology-Oncology, Memorial Health Group, Medstar Yıldız Hospital, Antalya, Turkey
| | - Barış Malbora
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| | - Alphan Küpesiz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Utku Aygüneş
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Acıbadem Adana Hospital, Adana, Turkey
| | - Tunç Fışgın
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Bahçelievler Medicalpark Hospital, Altınbaş University School of Medicine, Istanbul, Turkey
| | - Musa Karakükçü
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Erciyes University School of Medicine, Kayseri, Turkey
| | - Barış Kuşkonmaz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hacettepe University School of Medicine, Ankara, Turkey
| | - Suar Çakı Kılıç
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Derya Bayırlı
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| | - Özlem Arman Bilir
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara City Hospital, Ankara, Turkey
| | - Koray Yalçın
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Salih Gözmen
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Behçet Uz Training and Research Hospital, Izmir, Turkey
| | - Vedat Uygun
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Antalya Hospital, Antalya, Turkey
| | - Murat Elli
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medipol University School of Medicine, Istanbul, Turkey
| | - Hakan Sarbay
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| | - Funda Tayfun Küpesiz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Hatice İlgen Şaşmaz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Acıbadem Adana Hospital, Adana, Turkey
| | - Başak Adaklı Aksoy
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Bahçelievler Medicalpark Hospital, Altınbaş University School of Medicine, Istanbul, Turkey
| | - Ebru Yılmaz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Erciyes University School of Medicine, Kayseri, Turkey
| | - Fatma Visal Okur
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hacettepe University School of Medicine, Ankara, Turkey
| | - Funda Tekkeşin
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Fatma Demir Yenigürbüz
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Acıbadem University School of Medicine, Istanbul, Turkey
| | - Gülcihan Özek
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ege University School of Medicine, İzmir, Turkey
| | - Abdullah Avni Atay
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Yeni Yüzyıl University School of Medicine, Istanbul, Turkey
| | - İkbal Ok Bozkaya
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara City Hospital, Ankara, Turkey
| | - Suna Çelen
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Seda Öztürkmen
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Antalya Hospital, Antalya, Turkey
| | - Adalet Meral Güneş
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Uludağ University School of Medicine, Bursa, Turkey
| | - Orhan Gürsel
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Gülhane Training and Research Hospital, Ankara, Turkey
| | - Elif Güler
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Akdeniz University School of Medicine, Antalya, Turkey
| | - Alper Özcan
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Erciyes University School of Medicine, Kayseri, Turkey
| | - Duygu Uçkan Çetinkaya
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Hacettepe University School of Medicine, Ankara, Turkey
| | - Selime Aydoğdu
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ümraniye Training and Research Hospital, Istanbul, Turkey
| | - Namık Yaşar Özbek
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara City Hospital, Ankara, Turkey
| | - Gülsün Karasu
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Göztepe Hospital, Istanbul, Turkey
| | - Gülay Sezgin
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Çukurova University School of Medicine, Adana, Turkey
| | - Ömer Doğru
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Marmara University School of Medicine, Istanbul, Turkey
| | - Davut Albayrak
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Samsun Hospital, Samsun, Turkey
| | - Gülyüz Öztürk
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Acıbadem University School of Medicine, Istanbul, Turkey
| | - Serap Aksoylar
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ege University School of Medicine, İzmir, Turkey
| | - Hayriye Daloğlu
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medical Park Antalya Hospital, Antalya, Turkey
| | - Işık Odaman Al
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Medipol University School of Medicine, Istanbul, Turkey
| | - Melike Sezgin Evim
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Uludağ University School of Medicine, Bursa, Turkey
| | - Sinan Akbayram
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Gaziantep University School of Medicine, Gaziantep, Turkey
| | - Yurday Öncül
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Inönü University School of Medicine, Malatya, Turkey
| | - Emine Zengin
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Kocaeli University School of Medicine, Kocaeli, Turkey
| | - Canan Albayrak
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Çetin Timur
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Yeditepe University School of Medicine, Istanbul, Turkey
| | - Yeter Düzenli Kar
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Afyon Health Sciences University School of Medicine, Afyonkarahisar, Turkey
| | - Hasan Fatih Çakmaklı
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Ankara University School of Medicine, Ankara, Turkey
| | - Özlem Tüfekçi
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Dokuz Eylül University School of Medicine, İzmir, Turkey
| | - Ersin Töret
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Osmangazi University School of Medicine, Eskişehir, Turkey
| | - Bülent Antmen
- Department of Pediatric Hematology-Oncology and Bone Marrow Transplantation, Acıbadem Adana Hospital, Adana, Turkey
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Isik E, Aydinok Y, Albayrak C, Durmus B, Karakas Z, Orhan MF, Sarper N, Aydın S, Unal S, Oymak Y, Karadas N, Turedi A, Albayrak D, Tayfun F, Tugcu D, Karaman S, Tobu M, Unal E, Ozcan A, Unal S, Aksu T, Unuvar A, Bilici M, Azik F, Ay Y, Gelen SA, Zengin E, Albudak E, Eker I, Karakaya T, Cogulu O, Ozkinay F, Atik T. Identification of the molecular etiology in rare congenital hemolytic anemias using next-generation sequencing with exome-based copy number variant analysis. Eur J Haematol 2024. [PMID: 38556258 DOI: 10.1111/ejh.14194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 02/29/2024] [Accepted: 03/09/2024] [Indexed: 04/02/2024]
Abstract
OBJECTIVES In congenital hemolytic anemias (CHA), it is not always possible to determine the specific diagnosis by evaluating clinical findings and conventional laboratory tests. The aim of this study is to evaluate the utility of next-generation sequencing (NGS) and clinical-exome-based copy number variant (CNV) analysis in patients with CHA. METHODS One hundred and forty-three CHA cases from 115 unrelated families referred for molecular analysis were enrolled in the study. Molecular analysis was performed using two different clinical exome panels in 130 patients, and whole-exome sequencing in nine patients. Exome-based CNV calling was incorporated into the traditional single-nucleotide variant and small insertion/deletion analysis pipeline for NGS data in 92 cases. In four patients from the same family, the PK Gypsy variant was investigated using long-range polymerase chain reaction. RESULTS Molecular diagnosis was established in 86% of the study group. The most frequently mutated genes were SPTB (31.7%) and PKLR (28.5%). CNV analysis of 92 cases revealed that three patients had different sizes of large deletions in the SPTB and six patients had a deletion in the PKLR. CONCLUSIONS In this study, NGS provided a high molecular diagnostic rate in cases with rare CHA. Analysis of the CNVs contributed to the diagnostic success.
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Affiliation(s)
- Esra Isik
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Yesim Aydinok
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Canan Albayrak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Basak Durmus
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Zeynep Karakas
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mehmet Fatih Orhan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Sakarya University, Sakarya, Turkey
| | - Nazan Sarper
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Sultan Aydın
- Division of Pediatric Hematology and Oncology, Antalya Training and Research Hospital, Antalya, Turkey
| | - Selma Unal
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Mersin University, Mersin, Turkey
| | - Yesim Oymak
- Division of Pediatric Hematology, Dr. Behcet Uz Children's Hospital, Izmir, Turkey
| | - Nihal Karadas
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Aysen Turedi
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Celal Bayar University, Manisa, Turkey
| | - Davut Albayrak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Medical Park Samsun Hospital, Samsun, Turkey
| | - Funda Tayfun
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Akdeniz University, Antalya, Turkey
| | - Deniz Tugcu
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Serap Karaman
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mahmut Tobu
- Department of Hematology, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ekrem Unal
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Alper Ozcan
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Erciyes University, Kayseri, Turkey
| | - Sule Unal
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Tekin Aksu
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Aysegul Unuvar
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Mustafa Bilici
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Fatih Azik
- Department of Pediatrics, Division of Pediatric Hematology, Faculty of Medicine, Muğla Sıtkı Koçman University, Mugla, Turkey
| | - Yilmaz Ay
- Division of Pediatric Hematology and Oncology, Kartal Dr Lütfi Kırdar Training and Research Hospital, Istanbul, Turkey
| | - Sema Aylan Gelen
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Emine Zengin
- Division of Pediatric Hematology, Department of Pediatrics, Faculty of Medicine, Kocaeli University, Kocaeli, Turkey
| | - Esin Albudak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Tepecik Training and Research Hospital, Izmir, Turkey
| | - Ibrahim Eker
- Department of Pediatric Hematology and Oncology and Pediatric Hematopoietic Stem Cell Transplantation Unit, Afyonkarahisar Health Science University Faculty of Medicine, Afyon, Turkey
| | - Taner Karakaya
- Department of Medical Genetics, Samsun Education and Research Hospital, Samsun, Turkey
| | - Ozgur Cogulu
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Ferda Ozkinay
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Tahir Atik
- Division of Pediatric Genetics, Department of Pediatrics, Faculty of Medicine, Ege University, Izmir, Turkey
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Kartal İ, Albayrak C, Dağdemir A, Dinçer OS, Şimşek HK, Özgen Ü, Albayrak D. Clinical features and risk factors of hepatic sinusoidal obstruction syndrome in children after hematopoietic stem cell transplantation: A single-center experience. Transfus Apher Sci 2024:103909. [PMID: 38467529 DOI: 10.1016/j.transci.2024.103909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Revised: 02/06/2024] [Accepted: 03/07/2024] [Indexed: 03/13/2024]
Abstract
Hepatic sinusoidal obstruction syndrome (SOS) is an illness with serious life effects that develops after hematopoietic stem cell transplantation (HSCT). We investigated the risk factors and clinical features of hepatic SOS in children following HSCT in 210 children who underwent allogeneic or autologous HSCT between 2009 and 2021 were analyzed in the context of SOS. The syndrome developed in 22 (10.4%) patients:frequently in neuroblastoma [24% (5/21)], hemophagocytic lymphohistiocytosis [57% (4/7)], and thalassemia major [22% (7/31)]. The median time from HSCT to diagnosis was 16 (6-38) days. Severe disease occurred in 8 (36%) patients, and mild/moderate in 14 (64%) and 4 patients died (18%). In univariate analyses, patient's age ≤ 2 years [odds ratio (OR)= 3.043, P = 0.028], pretransplant AST and ALT levels > 100 U/L (OR=3.576, P = 0.045), and chemotherapy/radiotherapy to abdomen before transplantation (OR = 3.162, P = 0.044) were determined as risk factors. In multivariate analysis, pre-transplant AST and ALT levels > 100 U/L (OR = 16.04, P = 0.010) and ferritin levels over 1000 mg/dl (OR=5.15, P = 0.047) were significant. The only independent risk factor on mortality was the age ≤ 2 years (P = 0.001). Although our study confirmed several risk factors for SOS, we failed to achieve some well-known risk factors. Precautions should be taken considering the factors affecting liver function before transplantation and the risk of SOS in infants receiving chemotherapy and radiotherapy before transplantation, such as neuroblastoma in which comparable results in respect to the chemotherapy only. The risk factors should be fully elucidated in multicenter studies to improve preventive and therapeutic strategies.
