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Özalp Gerçeker G, Yıldırım BG, Önal A, Ören H, Olgun HN, Bektaş M. The effect of the closed intravenous catheter system on first insertion success, indwelling time, and complications in pediatric hematology and oncology patients: A randomized controlled study. Eur J Oncol Nurs 2023; 67:102430. [PMID: 37879193 DOI: 10.1016/j.ejon.2023.102430] [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] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Revised: 09/20/2023] [Accepted: 09/29/2023] [Indexed: 10/27/2023]
Abstract
PURPOSE The primary purpose of this research is to evaluate the effect of two different catheter systems (closed IV catheter system: BD Nexiva™, peripheral open IV catheter: BD Insyte™ Autoguard™) on first insertion success, catheter indwelling time, and the catheter complications. METHOD This randomized controlled study used a single-blind and parallel trial design guided by the CONSORT checklist. The "Peripheral Intravenous Catheter (PIVC) Bundle" was applied to all patients. A total of 214 catheters of 38 patients were included in the intervention (BD Nexiva™) (n = 107 catheter) and control (open IV catheter) groups (n = 107 catheter) of the study. The indwelling time and PIVC complications were followed. RESULTS The mean age of the patients in the study group was 5.9 ± 2.2, and the mean age of the patients in the control group was 5.7 ± 1.9. The PIVC was successfully placed in 68.2% of the patients in the study group and in 65.4% of the patients in the control group at the first attempt. It was determined that the indwelling time was 4.9 ± 3.9 (max. 20.25 days) in the study group and 2.9 ± 2.8 (max. 11.25 days) days in the control group. The complication rates were found to be 86.8 for the study group and 166.9 for the control group in 1000 catheter days. In this study, no difference was found in terms of complication. CONCLUSIONS The PIVC indwelling time is longer in patients with the closed IV catheter system. These new technology PIVCs can be used for this special patient population. CLINICALTRIALS GOV IDENTIFIER NCT05769452.
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Affiliation(s)
- Gülçin Özalp Gerçeker
- Pediatric Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, Turkey.
| | - Büşra Güliz Yıldırım
- Dokuz Eylul University Child Hospital, Izmir, Turkey; Dokuz Eylul University, Institute of Health Sciences, Department of Nursing, Izmir, Turkey.
| | - Ayşe Önal
- Dokuz Eylul University Child Hospital, Izmir, Turkey; Dokuz Eylul University, Institute of Health Sciences, Department of Nursing, Izmir, Turkey.
| | - Hale Ören
- Dokuz Eylül University Hospital, Department of Paediatric Hematology, Izmir, Turkey.
| | - Hatice Nur Olgun
- Dokuz Eylül University Hospital, Department of Paediatric Oncology, Izmir, Turkey.
| | - Murat Bektaş
- Pediatric Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, Turkey.
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Özdemir B, Gerçeker GÖ, Özdemir EZ, Yildirim BG, Ören H, Yiş U, Günay Ç, Thomas GÖ. Evaluation of vincristine-induced peripheral neuropathy in children with cancer: Turkish validity and reliability study. J Pediatr Nurs 2023; 72:185-190. [PMID: 37076371 DOI: 10.1016/j.pedn.2023.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/04/2023] [Revised: 04/08/2023] [Accepted: 04/10/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND The evaluation of peripheral neuropathy in children receiving Vincristine treatment is challenging. This study examined the Turkish validity and reliability of the Total Neuropathy Score-Pediatric Vincristine (TNS-PV) measurement tool, which can measure Vincristine-induced peripheral neuropathy symptoms in children with cancer. METHODS A total of 53 children aged 5-17 years who received Vincristine treatment in two pediatric hematology-oncology centers participated in the study. Data was collected using the Total Neuropathy Score-Pediatric Vincristine (TNS-PV), the Common Terminology Criteria for Adverse Events (CTCAE), the Wong-Baker FACES Pain Scale, and the Adolescent Pediatric Pain Tool (APPT). The correlation between the TNS-PV total score and other scales and the inter-rater reliability coefficient was evaluated. FINDINGS Of the children, 81.1% were diagnosed with ALL and 13.2% with Ewing Sarcoma. Cronbach's alpha values of form A and B of the TNS-PV scale were 0.628 and 0.639, respectively. As the cumulative Vincristine dose increased, the children's scores on TNS-PV were higher. A moderate and significant positive correlation was found between the TNS-PV form A total score and the worst subjective symptoms a, b (A), strength, tendon reflexes, and autonomic / constipation (r = 0.441, r = 0.545, r = 0.472, r = 0.536, p < 0.01). DISCUSSION The TNS-PV form B total score was found to have a moderate level, significant correlation with CTCAE sensory neuropathy score and Wong-Baker FACES Pain Scale, and a high level, significant positive correlation with CTCAE motor neuropathy score. APPLICATION TO PRACTICE The TNS-PV is valid and reliable for measuring Vincristine-induced peripheral neuropathy in practice in Turkish children 5 years and older.
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Affiliation(s)
- Bilge Özdemir
- Istanbul Gedik University, Gedik Vocational School, Department of Medical Services of Techniques, Anesthesia Program, Istanbul, Turkey; Dokuz Eylul University Health Sciences Institute, Turkey.
| | | | - Emine Zahide Özdemir
- Dokuz Eylul University, Faculty of Nursing, Department of Nursing, Izmir, Turkey
| | - Büşra Güliz Yildirim
- Dokuz Eylul University Health Sciences Institute, Turkey; Dokuz Eylul University Child Hospital, Izmir 35340, Turkey
| | - Hale Ören
- Dokuz Eylul University Children's Hospital, Pediatric Hematology Department, Izmir, Turkey.
| | - Uluç Yiş
- Dokuz Eylul University Children's Hospital, Department of Pediatric Neurology, Izmir, Turkey.
| | - Çağatay Günay
- Dokuz Eylul University Children's Hospital, Department of Pediatric Neurology, Izmir, Turkey
| | - Gülten Öztürk Thomas
- Marmara University Pendik Training and Research Hospital, Department of Pediatric Neurology, Istanbul, Turkey.
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Erbaş İC, Çakıl Güzin A, Özdem Alataş Ş, Karaoğlu Asrak H, Akansu İ, Akyol Ş, Özlü C, Tüfekçi Ö, Yılmaz Ş, Ören H, Belet N. Etiology and Factors Affecting Severe Complications and Mortality of Febrile Neutropenia in Children with Acute Leukemia. Turk J Haematol 2023; 40:143-153. [PMID: 37525503 PMCID: PMC10476243 DOI: 10.4274/tjh.galenos.2023.2023.0185] [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] [Subscribe] [Scholar Register] [Received: 05/06/2023] [Accepted: 07/31/2023] [Indexed: 08/02/2023] Open
Abstract
Objective Febrile neutropenia (FN) is an important complication that causes high rates of morbidity and mortality in patients with malignancies. We aimed to investigate the etiology, epidemiological distribution and its change over the years, clinical courses, and outcomes of FN in children with acute leukemia. Materials and Methods We retrospectively analyzed the demographic data, clinical characteristics, laboratory results, severe complications, and mortality rates of pediatric patients with FN between January 2010 and December 2020. Results In 153 patients, a total of 450 FN episodes (FNEs) occurred. Eighty-four (54.9%) of these patients were male, the median age of the patients was 6.5 (range: 3-12.2) years, and 127 patients (83%) were diagnosed with acute lymphoblastic leukemia. Fever with a focus was found in approximately half of the patients, and an etiology was identified for 38.7% of the patients. The most common fever focus was bloodstream infection (n=74, 16.5%). Etiologically, a bacterial infection was identified in 22.7% (n=102), a viral infection in 13.3% (n=60), and a fungal infection in 5.8% (n=26) of the episodes. Twenty-six (23.2%) of a total of 112 bacteria were multidrug resistant (MDR) The rate of severe complications was 7.8% (n=35) and the mortality rate was 2% (n=9). In logistic regression analysis, refractory/relapsed malignancies and high C-reactive protein (CRP) at first admission were found to be the most important independent risk factors for mortality. Prolonged neutropenia after chemotherapy, diagnosis of acute myeloid leukemia, identification of fever focus or etiological agents, invasive fungal infections, polymicrobial infections, and need for intravenous immunoglobulin treatment increased the frequency of severe complications. Conclusion We found that there was no significant change in the epidemiological distribution or frequency of resistant bacteria in our center in the last 10 years compared to previous years. Prolonged duration of fever, relapsed/refractory malignancies, presence of fever focus, and high CRP level were significant risk factors for poor clinical course and outcome.
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Affiliation(s)
- İrem Ceren Erbaş
- Dokuz Eylül University Faculty of Medicine, Division of Pediatric Infectious Diseases, İzmir, Türkiye
| | - Ayşe Çakıl Güzin
- Dokuz Eylül University Faculty of Medicine, Division of Pediatric Infectious Diseases, İzmir, Türkiye
| | - Şilem Özdem Alataş
- Dokuz Eylül University Faculty of Medicine, Division of Pediatric Infectious Diseases, İzmir, Türkiye
| | - Hatice Karaoğlu Asrak
- Dokuz Eylül University Faculty of Medicine, Division of Pediatric Infectious Diseases, İzmir, Türkiye
| | - İlknur Akansu
- Dokuz Eylül University Faculty of Medicine, Department of Pediatrics, İzmir, Türkiye
| | - Şefika Akyol
- Dokuz Eylül University Faculty of Medicine, Division of Pediatric Hematology and Oncology, İzmir, Türkiye
| | - Canan Özlü
- Dokuz Eylül University Faculty of Medicine, Division of Pediatric Infectious Diseases, İzmir, Türkiye
| | - Özlem Tüfekçi
- Dokuz Eylül University Faculty of Medicine, Division of Pediatric Hematology and Oncology, İzmir, Türkiye
| | - Şebnem Yılmaz
- Dokuz Eylül University Faculty of Medicine, Division of Pediatric Hematology and Oncology, İzmir, Türkiye
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Division of Pediatric Hematology and Oncology, İzmir, Türkiye
| | - Nurşen Belet
- Dokuz Eylül University Faculty of Medicine, Division of Pediatric Infectious Diseases, İzmir, Türkiye
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Şik N, Duman M, Küme T, Gürsoy Doruk Ö, Yilmaz D, Ören H. Roles of Vitamin-K-dependent Factors Protein S and GAS6 With TAM Receptors and HMGB1 in Pediatric COVID-19 Disease. J Pediatr Hematol Oncol 2023; 45:e298-e303. [PMID: 35973116 DOI: 10.1097/mph.0000000000002528] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 02/25/2022] [Accepted: 06/17/2022] [Indexed: 11/27/2022]
Abstract
OBJECTIVE This study was designed to evaluate serum high-mobility group box 1 (HMGB1), protein S (PS), growth arrest-specific gene 6 (GAS6), and TAM receptor (TYRO3, AXL, and MERTK) levels in children with COVID-19 disease. METHODS A prospective case-control study was conducted in our pediatric emergency department and 57 patients with SARS-CoV-2 polymerase chain reaction (PCR) positivity, 6 patients with multisystem inflammatory syndrome in children (MIS-C), and 17 healthy children were included. Demographic data, clinical findings, laboratory and radiologic data, the need for hospitalization, and prognosis were recorded. Serum HMGB1, PS, GAS6, and TAM receptor levels were studied by enzyme-linked immunosorbent assay method. RESULTS While SARS-CoV-2 PCR-positive patients and healthy controls were similar in terms of gender and age, GAS6 and MERTK levels were significantly lower in SARS-CoV-2 PCR-positive patients compared with healthy controls. Among SARS-CoV-2 PCR-positive patients, no difference was found in terms of serum markers in those with and without gastrointestinal or respiratory system symptoms. However, in patients with respiratory distress at admission, PS and TYRO3 levels were significantly lower. AXL levels were lower in patients diagnosed with MIS-C compared with healthy controls. Activated partial thromboplastin time was negatively correlated with HMGB1, PS, GAS6, and AXL levels. CONCLUSION Our results suggest that such measurements may be informative and warranted in children with COVID-19 who show evidence of coagulopathy and respiratory distress. Further studies are needed to clarify the roles of these markers in diagnosis, to predict clinical severity, and to evaluate their roles in treatment approaches for COVID-19 disease.