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Affiliation(s)
- İbrahim Kartal
- Ondokuz Mayıs University, Faculty of Medicine, Department of Pediatric Hematology and Oncology, Samsun, Turkey.
| | - Canan Albayrak
- Ondokuz Mayıs University, Faculty of Medicine, Department of Pediatric Hematology and Oncology, Samsun, Turkey
| | - Ayhan Dağdemir
- Ondokuz Mayıs University, Faculty of Medicine, Department of Pediatric Hematology and Oncology, Samsun, Turkey
| | - Oğuz Salih Dinçer
- Ondokuz Mayıs University, Faculty of Medicine, Department of Pediatric Hematology and Oncology, Samsun, Turkey
| | - Hülya Kangal Şimşek
- Ondokuz Mayıs University, Faculty of Medicine, Department of Pediatric Hematology and Oncology, Samsun, Turkey
| | - Ünsal Özgen
- Ondokuz Mayıs University, Faculty of Medicine, Department of Pediatric Hematology and Oncology, Samsun, Turkey
| | - Davut Albayrak
- Department of Pediatric Hematology and Oncology, Medicalpark Samsun Hospital, Samsun, Turkey
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Yakici N, Kreins AY, Catak MC, Babayeva R, Erman B, Kenney H, Eke-Gungor H, Cea PA, Kawai T, Bosticardo M, Delmonte OM, Adams S, Fan YT, Pala F, Turkyilmaz A, Howley E, Worth A, Kot H, Sefer AP, Kara A, Bulutoglu A, Bilgic-Eltan S, Yorgun Altunbas M, Bayram Catak F, Karakus IS, Karatay E, Tekeoglu SD, Eser M, Albayrak D, Citli S, Kiykim A, Karakoc-Aydiner E, Ozen A, Ghosh S, Gohlke H, Orhan F, Notarangelo LD, Davies EG, Baris S. Corrigendum to "Expanding the clinical and immunological phenotypes of PAX1-deficient SCID and CID patients" [Clinical Immunology 255 (2023) 109757]. Clin Immunol 2023; 256:109799. [PMID: 37845128 PMCID: PMC10999786 DOI: 10.1016/j.clim.2023.109799] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2023]
Affiliation(s)
- Nalan Yakici
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey
| | - Alexandra Y. Kreins
- Great Ormond Street Institute of Child Health, Infection, Immunity and Inflammation Research & Teaching Department, University College London, London, United Kingdom
- Department of Immunology and Gene therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Mehmet Cihangir Catak
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey
- Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey
- The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Royala Babayeva
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey
- Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey
- The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Baran Erman
- Institute of Child Health, Hacettepe University, Ankara, Turkey
- Can Sucak, Research Laboratory for Translational Immunology, Center for Genomics and Rare Diseases, Hacettepe University, Ankara, Turkey
| | - Heather Kenney
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - Hatice Eke-Gungor
- Division of Pediatric Allergy and Immunology, Kayseri City Training and Research Hospital, University of Health Sciences, Kayseri, Turkey
| | - Pablo A. Cea
- Institute for Pharmaceutical and Medicinal Chemistry, Heinrich Heine University, Düsseldorf, Germany
| | - Tomoki Kawai
- Shizuoka Children's Hospital, Shizuoka, Department of Allergy and Clinical Immunology, Japan
| | - Marita Bosticardo
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - Ottavia Maria Delmonte
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - Stuart Adams
- SIHMDS-Hematology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Yu-Tong Fan
- Great Ormond Street Institute of Child Health, Infection, Immunity and Inflammation Research & Teaching Department, University College London, London, United Kingdom
| | - Francesca Pala
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - Ayberk Turkyilmaz
- Department of Medical Genetics, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey
| | - Evey Howley
- Department of Immunology and Gene therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Austen Worth
- Department of Immunology and Gene therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Hakan Kot
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey
| | - Asena Pinar Sefer
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey
- Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey
- The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Altan Kara
- TUBITAK Marmara Research Center, Gene Engineering and Biotechnology Institute, Gebze, Turkey
| | - Alper Bulutoglu
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey
- Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey
- The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Sevgi Bilgic-Eltan
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey
- Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey
- The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Melek Yorgun Altunbas
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey
- Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey
- The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Feyza Bayram Catak
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey
- Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey
- The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | | | - Emrah Karatay
- Department of Radiology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Sidem Didar Tekeoglu
- Can Sucak, Research Laboratory for Translational Immunology, Center for Genomics and Rare Diseases, Hacettepe University, Ankara, Turkey
- Department of Pediatric Immunology, Hacettepe University, Ankara, Turkey
| | - Metin Eser
- Department of Medical Genetics, Umraniye Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Davut Albayrak
- Department of Pediatrics, Division of Pediatric Hematology, Medicalpark Hospital, Samsun, Turkey
| | - Senol Citli
- Department of Medical Genetics, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ayca Kiykim
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Elif Karakoc-Aydiner
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey
- Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey
- The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Ahmet Ozen
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey
- Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey
- The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Sujal Ghosh
- Department for Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Center of Child and Adolescent Health, Heinrich Heine University, Düsseldorf, Germany
| | - Holger Gohlke
- Institute for Pharmaceutical and Medicinal Chemistry, Heinrich Heine University, Düsseldorf, Germany
- Institute of Bio- and Geosciences (IBG-4: Bioinformatics), Forschungszentrum Jülich GmbH, Jülich, Germany
| | - Fazil Orhan
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey
| | - Luigi D. Notarangelo
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - E. Graham Davies
- Great Ormond Street Institute of Child Health, Infection, Immunity and Inflammation Research & Teaching Department, University College London, London, United Kingdom
- Department of Immunology and Gene therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Safa Baris
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey
- Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey
- The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
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5
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Yakici N, Kreins AY, Catak MC, Babayeva R, Erman B, Kenney H, Gungor HE, Cea PA, Kawai T, Bosticardo M, Delmonte OM, Adams S, Fan YT, Pala F, Turkyilmaz A, Howley E, Worth A, Kot H, Sefer AP, Kara A, Bulutoglu A, Bilgic-Eltan S, Altunbas MY, Bayram Catak F, Karakus IS, Karatay E, Tekeoglu SD, Eser M, Albayrak D, Citli S, Kiykim A, Karakoc-Aydiner E, Ozen A, Ghosh S, Gohlke H, Orhan F, Notarangelo LD, Davies EG, Baris S. Expanding the clinical and immunological phenotypes of PAX1-deficient SCID and CID patients. Clin Immunol 2023; 255:109757. [PMID: 37689091 PMCID: PMC10958138 DOI: 10.1016/j.clim.2023.109757] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/13/2023] [Accepted: 09/02/2023] [Indexed: 09/11/2023]
Abstract
Paired box 1 (PAX1) deficiency has been reported in a small number of patients diagnosed with otofaciocervical syndrome type 2 (OFCS2). We described six new patients who demonstrated variable clinical penetrance. Reduced transcriptional activity of pathogenic variants confirmed partial or complete PAX1 deficiency. Thymic aplasia and hypoplasia were associated with impaired T cell immunity. Corrective treatment was required in 4/6 patients. Hematopoietic stem cell transplantation resulted in poor immune reconstitution with absent naïve T cells, contrasting with the superior recovery of T cell immunity after thymus transplantation. Normal ex vivo differentiation of PAX1-deficient CD34+ cells into mature T cells demonstrated the absence of a hematopoietic cell-intrinsic defect. New overlapping features with DiGeorge syndrome included primary hypoparathyroidism (n = 5) and congenital heart defects (n = 2), in line with PAX1 expression during early embryogenesis. Our results highlight new features of PAX1 deficiency, which are relevant to improving early diagnosis and identifying patients requiring corrective treatment.
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Affiliation(s)
- Nalan Yakici
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey
| | - Alexandra Y Kreins
- Great Ormond Street Institute of Child Health, Infection, Immunity and Inflammation Research & Teaching Department, University College London, London, United Kingdom; Department of Immunology and Gene therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom.
| | - Mehmet Cihangir Catak
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey; Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Royala Babayeva
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey; Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Baran Erman
- Institute of Child Health, Hacettepe University, Ankara, Turkey; Can Sucak, Research Laboratory for Translational Immunology, Center for Genomics and Rare Diseases, Hacettepe University, Ankara, Turkey
| | - Heather Kenney
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - Hatice Eke Gungor
- Division of Pediatric Allergy and Immunology, Erciyes City Hospital, Turkey
| | - Pablo A Cea
- Institute for Pharmaceutical and Medicinal Chemistry, Heinrich Heine University, Düsseldorf, Germany
| | - Tomoki Kawai
- Shizuoka Children's Hospital, Shizuoka, Department of Allergy and Clinical Immunology, Japan
| | - Marita Bosticardo
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - Ottavia Maria Delmonte
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - Stuart Adams
- SIHMDS-Haematology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Yu-Tong Fan
- Great Ormond Street Institute of Child Health, Infection, Immunity and Inflammation Research & Teaching Department, University College London, London, United Kingdom
| | - Francesca Pala
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - Ayberk Turkyilmaz
- Department of Medical Genetics, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey
| | - Evey Howley
- Department of Immunology and Gene therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Austen Worth
- Department of Immunology and Gene therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Hakan Kot
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey
| | - Asena Pinar Sefer
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey; Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Altan Kara
- TUBITAK Marmara Research Center, Gene Engineering and Biotechnology Institute, Gebze, Turkey
| | - Alper Bulutoglu
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey; Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Sevgi Bilgic-Eltan
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey; Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Melek Yorgun Altunbas
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey; Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Feyza Bayram Catak
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey; Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | | | - Emrah Karatay
- Department of Radiology, Marmara University Pendik Training and Research Hospital, Istanbul, Turkey
| | - Sidem Didar Tekeoglu
- Can Sucak, Research Laboratory for Translational Immunology, Center for Genomics and Rare Diseases, Hacettepe University, Ankara, Turkey; Department of Pediatric Immunology, Hacettepe University, Ankara, Turkey
| | - Metin Eser
- Department of Medical Genetics, Umraniye Education and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Davut Albayrak
- Department of Pediatrics, Division of Pediatric Hematology, Medicalpark Hospital, Samsun, Turkey
| | - Senol Citli
- Department of Medical Genetics, Faculty of Medicine, Recep Tayyip Erdogan University, Rize, Turkey
| | - Ayca Kiykim
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Istanbul University-Cerrahpasa, Istanbul, Turkey
| | - Elif Karakoc-Aydiner
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey; Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Ahmet Ozen
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey; Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey
| | - Sujal Ghosh
- Department for Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Center of Child and Adolescent Health, Heinrich Heine University, Düsseldorf, Germany
| | - Holger Gohlke
- Institute for Pharmaceutical and Medicinal Chemistry, Heinrich Heine University, Düsseldorf, Germany; Institute of Bio- and Geosciences (IBG-4: Bioinformatics), Forschungszentrum Jülich GmbH, Jülich, Germany
| | - Fazil Orhan
- Department of Pediatrics, Division of Pediatric Allergy and Immunology, Faculty of Medicine, Karadeniz Technical University Trabzon, Turkey
| | - Luigi D Notarangelo
- Immune Deficiency Genetics Section, Laboratory of Clinical Immunology and Microbiology (LCIM), National Institute of Allergy and Infectious Diseases (NIAID), NIH, Bethesda, MD, USA
| | - E Graham Davies
- Great Ormond Street Institute of Child Health, Infection, Immunity and Inflammation Research & Teaching Department, University College London, London, United Kingdom; Department of Immunology and Gene therapy, Great Ormond Street Hospital for Children NHS Foundation Trust, London, United Kingdom
| | - Safa Baris
- Division of Pediatric Allergy and Immunology, School of Medicine, Marmara University, Istanbul, Turkey; Istanbul Jeffrey Modell Diagnostic and Research Center for Primary Immunodeficiencies, Istanbul, Turkey; The Isil Berat Barlan Center for Translational Medicine, Istanbul, Turkey.
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6
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Yesilipek MA, Uygun V, Kupesiz A, Karasu G, Ozturk G, Ertem M, Şaşmaz İ, Daloğlu H, Güler E, Hazar V, Fisgin T, Sezgin G, Kansoy S, Kuşkonmaz B, Akıncı B, Özbek N, İnce EÜ, Öztürkmen S, Küpesiz FT, Yalçın K, Anak S, Bozkurt C, Karakükçü M, Küpeli S, Albayrak D, Öniz H, Aksoylar S, Okur FV, Albayrak C, Yenigürbüz FD, Bozkaya İO, İleri T, Gürsel O, Karagün BŞ, Kintrup GT, Çelen S, Elli M, Aksoy BA, Yılmaz E, Tanyeli A, Akyol ŞT, Siviş ZÖ, Özek G, Uçkan D, Kartal İ, Atay D, Akyay A, Bilir ÖA, Çakmaklı HF, Kürekçi E, Malbora B, Akbayram S, Demir HA, Kılıç SÇ, Güneş AM, Zengin E, Özmen S, Antmen AB. Thalassemia-free and graft-versus-host-free survival: outcomes of hematopoietic stem cell transplantation for thalassemia major, Turkish experience. Bone Marrow Transplant 2022; 57:760-767. [PMID: 35210564 DOI: 10.1038/s41409-022-01613-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 02/07/2022] [Accepted: 02/08/2022] [Indexed: 02/07/2023]
Abstract
We report the national data on the outcomes of hematopoietic stem cell transplantation (HSCT) for thalassemia major (TM) patients in Turkey on behalf of the Turkish Pediatric Stem Cell Transplantation Group. We retrospectively enrolled 1469 patients with TM who underwent their first HSCT between 1988 and 2020 in 25 pediatric centers in Turkey. The median follow-up duration and transplant ages were 62 months and 7 years, respectively; 113 patients had chronic graft versus host disease (cGVHD) and the cGVHD rate was 8.3% in surviving patients. Upon the last visit, 30 patients still had cGvHD (2.2%). The 5-year overall survival (OS), thalassemia-free survival (TFS) and thalassemia-GVHD-free survival (TGFS) rates were 92.3%, 82.1%, and 80.8%, respectively. cGVHD incidence was significantly lower in the mixed chimerism (MC) group compared to the complete chimerism (CC) group (p < 0.001). In survival analysis, OS, TFS, and TGFS rates were significantly higher for transplants after 2010. TFS and TGFS rates were better for patients under 7 years and at centers that had performed over 100 thalassemia transplants. Transplants from matched unrelated donors had significantly higher TFS rates. We recommend HSCT before 7 years old in thalassemia patients who have a matched donor for improved outcomes.