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Affiliation(s)
- Nihan Şik
- Division of Pediatric Emergency Care; Department of Pediatrics
| | - Murat Duman
- Division of Pediatric Emergency Care; Department of Pediatrics
| | - Tuncay Küme
- Division of Pediatric Hematology, Department of Biochemistry
| | | | - Durgül Yilmaz
- Division of Pediatric Emergency Care; Department of Pediatrics
| | - Hale Ören
- Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
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Özdemir B, Gerçeker GÖ, Özdemir EZ, Yıldırım BG, Ören H, Yiş U, Günay Ç, Thomas GÖ. Examination of the psychometric properties of pediatric-modified total neuropathy score in Turkish children with cancer. J Pediatr Nurs 2023; 69:31-37. [PMID: 36603498 DOI: 10.1016/j.pedn.2022.12.017] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 11/20/2022] [Accepted: 12/18/2022] [Indexed: 01/05/2023]
Abstract
BACKGROUND Evaluation of chemotherapy-induced peripheral neuropathy has gained importance in symptom management of pediatric patients with cancer. This study aimed to perform the Turkish validity and reliability study of the Pediatric-Modified Total Neuropathy Score (Ped-mTNS). METHODS A methodological, descriptive, and cross-sectional design was used in the study. Forty children aged between 5 and 18 and were treated for cancer and 40 age- and gender-matched healthy children (control group) were included in the study. The mean scores of the items on the Ped-mTNS were compared, and item-total score correlations were evaluated. Cronbach's alpha coefficient of the Ped-mTNS was calculated for internal consistency. FINDINGS Cronbach's alpha value of the scale was found as 0.709. The item-total correlations of the scale items ranged from 0.260 to 0.658. The mean score of cancer patients on the Ped-mTNS was found as 4.4 ± 3.8. DISCUSSION Ped-mTNS scores of children with cancer indicated more deficits than those of the control group. In the evaluation of children in the patient and control groups, a difference was found in terms of light touch sensation, which is one of the sensory symptoms in the items of the Ped-mTNS, and pin sensibility and strength, which are among the clinical symptoms. APPLICATION TO PRACTICE The Ped-mTNS was determined to be a valid and reliable measurement tool for children with cancer aged between 5 and 18 in the Turkish population.
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Affiliation(s)
- Bilge Özdemir
- Istanbul Gedik University, Gedik Vocational School, Department of Medical Services of Techniques, Anesthesia Program, Istanbul, Turkey; Dokuz Eylul University Health Sciences Institute PhD Student, Turkey.
| | | | - Emine Zahide Özdemir
- Dokuz Eylul University, Faculty of Nursing, Department of Nursing, Izmir, Turkey
| | - Büşra Güliz Yıldırım
- Dokuz Eylul University Child Hospital, Izmir 35340, Turkey; Dokuz Eylul University Health Sciences Institute PhD Student, Turkey
| | - Hale Ören
- Dokuz Eylul University Children's Hospital Pediatric Hematology Department, Izmir, Turkey.
| | - Uluç Yiş
- Dokuz Eylul University Children's Hospital Department of Pediatric Neurology, Izmir, Turkey.
| | - Çağatay Günay
- Dokuz Eylul University Children's Hospital Department of Pediatric Neurology, Izmir, Turkey
| | - Gülten Öztürk Thomas
- Marmara University Pendik Training and Research Hospital, Department of Pediatric Neurology, Istanbul, Turkey.
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Akyol Ş, Yılmaz Ş, Tüfekçi Ö, Arslan N, Ören H. A complication of lysinuric protein intolerance: Intermittent haemophagocytic lymphohistiocytosis. J Paediatr Child Health 2022; 58:2300-2301. [PMID: 35938785 DOI: 10.1111/jpc.16158] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 07/17/2022] [Accepted: 07/26/2022] [Indexed: 11/26/2022]
Affiliation(s)
- Şefika Akyol
- Department of Pediatric Hematology, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Şebnem Yılmaz
- Department of Pediatric Hematology, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Özlem Tüfekçi
- Department of Pediatric Hematology, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Nur Arslan
- Department of Pediatric Metabolic Diseases, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
| | - Hale Ören
- Department of Pediatric Hematology, Dokuz Eylül University, Faculty of Medicine, İzmir, Turkey
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Ören H. EARLY T-CELL PRECURSOR ACUTE LYMPHOBLASTIC LEUKEMIA IN CHILDHOOD. Hematol Transfus Cell Ther 2022. [DOI: 10.1016/j.htct.2022.09.1203] [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: 11/06/2022] Open
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Akyol Ş, Tüfekçi Ö, Baysal B, Yılmaz Ş, Ören H. Abscess-like skin and lung lesions in a patient with acute lymphoblastic leukemia: Pyoderma gangrenosum. Pediatr Blood Cancer 2022; 69:e29655. [PMID: 35278042 DOI: 10.1002/pbc.29655] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Revised: 02/19/2022] [Accepted: 02/27/2022] [Indexed: 11/10/2022]
Affiliation(s)
- Şefika Akyol
- Department of Pediatric Hematology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Özlem Tüfekçi
- Department of Pediatric Hematology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Birsen Baysal
- Department of Pediatric Hematology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Şebnem Yılmaz
- Department of Pediatric Hematology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
| | - Hale Ören
- Department of Pediatric Hematology, Faculty of Medicine, Dokuz Eylül University, İzmir, Turkey
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Akyol Ş, Tüfekçi Ö, Yilmaz Ş, Ören H. Evaluation of paediatric immune thrombocytopenia patients with clinical and laboratory findings: emphasizing the role of monocytosis. Blood Coagul Fibrinolysis 2022; 33:315-321. [PMID: 35834725 DOI: 10.1097/mbc.0000000000001146] [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] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
We aimed to investigate the relationship between demographics, clinical features, laboratory findings including monocytosis and clinical course in children with immune thrombocytopenia (ITP). Data of 100 ITP patients were analysed. Complete blood count findings of the patients at certain time points were evaluated to classify the disease as acute, persistent and chronic. An effect of sex on chronicity was not observed ( P = 0.166). Of the patients enrolled in the study, 38% ( n = 38) had chronic course. The mean age of patients with the chronic course was 7 ± 4.1 years, which was significantly higher than the other groups ( P = 0.007). Sixty-five percent ( n = 13) of the patients presenting with mucosal bleeding and 27.4% ( n = 20) of the patients presenting with skin bleeding became chronic ( P = 0.008). MPV was found to be significantly high in chronic ITP patients ( P = 0.049). Monocytosis was noted in 80% of the patients at diagnosis. Intravenous immunoglobulin was used in 84% of the patients with acute ITP; 33% of them developed chronic ITP. The age at diagnosis, presence of mucosal bleeding and increased MPV on admission were high-risk factors for the development of the chronic course. Monocytosis was detected in 80% of the patients on admission, and it may play a role in the pathogenesis of ITP.
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Affiliation(s)
- Şefika Akyol
- Dokuz Eylul University, Department of Pediatric Hematology, Izmir, Turkey
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Tüfekçi Ö, Evim MS, Güneş AM, Celkan T, Karapinar DY, Kaya Z, Baysal B, Baytan B, Koçak Ü, Yilmaz Ş, Çinar S, Ören H. Assessment of Minimal Residual Disease in Childhood Acute Lymphoblastic Leukemia: A Multicenter Study From Turkey. J Pediatr Hematol Oncol 2022; 44:e396-e402. [PMID: 35129146 DOI: 10.1097/mph.0000000000002419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 02/10/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
Assestment of minimal residual disease (MRD) in childhood acute lymphoblastic leukemia (ALL) is of utmost importance both for risk classification and tailoring of the therapy. The data of pediatric ALL patients that received treatment with Berlin-Frankfurt-Münster (BFM) protocols were retrospectively collected from 5 university hospitals in Turkey. Of the 1388 patients enrolled in the study 390 were treated according to MRD-based protocols. MRD assestment was with real time quantitative polymerase chain reaction (qPCR) in 283 patients and with multiparametric flow cytometry (MFC)-MRD in 107 patients. MRD monitoring had upstaged a total of 8 patients (2%) from intermediate risk group to high-risk group. Univariate analysis revealed age 10 years or above, prednisone poor response, PCR-MRD ≥10-3 on day 33 and on day 78 as poor prognostic factors affecting event-free survival (EFS). Detection of >10% blasts on day 15 with MFC (MFC-high-risk group) was not shown to affect EFS and/or overall survival (log-rank P=0.339). Multiple logistic regression analysis revealed PCR-MRD ≥10-3 on day 78 as the only poor prognostic factor affecting EFS (odds ratio: 8.03; 95% confidence interval: 2.5-25; P=0.000). It is very important to establish the infrastructure and ensure necessary standardization for both MRD methods for optimal management of children with ALL.