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Affiliation(s)
- M Akif Yesilipek
- Medicalpark Antalya Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Antalya, Turkey.
| | - Vedat Uygun
- Medicalpark Antalya Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Antalya, Turkey
- Istinye University School of Medicine Department of Pediatric Hematology and Oncology Unit, Istanbul, Turkey
| | - Alphan Kupesiz
- Akdeniz University School of Medicine, Department of Pediatrics, Division of Hematology/Oncology, Antalya, Turkey
| | - Gulsun Karasu
- Medicalpark Göztepe Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Istanbul, Turkey
| | - Gulyuz Ozturk
- Acıbadem University School of Medicine, Altunizade Hospital, Istanbul, Turkey
| | - Mehmet Ertem
- Ankara University Faculty of Medicine, Division of Pediatric Hematology Oncology, Dikimevi, Ankara, Turkey
| | - İlgen Şaşmaz
- Acıbadem Adana Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Adana, Turkey
| | - Hayriye Daloğlu
- Medicalpark Antalya Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Antalya, Turkey
- Antalya Bilim University Faculty of Health Sciences, Antalya, Turkey
| | - Elif Güler
- Akdeniz University School of Medicine, Department of Pediatrics, Division of Hematology/Oncology, Antalya, Turkey
| | - Volkan Hazar
- Medicalpark Göztepe Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Istanbul, Turkey
| | - Tunç Fisgin
- Altınbaş University School of Medicine Department of Pediatric Hematology and Oncology BMT Unit, Istanbul, Turkey
| | - Gülay Sezgin
- Çukurova University School of Medicine Department of Pediatric Oncology and BMT Unit, Adana, Turkey
| | - Savaş Kansoy
- Ege University School of Medicine Division of Pediatric Hematology Oncology, İzmir, Turkey
| | - Barış Kuşkonmaz
- Hacettepe University Faculty of Medicine BMT Unit, Ankara, Turkey
| | - Burcu Akıncı
- Acıbadem University School of Medicine, Altunizade Hospital, Istanbul, Turkey
| | - Namık Özbek
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Elif Ünal İnce
- Ankara University Faculty of Medicine, Division of Pediatric Hematology Oncology, Dikimevi, Ankara, Turkey
| | - Seda Öztürkmen
- Medicalpark Antalya Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Antalya, Turkey
| | - Funda Tayfun Küpesiz
- Akdeniz University School of Medicine, Department of Pediatrics, Division of Hematology/Oncology, Antalya, Turkey
| | - Koray Yalçın
- Medicalpark Göztepe Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Istanbul, Turkey
- Bahcesehir University School of Medicine Departments of Pediatrics, Istanbul, Turkey
| | - Sema Anak
- Medipol University School of Medicine Division of Pediatric Hematology Oncology, Istanbul, Turkey
| | - Ceyhun Bozkurt
- Istinye University School of Medicine Department of Pediatric Hematology and Oncology Unit, Istanbul, Turkey
| | - Musa Karakükçü
- Erciyes University KANKA Pediatric BMT Center, Kayseri, Turkey
| | - Serhan Küpeli
- Çukurova University School of Medicine Department of Pediatric Oncology and BMT Unit, Adana, Turkey
| | - Davut Albayrak
- Medicalpark Samsun Hospital Pediatric BMT Unit, Samsun, Turkey
| | - Haldun Öniz
- University of Health Sciences, İzmir Tepecik Hospital, İzmir, Turkey
| | - Serap Aksoylar
- Ege University School of Medicine Division of Pediatric Hematology Oncology, İzmir, Turkey
| | - Fatma Visal Okur
- Hacettepe University Faculty of Medicine BMT Unit, Ankara, Turkey
| | - Canan Albayrak
- Ondokuzmayıs University School of Medicine Department of Pediatric Hematology and Oncology BMT Unit, Samsun, Turkey
| | | | - İkbal Ok Bozkaya
- University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Talia İleri
- Ankara University Faculty of Medicine, Division of Pediatric Hematology Oncology, Dikimevi, Ankara, Turkey
| | - Orhan Gürsel
- University of Health Sciences, Division of Pediatric Hematology Oncology, Ankara, Turkey
| | - Barbaros Şahin Karagün
- Acıbadem Adana Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Adana, Turkey
| | - Gülen Tüysüz Kintrup
- Akdeniz University School of Medicine, Department of Pediatrics, Division of Hematology/Oncology, Antalya, Turkey
| | - Suna Çelen
- Medicalpark Göztepe Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Istanbul, Turkey
- Bahcesehir University School of Medicine Departments of Pediatrics, Istanbul, Turkey
| | - Murat Elli
- Medipol University School of Medicine Division of Pediatric Hematology Oncology, Istanbul, Turkey
| | - Basak Adaklı Aksoy
- Altınbaş University School of Medicine Department of Pediatric Hematology and Oncology BMT Unit, Istanbul, Turkey
| | - Ebru Yılmaz
- Erciyes University KANKA Pediatric BMT Center, Kayseri, Turkey
| | - Atila Tanyeli
- Çukurova University School of Medicine Department of Pediatric Oncology and BMT Unit, Adana, Turkey
| | | | - Zuhal Önder Siviş
- University of Health Sciences, İzmir Tepecik Hospital, İzmir, Turkey
| | - Gülcihan Özek
- Ege University School of Medicine Division of Pediatric Hematology Oncology, İzmir, Turkey
| | - Duygu Uçkan
- Hacettepe University Faculty of Medicine BMT Unit, Ankara, Turkey
| | - İbrahim Kartal
- Ondokuzmayıs University School of Medicine Department of Pediatric Hematology and Oncology BMT Unit, Samsun, Turkey
| | - Didem Atay
- Acıbadem University School of Medicine, Altunizade Hospital, Istanbul, Turkey
| | - Arzu Akyay
- Inönü University School of Medicine Department of Pediatric Hematology and Oncology BMT Unit, Malatya, Turkey
| | | | - Hasan Fatih Çakmaklı
- Ankara University Faculty of Medicine, Division of Pediatric Hematology Oncology, Dikimevi, Ankara, Turkey
| | - Emin Kürekçi
- University of Health Sciences, Division of Pediatric Hematology Oncology, Ankara, Turkey
| | - Barış Malbora
- İstanbul Yeni Yüzyıl University Gaziosmanpaşa Hospital Pediatric BMT Unit, Istanbul, Turkey
| | - Sinan Akbayram
- Gaziantep University School of Medicine Department of Pediatric Hematology and Oncology BMT Unit, Gaziantep, Turkey
| | - Hacı Ahmet Demir
- Memorial Ankara Hospital Pediatric Hematology and Oncology, Ankara, Turkey
| | - Suar Çakı Kılıç
- Ümraniye Education and Research Hospital, Department of Pediatric Bone Marrow Transplantation Unit, Istanbul, Turkey
| | - Adalet Meral Güneş
- Uludağ University School of Medicine Department of Pediatric Hematology and Oncology BMT Unit, Bursa, Turkey
| | - Emine Zengin
- Kocaeli University School of Medicine Department of Pediatric Hematology and Oncology BMT Unit, Kocaeli, Turkey
| | - Salih Özmen
- Behçet Uz Children's Hospital Pediatric BMT Centre, İzmir, Turkey
| | - Ali Bülent Antmen
- Acıbadem Adana Hospital, Pediatric Hematology and Stem Cell Transplantation Unit, Adana, Turkey
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Albayrak D, Albayrak C. Clinical follow-up of children with high vitamin B12 values: should we worry? Turk J Pediatr 2022; 63:1064-1071. [PMID: 35023657 DOI: 10.24953/turkjped.2021.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Requests of Vitamin B12 test increased with the widespread use of autoanalysers. Although the cause of requests was deficiency suspicions, an important ratio of high levels of Vitamin B12 were reported to physicians by laboratory. Ratios of values of high Vitamin B12 among test request in adults are reported as 14- 20% in present three monocentre studies and one multicentre study. There is no report on children with high vitamin B12 for both ratio in lab requests or clinical follow up. METHODS We evaluated the records of 40 children (23 male /17 female) with high B12 values ( > 1000 pg/ ml) retrospectively. Children were otherwise healthy children and were seen at outpatient pediatric clinics. Additionally, vitamin B12 values of 13 acute lymphoblastic leukemia patients at diagnosis time were retrieved to enlighten possible role of lymphocytes. RESULT Children did not have any malign or chronic diseases causing the high Vitamin B12 values. Holotranscobalamin levels were normal or slightly above. Two patients did develop leukemia later. Our follow up showed that high vitamin B12 values slightly decreased at 3 months and then remained unchanged later. The high numbers of T and B cells are not the source of vitamin B12 elevation. CONCLUSIONS Our study suggests that high-vitamin B12 values are usually benign in children but some patients may develop leukemia later. We suggest that patients should be followed up for some time after testing for severe hematological diseases.
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Affiliation(s)
- Davut Albayrak
- Department of Pediatric Hematology and Oncology, Medicalpark Samsun Hospital, Samsun
| | - Canan Albayrak
- Department of Pediatric Hematology and Oncology, Ondokuz Mayis University Faculty of Medi-cine, Samsun, Turkey
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8
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Ünüvar A, Evim MS, Karaman S, Akçay A, Eker İ, Küpesiz FT, Özbek N, Ertem M, Aydın S, Keskin Z, Aral YZ, Gördü Z, Elli M, Karagenç AÖ, Apak BB, Uzel H, Söker M, Karapınar T, Oymak Y, Karadaş N, Özcan A, Töret E, Koçak Ü, Akbayram S, Cangül ŞÜ, Ayhan AC, Celkan T, Tuğcu D, Zülfikar B, Kebudi R, Hacısalihoğlu Ş, Erduran E, Gelen SA, Sarper N, Erbey F, Kürekçi E, Gülen H, Yılmaz B, Doğru Ö, Koç A, Ünal S, Tokgöz H, Albayrak C, Ay Y, Orhan F, Albayrak D, Karakurt N, Orhaner B, Türkkan E, Yıldırmak Y, Geylani H, Koç B, Öner AF, Timur Ç, Ören H. CHILDHOOD IMMUNE THROMBOCYTOPENIA: A MULTICENTER QUESTIONNAIRE STUDY. Hematol Transfus Cell Ther 2021. [DOI: 10.1016/j.htct.2021.10.1070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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9
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Cokyaman T, Elli M, Aydin ÖF, Albayrak C, Albayrak D, Özyürek E. Neuroprotective Efficacy of Prophylactic Antiepileptic Therapies in Busulfan Conditioning Regimen. Journal of Pediatric Neurology 2021. [DOI: 10.1055/s-0040-1708833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
AbstractBusulfan (BU) is commonly used in the anticancer treatment and bone marrow/hematopoietic stem cell transplantation (BM/HSCT) conditioning regimen. This study aimed to evaluate the neuroprotective efficacy of antiepileptic therapies in the BU conditioning regimen. Patients who underwent BM/HSCT between January 1, 2009, and January 1, 2014, were evaluated retrospectively. Diagnosis, demographic characteristics, neurological side effects, electroencephalography (EEG) abnormalities, and antiepileptic drugs were determined. Levetiracetam was given to 49% and phenytoin to 23% of patients as antiepileptic prophylaxis. After BU treatment, seizures developed in three patients, posterior reversible leukoencephalopathy in two patients, and peripheral neuropathy in two patients. Forty-five patients who underwent EEG before and after BU treatment were identified. The effects of antiepileptic prophylaxis over the electroencephalographic abnormalities after the BU conditioning regimen were found to be not different (p = 0.491). Neurological side effects and electroencephalographic abnormalities following BU conditioning regimen under antiepileptic prophylaxis are comparable.
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Affiliation(s)
- Turgay Cokyaman
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Murat Elli
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Ömer F. Aydin
- Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Canan Albayrak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Davut Albayrak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Emel Özyürek
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey
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10
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Koker MY, Sarper N, Albayrak C, Zulfikar B, Zengin E, Saraymen B, Albayrak D, Koc B, Avcilar H, Karakükcü M, Chenet C, Bianchi F, de Brevern AG, Petermann R, Jallu V. New αIIbβ3 variants in 28 Turkish Glanzmann patients; Structural hypothesis for complex activation by residues variations in I-EGF domains. Platelets 2021; 33:551-561. [PMID: 34275420 DOI: 10.1080/09537104.2021.1947481] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Glanzmann thrombasthenia (GT) is a rare autosomal recessive bleeding disorder characterized by impaired platelet aggregation due to defects in integrin αIIbβ3, a fibrinogen receptor. Platelet phenotypes and allelic variations in 28 Turkish GT patients are reported. Platelets αIIbβ3 expression was evaluated by flow cytometry. Sequence analyzes of ITGA2B and ITGB3 genes allowed identifying nine variants. Non-sense variation effect on αIIbβ3 expression was studied by using transfected cell lines. 3D molecular dynamics (MDs) simulations allowed characterizing structural alterations. Five new alleles were described. αIIb:p.Gly423Asp, p.Asp560Ala and p.Tyr784Cys substitutions impaired αIIbβ3 expression. The αIIb:p.Gly128Val substitution allowed normal expression; however, the corresponding NM_000419.3:c.476G>T variation would create a cryptic donor splicing site altering mRNA processing. The β3:p.Gly540Asp substitution allowed αIIbβ3 expression in HEK-293 cells but induced its constitutive activation likely by impairing αIIb and β3 legs interaction. The substitution alters the β3 I-EGF-3 domain flexibility as shown by MDs simulations. GT variations are mostly unique although the NM_000419.3:c.1752 + 2 T > C and NM_000212.2:c.1697 G > A variations identified in 4 and 8 families, respectively, might be a current cause of GT in Turkey. MD simulations suggested how some subtle structural variations in the β3 I-EGF domains might induce constitutive activation of αIIbβ3 without altering the global domain structure.
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Affiliation(s)
- M Y Koker
- Faculty of Medicine, Department of Immunology, Erciyes University, Kayseri, Turkey
| | - N Sarper
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kocaeli University, Kocaeli, Turkey
| | - C Albayrak
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Ondokuz Mayis University, Samsun, Turkey
| | - B Zulfikar
- Oncology Institute, Department of Pediatric Hematology/Oncology, Istanbul University, İstanbul, Turkey
| | - E Zengin
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kocaeli University, Kocaeli, Turkey
| | - B Saraymen
- Nanotechnology Research and Application Center, Erciyes University, Kayseri, Turkey
| | - D Albayrak
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology and Oncology, Ondokuz Mayis University, Samsun, Turkey
| | - B Koc
- Oncology Institute, Department of Pediatric Hematology/Oncology, Istanbul University, İstanbul, Turkey
| | - H Avcilar
- Faculty of Medicine, Department of Immunology, Erciyes University, Kayseri, Turkey
| | - M Karakükcü
- Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Erciyes University, Kayseri, Turkey
| | - C Chenet
- Département d'Immunologie Plaquettaire, Institut National De La Transfusion Sanguine (INTS), Paris, France.,Centre National de Référence en Hémobiologie Périnatale (CNRHP), Site St Antoine, DMU Biologie et Génomique Médicales, AP-HP, Sorbonne Université PARIS, FRANCE
| | - F Bianchi
- Département d'Immunologie Plaquettaire, Institut National De La Transfusion Sanguine (INTS), Paris, France.,Centre National de Référence en Hémobiologie Périnatale (CNRHP), Site St Antoine, DMU Biologie et Génomique Médicales, AP-HP, Sorbonne Université PARIS, FRANCE
| | - A G de Brevern
- Biologie Intégrée du Globule Rouge UMR_S1134, Inserm, DSIMB, Univ. Paris, Univ. De La Réunion, Univ. Des Antilles, Paris, France.,Institut National de la Transfusion Sanguine (INTS), Paris, France.,Laboratoire d'Excellence GR-Ex, Paris, France
| | - R Petermann
- Département d'Immunologie Plaquettaire, Institut National De La Transfusion Sanguine (INTS), Paris, France.,Centre National de Référence en Hémobiologie Périnatale (CNRHP), Site St Antoine, DMU Biologie et Génomique Médicales, AP-HP, Sorbonne Université PARIS, FRANCE.,Centre De Recherche Des Cordeliers, UMRS-1138, INSERM, Sorbone Université De Paris, Equipe ETREs (Ethics, Research, Translations), Paris, France
| | - V Jallu
- Département d'Immunologie Plaquettaire, Institut National De La Transfusion Sanguine (INTS), Paris, France.,Centre National de Référence en Hémobiologie Périnatale (CNRHP), Site St Antoine, DMU Biologie et Génomique Médicales, AP-HP, Sorbonne Université PARIS, FRANCE
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Tüfekçi Ö, Koçak Ü, Kaya Z, Yenicesu İ, Albayrak C, Albayrak D, Yılmaz Bengoa Ş, Patıroğlu T, Karakükçü M, Ünal E, Ünal İnce E, İleri T, Ertem M, Celkan T, Özdemir GN, Sarper N, Kaçar D, Yaralı N, Özbek NY, Küpesiz A, Karapınar T, Vergin C, Çalışkan Ü, Tokgöz H, Sezgin Evim M, Baytan B, Güneş AM, Yılmaz Karapınar D, Karaman S, Uygun V, Karasu G, Yeşilipek MA, Koç A, Erduran E, Atabay B, Öniz H, Ören H. Juvenile Myelomonocytic Leukemia in Turkey: A Retrospective Analysis of Sixty-five Patients. Turk J Haematol 2017; 35:27-34. [PMID: 28179213 PMCID: PMC5843771 DOI: 10.4274/tjh.2017.0021] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
OBJECTIVE This study aimed to define the status of juvenile myelomonocytic leukemia (JMML) patients in Turkey in terms of time of diagnosis, clinical characteristics, mutational studies, clinical course, and treatment strategies. MATERIALS AND METHODS Data including clinical and laboratory characteristics and treatment strategies of JMML patients were collected retrospectively from pediatric hematology-oncology centers in Turkey. RESULTS Sixty-five children with JMML diagnosed between 2002 and 2016 in 18 institutions throughout Turkey were enrolled in the study. The median age at diagnosis was 17 months (min-max: 2-117 months). Splenomegaly was present in 92% of patients at the time of diagnosis. The median white blood cell, monocyte, and platelet counts were 32.9x109/L, 5.4x109/L, and 58.3x109/L, respectively. Monosomy 7 was present in 18% of patients. JMML mutational analysis was performed in 32 of 65 patients (49%) and PTPN11 was the most common mutation. Hematopoietic stem cell transplantation (HSCT) could only be performed in 28 patients (44%), the majority being after the year 2012. The most frequent reason for not performing HSCT was the inability to find a suitable donor. The median time from diagnosis to HSCT was 9 months (min-max: 2-63 months). The 5-year cumulative survival rate was 33% and median estimated survival time was 30±17.4 months (95% CI: 0-64.1) for all patients. Survival time was significantly better in the HSCT group (log-rank p=0.019). Older age at diagnosis (>2 years), platelet count of less than 40x109/L, and PTPN11 mutation were the factors significantly associated with shorter survival time. CONCLUSION Although there has recently been improvement in terms of definitive diagnosis and HSCT in JMML patients, the overall results are not satisfactory and it is necessary to put more effort into this issue in Turkey.
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Affiliation(s)
- Özlem Tüfekçi
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Ülker Koçak
- Gazi University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Zühre Kaya
- Gazi University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - İdil Yenicesu
- Gazi University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Canan Albayrak
- Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Hematology, Samsun, Turkey
| | - Davut Albayrak
- Ondokuz Mayıs University Faculty of Medicine, Department of Pediatric Hematology, Samsun, Turkey
| | - Şebnem Yılmaz Bengoa
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Türkan Patıroğlu
- Erciyes University Faculty of Medicine, Department of Pediatric Hematology and Oncology, Kayseri, Turkey
| | - Musa Karakükçü
- Erciyes University Faculty of Medicine, Department of Pediatric Hematology and Oncology, Kayseri, Turkey
| | - Ekrem Ünal
- Erciyes University Faculty of Medicine, Department of Pediatric Hematology and Oncology, Kayseri, Turkey
| | - Elif Ünal İnce
- Ankara University Faculty of Medicine, Department of Pediatric Hematology and Oncology, Ankara, Turkey
| | - Talia İleri
- Ankara University Faculty of Medicine, Department of Pediatric Hematology and Oncology, Ankara, Turkey
| | - Mehmet Ertem
- Ankara University Faculty of Medicine, Department of Pediatric Hematology and Oncology, Ankara, Turkey
| | - Tiraje Celkan
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Hematology and Oncology, İstanbul, Turkey
| | - Gül Nihal Özdemir
- İstanbul University Cerrahpaşa Faculty of Medicine, Department of Pediatric Hematology and Oncology, İstanbul, Turkey
| | - Nazan Sarper
- Kocaeli University Faculty of Medicine, Department of Pediatric Hematology, Kocaeli, Turkey
| | - Dilek Kaçar
- Ankara Children's Hematology and Oncology Training and Research Hospital, Ankara, Turkey
| | - Neşe Yaralı
- Ankara Children's Hematology and Oncology Training and Research Hospital, Ankara, Turkey
| | - Namık Yaşar Özbek
- Ankara Children's Hematology and Oncology Training and Research Hospital, Ankara, Turkey
| | - Alphan Küpesiz
- Akdeniz University Faculty of Medicine, Department of Pediatric Hematology and Oncology, Antalya, Turkey
| | - Tuba Karapınar
- Dr. Behçet Uz Children Training and Research Hospital, Clinic of Pediatric Hematology and Oncology, İzmir, Turkey
| | - Canan Vergin
- Dr. Behçet Uz Children Training and Research Hospital, Clinic of Pediatric Hematology and Oncology, İzmir, Turkey
| | - Ümran Çalışkan
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatric Hematology, Konya, Turkey
| | - Hüseyin Tokgöz
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatric Hematology, Konya, Turkey
| | - Melike Sezgin Evim
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Birol Baytan
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Adalet Meral Güneş
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | | | - Serap Karaman
- Şişli Hamidiye Etfal Training and Research Hospital, Clinic of Pediatric Hematology and Oncology, İstanbul, Turkey
| | - Vedat Uygun
- Bahçeşehir University Faculty of Medicine, Department of Pediatric Hematology and Oncology, İstanbul, Turkey
| | - Gülsun Karasu
- Bahçeşehir University Faculty of Medicine, Department of Pediatric Hematology and Oncology, İstanbul, Turkey
| | - Mehmet Akif Yeşilipek
- Bahçeşehir University Faculty of Medicine, Department of Pediatric Hematology and Oncology, İstanbul, Turkey
| | - Ahmet Koç
- Marmara University Faculty of Medicine, Department of Pediatric Hematology and Oncology, İstanbul, Turkey
| | - Erol Erduran
- Karadeniz Technical University Faculty of Medicine, Department of Pediatric Hematology and Oncology, Trabzon, Turkey
| | - Berna Atabay
- Tepecik Training and Research Hospital, Clinic of Pediatric Hematology and Oncology, İzmir, Turkey
| | - Haldun Öniz
- Tepecik Training and Research Hospital, Clinic of Pediatric Hematology and Oncology, İzmir, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
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Walne AJ, Collopy L, Cardoso S, Ellison A, Plagnol V, Albayrak C, Albayrak D, Kilic SS, Patıroglu T, Akar H, Godfrey K, Carter T, Marafie M, Vora A, Sundin M, Vulliamy T, Tummala H, Dokal I. Marked overlap of four genetic syndromes with dyskeratosis congenita confounds clinical diagnosis. Haematologica 2016; 101:1180-1189. [PMID: 27612988 DOI: 10.3324/haematol.2016.147769] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 06/21/2016] [Indexed: 11/09/2022] Open
Abstract
Dyskeratosis congenita is a highly pleotropic genetic disorder. This heterogeneity can lead to difficulties in making an accurate diagnosis and delays in appropriate management. The aim of this study was to determine the underlying genetic basis in patients presenting with features of dyskeratosis congenita and who were negative for mutations in the classical dyskeratosis congenita genes. By whole exome and targeted sequencing, we identified biallelic variants in genes that are not associated with dyskeratosis congenita in 17 individuals from 12 families. Specifically, these were homozygous variants in USB1 (8 families), homozygous missense variants in GRHL2 (2 families) and identical compound heterozygous variants in LIG4 (2 families). All patients had multiple somatic features of dyskeratosis congenita but not the characteristic short telomeres. Our case series shows that biallelic variants in USB1, LIG4 and GRHL2, the genes mutated in poikiloderma with neutropenia, LIG4/Dubowitz syndrome and the recently recognized ectodermal dysplasia/short stature syndrome, respectively, cause features that overlap with dyskeratosis congenita. Strikingly, these genes also overlap in their biological function with the known dyskeratosis congenita genes that are implicated in telomere maintenance and DNA repair pathways. Collectively, these observations demonstrate the marked overlap of dyskeratosis congenita with four other genetic syndromes, confounding accurate diagnosis and subsequent management. This has important implications for establishing a genetic diagnosis when a new patient presents in the clinic. Patients with clinical features of dyskeratosis congenita need to have genetic analysis of USB1, LIG4 and GRHL2 in addition to the classical dyskeratosis congenita genes and telomere length measurements.