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Affiliation(s)
- Özlem Tüfekçi
- Department of Pediatric Hematology, Dokuz Eylül University Medical Faculty, İzmir
| | - Melike Sezgin Evim
- Department of Pediatric Hematology, Uludağ University Medical Faculty, Bursa
| | - Adalet Meral Güneş
- Department of Pediatric Hematology, Uludağ University Medical Faculty, Bursa
| | - Tiraje Celkan
- Department of Pediatric Hematology-Oncology, İstanbul University Cerrahpaşa Medical Faculty
| | | | - Zühre Kaya
- Department of Pediatric Hematology, Gazi University Medical Faculty, Ankara, Turkey
| | - Birsen Baysal
- Department of Pediatric Hematology, Dokuz Eylül University Medical Faculty, İzmir
| | - Birol Baytan
- Department of Pediatric Hematology, Uludağ University Medical Faculty, Bursa
| | - Ülker Koçak
- Department of Pediatric Hematology, Gazi University Medical Faculty, Ankara, Turkey
| | - Şebnem Yilmaz
- Department of Pediatric Hematology, Dokuz Eylül University Medical Faculty, İzmir
| | - Suzan Çinar
- İstanbul University Institute of Experimental Medicine, İstanbul
| | - Hale Ören
- Department of Pediatric Hematology, Dokuz Eylül University Medical Faculty, İzmir
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Gündüz E, Kırkızlar HO, Ümit EG, Karaman Gülsaran S, Özkocaman V, Özkalemkaş F, Candar Ö, Elverdi T, Küçükyurt S, Paydaş S, Ceneli Ö, Karakuş S, Maral S, Ekinci Ö, İpek Y, Kis C, Güven ZT, Akdeniz A, Celkan T, Eroğlu Küçükdiler AH, Akgün Çağlıyan G, Özçelik Şengöz C, Karataş A, Bulduk T, Özcan A, Belen Apak FB, Canbolat A, Kartal İ, Ören H, Töret E, Özdemir GN, Bakanay Öztürk ŞM. Castleman Disease: A Multicenter Case Series from Turkey. Turk J Haematol 2022; 39:130-135. [PMID: 35176839 PMCID: PMC9160699 DOI: 10.4274/tjh.galenos.2022.2021.0670] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Castleman disease (CD) is a rare disease also known as angiofollicular lymph node hyperplasia. The two main histological subtypes are the hyaline vascular and plasma cell variants. It is further classified as unicentric CD (UCD) or multicentric CD (MCD) according to the anatomical distribution of the disease and the number of lymph nodes involved. The aim of this multicenter study was to evaluate all cases of CD identified to date in Turkey to set up a national registry to improve the early recognition, treatment, and follow-up of CD. Materials and Methods: Both adult (n=130) and pediatric (n=10) patients with lymph node or involved field biopsy results reported as CD were included in the study. Patients’ demographic information, clinical and laboratory characteristics, imaging study results, treatment strategies, and clinical outcomes were evaluated retrospectively. Results: A total of 140 patients (69 male and 71 female) with a diagnosis of UCD (n=73) or MCD (n=67) were included. The mean age was 39 years in the UCD group and 47 years in the MCD group. Female patients were more common in the UCD group. The most common histological subtype was hyaline vascular for both UCD and MCD patients. Asymptomatic patients were more common in the UCD group. Anemia, elevations of acute phase reactants, and hypoalbuminemia were more common in the MCD group. The most commonly used treatment strategies for UCD were surgical excision, rituximab, and radiotherapy, respectively. All UCD patients were alive at a median of 19.5 months of follow-up. The most commonly used treatment strategies for MCD were methyl prednisolone, R-CHOP, R-CVP, and rituximab. Thirteen MCD patients had died at a median of 34 months of follow-up. Conclusion: This study is important in presenting the patient characteristics and treatment strategies for CD from Turkey, with the potential of increasing awareness about CD. Treatment data may help in making decisions, particularly in countries that do not have access to siltuximab. However, larger prospective studies are needed to make definitive conclusions.
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Affiliation(s)
- Eren Gündüz
- Eskişehir Osmangazi University Faculty of Medicine Department of Hematology, Eskişehir, Turkey
| | | | - Elif Gülsüm Ümit
- Trakya University Faculty of Medicine Department of Hematology, Edirne, Turkey
| | | | - Vildan Özkocaman
- Uludag University Faculty of Medicine Department of Hematology, Bursa, Turkey
| | - Fahir Özkalemkaş
- Uludag University Faculty of Medicine Department of Hematology, Bursa, Turkey
| | - Ömer Candar
- Uludag University Faculty of Medicine Department of Hematology, Bursa, Turkey
| | - Tuğrul Elverdi
- İstanbul University Cerrahpaşa Faculty of Medicine Department of Hematology, İstanbul, Turkey
| | - Selin Küçükyurt
- İstanbul University Cerrahpaşa Faculty of Medicine Department of Hematology, İstanbul, Turkey
| | - Semra Paydaş
- Çukurova University Faculty of Medicine Department of Hematology, Adana, Turkey
| | - Özcan Ceneli
- Necmettin Erbakan University Meram Faculty of Medicine Department of Hematology, Konya, Turkey
| | - Sema Karakuş
- Ankara Başkent University Faculty of Medicine Department of Hematology, Ankara, Turkey
| | - Senem Maral
- Health Sciences University Dışkapı Yıldırım Beyazıt Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Ömer Ekinci
- Fırat University Faculty of Medicine Department of Hematology, Elazığ, Turkey
| | - Yıldız İpek
- Kartal Dr Lutfi Kirdar City Hospital Department of Hematology, İstanbul, Turkey
| | - Cem Kis
- Adana Baskent University Faculty of Medicine Department of Hematology, Adana, Turkey
| | - Zeynep Tuğba Güven
- Erciyes University Faculty of Medicine Department of Hematology, Kayseri, Turkey
| | - Aydan Akdeniz
- Mersin University Faculty of Medicine Department of Hematology, Mersin, Turkey
| | - Tiraje Celkan
- İstinye University Faculty of Medicine Department of Pediatric Hematology, İstanbul, Turkey
| | | | | | - Ceyda Özçelik Şengöz
- Karadeniz Technical University Faculty of Medicine Department of Hematology, Trabzon, Turkey
| | - Ayse Karataş
- Hacettepe University Faculty of Medicine Department of Hematology, Ankara, Turkey
| | - Tuba Bulduk
- Health Sciences University Gulhane Training and Research Hospital, Department of Hematology, Ankara, Turkey
| | - Alper Özcan
- Erciyes University Faculty of Medicine Department of Pediatric Hematology, Kayseri, Turkey
| | - Fatma Burcu Belen Apak
- Ankara Başkent University Faculty of Medicine Department of Pediatric Hematology, Ankara, Turkey
| | - Aylin Canbolat
- İstanbul Medeniyet University Faculty of Medicine Department of Pediatric Hematology, İstanbul, Turkey
| | - İbrahim Kartal
- Ondokuz Mayıs University Faculty of Medicine Department of Pediatric Hematology, Samsun, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine Department of Pediatric Hematology, İzmir, Turkey
| | - Ersin Töret
- Eskişehir Osmangazi University Faculty of Medicine Department of Pediatric Hematology, Eskişehir, Turkey
| | - Gül Nihal Özdemir
- İstinye University Faculty of Medicine Department of Pediatric Hematology, İstanbul, Turkey
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12
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Deliloğlu B, Tüfekçi Ö, Tüzün F, Aykut A, Ceylan Eİ, Durmaz A, Yılmaz Ş, Duman N, Özkan H, Ören H. A novel Mecom gene mutation associated with amegakaryocytic thrombocytopenia in a premature infant. Turk J Pediatr 2022; 64:736-740. [PMID: 36082647 DOI: 10.24953/turkjped.2021.4855] [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] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Hereditary bone marrow failure syndromes are a category of biologically different syndromes that can cause cytopenia in at least one hematopoietic cell lineage. CASE We present a 29-week-old male infant who had a low Apgar Score, advanced delivery room resuscitation, widespread petechial rash, and ecchymoses at birth, without any dysmorphic features. Initial laboratory tests revealed bicytopenia (platelet count 7x10 3 /uL, hemoglobin of 3.9 g/dL, neutrophil 2.0x103 /uL) with findings of disseminated intravasculer coagulation (DIC). Imaging studies demonstrated accompanying left-sided congenital pulmonary airway malformation. On the second postnatal week pancytopenia occurred and the bone marrow findings were consistent with congenital amegakaryocytic thrombocytopenia. Further evaluations for differential diagnosis of pancitopenia were performed and the results of congenital viral infections, metabolic and immunologic tests were negative. While supportive treatments were in progress, haploidentical bone marrow transplantation (BMT) was performed from the father at 84th day due to unavailability of HLA-matched relative or nonrelative donor. Whole exome sequencing revealed a novel heterozygous frameshift variation (c.1242dupT [p. Thr538fs]) in exon 8 of the MECOM gene and validated by Sanger sequencing. No variation was detected in the parents genetic analysis. CONCLUSIONS In this report, we present a patient with congenital bone marrow failure successfully treated with haploidentic BMT and describe a novel, de novo pathogenic variant in MECOM gene.
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Affiliation(s)
- Burak Deliloğlu
- Department of Pediatrics, Divisions of Neonatology, Dokuz Eylul University Faculty of Medine, İzmir, Turkey
| | - Özlem Tüfekçi
- Department of Pediatric Hematology, Dokuz Eylul University Faculty of Medine, İzmir, Turkey
| | - Funda Tüzün
- Department of Pediatrics, Divisions of Neonatology, Dokuz Eylul University Faculty of Medine, İzmir, Turkey
| | - Ayça Aykut
- Department of Medical Genetics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Emine İpek Ceylan
- Department of Medical Genetics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Asude Durmaz
- Department of Medical Genetics, Ege University Faculty of Medicine, İzmir, Turkey
| | - Şebnem Yılmaz
- Department of Pediatric Hematology, Dokuz Eylul University Faculty of Medine, İzmir, Turkey
| | - Nuray Duman
- Department of Pediatrics, Divisions of Neonatology, Dokuz Eylul University Faculty of Medine, İzmir, Turkey
| | - Hasan Özkan
- Department of Pediatrics, Divisions of Neonatology, Dokuz Eylul University Faculty of Medine, İzmir, Turkey
| | - Hale Ören
- Department of Pediatric Hematology, Dokuz Eylul University Faculty of Medine, İzmir, Turkey
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13
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Tüfekçi Ö, Özdemir HH, Malbora B, Özbek NY, Yarali N, Erdem A, Evim M, Baytan B, Güneş AM, Karapinar T, Oymak Y, Töret E, Bör Ö, Yilmaz Ş, Ören H, Özdemir GN, Karapinar DY. Hepatitis-Associated Aplastic Anemia: Etiology, Clinical Characteristics and Outcome. J Pediatr Hematol Oncol 2022; 44:e223-e226. [PMID: 34669357 DOI: 10.1097/mph.0000000000002268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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: 02/02/2021] [Accepted: 05/27/2021] [Indexed: 11/26/2022]
Abstract
Hepatitis-associated aplastic anemia (HAA) is a form of acquired aplastic anemia (AA) in which bone marrow failure develops after an acute attack of hepatitis. Bone marrow failure leading to AA is generally severe in cases of HAA and fatal if left untreated. This retrospective multicenter study investigated clinical and laboratory characteristics, possible causes, treatment, and outcome of HAA in children. Twenty patients from 8 centers were included in the study. Aspartate aminotransferase and alanine aminotransferase were <3 to 5×upper limit of normal (ULN) in 2 patients, <5 to 10×ULN in 2 patients, and >10×ULN in 16 patients. Acute liver failure developed in 5 (29%) patients. Pancytopenia was simultaneously present in 6 of 20 (30%) patients. Eleven of the 20 patients (55%) were alive, in remission and transfusion free. Those who were alive either had undergone hematopoietic stem cell transplantation and/or immunosuppressive treatment, except 1 patient who had received no treatment. Patients with the diagnosis of acute hepatitis should be evaluated and followed up carefully for presence of cytopenia, so that definitive treatment of AA can be initiated in a timely and appropriate manner when needed.