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Affiliation(s)
- Amanda J Walne
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | - Laura Collopy
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | - Shirleny Cardoso
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | - Alicia Ellison
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | | | - Canan Albayrak
- Department of Pediatric Hematology, Ondokuz Mayis University, Samsun, Turkey
| | - Davut Albayrak
- Department of Pediatric Hematology, Ondokuz Mayis University, Samsun, Turkey
| | | | - Turkan Patıroglu
- Department of Pediatric Immunology Erciyes University Medical Facility, Kayseri, Turkey
| | - Haluk Akar
- Department of Pediatric Immunology Erciyes University Medical Facility, Kayseri, Turkey
| | - Keith Godfrey
- Department of Pediatric Dermatology and NIHR Southampton Biomedical Research Center, University Hospital, Southampton and University of Southampton, UK
| | - Tina Carter
- Department of Oncology and Haematology, Princess Margaret Hospital, Perth, WA, Australia
| | - Makia Marafie
- Clinical Cancer and Community Genetics, Kuwait Medical Genetics Center, Al-Sabah Medical area, Kuwait
| | - Ajay Vora
- Department of Haematology, Sheffield Children's NHS foundation Trust, Sheffield, UK
| | - Mikael Sundin
- Section of Pediatric Hematology/Immunology/SCT, Astrid Lindgren Children's Hospital, Karolinska University Hospital, Stockholm, Sweden Division of Pediatrics, CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - Thomas Vulliamy
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | - Hemanth Tummala
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
| | - Inderjeet Dokal
- Centre for Genomics and Child Health, Blizard Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, Barts NHS Trust, London, UK
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Erduran E, Bahadir A, Albayrak D, Aliyazicioglu Y, Buyukavci M, Turan I. Positive correlation between insulin resistance and iron overload-induced oxidative stress in patients with fanconi anemia (FA)- and non-FA-related bone marrow failure: The results of a multicenter study. Pediatr Hematol Oncol 2016; 33:13-20. [PMID: 26918367 DOI: 10.3109/08880018.2015.1106626] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This study investigated the relationship between DNA, protein, and lipid oxidations and insulin resistance in patients with Fanconi anemia (FA)- and non-FA-related bone marrow failure. Sixteen patients with FA, 7 non-FA-related aplastic anemia, and 10 controls were included in the study. Fasting blood glucose, simultaneous insulin, hepcidin, ferritin, 8-hydroxy deoxyguanosine (8-OHdG), protein carbonyls, malondialdehyde (MDA), and homeostatic model assessment-insulin resistance (HOMA-IR) were investigated in the patients and controls. Diepoxybutane test-positive (DEB+) patients were diagnosed with FA, whereas DEB-patients were diagnosed as non-FA. 8-OHdG levels in both FA and non-FA patients were significantly higher than those in the controls (P = .001 and P = .005, respectively). Serum ferritin levels were also higher in FA and non-FA patients than in the controls (P = .0001 and P = .005, respectively). Insulin resistance (IR) was significantly higher in FA patients than in non-FA patients and controls (P = .005 and P = .015, respectively). Significant differences were observed between 8-OHdG, ferritin, and MDA levels in patients with or without IR (P = .009, P = .001, and P = .013, respectively). Moderate and strong relations of 44% and 85% were determined between IR and ferritin levels in patients with FA or non-FA (P = .08 and P = .014, respectively). FA and non-FA patients exhibited a tendency to IR. IR was related to ferritin levels, and ferritin levels were also correlated with oxidative stress. These findings suggest that the increased rate of IR in patients with FA and non-FA may derive from increased oxidative stress, which may in turn be due to elevated serum ferritin levels.
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Affiliation(s)
- Erol Erduran
- a Department of Pediatric Hematology and Oncology, Karadeniz Technical University , Trabzon , Turkey
| | - Aysenur Bahadir
- a Department of Pediatric Hematology and Oncology, Karadeniz Technical University , Trabzon , Turkey
| | - Davut Albayrak
- b Department of Pediatric Hematology, Ondokuz Mayis University , Samsun , Turkey
| | - Yuksel Aliyazicioglu
- c Department of Medical Biochemistry, Karadeniz Technical University , Trabzon , Turkey
| | - Mustafa Buyukavci
- d Department of Pediatric Hematology and Oncology, Ataturk University , Erzurum , Turkey
| | - Ibrahim Turan
- e Department of Genetic and Bioengineering, Gumushane University , Gumushane , Turkey
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Karli A, Sensoy G, Albayrak C, Koken O, Cıraklı S, Belet N, Albayrak D. Pancytopenia As the Initial Manifestation of Brucellosis in Children. Vector Borne Zoonotic Dis 2015; 15:545-9. [PMID: 26367782 DOI: 10.1089/vbz.2015.1775] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Presenting with severe thrombocytopenia and pancytopenia is rare in children with brucellosis, and at the beginning it can be misdiagnosed as a hematological or a viral hemorrhagic disease. The follow-ups of 52 patients diagnosed with brucellosis from January, 2008, to December, 2013, in our clinic have shown the following results. Eleven out of these 52 patients revealed the fact that they had pancytopenia at the admission phase. Anemia and leukopenia were defined as hemoglobin levels and leukocyte counts below the standard values in terms of ages, thrombocytopenia as thrombocyte counts below 150,000/mm(3), and severe thrombocytopenia as thrombocyte counts below 20,000/mm(3). The most frequent admission symptoms and findings of the patients with pancytopenia were fever (75%), fatigue (50%), splenomegaly (75%), and hepatomegaly (41%). Laboratory results were hemoglobin 9.3±0.96 gram/dL, white blood cell count 2226±735.9/mm(3), and thrombocyte count 70,090±47,961/mm(3). The standard tube agglutination test was positive for all patients, and Brucellosis spp. were isolated in the blood cultures of six (54%) patients. Three of the 11 patients had severe thrombocytopenia, and they were admitted with complaints of epistaxis, gingival bleeding, petechiae, and purpura. At the beginning, two of three cases were misdiagnosed as Crimean-Congo hemorrhagic fever (CCHF), another zoonotic endemic disease in Turkey. Pancytopenia improved with treatment of brucellosis on all patients. In conclusion, brucellosis can show great similarity with hematologic and zoonotic diseases like CCHF. Brucellosis should be considered in the differential diagnosis of pancytopenia, treatment-resistant immune thrombocytopenia, and viral hemorrhagic disease, especially in countries where brucellosis is endemic.
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Affiliation(s)
- Arzu Karli
- 1 Ondokuz Mayis University Faculty of Medicine , Department of Pediatric Infectious Diseases, Samsun, Turkey
| | - Gulnar Sensoy
- 1 Ondokuz Mayis University Faculty of Medicine , Department of Pediatric Infectious Diseases, Samsun, Turkey
| | - Canan Albayrak
- 2 Ondokuz Mayis University Faculty of Medicine , Department of Pediatric Hematology and Oncology, Samsun, Turkey
| | - Ozlem Koken
- 3 Ondokuz Mayis University Faculty of Medicine , Department of Pediatrics, Samsun, Turkey
| | - Sevgi Cıraklı
- 3 Ondokuz Mayis University Faculty of Medicine , Department of Pediatrics, Samsun, Turkey
| | - Nursen Belet
- 1 Ondokuz Mayis University Faculty of Medicine , Department of Pediatric Infectious Diseases, Samsun, Turkey
| | - Davut Albayrak
- 2 Ondokuz Mayis University Faculty of Medicine , Department of Pediatric Hematology and Oncology, Samsun, Turkey
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Albayrak C, Albayrak D. Red cell glucose 6-phosphate dehydrogenase deficiency in the northern region of Turkey: is G6PD deficiency exclusively a male disease? Pediatr Hematol Oncol 2015; 32:85-91. [PMID: 25116429 DOI: 10.3109/08880018.2014.940074] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Glucose-6-phosphate dehydrogenase (G6PD) deficiency is an X-linked recessive genetic defect that can cause hemolytic crisis. However, this disease affects both males and females. In Turkey, the frequency of this enzyme deficiency was reported to vary, from 0.25 to 18%, by the geographical area. Its prevalence in the northern Black Sea region of Turkey is unknown. The aims of this study were to assess the prevalence of G6PD deficiency in the northern region Turkey in children and adults with hyperbilirubinemia and hemolytic anemia. This report included a total of 976 G6PD enzyme results that were analyzed between May 2005 and January 2014. G6PD deficiency was detected in 5.0% of all patients. G6PD deficiency was significantly less frequent in females (1.9%, 6/323) than in males (6.6%, 43/653). G6PD deficiency was detected in 3.7% of infants with hyperbilirubinemia, 9.2% of children, and 4.5% of adults with hemolytic anemia. In both the newborn group and the group of children, G6PD deficiency was significantly more frequent in males. In the combined group of children (groups I and II), the proportion of males was 74% and 67% in all groups (P = .0008). In conclusion, in northern region of Turkey, G6PD deficiency is an important cause of neonatal hyperbilirubinemia and hemolytic crisis in children and adults. This study suggests that most pediatricians thought that G6PD deficiency is exclusively a male disease. For this reason, some female patients may have been undiagnosed.
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Affiliation(s)
- Canan Albayrak
- Department of Pediatric Hematology and Oncology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey
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Aydin F, Pancar Yuksel E, Albayrak D. Platelet collection efficiencies of three different platelet-rich plasma preparation systems. J COSMET LASER THER 2015; 17:165-8. [DOI: 10.3109/14764172.2014.1003237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Aydin I, Yeldan E, Ibiş AC, Albayrak D, Oğuz S, Senlikci A. Comparison between electronic method and conventional method recording and follow-up of general surgery ward-round notes taken. MINERVA CHIR 2014; 69:331-336. [PMID: 25493394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
AIM Patient anamneses and ward-rounds notes taken are two key elements which have been and will be used to ensure accurate and reliable sustainability at surgery services. In this study, we aimed to find a new method which is capable of better addressing the needs in this process, simplifying it and also saving time. We also targeted to compare this new method used by us with the method, also known as conventional method, having been used for years. METHODS Thirty patients were included in the study. The prehospitalization anamneses of the patients were taken using the two methods and the durations were recorded separately for the two methods. Thereafter, the patients were visited by two methods in the morning on each day of their stay. The durations were recorded daily and separately for the two methods. The durations were statistically evaluated separately for the anamneses and ward-round notes taken. RESULTS Evaluations showed that the method using hand terminal (1.2250 minutes) is more advantageous in terms of duration in recording ward-round scores than the conventional method (1.3853 minutes). It was founded that in regard to the duration, the average duration of manual anamnesis taking (16.3350 minutes) is higher than that of taking anamnesis by means of hand terminal (15.4733 minutes). Furthermore, it was also seen that the use of this new technique eliminated the problems previously experienced in data transfer, access to historical data etc. CONCLUSION In conclusion, this method that is tested by use of hand terminal is more advantageous than the conventional method in terms of time saving and accurate data transfer. It is our opinion that it will provide advantages in many more aspects if it is worked on.
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Affiliation(s)
- I Aydin
- General Surgery Clinic at the Faculty of Medicine of Trakya University Edirne, Turkey -
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Albayrak C, Albayrak D. PP-049 THE CONTRIBUTION OF CD49F TO THE FLOW CYTOMETRIC MINIMAL RESIDUAL DISEASE DETERMINATION IN PEDIATRIC B CELL ACUTE LYMPHOBLASTIC LEUKEMIA. Leuk Res 2014. [DOI: 10.1016/s0145-2126(14)70103-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Watzka M, Geisen C, Scheer M, Wieland R, Wiegering V, Dörner T, Laws HJ, Gümrük F, Hanalioglu S, Unal S, Albayrak D, Oldenburg J. Bleeding and non-bleeding phenotypes in patients with GGCX gene mutations. Thromb Res 2014; 134:856-65. [PMID: 25151188 DOI: 10.1016/j.thromres.2014.07.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2014] [Revised: 06/13/2014] [Accepted: 07/07/2014] [Indexed: 11/30/2022]
Abstract
Functional limitations for the vitamin K cycle, caused either by mutations in gamma-glutamyl carboxylase or vitamin K epoxide reductase genes, result in hereditary deficiency of vitamin K-dependent coagulation factors (VKCFD1 and VKCFD2, respectively). Patients suffering from VKCFD often share several other anatomical irregularities which are not related to haemostasis. Here we report on nine patients, eight of them previously unreported, who presented with VKCFD1. All were examined with special attention to vitamin K-dependent coagulation factors as well as to bone and heart development and to other anatomical signs of embryonal vitamin K deficiency. In total, we detected ten mutations in the gamma-glutamyl carboxylase gene of which seven have not been previously reported. Most interestingly, additional non-bleeding phenotypes were observed in all patients including midfacial hypoplasia, premature osteoporosis, cochlear hearing loss, heart valve defects, pulmonary stenosis, or pseudoxanthoma elasticum-like phenotype. Undercarboxylated matrix Gla protein, osteocalcin, and periostin appear to be responsible for these defects which are also observed in cases of fetal warfarin syndrome.