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Affiliation(s)
- Özlem Tüfekçi
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine
| | - Hamiyet H Özdemir
- Department of Pediatric Hematology, Ege University Faculty of Medicine
| | - Bariş Malbora
- Department of Pediatric Hematology/Oncology, Ankara City Hospital, The University of Health Sciences, Ankara
| | - Namik Y Özbek
- Department of Pediatric Hematology/Oncology, Ankara City Hospital, The University of Health Sciences, Ankara
| | - Neşe Yarali
- Department of Pediatric Hematology/Oncology, Ankara City Hospital, The University of Health Sciences, Ankara
| | - Arzu Erdem
- Department of Pediatric Hematology/Oncology, Ankara City Hospital, The University of Health Sciences, Ankara
| | - Melike Evim
- Department of Pediatric Hematology, Uludağ University Faculty of Medicine, Bursa
| | - Birol Baytan
- Department of Pediatric Hematology, Uludağ University Faculty of Medicine, Bursa
| | - Adalet M Güneş
- Department of Pediatric Hematology, Uludağ University Faculty of Medicine, Bursa
| | - Tuba Karapinar
- Department of Pediatric Hematology/Oncology, İstinye University Faculty of Medicine, İstanbul, Turkey
| | - Yeşim Oymak
- Department of Pediatric Hematology/Oncology, İstinye University Faculty of Medicine, İstanbul, Turkey
| | - Ersin Töret
- Department of Pediatric Hematology, Osmangazi University Faculty of Medicine, Eskişehir
| | - Özcan Bör
- Department of Pediatric Hematology, Osmangazi University Faculty of Medicine, Eskişehir
| | - Şebnem Yilmaz
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine
| | - Hale Ören
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine
| | - Gül N Özdemir
- Department of Pediatric Hematology/Oncology, İstinye University Faculty of Medicine, İstanbul, Turkey
| | - Deniz Y Karapinar
- Department of Pediatric Hematology, Ege University Faculty of Medicine
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14
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Er A, Çağlar A, Çitlenbik H, Akgül F, Ulusoy E, Ören H, Yιlmaz D, Duman M. Which Device Is Favorable for Intubation Attempts of Pediatric Residents on Four Different Pediatric Airway Simulations? Pediatr Emerg Care 2022; 38:e272-e277. [PMID: 33003132 DOI: 10.1097/pec.0000000000002247] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Endotracheal intubation is an essential skill for the pediatric airway management. Although direct laryngoscopy (DL) is the standard method, several videolaryngoscopes (VLs) have been recently enhanced as an alternative especially for difficult intubations. We aimed to compare McGrath MAC (McG) and Storz C-MAC PM (ST) VLs with DL in terms of intubation success rate, time to intubation (TTI), and duration of obtaining glottis view of intubation attempts performed by pediatric residents on different pediatric airway manikins. METHODS The pediatric residents with no experience in videolaryngoscopy were included. After a brief demonstration, intubation attempts with 3 randomly handled different devices with 6 different blades were performed on a child manikin, an infant manikin, a Pierre-Robin sequence infant manikin, and a child manikin with cervical immobilization sequentially. RESULTS Fifty pediatric residents were enrolled. The attempts of DL on child manikin and attempts of all devices on child with cervical immobilization simulation were completely successful. For the attempts on both infant manikin and Pierre-Robin sequence infant manikin, the success rate of McG was significantly lower than ST and DL (P = 0.011 and P = 0.001). In the child manikin, McG and ST had prolonged TTI compared with DL (P = 0.016 and P = 0.001). For the child with cervical immobilization simulation, TTI of DL was significantly shorter than McG and ST (P = 0.011 and P = 0.001). Time to intubation of McG was significantly longer than DL and ST for the attempts on both 2 infant manikins. The rate of Cormack-Lehane grade I glottis view was similar for the attempts on both 2 child airway simulations. For infant manikin and Pierre-Robin sequence infant simulation, the rate of Cormack-Lehane grade I of ST was higher than attempts of DL and McG. CONCLUSIONS The attempts of pediatric residents on infant normal airway and Pierre-Robin sequence infant airway simulations resulted with enhanced glottis view by the utilization of Storz C-MAC PM, but both 2 VLs did not provide the improvement of intubation success rate and TTI compared with DL on these 4 different pediatric manikins. Further clinical studies of different VLs in different clinical courses are required for a reliable utilization in children.
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Affiliation(s)
- Anıl Er
- From the Division of Pediatric Emergency Medicine, Department of Pediatrics
| | - Aykut Çağlar
- From the Division of Pediatric Emergency Medicine, Department of Pediatrics
| | - Hale Çitlenbik
- From the Division of Pediatric Emergency Medicine, Department of Pediatrics
| | - Fatma Akgül
- From the Division of Pediatric Emergency Medicine, Department of Pediatrics
| | - Emel Ulusoy
- From the Division of Pediatric Emergency Medicine, Department of Pediatrics
| | - Hale Ören
- Department of Pediatrics, Dokuz Eylul University, School of Medicine, Izmir, Turkey
| | - Durgül Yιlmaz
- From the Division of Pediatric Emergency Medicine, Department of Pediatrics
| | - Murat Duman
- From the Division of Pediatric Emergency Medicine, Department of Pediatrics
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15
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Zengin E, Sarper N, Yazal Erdem A, Odaman Al I, Sezgin Evim M, Yaralı N, Belen B, Akçay A, Türedi Yıldırım A, Karapınar TH, Güneş AM, Aylan Gelen S, Ören H, Olcay L, Baytan B, Gülen H, Öztürk G, Orhan MF, Oymak Y, Akpınar S, Tüfekçi Ö, Albayrak M, Tatlı Güneş B, Canpolat A, Özbek N. Thrombolysis with Systemic Recombinant Tissue Plasminogen Activator in Children: A Multicenter Retrospective Study. Turk J Haematol 2021; 38:294-305. [PMID: 34431642 PMCID: PMC8656121 DOI: 10.4274/tjh.galenos.2021.2021.0038] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 08/18/2021] [Indexed: 12/01/2022] Open
Abstract
Objective This study aimed to evaluate systemic thrombolysis experiences with recombinant tissue plasminogen activator (rtPA). Materials and Methods Retrospective data were collected from 13 Turkish pediatric hematology centers. The dose and duration of rtPA treatment, concomitant anticoagulant treatment, complete clot resolution (CCR), partial clot resolution (PCR), and bleeding complications were evaluated. Low-dose (LD) rtPA treatment was defined as 0.01-0.06 mg/kg/h and high-dose (HD) rtPA as 0.1-0.5 mg/kg/h. Results Between 2005 and 2019, 55 thrombotic episodes of 54 pediatric patients with a median age of 5 years (range: 1 day to 17.75 years) were evaluated. These patients had intracardiac thrombosis (n=16), deep vein thrombosis (DVT) (n=15), non-stroke arterial thrombosis (n=14), pulmonary thromboembolism (PE) (n=6), and stroke (n=4). The duration from thrombus detection to rtPA initiation was a median of 12 h (range: 2-504 h) and it was significantly longer in cases of DVT and PE compared to stroke, non-stroke arterial thrombosis, and intracardiac thrombosis (p=0.024). In 63.6% of the episodes, heparin was initiated before rtPA treatment. LD and HD rtPA were administered in 22 and 33 of the episodes, respectively. Concomitant anticoagulation was used in 90% and 36% of the episodes with LD and HD rtPA, respectively (p=0.0001). Median total duration of LD and HD rtPA infusions was 30 h (range: 2-120 h) and 18 h (2-120 h), respectively (p=0.044). Non-fatal major and minor bleeding rates were 12.5% and 16.7% for LD and 3.2% and 25.8% for HD rtPA, respectively. At the end of the rtPA infusions, CCR and PCR were achieved in 32.7% and 49.0% of the episodes, respectively. The most successful site for thrombolysis was intracardiac thrombosis. HD versus LD rtPA administration was not correlated with CCR/PCR or bleeding (p>0.05). Conclusion Systemic thrombolytic therapy may save lives and organs effectively if it is used at the right indications and the right times in children with high-risk thrombosis by experienced hematologists with close monitoring of recanalization and bleeding.
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Affiliation(s)
- Emine Zengin
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kocaeli, Turkey
| | - Nazan Sarper
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kocaeli, Turkey
| | - Arzu Yazal Erdem
- University of Health Sciences Turkey, Ankara City Hospital, Department of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
| | - Işık Odaman Al
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatrics and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Melike Sezgin Evim
- Uludağ University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Neşe Yaralı
- University of Health Sciences Turkey, Ankara City Hospital, Department of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
| | - Burcu Belen
- Başkent University Ankara Hospital, Clinic of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
| | - Arzu Akçay
- Acıbadem Mehmet Ali Aydınlar University Acıbadem Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Ayşen Türedi Yıldırım
- Celal Bayar University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Manisa, Turkey
| | - Tuba Hilkay Karapınar
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatrics and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Adalet Meral Güneş
- Uludağ University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Sema Aylan Gelen
- Kocaeli University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kocaeli, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, İzmir, Turkey
| | - Lale Olcay
- Başkent University Ankara Hospital, Clinic of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
| | - Birol Baytan
- Uludağ University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Hüseyin Gülen
- Celal Bayar University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Manisa, Turkey
| | - Gülyüz Öztürk
- Acıbadem Mehmet Ali Aydınlar University Acıbadem Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Mehmet Fatih Orhan
- Sakarya University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Sakarya, Turkey
| | - Yeşim Oymak
- University of Health Sciences Turkey, Dr. Behçet Uz Pediatrics and Pediatric Surgery Training and Research Hospital, İzmir, Turkey
| | - Sibel Akpınar
- University of Health Sciences Turkey, Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatrics, Division of Pediatric Hematology, İstanbul, Turkey
| | - Özlem Tüfekçi
- Dokuz Eylül University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, İzmir, Turkey
| | - Meryem Albayrak
- Kırıkkale University Faculty of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kırıkkale, Turkey
| | - Burçak Tatlı Güneş
- University of Health Sciences Turkey, Tepecik Training and Research Hospital, Department of Pediatrics, Division of Pediatric Hematology, İzmir, Turkey
| | - Aylin Canpolat
- İstanbul Medeniyet University Göztepe Training and Research Hospital, Clinic of Pediatrics, Division of Pediatric Hematology, İstanbul, Turkey
| | - Namık Özbek
- University of Health Sciences Turkey, Ankara City Hospital, Department of Pediatrics, Division of Pediatric Hematology, Ankara, Turkey
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16
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Sezgin Evim M, Tüfekçi Ö, Baytan B, Ören H, Çelebi S, Ener B, Üstün Elmas K, Yılmaz Ş, Erdem M, Hacımustafaoğlu MK, Güneş AM. Invasive Fungal Infections in Children with Leukemia: The Clinical Features and Prognosis. Turk J Haematol 2021; 39:94-102. [PMID: 34792308 PMCID: PMC9160694 DOI: 10.4274/tjh.galenos.2021.2021.0203] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective The incidence of invasive fungal infections (IFI) increased due to intensive chemotherapy in childhood leukemia. The aim of this study was to evaluate the incidence, risk factors, causative pathogens and the impact on survival of IFI in pediatric leukemia patients. Materials and Methods The hospital records of 307 children with acute lymphoblastic leukemia (ALL, n=238), acute myeloid leukemia (AML, n=51) and relapsed leukemia (n=18) between January 2010 and December 2015 were retrospectively evaluated. Results A total of 1213 febrile neutropenia episodes were recorded and 127(10.4%) of them were related to IFI. Of 307 children, 121(39.4%) developed IFI. The mean age was found significantly older in the IFI group compared to children without IFI (p<0.001). IFI were defined as possible, probable and proven in 73.2%, 11.9%, and 14.9% of the attacks, respectively. Invasive aspergillosis (81.9%) was the most frequent infection, followed by invasive candidiasis (13.4%) and rare fungal diseases (4.8%). Majority of the IFI attacks both in ALL and AML occurred during the induction phase. In total, the death rate was 24% and IFI related mortality was found 18%. The mortality rate in children with IFI was found significantly higher in children without IFI (p<0.001). Overall and event free survivals at 5 years was also found significantly lower in the IFI group (p<0.001). Relapse (Odds ratio, 8.49) was the most effective risk factor on mortality which was followed by developing an IFI episode (Odds ratio, 3.2) and AML (Odds ratio, 2.33) by multivariate regression analysis. Conclusions Our data showed that IFI was more common in older children. Although proven and probable IFI episodes were more frequently diagnosed in relapse and AML, children with ALL and AML had a similar frequency of experiencing at least one episode of IFI. Rare fungal diseases were also defined as a major problem. Despite the success in treatment, IFI increased the rate of mortality in children with acute leukemia.
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Affiliation(s)
- Melike Sezgin Evim
- Uludağ University Medical Faculty, Department of Pediatric Hematology, Bursa, Turkey
| | - Özlem Tüfekçi
- Dokuz Eylül University Medical Faculty, Department of Pediatric Hematology, Izmir, Turkey
| | - Birol Baytan
- Uludağ University Medical Faculty, Department of Pediatric Hematology, Bursa, Turkey
| | - Hale Ören
- Dokuz Eylül University Medical Faculty, Department of Pediatric Hematology, Izmir, Turkey
| | - Solmaz Çelebi
- Uludağ University Medical Faculty, Department of Pediatric Infection Disease, Bursa, Turkey
| | - Beyza Ener
- Uludağ University Medical Faculty, Medical Microbiology, Bursa, Turkey
| | - Kevser Üstün Elmas
- Uludağ University Medical Faculty, Department of Pediatrics, Bursa, Turkey
| | - Şebnem Yılmaz
- Dokuz Eylül University Medical Faculty, Department of Pediatric Hematology, Izmir, Turkey
| | - Melek Erdem
- Dokuz Eylül University Medical Faculty, Department of Pediatric Hematology, Izmir, Turkey
| | | | - Adalet Meral Güneş
- Uludağ University Medical Faculty, Department of Pediatric Hematology, Bursa, Turkey
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17
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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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18
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Şık N, Uzun A, Öztürk A, Tüfekçi Ö, Yılmaz Ş, Yılmaz D, Ören H, Duman M. Pediatric trauma: Blood product transfusion characteristics in a pediatric emergency department, a single center experience. Transfus Apher Sci 2021; 61:103288. [PMID: 34627713 DOI: 10.1016/j.transci.2021.103288] [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: 07/19/2021] [Revised: 09/28/2021] [Accepted: 09/30/2021] [Indexed: 11/27/2022]
Abstract
AIM To investigate clinical and laboratory data, management and outcomes of pediatric trauma patients who initially received blood product transfusions. METHODS Between January 2011-January 2021, traumatic children who underwent blood product transfusions within 24 h of arrival at the emergency department were included. Demographics, clinical and laboratory data, Injury Severity Score (ISS), volume of transfused blood products and crystalloid boluses in 24 h were recorded. Massive transfusion (MT) was defined as transfusion of ≥40 mL/kg of all blood products in 24 h. RESULTS Among 32 cases, 8 (25.0 %) patients met the MT threshold criterion. Length of pediatric intensive care unit (PICU) stay and mechanical ventilation (MV) were longer for patients who received MT although there was no difference for age, ISS, volume of crystalloid boluses, length of hospital stay, and 30-day mortality between those who received MT or not. Volume of crystalloid boluses was higher in patients who died than those who survived but the volume of blood products was similar for two groups. An APTT value of >37.5 s was identified as a predictor of 30-day mortality (OR = 48.000, 95 % CI: 3.704-621.998, p: 0.003). CONCLUSION Children who received MT had longer durations of MV and PICU stay than those who did not receive, but there was no significance for ISS, volume of crystalloid boluses, hospital stay, or mortality between two groups. Volume of crystalloid boluses was higher in patients who died than those who survived. An APTT value of >37.5 s can be used to predict 30-day mortality.
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Affiliation(s)
- Nihan Şık
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Aslıhan Uzun
- Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ali Öztürk
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Özlem Tüfekçi
- Division of Pediatric Hematology, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Şebnem Yılmaz
- Division of Pediatric Hematology, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Durgül Yılmaz
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Hale Ören
- Division of Pediatric Hematology, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Murat Duman
- Division of Pediatric Emergency Care, Department of Pediatrics, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey.
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Gerçeker GÖ, Bektaş M, Aydınok Y, Ören H, Ellidokuz H, Olgun N. The effect of virtual reality on pain, fear, and anxiety during access of a port with huber needle in pediatric hematology-oncology patients: Randomized controlled trial. Eur J Oncol Nurs 2020; 50:101886. [PMID: 33321461 DOI: 10.1016/j.ejon.2020.101886] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 11/24/2020] [Accepted: 11/26/2020] [Indexed: 11/16/2022]
Abstract
PURPOSE Port needle insertions are painful and distressing for Pediatric Hematology-Oncology patients. Virtual Reality (VR) can be used during needle-related procedures in these patients. This study aimed to investigate the effect of VR distraction during access to the venous port with a Huber needle in reducing needle-related pain, fear, and anxiety of children and adolescents with cancer. METHODS This randomized controlled study used a parallel trial design guided by the CONSORT checklist. The sample of children (n = 42) was allocated to the VR group (n = 21) and the control group (n = 21). Port needle-related pain was assessed using the Wong-Baker Faces Pain Rating Scale after the procedure. Before and after the port needle insertion procedure, anxiety and fear assessed using self- and parent-report using the Children's Anxiety Meter and Child Fear Scale. The primary outcome was the patient-reported pain scores after the procedure and fear and anxiety scores before and after the procedure. Pain, anxiety, and fear scores of the two groups and within groups were analyzed and also Spearman correlation analysis was used. RESULTS Self-reported pain scores of patients in the VR and control group were 2.4 ± 1.8 and 5.3 ± 1.8, respectively. This study found a statistically significant difference between groups in pain scores (p < .001). A statistically significant difference was found between groups according to the self- and parent-reported fear and anxiety scores after the procedure. Self-reported fear scores in the VR and control group were 0.8 ± 0.9, 2.0 ± 1.0, self-reported anxiety scores were 2.9 ± 2.0, 5.4 ± 2.0, respectively (p < .001). CONCLUSION Virtual reality is an effective distraction method in reducing port needle-related pain, fear, and anxiety in Pediatric Hematology-Oncology patients. ClinicalTrials.gov NCT04093154.
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Affiliation(s)
- Gülçin Özalp Gerçeker
- Pediatric Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, 35340, Turkey.
| | - Murat Bektaş
- Pediatric Nursing Department, Dokuz Eylul University Faculty of Nursing, Izmir, 35340, Turkey.
| | - Yeşim Aydınok
- Ege University Hospital, Department of Paediatric Hematology-Oncology, Izmir, Turkey.
| | - Hale Ören
- Dokuz Eylül University Hospital, Department of Paediatric Hematology, Izmir, Turkey.
| | - Hülya Ellidokuz
- Dokuz Eylül University Hospital, Institue of Oncology, Izmir, Turkey.
| | - Nur Olgun
- Dokuz Eylül University Hospital, Department of Paediatric Oncology, Izmir, Turkey.
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Koca Yozgat A, Leblebisatan G, Akbayram S, Çınar Özel S, Karakaş Z, Erduran E, Yılmaz Ş, Koçak Ü, Ünal Ş, Özdemir GN, Albayrak M, Zengin E, Oymak Y, Bör Ö, Çakmaklı HF, Söker M, Gürlek Gökçebay D, Tokgöz H, Malbora B, Karaman S, Celkan T, Şaşmaz İ, Yaralı N, Ören H, Ünüvar A, Özbek NY. Outcomes of Eltrombopag Treatment and Development of Iron Deficiency in Children with Immune Thrombocytopenia in Turkey. Turk J Haematol 2020; 37:139-144. [PMID: 32181630 PMCID: PMC7463208 DOI: 10.4274/tjh.galenos.2020.2019.0380] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Objective Immune thrombocytopenia (ITP) is a rare autoimmune disease and hematologic disorder characterized by reduced platelet counts that can result in significant symptoms, such as bleeding, bruising, epistaxis, or petechiae. The thrombopoietin receptor agonist eltrombopag (EPAG) is a second-line agent used to treat chronic ITP purpura in adults and children. Materials and Methods The present retrospective study evaluated the efficacy, safety, and side effects of EPAG treatment in pediatric patients with acute refractory and chronic immune thrombocytopenia, particularly focusing on iron-deficiency anemia. Results The diagnosis was chronic ITP in 89 patients and acute refractory ITP in 16 patients. The mean age of patients was 9.5±4.5 years (minimum-maximum: 1.2-18 years) at the beginning of EPAG treatment. The overall response rate was 74.3% (n=78). The mean time for platelet count of ≥50x109/L was 11.6±8 weeks (range: 1-34 weeks). The treatment was stopped for 27 patients (25.7%) at an average of 6.8±9 months (range: 1-38 months). The reason for discontinuation was lack of response in 18 patients, nonadherence in 4 patients, and hepatotoxicity in 2 patients. Response to treatment continued for an average of 4 months after cessation of EPAG in 3 patients. Conclusion Results of the current study imply that EPAG is an effective therapeutic option in pediatric patients with acute refractory and chronic ITP. However, patients must be closely monitored for response and side effects during treatment, and especially for iron deficiency.