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Affiliation(s)
- Matthias Watzka
- Institute of Experimental Haematology and Transfusion Medicine, University Clinic Bonn, 53105 Bonn, Germany
| | - Christof Geisen
- Institute of Transfusion Medicine and Immunohaematology, DRK Blood Donor Service Baden-Württemberg-Hessen, 60526 Frankfurt/Main, Germany
| | - Monika Scheer
- Pediatrics 5 (Oncology, Hematology, Immunology), Klinikum Stuttgart, Olgahospital, 70176 Stuttgart, Germany
| | - Regina Wieland
- Department of Paediatric Haematology and Oncology, Children's Hospital, University of Essen, 45122 Essen, Germany
| | - Verena Wiegering
- Department of Paediatric Haematology, Oncology, Paediatric Stem Cell Transplantation Program, University Children's Hospital Würzburg, 97080 Würzburg, Germany
| | - Thomas Dörner
- Department of Medicine/ Rheumatology and Clinical Immunology, Clinical Hemostaseology, Charité University Medicine Berlin, 10098 Berlin, Germany
| | - Hans-Jürgen Laws
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Center of Child and Adolescent Health, Heinrich-Heine-University, 40225 Düsseldorf, Germany
| | - Fatma Gümrük
- Division of Pediatric Hematology, Faculty of Medicine, Hacettepe University, 06100 Sihhiye/Ankara, Turkey
| | - Sahin Hanalioglu
- Division of Pediatric Hematology, Faculty of Medicine, Hacettepe University, 06100 Sihhiye/Ankara, Turkey
| | - Sule Unal
- Division of Pediatric Hematology, Faculty of Medicine, Hacettepe University, 06100 Sihhiye/Ankara, Turkey
| | - Davut Albayrak
- Department of Pediatric Hematology, Ondokuz Mayis University, 55139 Samsun, Turkey
| | - Johannes Oldenburg
- Institute of Experimental Haematology and Transfusion Medicine, University Clinic Bonn, 53105 Bonn, Germany.
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Pangrazio A, Fasth A, Sbardellati A, Orchard PJ, Kasow KA, Raza J, Albayrak C, Albayrak D, Vanakker OM, De Moerloose B, Vellodi A, Notarangelo LD, Schlack C, Strauss G, Kühl JS, Caldana E, Lo Iacono N, Susani L, Kornak U, Schulz A, Vezzoni P, Villa A, Sobacchi C. SNX10 mutations define a subgroup of human autosomal recessive osteopetrosis with variable clinical severity. J Bone Miner Res 2013; 28:1041-9. [PMID: 23280965 DOI: 10.1002/jbmr.1849] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 11/21/2012] [Accepted: 12/05/2012] [Indexed: 11/05/2022]
Abstract
Human Autosomal Recessive Osteopetrosis (ARO) is a genetically heterogeneous disorder caused by reduced bone resorption by osteoclasts. In 2000, we found that mutations in the TCIRG1 gene encoding for a subunit of the proton pump (V-ATPase) are responsible for more than one-half of ARO cases. Since then, five additional genes have been demonstrated to be involved in the pathogenesis of the disease, leaving approximately 25% of cases that could not be associated with a genotype. Very recently, a mutation in the sorting nexin 10 (SNX10) gene, whose product is suggested to interact with the proton pump, has been found in 3 consanguineous families of Palestinian origin, thus adding a new candidate gene in patients not previously classified. Here we report the identification of 9 novel mutations in this gene in 14 ARO patients from 12 unrelated families of different geographic origin. Interestingly, we define the molecular defect in three cases of "Västerbottenian osteopetrosis," named for the Swedish Province where a higher incidence of the disease has been reported. In our cohort of more than 310 patients from all over the world, SNX10-dependent ARO constitutes 4% of the cases, with a frequency comparable to the receptor activator of NF-κB ligand (RANKL), receptor activator of NF-κB (RANK) and osteopetrosis-associated transmembrane protein 1 (OSTM1)-dependent subsets. Although the clinical presentation is relatively variable in severity, bone seems to be the only affected tissue and the defect can be almost completely rescued by hematopoietic stem cell transplantation (HSCT). These results confirm the involvement of the SNX10 gene in human ARO and identify a new subset with a relatively favorable prognosis as compared to TCIRG1-dependent cases. Further analyses will help to better understand the role of SNX10 in osteoclast physiology and verify whether this protein might be considered a new target for selective antiresorptive therapies.
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Affiliation(s)
- Alessandra Pangrazio
- Unità Organizzativa di Supporto/Istituto di Ricerca Genetica e Biomedica, Milan Unit, CNR, Milano, Italy
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21
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Işeri Eİ, Albayrak D, Gülen D. Electronic Excited States of the CP29 Antenna Complex of Green Plants: A Model Based on Exciton Calculations. J Biol Phys 2013; 26:321-39. [PMID: 23345730 DOI: 10.1023/a:1010352731838] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We have suggested a model for the electronic excited states of the minorplant antenna, CP29, by incorporating a considerable part of the currentinformation offered by structure determination, site-directed mutagenesis,and spectroscopy in the modeling.We have assumed that the electronic excited states of the complex havebeen decided by the chlorophyll-chlorophyll (Chl) and Chl-proteininteractions and have modeled the Coulombic interaction between a pairof Chls in the point-dipole approximation and the Chl-protein interactionsare treated as empirical fit parameters.We have suggested the Q(y) dipole moment orientations and the siteenergies for all the chlorophylls in the complex through a simultaneoussimulation of the absorption and linear dichroism spectra.The assignments proposed have been discussed to yield a satisfactoryreproduction of all prominent features of the absorption, linear and circulardichroism spectra as well as the key spectral and temporal characteristics ofthe energy transfer processes among the chlorophylls.The orientations and the spectral assignments obtained by relatively simpleexciton calculations have been necessary to provide a good point ofdeparture for more detailed treatments of structure-function relationship inCP29. Moreover, it has been discussed that the CP29 model suggested canguide the studies for a better understanding of the structure-functionrelationship in the major plant antenna, LHCII.
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Affiliation(s)
- E İ Işeri
- Physics Department, Middle East Technical University, 06531 Ankara, Turkey
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22
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Albayrak C, Albayrak D, Kilinç AA, Kara C. Myelofibrosis associated with rickets in a child with Down syndrome. Pediatr Blood Cancer 2012; 58:647-8. [PMID: 21913314 DOI: 10.1002/pbc.23353] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2011] [Accepted: 08/23/2011] [Indexed: 11/11/2022]
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23
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Aliyazicioglu Y, Dagdemir A, Dilber C, Albayrak D. Serum prealbumin levels in hepatotoxicity of chemotherapy in children with cancer. BRATISL MED J 2012; 113:368-71. [DOI: 10.4149/bll_2012_083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
In Crimean-Congo haemorrhagic fever (CCHF), haemorrhagic manifestations are usually petechiae and ecchymoses on mucous membranes and skin. Rarely, there is bleeding from the nose, gingiva, gastro-intestinal tract, genito-urinary tract, brain and lungs. A 13-year-old boy with CCHF presented with gastro-intestinal bleeding and developed peritoneal and pleural effusion. He made a complete recovery with supportive treatment and ribavirin, without requiring chest or peritoneal fluid drainage. To our knowledge, this is the first report of CCHF associated with peritoneal and pleural fluid.
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Affiliation(s)
- G Şensoy
- Division of Pediatric Infectious Diseases, Ondokuz Mayıs University Hospital, Samsun, Turkey.
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25
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Paksu MS, Paksu S, Akbalik M, Ozyurek E, Duru F, Albayrak D, Fisgin T. Comparison of the approaches to non-febrile neutropenia developing in children with acute lymphoblastic leukemia. Fundam Clin Pharmacol 2011; 26:418-23. [PMID: 21395681 DOI: 10.1111/j.1472-8206.2011.00938.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The objectives of this study was to investigate of the influences of high-dose (20 mg/kg/day) methyl prednisolone (HDMP) and granulocyte colony stimulating factor (G-CSF) in shortening the duration of chemotherapy-induced neutropenia encountered in children with ALL receiving maintenance therapy. Sixty-four non-febrile neutropenic attacks developed in 29 patients with ALL receiving St Jude XIII maintenance protocol were evaluated retrospectively. The patients were clinically followed up without drugs for shortening the duration of neutropenia in 21 (32.8%) attacs, while HDMP and G-CSF were administered in 26 (40.6%) and 17 (26.6%) attacks, respectively. After the detection of neutropenia, restoration of neutrophil counts at 2nd or 4th days to the levels that allow resuming the chemotherapy were considered as success. While second day and overall success rates in patients administered HDMP and G-CSF were significantly higher than the patients who were observed clinically. Both second day and overall neutrophil counts were significantly higher in patients administered G-CSF than the other groups. Methyl prednisolone and G-CSF treatments were well-tolerated by the patients. The cost-per neutropenic attack was significantly higher in G-CSF group than of the HDMP group. Especially in patients experiencing frequent neutropenic attacks and hence interruptions of the therapy, one of the myelopoiesis induction therapies can be used to shorten the duration of neutropenia. For this indication short-course HDMP therapy can be considered as an alternative to G-CSF in this patients due to its relatively low cost, amenability to outpatient administration, and well-tolerability by children.
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Guler N, Turgut M, Ozatli D, Turgut Y, Gokce AK, Koc S, Albayrak D. High ratio of Duffy (a+b+) phenotype in patients with multiple myeloma compared to healthy controls. Hematol Oncol 2009; 27:50-1. [PMID: 19206111 DOI: 10.1002/hon.887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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27
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Erduran E, Deger O, Albayrak D, Tekelioglu Y, Ozdemir T. In VitroInvestigation of the Apoptotic Effect of Heparin on Lymphoblasts by Using Flow Cytometric DNA Analysis and Fluorometric Caspase-3 and -8 Activities. DNA Cell Biol 2007; 26:803-8. [DOI: 10.1089/dna.2007.0609] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Erol Erduran
- Department of Pediatric Hematology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Orhan Deger
- Department of Biochemistry, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Davut Albayrak
- Department of Pediatric Hematology, School of Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Yavuz Tekelioglu
- Department of Histology and Embryology, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
| | - Tugba Ozdemir
- Department of Pediatrics, School of Medicine, Karadeniz Technical University, Trabzon, Turkey
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Abstract
Selenium (Se) is a trace element contributing to the structure of antioxidant system that saves cells from reactive oxygen species. Low serum Se levels have been reported in pediatric and adult patients with cancers. On the other hand, hair Se levels, predicting the long-term body Se status, have been reported in only adult patients with cancer. The aim of the study was to investigate the hair Se status in children with newly diagnosed lymphoid malignancies and the relation between malnutrition and Se deficiency. Thirty patients with leukemia (n=17) and lymphoma (n=13), and 25 healthy controls were enrolled to the study. Se was determined with atomic absorption spectrophotometrical method. Hair Se levels of the patients were significantly lower than those of control group [666.96+/-341.46 ng/g vs. 1019.22+/-371.83 ng/g (P<0.001)]. Children with lymphoma had lower Se than the children with acute lymphoblastic leukemia but not statistically significant [547.03+/-283.67 ng/g vs. 758.67+/-361.05 ng/g (P>0.05)]. Malnourished patients (11/30) had lower hair Se levels (483.51+/-235.55 ng/g) than those of the controls (P=0.036), whereas the Se levels of the patients who had no malnutrition (773.17+/-352.92 ng/g) were also lower than those of the controls but not statistically significant (P=0.053). There was no correlation between age, sex, and the hair Se levels. In this study, we found that hair Se levels of the children with leukemia and lymphoma, especially those of malnourished patients, were lower than those of controls. Additional studies are needed to determinate whether low levels of hair Se may play a role in carcinogenesis.
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Affiliation(s)
- Ilker Tolga Ozgen
- Divisionsof Pediatric Oncology, Ondokuz Mayis University, Medical Faculty, Samsun, Turkey.
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29
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Akbalik M, Duru F, Fisgin T, Tasdemir HA, Incesu L, Albayrak D, Ozyurek E. Cerebral thrombosis associated with heterozygous factor V Leiden mutation and high lipoprotein(a) level in a girl with factor XIII deficiency. Blood Coagul Fibrinolysis 2007; 18:371-4. [PMID: 17473580 DOI: 10.1097/mbc.0b013e3280d5a7be] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
A 5-year-old girl in whom the diagnosis of inherited factor XIII deficiency was established at the age of 1 day presented with cryptic tonsillitis along with drowsiness and an abrupt occurrence of getting left interior cross eyed. While an intracranial hemorrhage was expected, cerebral imaging studies surprisingly revealed multiple sino venous thrombosis. In prothrombotic screening studies she and her father were both found to be heterozygous for factor V Leiden mutation along with having elevated levels of lipoprotein(a). Low-molecular-weight heparin was started. Ventriculoperitoneal shunt was applied because of persistence of increased intracranial pressure. Thrombosis disappeared and blood flow was normalized by the end of 2 months and the patient was discharged on coumadin therapy as being well. We would like to report this unusual case and to discuss the possible effects of two major genetic prothrombotic risk factors on inherited bleeding tendency or vice versa.
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Affiliation(s)
- Mehtap Akbalik
- Faculty of Medicine, Department of Pediatric Hematology, Ondokuz Mayis University, Samsun, Turkey
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30
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Akbalik M, Duru F, Fisgin T, Tasdemir H, Incesu L, Albayrak D, Ozyurek H. CEREBRAL THROMBOSIS ASSOCIATED WITH HETEROZYGOUS FV LEIDEN MUTATION AND HIGH LIPOPROTEIN A LEVEL IN A GIRL WITH FACTOR XIII DEFICIENCY. J Thromb Haemost 2007. [DOI: 10.1111/j.1538-7836.2007.tb01799.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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31
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Bek K, Ozkaya O, Fişgin T, Aliyazicioğlu Y, Paksu MS, Ozgen T, Albayrak D, Baysal K. Protein Z and natural anticoagulants in children on peritoneal dialysis and hemodialysis. Pediatr Nephrol 2007; 22:881-6. [PMID: 17124603 DOI: 10.1007/s00467-006-0351-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/13/2006] [Revised: 09/08/2006] [Accepted: 10/02/2006] [Indexed: 10/23/2022]
Abstract
Hemostatic alterations due to abnormalities in the coagulation and fibrinolytic system may occur in dialysis patients. Protein Z (PZ) is a vitamin K-dependent coagulation protein promoting assembly of thrombin with phospholipid vesicles. The aim of this study was to investigate PZ and natural anticoagulants in children on hemodialysis (HD) and peritoneal dialysis (PD). Protein Z, protein C (PC), protein S (PS), antithrombin III (AT III), and fibrinogen levels were studied in 24 PD, 13 HD patients and 23 controls. Plasma PZ levels in patients on HD were significantly higher than those on PD and control group (p = 0.04, p = 0.03). We observed elevated PC, PS and AT III activities in children on PD when compared to controls (p = 0.011, p = 0.003, p < 0.001). In HD patients, only PS activity was increased compared to controls (p = 0.016). PC and PS activities did not differ between PD and HD patients whereas AT III activity was higher in PD patients compared to HD patients (p < 0.001). Normal/high levels of PC, PS and AT III suggest that children on PD or HD treatment do not seem to have an increased risk of thrombogenesis due to reduction of these proteins. Increased PZ levels, however, might contribute to the hemostatic alterations in children on HD treatment along with other well known abnormalities.
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Affiliation(s)
- Kenan Bek
- Department of Pediatric Nephrology, Ondokuz Mayis University Faculty of Medicine, Samsun, Turkey.
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32
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Keles GC, Cetinkaya BO, Albayrak D, Koprulu H, Acikgoz G. Comparison of platelet pellet and bioactive glass in periodontal regenerative therapy. Acta Odontol Scand 2006; 64:327-33. [PMID: 17123908 DOI: 10.1080/00016350600758651] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE In recent years, platelet-rich plasma combined with graft materials has been used for periodontal regeneration. The individual role of blood products with guided tissue regeneration in periodontal regenerative therapy is unclear and needs to be elucidated. The purpose of this study was to compare the clinical and radiological effectiveness of platelet pellet/guided tissue regeneration (PP/GTR) and bioactive glass/GTR (BG/GTR) treatments in patients with periodontal disease. MATERIAL AND METHODS Using a split mouth design, 15 chronic periodontitis patients with pocket depths > or = 6 mm following periodontal initial therapy were randomly assigned to treatment with a combination of PP/GTR or BG/GTR in contralateral dentition areas. An absorbable membrane of polylactic acid was used GTR. The criteria for the comparative study were preoperative and postoperative 6 months pocket depth, clinical attachment level, and radiological alveolar bone level. RESULTS Both treatment modalities resulted in significant pocket depth reduction and gain in clinical attachment and alveolar bone level compared to the preoperative values (p < 0.01). Reduction in pocket depth, gain in clinical attachment and alveolar bone level were 4(3-6), 4.1+/-0.7, 4.9+/-1.4 mm in the PP/GTR group and 4(3-7), 4.1+/-1.2, 5.9+/-1.7 mm in the BG/GTR group, respectively. The differences between the two groups were not statistically significant (p > 0.05). CONCLUSIONS Within the limits of this study, it was concluded that PP may be effective as a bioactive glass graft material and used as a graft material for treating intrabony defects. PP thus appears to be a suitable alternative in the regenerative treatment of intrabony periodontal defects.
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Affiliation(s)
- Gonca Cayir Keles
- Department of Periodontology, Ondokuzmayis University, Faculty of Dentistry, Samsun, Turkey.
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Ozkaya O, Bek K, Fişgin T, Aliyazicioğlu Y, Sultansuyu S, Açikgöz Y, Albayrak D, Baysal K. Low protein Z levels in children with nephrotic syndrome. Pediatr Nephrol 2006; 21:1122-6. [PMID: 16810511 DOI: 10.1007/s00467-006-0167-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2006] [Revised: 03/14/2006] [Accepted: 03/21/2006] [Indexed: 10/24/2022]
Abstract
Acquired deficiency of anticoagulant proteins, due to loss in the urine, has been proposed as one of the major thrombogenic alterations in nephrotic syndrome (NS). Protein Z (PZ) is a single-chain vitamin K-dependent glycoprotein. Low PZ levels are reported to be a risk factor for thrombosis. The aim of this study was to investigate protein Z and other natural anticoagulant levels in children with NS. Thirty children aged between 1.5 and 12 years with NS (Groups I and II) and 19 age-and-sex-matched healthy controls (Group III) were enrolled into the study. Patients were divided into two groups: Group I (proteinuria >40 mg/m2/hr) and Group II (patients in remission). Plasma PZ levels in Group I were significantly lower than Group II (p=0.009) and group III (p=0.018). Plasma levels of AT III for Group I were significantly lower than for Groups II and III (p=0.009, p=0.005, respectively). Protein C levels in Group I were higher than in Group II and Group III (p=0.002, p=0.000, respectively). Protein Z levels positively correlated with serum total protein and albumin levels (p=0.003, p=0.003, respectively) and negatively with the degree of proteinuria (p=0.000). Protein Z levels were positively correlated with AT III (r=0.037, p=0.04). Along with the other coagulation abnormalities, decreased protein Z may contribute to increased risk of thromboembolic complications in children with NS. The negative correlation between proteinuria and PZ level suggests the possibility of renal PZ loss. Further studies are needed to investigate the mechanism and role of decreased PZ in NS.
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Affiliation(s)
- Ozan Ozkaya
- Department of Pediatric Nephrology, Ondokuz Mayis University, Samsun, Turkey.
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Akcaboy ZN, Akcaboy EY, Albayrak D, Altinoren B, Dikmen B, Gogus N. Can remifentanil be a better choice than propofol for colonoscopy during monitored anesthesia care? Acta Anaesthesiol Scand 2006; 50:736-41. [PMID: 16987370 DOI: 10.1111/j.1399-6576.2006.01047.x] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND OBJECTIVE This prospective, randomized trial was designed to test the hypothesis that continuous infusion of low-dose remifentanil can provide effective analgesia, sedation, amnesia, patient comfort and stable recovery profile without respiratory depression when compared with propofol infusion during colonoscopy. METHODS One hundred patients were randomly assigned to receive either remifentanil (group R, 0.5 microg/kg followed by 0.05 microg/kg/min, n = 50) or propofol (group P, 0.5 mg/kg followed by 50 microg/kg/min, n = 50). Supplemental doses of remifentanil 12.5 microg in group R and propofol 10 mg in group P were given to treat complaints of moderate to severe pain and discomfort. Hemodynamic and respiratory data, pain, discomfort and sedation scores, patient and gastroenterologist satisfaction and recovery profiles were recorded. RESULTS The duration of colonoscopy was longer in group P. The mean arterial pressure, heart rate and end-tidal CO2 remained stable during the procedure and were comparable between the groups. After bolus injection of the study drugs, the respiratory rate and oxygen saturation values were lower in group R than in group P. Only one patient in group R required airway support. Pain and discomfort scores were better in group R than in group P. Sedation levels were higher in group P than in group R. Group P needed more supplemental doses than group R. The time to reach an Aldrete score of nine or more was shorter in group R, but discharge times were similar in the two groups. Amnesia was better in group P. Nausea and vomiting were more frequent in group R during the recovery phase. CONCLUSION Low-dose remifentanil infusion with intermittent bolus injections can provide adequate sedation, amnesia and better analgesia than propofol infusion during colonoscopy. However, remifentanil-induced nausea and vomiting may be a problem during the recovery phase.
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Affiliation(s)
- Z N Akcaboy
- Department of Anesthesiology, The Ministry of Health Ankara Numune Research and Training Hospital, Ankara, Turkey.
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35
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Abstract
Fanconi's anemia is an autosomal recessive disorder characterized by progressive pancytopenia and congenital malformation of the skeleton. This study investigated the oral health status of 15 children with Fanconi's anemia, including oral lesions, gingival and periodontal status, and dental abnormalities. All children in the group were found to have a tendency to develop tooth decay and were in need of dental treatment. Two had aggressive periodontitis. In one patient supernumerary teeth were found, while in another teeth were congenitally missing. The increased tendency toward periodontal disease in patients with Fanconi's anemia may be due not only to the anemia, leukopenia, and defective detoxification of oxygen radicals that are characteristic of the disease itself, but also to medications applied during intense immunosuppressive treatment, such as prednisolone.
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Affiliation(s)
- Aydan Açikgöz
- Baskent University Faculty of Dentistry, Department of Oral Diagnosis and Radiology, Ankara, Turkey
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36
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Abstract
AIM Iron deficiency anaemia is a frequent finding seen in coeliac disease, which can be diagnosed alone or with other findings. In this study, our aim was to determine the prevalence of coeliac disease in children with iron deficiency anaemia without significant gastrointestinal symptoms. METHODS There were 135 children with iron deficiency anaemia in the patient group (group 1), and 223 healthy children without iron deficiency anaemia in the control group (group 2) in this study. Antiendomysial antibody (EMA) IgA test was given to both groups. Antiendomysial antibody-positive patients underwent small intestine biopsy. RESULTS The mean age was 7.2+/-4.6 (2-16) y in the patient group (group 1) and 8.2+/-3.8 (2-16) y in the control group (group 2), and no significant difference between the two groups was detected. In terms of gender, there was a significant difference between groups 1 and 2 (M/F: 74/61 and 98/125, respectively) ( p<0.05). EMA was positive in six cases in group 1 (4.4%), and villous atrophy and/or inflammation in the lamina propria with increased intraepithelial lymphocytes was seen on small intestine biopsy in these patients. In the control group, EMA was negative in all children. In detailed histories of patients with coeliac disease diagnosis, recurrent iron deficiency anaemia/pica was found in four patients (66.7%) and occasionally foul-smelling or watery stool attacks were seen in four patients (66.7%). Three of these six patients (50%) had short stature. CONCLUSION The prevalence of coeliac disease was high in patients with iron deficiency anaemia; therefore, gastrointestinal findings should be further examined for coeliac disease, and the possibility of coeliac disease should be investigated in patients with recurrent iron deficiency anaemia and short stature.
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Affiliation(s)
- Ayhan Gazi Kalayci
- Department of Paediatric Gastroenterology, Ondokuz Mayis University, Samsun, Turkey.