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Affiliation(s)
- Ayça Koca Yozgat
- Ankara City Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
| | - Göksel Leblebisatan
- Çukurova University Faculty of Medicine, Department of Pediatric Hematology, Adana, Turkey
| | - Sinan Akbayram
- Gaziantep University Faculty of Medicine, Department of Pediatric Hematology, Gaziantep, Turkey
| | - Simge Çınar Özel
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Zeynep Karakaş
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Erol Erduran
- Karadeniz Technical University Faculty of Medicine, Department of Pediatric Hematology, Trabzon, Turkey
| | - Şebnem Yılmaz
- 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
| | - Şule Ünal
- Hacettepe University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Gül Nihal Özdemir
- Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Meryem Albayrak
- Kırıkkale University Faculty of Medicine, Department of Pediatric Hematology, Kırıkkale, Turkey
| | - Emine Zengin
- Kocaeli University Faculty of Medicine, Department of Pediatric Hematology, Kocaeli, Turkey
| | - Yeşim Oymak
- Dr. Behçet Uz Children’s Training and Research Hospital, Clinic of Pediatric Hematology, İzmir, Turkey
| | - Özcan Bör
- Eskişehir University Faculty of Medicine, Department of Pediatric Hematology, Eskişehir, Turkey
| | - Hasan Fatih Çakmaklı
- Ankara University Faculty of Medicine, Department of Pediatric Hematology, Ankara, Turkey
| | - Murat Söker
- Dicle University Faculty of Medicine, Department of Pediatric Hematology, Diyarbakır, Turkey
| | - Dilek Gürlek Gökçebay
- Ankara Keçiören Training and Research Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
| | - Hüseyin Tokgöz
- Necmettin Erbakan University Meram Faculty of Medicine, Department of Pediatric Hematology, Konya, Turkey
| | - Barış Malbora
- Yeni Yüzyıl University, Gaziosmanpaşa Hospital, Clinic of Pediatric Hematology, İstanbul, Turkey
| | - Serap Karaman
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Tiraje Celkan
- İstanbul University-Cerrahpaşa Cerrahpaşa Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - İlgen Şaşmaz
- Çukurova University Faculty of Medicine, Department of Pediatric Hematology, Adana, Turkey
| | - Neşe Yaralı
- Ankara City Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Ayşegül Ünüvar
- İstanbul University, İstanbul Faculty of Medicine, Department of Pediatric Hematology, İstanbul, Turkey
| | - Namık Yaşar Özbek
- Ankara City Hospital, Clinic of Pediatric Hematology, Ankara, Turkey
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Demir Yenigürbüz F, Ören H. Pediatric Deep Venous Thrombosis and Pulmonary Embolism: Can It Be Antiphospholipid Syndrome? Turk J Haematol 2019; 36:205-206. [PMID: 30201599 PMCID: PMC6682786 DOI: 10.4274/tjh.galenos.2018.2018.0214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
- Fatma Demir Yenigürbüz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
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Tüfekçi Ö, Yılmaz Ş, Erdem M, Baysal B, Ören H. Isolated Mediastinal Myeloid Sarcoma After NPM1 Positive Acute Myeloid Leukemia. Turk J Haematol 2019; 36:285-286. [PMID: 30859798 PMCID: PMC6863024 DOI: 10.4274/tjh.galenos.2019.2018.0434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Erdem M, Tüfekçi Ö, Yılmaz Ş, Alacacıoğlu İ, Ören H. Long-Term Follow-Up of a Case with Dyskeratosis Congenita Caused by NHP2-V126M/X154R Mutation: Genotype-Phenotype Association. Acta Haematol 2018; 141:28-31. [PMID: 30472699 DOI: 10.1159/000494421] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 02/26/2018] [Accepted: 10/04/2018] [Indexed: 11/19/2022]
Abstract
Dyskeratosis congenita (DC) is a rare inherited syndrome characterized by classical mucocutaneous features and the presence of other clinical features including bone marrow failure, pulmonary fibrosis, liver cirrhosis, and a predisposition to cancer. The symptoms develop at various ages and may manifest over time. Gene mutations associated with DC, such as DC1, TERC, TERT, TINF2, NHP2, NOP10, ACD, CTC1, NAF1, PARN, POT1, RTEL1, STN1, and WRAP53, have been identified in about 70% of patients. Since the number of patients with DC is small and the effect of genetic pathogenic variant may affect the phenotype, we wanted to present the clinical features and course of illness in a patient with NHP2 gene mutation (compound heterozygote for the NHP2 mutations c.376G>A/c.460T>A; amino acid substitutions: p.Val126Met and p.X154Arg) that occurred as a compound heterozygous state.
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Affiliation(s)
- Melek Erdem
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Özlem Tüfekçi
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Şebnem Yılmaz
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - İnci Alacacıoğlu
- Department of Hematology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey
| | - Hale Ören
- Department of Pediatric Hematology, Dokuz Eylül University Faculty of Medicine, İzmir, Turkey,
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Kızmazoğlu D, Sarı S, Evim Sezgin M, Kantarcıoğlu A, Tüfekçi Ö, Demir Yenigürbüz F, Baytan B, Yılmaz Ş, Güneş AM, Ören H. Assessment of Health-Related Quality of Life in Pediatric Acute Lymphoblastic Leukemia Survivors: Perceptions of Children, Siblings, and Parents. Turk J Haematol 2018; 36:112-116. [PMID: 30401658 PMCID: PMC6516105 DOI: 10.4274/tjh.galenos.2018.2018.0351] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [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 We investigated the health-related quality of life (HRQL) in survivors of pediatric acute lymphoblastic leukemia (ALL) and evaluated the perceptions of the children, their siblings, and their parents. Materials and Methods Seventy ALL survivors, who were between 7 and 17 years of age and had completed therapy ≥2 years, were included. The control group consisted of their healthy siblings. HRQL was assessed by the age-specific KINDLR questionnaire. Results No significant differences could be found among HRQL scores of ALL survivors with respect to variables such as sex, risk group, and having chronic illness. HRQL scores for physical well-being, emotional well-being, family, and social functioning of the patient and sibling self-reports and parent proxy reports were lower than the expected values for healthy and chronically ill children. Conclusion These results demonstrate that both ALL survivors and their families need help via psychological counseling programs to improve their HRQL even after completion of therapy.
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Affiliation(s)
- Deniz Kızmazoğlu
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Seher Sarı
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Melike Evim Sezgin
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Arzu Kantarcıoğlu
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Özlem Tüfekçi
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Fatma Demir Yenigürbüz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Birol Baytan
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Şebnem Yılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Adalet Meral Güneş
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
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Kızmazoğlu D, Sarı S, Evim Sezgin M, Kantarcıoğlu A, Tüfekçi Ö, Demir Yenigürbüz F, Baytan B, Yılmaz Ş, Güneş AM, Ören H. Assessment of Health-Related Quality of Life in Pediatric Acute Lymphoblastic Leukemia Survivors: Perceptions of Children, Siblings, and Parent. Turk J Haematol 2018. [DOI: 10.4274/tjh.2018.0351] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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26
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Kılınç G, Bulut G, Ertuğrul F, Ören H, Demirağ B, Demiral A, Aksoylar S, Kamer ES, Ellidokuz H, Olgun N. Long-term Dental Anomalies After Pediatric Cancer Treatment in Children. Turk J Haematol 2018. [DOI: 10.4274/tjh.2018.0248] [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] Open
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27
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Kılınç G, Bulut G, Ertuğrul F, Ören H, Demirağ B, Demiral A, Aksoylar S, Kamer ES, Ellidokuz H, Olgun N. Long-term Dental Anomalies after Pediatric Cancer Treatment in Children. Turk J Haematol 2018; 36:155-161. [PMID: 30322830 PMCID: PMC6682778 DOI: 10.4274/tjh.galenos.2018.2018.0248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [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: 12/29/2022] Open
Abstract
Objective: The aim of this study is to determine the frequency of dental anomalies (DAs) (microdontia, hypodontia, hyperdontia, enamel defect, root malformation) in pediatric cancer patients at the ages <5 years and between 5 and 7 years, and understand their relationship with the received therapy. Materials and Methods: Pediatric patients who were diagnosed with cancer and treated before the age of 7 years were investigated in a case- control design. The study included 93 pediatric patients whose ages at diagnosis were between 9 months and 7 years and whose treatments were completed before 5-8 years. Group A consisted of patients in the age range of 9 months to 4 years and Group B consisted of patients in the age range of 5-7 years. Seventy-two siblings with compatible dental age ranges were included in the control group. For both groups, intraoral examinations were performed and panoramic radiographs were taken. Results: Among the 93 pediatric patients, the mean age was 9.54±1.25 (range: 8-13 years) and 48 (51.6%) patients were male. The most common diagnosis was hematologic malignancy with a rate of 65.5%. At least one DA was detected in 7 (9.7%) individuals of the control group and in 78 (83.9%) of the patient group. While the patients in the study group had all kinds of DAs, those in the control group had only enamel defects. The rates of microdontia (p=0.077) and hypodontia (p=0.058) were detected to be significantly higher in Group A than in Group B. Root malformation was more common in patients receiving chemotherapy and radiotherapy than in those receiving only chemotherapy (p=0.006). Conclusion: In this study it was found that the pediatric patients who received cancer treatment before the age of 7 years constituted a high-risk group for DAs. The frequencies of microdontia and hypodontia were increased even more when the patient was treated for cancer before 5 years of age.
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Affiliation(s)
- Gülser Kılınç
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Dentistry, İzmir, Turkey
| | - Gülçin Bulut
- İzmir Training Dental Hospital, Clinic of Pediatric Dentistry, İzmir, Turkey
| | - Fahinur Ertuğrul
- Ege University Faculty of Dentistry, Department of Pedodontics, İzmir, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Bengü Demirağ
- Behçet Uz Children’s Hospital, Clinic of Pediatric Hematology and Oncology, İzmir, Turkey
| | - Ayşe Demiral
- Dokuz Eylül University Faculty of Medicine, Department of Radiation Oncology, İzmir, Turkey
| | - Serap Aksoylar
- Ege University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Emine Serra Kamer
- Ege University Faculty of Medicine, Department of Radiation Oncology, İzmir, Turkey
| | - Hülya Ellidokuz
- Dokuz Eylül University, Institute of Oncology, Department of Preventive Oncology, İzmir, Turkey
| | - Nur Olgun
- Dokuz Eylül University, Institute of Oncology, Department of Pediatric Oncology, İzmir, Turkey
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Erdem M, Tüfekçi Ö, Kızıldağ S, Yılmaz Ş, Kızmazoğlu D, Eroğlu Filibeli B, Ören H. Investigation of the Relationship Between Fok1 and Col1A1 Gene Polymorphisms and Development of Treatment-Related Bone Complications in Children with Acute Lymphoblastic Leukemia. Turk J Haematol 2018; 36:12-18. [PMID: 30251958 PMCID: PMC6373515 DOI: 10.4274/tjh.galenos.2018.2018.0221] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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: In acute lymphoblastic leukemia (ALL), various clinical risk factors and genetic predispositions contribute to the development of bone complications during and after chemotherapy. In this study, we aimed to investigate whether vitamin D receptor (VDR) Fok1 and collagen protein Col1A1 Sp1-binding site gene polymorphisms, which are important in bone mineral and matrix formation, have effects on the development of bone abnormalities in childhood ALL survivors. Materials and Methods: Fifty children with ALL who were treated with the ALL Berlin-Frankfurt-Muenster-95 protocol between 1998 and 2008 and were followed for at least 7 years were enrolled. The control group consisted of 96 healthy children. VDR Fok1 and Col1A1 Sp1-binding site gene polymorphisms were analyzed by polymerase chain reaction and restriction fragment length polymorphism. Bone mineral density (BMD) and markers of bone metabolism were all noted. All patients who presented with pain in the joints were examined for bone pathologies while on chemotherapy or during long-term follow-up. Results: Low BMD (16%), osteoporosis (12%), and osteonecrosis (8%) were present in a total of 18 patients (36%). The frequency of osteonecrosis and total bone abnormalities was significantly higher in children aged ≥10 years (p=0.001). The risk of low BMD and osteonecrosis was higher in those with vitamin D deficiency. Only the Col1A1 Sp1-binding site gene polymorphism showed a significant association in ALL patients with osteonecrosis. Conclusion: The development of therapy-induced bone mineral loss and osteonecrosis in children with ALL is frequent and the risk is especially higher in children aged ≥10 years and with vitamin D deficiency. The association between Col1A1 Sp1-binding site gene polymorphisms and osteonecrosis has to be assessed in a larger group of ALL survivors.