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Dilber C, Dagdemir A, Albayrak D, Albayrak S, Kalayci AG, Aliyazicioglu Y, Basoglu T. Reduced bone mineral density in childhood chronic idiopathic thrombocytopenic purpura treated with high-dose methylprednisolone. Bone 2004; 35:306-11. [PMID: 15207771 DOI: 10.1016/j.bone.2004.04.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2003] [Revised: 02/27/2004] [Accepted: 04/07/2004] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate whether repeated courses of high-dose methylprednisolone (HDMP) affect the lumbar spine bone mineral density (BMD) in children with chronic idiopathic thrombocytopenic purpura (ITP). MATERIALS AND METHODS This study included 24 patients with chronic ITP and 149 healthy controls. The patients were allocated into three groups according to the number of HDMP courses (30 mg/kg per day as a single dose for 7 days); group 1 (10 patients), group 2 (9 patients), and group 3 (5 patients) had received less than 5, 6-10, and more than 10 courses, respectively. Lumbar spine BMD and body composition were measured using dual energy X-ray absorptiometry of lumbar spine (L2-L4), and volumetric bone mineral density (vBMD) values were calculated and compared with the controls. The z score of the vBMD was also calculated and compared in the patients of each other groups. Serum markers of the bone turnover were measured to exclude other factors that could effect BMD. RESULTS The vBMD values of the patients, corrected BMDs for age, were significantly lower than the values of controls (P = 0.018). It was significantly lower in group 3 than groups 1 and 2 (P = 0.005 and P = 0.006, respectively), but there was no statistically significant difference between groups 1 and 2 (P = 0.87). The vBMD z scores were significantly lower in group 3 than in groups 1 and 2 (P = 0.003 and P = 0.004, respectively), and also in group 2 than in group 1 (P = 0.034). There were a weak negative correlation between the cumulative dose of HDMP and vBMD (r = -0.39, P = 0.054), and strong negative correlation between the cumulative dose of HDMP and vBMD z score (r = -0.63, P = 0.001). CONCLUSION Children with chronic ITP are at risk for decreased BMD because of the repeated courses of HDMP; especially more than 2100 mg of cumulative dose. We therefore recommend that BMD should be monitored in patients with chronic ITP who received repeated courses of HDMP.
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Affiliation(s)
- Cengiz Dilber
- Department of Paediatrics, Medical Faculty, Ondokuz Mayis University, 55 139 Samsun, Turkey.
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Dagdemir A, Yildirim H, Aliyazicioglu Y, Kanber Y, Albayrak D, Acar S. Does vitamin A prevent high-dose-methotrexate-induced D-xylose malabsorption in children with cancer? Support Care Cancer 2004; 12:263-7. [PMID: 14767751 DOI: 10.1007/s00520-004-0591-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2003] [Accepted: 01/12/2004] [Indexed: 11/28/2022]
Abstract
PURPOSE Our aim was to explore whether vitamin A has protective effect on high-dose-methotrexate (HDMTX)-induced intestinal D-xylose malabsorption in children with leukemia and lymphoma. PATIENTS AND METHODS We performed a prospective randomized un-blinded study of vitamin A in 35 children with leukemia and lymphoma who were planned to receive HDMTX 3 g/m(2) and 5 g/m(2), respectively. Twenty-two patients (group 1) received a single dose of 180,000 IU a day before HDMTX was given, and 13 (group 2) received only HDMTX. The vitamin A group received the vitamin only once. Oral D-xylose absorption tests before and 7 days after HDMTX were carried out to evaluate intestinal absorption. Retinol-binding protein (RBP) levels prior to therapy were also measured for vitamin A status. RESULTS Although we observed no difference of HDMTX-induced toxicity, including hematological, dermatological, systemic, and other toxicities, between groups, the D-xylose absorption test was significantly better in-group 1 ( p=0.030). Absorption was decreased in five of 22 patients (23%) who received vitamin A comparing to eight of 13 (62%) who received only HDMTX ( p=0.033). RBP levels were lower than normal in 13 of 22 patients in-group 1 and nine of 13 in group 2. In patients whose RBP levels were lower than normal, HDMTX-induced toxicity was lower in the group 1 than group 2 but not statistically significant. No sign of vitamin A toxicity was observed throughout the study. CONCLUSION The administration of vitamin A before HDMTX may protect against drug-induced D-xylose malabsorption in children with cancer. Further studies are apparently needed to clarify the full benefits of vitamin A in preventing HDMTX-induced mucosal damage.
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Affiliation(s)
- Ayhan Dagdemir
- Medical Faculty, Department of Pediatric Oncology, Ondokuz Mayis University, 55139 Kurupelit-Samsun, Turkey.
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Kücüködük S, Sezer T, Yildiran A, Albayrak D. Randomized, double-blinded, placebo-controlled trial of early administration of recombinant human granulocyte colony-stimulating factor to non-neutropenic preterm newborns between 33 and 36 weeks with presumed sepsis. Scand J Infect Dis 2003; 34:893-7. [PMID: 12587621 DOI: 10.1080/0036554021000026966] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
A randomized, double-blinded, placebo-controlled trial was conducted of early administration of recombinant granulocyte colony-stimulating factor (rGCSF) to 40 non-neutropenic, preterm infants between 33 and 36 weeks of gestational age with the diagnosis of presumed sepsis. The treatment group (n = 20) received 5 microg/kg per day of intravenous rGCSF once daily for 3 d and the control group (n = 20) received the same volume of physiological serum. Immediately before the first dose and on the 4th day, plasma levels of GCSF and tumour necrosis factor-alpha (TNF-alpha), absolute neutrophil counts (ANC), immature neutrophil count (INC), immature/total neutrophil (I/T) ratios and platelet counts were determined. At study entry, the plasma GCSF and TNF-alpha levels were similar. On day 4, there was no significant change in GCSF levels in either groups, whereas there was a significant decrease in TNF-alpha levels in the treatment group. ANC and INC of the treatment group also increased significantly. The I/T ratio continued at the same level in the treatment group, but decreased significantly on days 4 and 7 day in the control group. The length of time on the neonatal intensive care unit (NICU) was significantly shorter in the treatment group. In conclusion, early administration of 3 daily doses of rGCSF (5 microg/kg per day) to non-neutropenic, preterm infants who had presumed sepsis increased circulating ANC and INC, decreased plasma TNF-alpha levels and shortened the length of time on the NICU.
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Affiliation(s)
- Sükrü Kücüködük
- Department of Pediatrics, Division of Neonatology, Ondokuz Mayis University of Medicine, Samsun, Turkey
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40
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Abstract
UNLABELLED Between 1981 and 2001, we retrospectively analysed 40 cases of visceral leishmaniasis (VL) admitted to the Paediatric Infection Unit of Ondokuz Mayis University Hospital, in the middle Black Sea region of Turkey. Median age at presentation was 3 y. Fever and splenomegaly were found in all patients. Bone marrow smear examination resulted in the diagnosis of VL in 95% of cases. All patients were treated initially with meglumine antimonate and 95% of them were cured with this therapy. The remaining patients were cured with liposomal amphotericin B. CONCLUSIONS VL should be considered in patients with fever and splenomegaly, particularly those residing in the Mediterranean region. Meglumine antimonate seems to be the first choice of treatment in childhood.
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Affiliation(s)
- M Totan
- Department of Paediatrics, Faculty of Medicine, Ondokuz Mayis University, Samsun, Turkey.
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Dagdemir A, Albayrak D, Dilber C, Totan M. G-CSF related capillary leak syndrome in a child with leukemia. Leuk Lymphoma 2001; 42:1445-7. [PMID: 11911434 DOI: 10.3109/10428190109097778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Affiliation(s)
- H Birinci
- Department of Ophthalmology, University of Ondokuz Mayis, Samsun, Turkey
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Timur AA, Albayrak D, Çağlayan SH. Rapid Identification of Family-Specific Mutations in the Factor VIII Gene by One-Step DGGE. Turk J Haematol 2001; 18:89-93. [PMID: 27264062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
Abstract
A one-step denaturing gradient gel electrophoresis (DGGE) strategy for the rapid detection of mutations in the factor VIII gene of haemophilia A patients is described. All coding (except the middle part of exon 14) and flanking intronic regions of the gene corresponding to approximately 6.6 kb were amplified in 27 fragments using four PCR programs. Heteroduplex formation was performed for each fragment. A common denaturant gradient gel (35-65%) was chosen that allowed the simultaneous analysis of all PCR amplified regions on a single gel and run for 3.5 h at 160 V. This method was implemented for a patient whose family was seeking carrier determinations. An abnormal pattern was detected in exon 23 and the family-specific mutation was found by subsequent DNA sequencing. One-step DGGE is a promising rapid method for the carrier detection and prenatal diagnosis in haemophilia A families when immediate results are required and when polymorphic markers fail to give information.
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Abstract
Osteopetrosis major (infantile autosomal recessive type) usually presents with pathological fractures, bone marrow failure and some neurological deficits due to remodelling defect of the bone and narrowed bonny channel of the blood supply. Herein we present a case of osteopetrosis major with neurological deficits not attributed to the narrowed carotid channel of the petrous bone, but due to middle cerebral arterial occlusion 2 cm distal to narrowed channel.
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Affiliation(s)
- H A Tasdemir
- Department of Pediatrics, Faculty of Medicine, Ondokuz Mayis Universitesi, Samsun, Turkey
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Totan M, Dagdemir A, Ak AR, Albayrak D, Kucukoduk S. Effects of high-dose methotrexate on the hemostatic system in childhood acute lymphoblastic leukemia. Med Pediatr Oncol 2001; 36:429-33. [PMID: 11260565 DOI: 10.1002/mpo.1106] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Thromboembolic and hemorrhagic complications are significant causes of death in patients with malignancy. These are well-known with the use of certain drugs. This study was planned to investigate whether there was any effect of high-dose methotrexate on the hemostatic system in childhood acute lymphoblastic leukemia. PROCEDURE To evaluate the hemostatic system, we investigated coagulation screening tests (prothrombin time, activated partial thromboplastin time, and fibrinogen), coagulation inhibitors (protein C, protein S, and antithrombin III), and fibrinolytic system (fibrin degradation products and tissue plasminogen activator). These parameters were measured in 35 cycles of high dose-methotrexate (3 g/m(2)) of 20 childhood acute lymphoblastic leukemia cases at baseline and on days 1 and 7 after the therapy. RESULTS We found that high-dose methotrexate administration adversely affected both the coagulation system (prolonged prothrombin time and activated partial thromboplastin time and decreased fibrinogen levels) and coagulation inhibitors (decreased protein C, protein S, antithrombin III) on day 1 after chemotherapy compared to the baseline values. The hemostatic parameters began to improve on day 7 after chemotherapy, except for fibrin degradation products. Tissue plasminogen activator levels were not changed with the therapy. CONCLUSIONS Coagulation cascade (prolonged prothrombin time and activated partial thromboplastin time and decreased fibrinogen) and coagulation inhibitors (decreased protein C, protein S, and antithrombin III levels) have been found to be affected by high-dose methotrexate therapy, but these transient changes did not cause clinical thromboembolic or hemorrhagic complications.
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Affiliation(s)
- M Totan
- Department of Pediatric Hematology, Medical Faculty of Ondokuz, Mayis University, Samsun, Turkey
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Affiliation(s)
- A G Kalayci
- Ondokuz Mayis University, Medical Faculty, Department of Pediatrics, Samsun, Turkey
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Işlek I, Gök F, Albayrak D, Küçüködük S. Nephrotic syndrome following cefixime therapy in a 10-month-old girl: spontaneous resolution without corticosteroid treatment. Nephrol Dial Transplant 1999; 14:2527. [PMID: 10528699 DOI: 10.1093/ndt/14.10.2527] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Abstract
A three months old girl was admitted to the hospital for evaluation of pallor and abdominal distension. There was anemia, thrombocytopenia and extramedullary hematopoiesis. In the long bone roentgenogram medullary areas could not be distinguished and bone densities were increased. The patient was diagnosed for osteopetrosis with these findings and prednisolone treatment was begun and then discontinued since it was not effective. In the follow up, the need for blood transfusions decreased and then disappeared. We present a case which was diagnosed as osteopetrosis and followed up by blood transfusions and of which hematologic findings improved with age.
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Affiliation(s)
- M Totan
- Medical Faculty of Ondokuz Mayis University, Department of Pediatrics Hematology, Samsun, Turkey
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Abstract
PURPOSE To determine gallbladder motor function and gallstone prevalence in beta-thalassemic children. Abnormalities in gallbladder function or bile acid metabolism may contribute to gallstone formation in these patients. MATERIAL AND METHODS In 17 beta-thalassemic patients and 12 normal healthy children with similar age, sex and weight, gallbladder size was measured using real-time US, and volume was calculated using the ellipsoid method. RESULTS In the beta-thalassemic patients, cholelithiasis was present in 2 patients (11.8%). Sludge, which can be a predisposing factor for cholelithiasis and cholecystitis when it persists, was detected in 5 patients (29.4%). One of the patients had both cholelithiasis and sludge. Compared with the control group, beta-thalassemic children had larger fasting volume, residual volume, and smaller contraction index. CONCLUSION Beta-thalassemic patients have enlarged gallbladders that retain an increased residual volume of bile. Gallbladder enlargement, bile stasis, and impaired emptying of sludge may be important events in the pathogenesis of pigment gallstones in beta-thalassemic patients.
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Affiliation(s)
- A G Kalayci
- Department of Pediatrics, Ondokuz Mayis University, School of Medicine, Samsun, Turkey
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