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Affiliation(s)
- Melek Erdem
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Özlem Tüfekçi
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Sefa Kızıldağ
- Dokuz Eylül University Faculty of Medicine, Department of Medical Biology, İzmir, Turkey
| | - Şebnem Yılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Deniz Kızmazoğlu
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Berna Eroğlu Filibeli
- Dokuz Eylül University Facullty of Medicine, Department of Pediatrics, İzmir, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
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Erdem M, Tüfekçi Ö, Kızıldağ S, Yılmaz Bengoa Ş, Kızmazoğlu D, Eroğlu Filibeli B, Ören H. The Investigation of Relationship Between Fok1 and Col1A1 Gene Polymorphisms and Development of Treatment-Related Bone Complications in Children with Acute Lymphoblastic Leukemia. Turk J Haematol 2018. [DOI: 10.4274/tjh.2018.0221] [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] Open
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30
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Demir Yenigürbüz F, Ören H. Pediatric Deep Venous Thrombosis and Pulmonary Embolism: Can It Be Antiphospholipid Syndrome? Turk J Haematol 2018. [DOI: 10.4274/tjh.2018.0214] [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] Open
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31
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Yıldırım Ö, Demircan T, Tüfekçi Ö, Kızılca Ö, Kuyum P, Kır M, Abacı A, Ünal N, Arslan N, Böber E, Yılmaz Ş, Ören H. Anemia and Its Effect on Cardiovascular Findings in Obese Adolescents. Turk J Haematol 2018; 35:192-196. [PMID: 29666035 PMCID: PMC6110443 DOI: 10.4274/tjh.2018.0103] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 04/17/2018] [Indexed: 12/01/2022] Open
Abstract
Objective We assessed the effect of anemia on cardiovascular findings in obese adolescents. Materials and Methods We studied 29 anemic and 33 nonanemic obese adolescents, and 33 nonobese healthy adolescents. These three groups were investigated for clinical and laboratory features of anemia and obesity. Echocardiography was used to examine cardiac functions. Results The anemia was mild (mean hemoglobin: 11.67±0.79g/dL), ferritin level was significantly low, and C-reactive protein and fibrinogen levels were significantly high in anemic obese patients. Increased cardiac pulse and echocardiographic findings, which may be indicative of early left ventricular diastolic dysfunction, were present in these patients. Conclusion Anemia may develop due to iron deficiency and chronic inflammation in obese adolescents. Even mild anemia may cause increased heart rate and affect left ventricular diastolic functions. Diet programs for obese children should be carefully planned to avoid iron deficiency anemia, which may worsen the cardiac events in long-term follow-up.
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Affiliation(s)
- Öner Yıldırım
- Dokuz Eylül University Faculty of Medicine, Department of Pediatrics, İzmir, Turkey
| | - Tülay Demircan
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Cardiology, İzmir, Turkey
| | - Özlem Tüfekçi
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Özgür Kızılca
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Cardiology, İzmir, Turkey
| | - Pınar Kuyum
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Gastroenterology and Metabolism, İzmir, Turkey
| | - Mustafa Kır
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Cardiology, İzmir, Turkey
| | - Ayhan Abacı
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Endocrinology, İzmir, Turkey
| | - Nurettin Ünal
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Cardiology, İzmir, Turkey
| | - Nur Arslan
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Gastroenterology and Metabolism, İzmir, Turkey
| | - Ece Böber
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Şebnem Yılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
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Ulusoy E, Duman M, Çağlar A, Küme T, Er A, Akgül F, Çitlenbik H, Yılmaz D, Ören H. Acute Traumatic Coagulopathy: The Value of Histone in Pediatric Trauma Patients. Turk J Haematol 2018; 35:122-128. [PMID: 29589832 PMCID: PMC5972334 DOI: 10.4274/tjh.2017.0444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 01/13/2023] Open
Abstract
OBJECTIVE Acute traumatic coagulopathy occurs after trauma with impairment of hemostasis and activation of fibrinolysis. Some endogenous substances may play roles in this failure of the coagulation system. Extracellular histone is one such molecule that has recently attracted attention. This study investigated the association between plasma histone-complexed DNA (hcDNA) fragments and coagulation abnormalities in pediatric trauma patients. MATERIALS AND METHODS This prospective case-control study was conducted in pediatric patients with trauma. Fifty trauma patients and 30 healthy controls were enrolled. Demographic data, anatomic injury characteristics, coagulation parameters, computerized tomography findings, trauma, and International Society on Thrombosis and Haemostasis disseminated intravascular coagulation (ISTH DIC) scores were recorded. Blood samples for hcDNA were collected and assessed by enzyme-linked immunosorbent assay. RESULTS Thirty-two patients had multiple trauma, while 18 patients had isolated brain injury. hcDNA levels were significantly higher in trauma patients than healthy controls (0.474 AU and 0.145 AU, respectively). There was an association between plasma hcDNA levels and trauma severity. Thirteen patients had acute coagulopathy of trauma shock (ACoTS). ACoTS patients had higher plasma histone levels than those without ACoTS (0.703 AU and 0.398 AU, respectively). Plasma hcDNA levels were positively correlated with the ISTH DIC score and length of stay in the intensive care unit and were negatively correlated with fibrinogen level. CONCLUSION This study indicated that hcDNA levels were increased in pediatric trauma patients and associated with the early phase of coagulopathy. Further studies are needed to clarify the role of hcDNA levels in mortality and disseminated intravascular coagulation.
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Affiliation(s)
- Emel Ulusoy
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Emergency Care, İzmir, Turkey
| | - Murat Duman
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Emergency Care, İzmir, Turkey
| | - Aykut Çağlar
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Emergency Care, İzmir, Turkey
| | - Tuncay Küme
- Dokuz Eylül University Faculty of Medicine, Department of Biochemistry, İzmir, Turkey
| | - Anıl Er
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Emergency Care, İzmir, Turkey
| | - Fatma Akgül
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Emergency Care, İzmir, Turkey
| | - Hale Çitlenbik
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Emergency Care, İzmir, Turkey
| | - Durgül Yılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Emergency Care, İzmir, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
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Yılmaz Bengoa Ş, Ataseven E, Kızmazoğlu D, Demir Yenigürbüz F, Erdem M, Ören H. FLAG Regimen with or without Idarubicin in Children with Relapsed/Refractory Acute Leukemia: Experience from a Turkish Pediatric Hematology Center. Turk J Haematol 2017; 34:46-51. [PMID: 27095144 PMCID: PMC5451688 DOI: 10.4274/tjh.2015.0411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: The optimal therapy to achieve higher rates of survival in pediatric relapsed/refractory acute leukemia (AL) is still unknown. In developing countries, it is difficult to obtain some of the recent drugs for optimal therapy and mostly well-known drugs proven to be effective are used. We assessed the efficacy of the combination of fludarabine, high-dose cytarabine, and granulocyte colony-stimulating factor (FLAG regimen) with or without idarubicin (IDA) in children with relapsed/refractory acute lymphoblastic leukemia and acute myeloid leukemia. Materials and Methods: Between September 2007 and May 2015, 18 children with refractory/relapsed AL attending our center, treated with a FLAG regimen with or without IDA, were included. The primary end point was the remission status of the bone marrow sampled after the first/second course of chemotherapy. The second end point was the duration of survival after hematopoietic stem cell transplantation (HSCT). Results: Complete remission (CR) was achieved in 7 patients (38.8%) after the first cycle, and at the end of the second cycle the total number of patients in CR was 8 (42.1%). All patients in CR underwent HSCT. The CR rate in patients who had IDA in combination therapy was 28.6%, and it was 50% in patients treated without IDA (p=0.36). Mean survival duration in transplanted patients was 24.7±20.8 months (minimum-maximum: 2-70, median: 25 months), and it was 2.7±1.64 months (minimum-maximum: 0-5, median: 3 months) in nontransplanted patients. Five of them (27.7%) were still alive at the end of the study and in CR. The median time of follow-up for these patients was 33 months (minimum-maximum: 25-70 months). Conclusion: FLAG regimens with or without IDA produced a CR of >24 months in 27.7% of children with relapsed/refractory AL and can be recommended as therapeutic options prior to HSCT in developing countries.
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Affiliation(s)
- Şebnem Yılmaz Bengoa
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey Phone: +90 505 5252163 E-mail:
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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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Kesik V, Ataş E, Karakükcü M, Aksoylar S, Erbey F, Taçyıldız N, Küpesiz A, Öniz H, Ünal E, Kansoy S, Öztürk G, Elli M, Kaya Z, Ünal E, Hazar V, Yılmaz Bengoa Ş, Karasu G, Atay D, Dağdemir A, Ören H, Koçak Ü, Yeşilipek MA. Prognostic Factors and a New Prognostic Index Model for Children and Adolescents with Hodgkin's Lymphoma Who Underwent Autologous Hematopoietic Stem Cell Transplantation: A Multicenter Study of the Turkish Pediatric Bone Marrow Transplantation Study Group. Turk J Haematol 2016; 33:265-272. [PMID: 27094103 PMCID: PMC5204179 DOI: 10.4274/tjh.2015.0280] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Objective: The prognostic factors and a new childhood prognostic index after autologous hematopoietic stem cell transplantation (AHSCT) in patients with relapsed/refractory Hodgkin’s lymphoma (HL) were evaluated. Materials and Methods: The prognostic factors of 61 patients who underwent AHSCT between January 1990 and December 2014 were evaluated. In addition, the Age-Adjusted International Prognostic Index and the Childhood International Prognostic Index (CIPI) were evaluated for their impact on prognosis. Results: The median age of the 61 patients was 14.8 years (minimum-maximum: 5-20 years) at the time of AHSCT. There were single relapses in 28 patients, ≥2 relapses in eight patients, and refractory disease in 25 patients. The chemosensitivity/chemorefractory ratio was 36/25. No pretransplant radiotherapy, no remission at the time of transplantation, posttransplant white blood cell count over 10x103/µL, posttransplant positron emission tomography positivity at day 100, and serum albumin of <2.5 g/dL at diagnosis were correlated with progression-free survival. No remission at the time of transplantation, bone marrow positivity at diagnosis, and relapse after AHSCT were significant parameters for overall survival. Conclusion: The major factors affecting the progression-free and overall survival were clearly demonstrated. A CIPI that uses a lactate dehydrogenase level of 500 IU/L worked well for estimating the prognosis. We recommend AHSCT at first complete remission for relapsed cases, and it should also be taken into consideration for patients with high prognostic scores at diagnosis.
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Affiliation(s)
- Vural Kesik
- Gülhane Training and Research Hospital Clinic of Pediatric Oncology, Ankara, Turkey Phone: +90 312 304 43 94 E-mail:
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Ataseven E, Özden Ö, Yılmaz Bengoa Ş, Güleryüz H, Duman M, Ören H. Radiologic Image of a Child with Leukemia Who Developed Sepsis and Fulminant Thrombosis during Induction Therapy. Turk J Haematol 2016; 33:84-5. [PMID: 25913020 PMCID: PMC4805352 DOI: 10.4274/tjh.2015.0046] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Affiliation(s)
| | | | | | | | | | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey. E-mail:
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Ataseven E, Özden Ö, Yılmaz Bengoa Ş, Güleryüz H, Duman M, Ören H. Radiologic Image of a Child with Leukemia Who Developed Sepsis and Fulminant Thrombosis during Induction Therapy. Turk J Haematol 2016. [DOI: 10.4274/tjh.2015-0046] [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] Open
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Tüfekçi Ö, Ören H, Demir Yenigürbüz F, Gözmen S, Karapınar TH, İrken G. Management of Two Juvenile Myelomonocytic Leukemia Patients According to Clinical and Genetic Features. Turk J Haematol 2015; 32:175-9. [PMID: 26316488 PMCID: PMC4451488 DOI: 10.4274/tjh.2014.0034] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Juvenile myelomonocytic leukemia (JMML) is a rare clonal myeloproliferative disorder of childhood. Major progress has been achieved in diagnosis and the understanding of the pathogenesis of JMML by identifying the genetic pathologies that occur in patients. Mutations of RAS, NF1, PTPN11, and CBL are found in approximately 80% of JMML patients. Distinct clinical features have been reported to be associated with specific gene mutations. The advent of genomic studies and recent identification of novel genetic mutations in JMML are important not only in diagnosis but also in the management and prognosis of the disease. Herein, we present 2 patients with JMML harboring different mutations, NRAS and c-CBL, respectively, with distinct clinical features and different therapeutic approaches.
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Affiliation(s)
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey Phone: +90 232 412 61 41 E-mail:
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Ataseven E, Yılmaz Bengoa Ş, Ören H. Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis Should Be Kept in Mind in Children with Febrile Neutropenia, Oral Cavity Lesions, and Skin Rash. Turk J Haematol 2015; 33:170-1. [PMID: 26376920 PMCID: PMC5100736 DOI: 10.4274/tjh.2014.0470] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
| | | | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey, Phone : +90 232 412 61 41, E-mail :
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Tüfekçi Ö, Yılmaz Bengoa Ş, Demir Yenigürbüz F, Şimşek E, Karapınar TH, İrken G, Ören H. Management of Invasive Fungal Infections in Pediatric Acute Leukemia and the Appropriate Time for Restarting Chemotherapy. Turk J Haematol 2015; 32:329-37. [PMID: 25913290 PMCID: PMC4805317 DOI: 10.4274/tjh.2014.0035] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective: Rapid and effective treatment of invasive fungal infection (IFI) in patients with leukemia is important for survival. In this study, we aimed to describe variations regarding clinical features, treatment modalities, time of restarting chemotherapy, and outcome in children with IFI and acute leukemia (AL). Materials and Methods: The charts of all pediatric AL patients in our clinic between the years of 2001 and 2013 were retrospectively reviewed. All patients received prophylactic fluconazole during the chemotherapy period. Results: IFI was identified in 25 (14%) of 174 AL patients. Most of them were in the consolidation phase of chemotherapy and the patients had severe neutropenia. The median time between leukemia diagnosis and definition of IFI was 122 days. Twenty-four patients had pulmonary IFI. The most frequent finding on computed tomography was typical parenchymal nodules. The episodes were defined as proven in 4 (16%) patients, probable in 7 (28%) patients, and possible in 14 (56%) patients. The median time for discontinuation of chemotherapy was 27 days. IFI was treated successfully in all patients with voriconazole, amphotericin B, caspofungin, or posaconazole alone or in combination. Chemotherapy was restarted in 50% of the patients safely within 4 weeks and none of those patients experienced reactivation of IFI. All of them were given secondary prophylaxis. The median time for antifungal treatment and for secondary prophylaxis was 26 and 90 days, respectively. None of the patients died due to IFI. Conclusion: Our data show that rapid and effective antifungal therapy with rational treatment modalities may decrease the incidence of death and that restarting chemotherapy within several weeks may be safe in children with AL and IFI.
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Affiliation(s)
| | | | | | | | | | | | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey Phone: +90 532 666 90 50 E-mail:
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Tüfekçi Ö, Yandım MK, Ören H, İrken G, Baran Y. Targeting FoxM1 transcription factor in T-cell acute lymphoblastic leukemia cell line. Leuk Res 2014; 39:342-7. [PMID: 25557384 DOI: 10.1016/j.leukres.2014.12.005] [Citation(s) in RCA: 4] [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] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/25/2014] [Accepted: 12/09/2014] [Indexed: 12/23/2022]
Abstract
The Forkhead box protein M1 (FoxM1) is an important transcription factor having significant roles in various cellular events. FoxM1 overexpression has been reported to be related with many types of cancer. However, it is not known whether it contributes to oncogenesis of acute lymphoblastic leukemia. Siomycin A, a thiazol antibiotic, is known to inhibit FoxM1 transcriptional activity. In this study, we aimed to determine gene expression levels of FoxM1 in Jurkat cells (T-cell acute lymphoblastic leukemia cell line) and therapeutic potential of targeting FoxM1 by siomycin A alone and in combination with dexamethasone which improves the survival of children with T-cell acute lymphoblastic leukemia (ALL). We also examined the molecular mechanisms of siomycin A and dexamethasone-induced cell death in Jurkat cells. We demonstrated that FoxM1 mRNA is highly expressed in Jurkat cells. Dexamethasone and siomycin A caused a significant reduction in gene expression levels of FoxM1 in Jurkat cells. Targeting FoxM1 by siomycin A and dexamethasone caused a significant decrease in T-ALL cell line proliferation through induction of G1 cell cycle arrest. All these findings suggest a possible role of FoxM1 in T-cell ALL pathogenesis and represent FoxM1 as an attractive target for T-cell ALL therapy.
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Affiliation(s)
- Özlem Tüfekçi
- Dokuz Eylül University, Faculty of Medicine, Department of Pediatric Hematology, Balçova, Izmir, Turkey
| | - Melis Kartal Yandım
- Izmir Institute of Technology, Faculty of Science, Department of Molecular Biology and Genetics, Urla, Izmir, Turkey
| | - Hale Ören
- Dokuz Eylül University, Faculty of Medicine, Department of Pediatric Hematology, Balçova, Izmir, Turkey.
| | - Gülersu İrken
- Dokuz Eylül University, Faculty of Medicine, Department of Pediatric Hematology, Balçova, Izmir, Turkey
| | - Yusuf Baran
- Izmir Institute of Technology, Faculty of Science, Department of Molecular Biology and Genetics, Urla, Izmir, Turkey
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Güneş AM, Ören H, Baytan B, Bengoa ŞY, Evim MS, Gözmen S, Tüfekçi Ö, Karapınar TH, İrken G. The long-term results of childhood acute lymphoblastic leukemia at two centers from Turkey: 15 years of experience with the ALL-BFM 95 protocol. Ann Hematol 2014; 93:1677-84. [DOI: 10.1007/s00277-014-2106-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Accepted: 05/07/2014] [Indexed: 10/25/2022]
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Kalafatçılar Aİ, Tüfekçi Ö, Ören H, Hız S, Güleryüz H, Akay A, Orçim E, Olgun Y, İrken G. Assessment of neuropsychological late effects in survivors of childhood leukemia. Pediatr Hematol Oncol 2014; 31:181-93. [PMID: 24088177 DOI: 10.3109/08880018.2013.803212] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [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] [Indexed: 01/10/2023]
Abstract
The neurologic dysfunctions caused by treatment may affect health and quality of life in survivors of childhood leukemia. The objective of this study was to identify the neuropsychological late effects of leukemia treatment to provide an assessment about the degree and incidence of these late effects. Neurological and ophtalmological examination, cranial magnetic resonance imaging (MRI), auditory and neurocognitive tests, and questionnaires of quality of life were performed to 44 acute leukemia survivors at least 5 years after diagnosis. Median time since completion of chemotherapy was 7.5 years (2-18) and median age at the time of the study was 16.4 years (8-31). At least one or more late effects detected by physical examination (PE), neurological tests, or neurocognitive tests encountered in 80% of the patients, and 64% of the patients specified at least one complaint in the quality of life questionnaire. MRI revealed pathological findings in 18% and electroencephalogram (EEG) abnormalities were present in 9% of the patients. Evaluation of total intelligence scores revealed that 30% of patients' IQ scores were <80 and 70% of the patients' scores demonstrated neurocognitive dysfunctions. The patients >6 years at the time of diagnosis were found to have more psychological problems and higher rates of smoking and alcohol consumption. The most frequent complaint was headache and the most common problem in school was denoted as difficulty in concentration. Our study demonstrated that most of the survivors of childhood leukemia are at risk of developing neuropsycological late effects.
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Ulusoy E, Tüfekçi Ö, Duman N, Kumral A, İrken G, Ören H. Thrombocytopenia in neonates: causes and outcomes. Ann Hematol 2013; 92:961-7. [DOI: 10.1007/s00277-013-1726-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2012] [Accepted: 03/06/2013] [Indexed: 10/27/2022]
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Karapınar TH, Gözmen S, Tüfekçi Ö, Yılmaz Ş, Özbek Z, Parlak M, İrken G, Ören H. Corneal epithelial microcysts due to high dose Cytarabine administration in acute myeloid leukemia. Turk J Haematol 2012; 29:85-6. [PMID: 24744631 PMCID: PMC3986776 DOI: 10.5505/tjh.2012.21704] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2010] [Accepted: 03/28/2011] [Indexed: 11/15/2022] Open
Affiliation(s)
- Tuba Hilkay Karapınar
- Dokuz Eylul University, School of Medicine, Department of Pediatric Hematology, Balcova, Izmir, Turkey
- * Address for Correspondence: Dokuz Eylül Üniversitesi, Tıp Fakültesi, 35140, Balcova, İzmir, Turkey Phone: +90 232 412 48 88 E-mail:
| | - Salih Gözmen
- Dokuz Eylul University, School of Medicine, Department of Pediatric Hematology, Balcova, Izmir, Turkey
| | - Özlem Tüfekçi
- Dokuz Eylul University, School of Medicine, Department of Pediatric Hematology, Balcova, Izmir, Turkey
| | - Şebnem Yılmaz
- Dokuz Eylul University, School of Medicine, Department of Pediatric Hematology, Balcova, Izmir, Turkey
| | - Zeynep Özbek
- Dokuz Eylul University, School of Medicine, Department of Ophthalmology, Balcova, Izmir, Turkey
| | - Melih Parlak
- Dokuz Eylul University, School of Medicine, Department of Ophthalmology, Balcova, Izmir, Turkey
| | - Gülersu İrken
- Dokuz Eylul University, School of Medicine, Department of Pediatric Hematology, Balcova, Izmir, Turkey
| | - Hale Ören
- Dokuz Eylul University, School of Medicine, Department of Pediatric Hematology, Balcova, Izmir, Turkey
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Tüfekçi Ö, Gözmen S, Yılmaz Ş, Hilkay Karapınar T, Çetin B, Burak Dursun O, Emiroğlu N, Ören H, Irken G. A case with unexplained bleeding from multiple sites: munchausen syndrome by proxy. Pediatr Hematol Oncol 2011; 28:439-43. [PMID: 21736476 DOI: 10.3109/08880018.2011.565493] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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] [Indexed: 11/13/2022]
Abstract
Munchausen syndrome by proxy (MBP) is an extreme form of child abuse where children were unnecessarily treated or investigated for medical conditions that were falsified by their caregivers. Here the authors report a 16-year-old female with the complaints of bleeding from multiple and unusual sites, including hemoptysis, hematuria, bloody tears, and bloody nipple discharge, all of which are only witnessed by her mother. Extensive investigation revealed no organic etiologies for bleeding. The diagnosis of MBP was put by a multidisciplinary team. The diagnosis of MBP must be kept in mind in conditions where there is no underlying organic pathology in a bleeding patient.
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Affiliation(s)
- Özlem Tüfekçi
- Department of Pediatric Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
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Ören H, Yılmaz Ş, Sercan Z, Demircioğlu F, Yüksel E, İrken G. Isolated myelosarcoma development in an adolescent chronic myeloid leukemia patient with t(9;22)(q34;q11.2), +8, +14, +21, and der(1)(p36). ACTA ACUST UNITED AC 2008; 182:43-5. [DOI: 10.1016/j.cancergencyto.2007.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2007] [Revised: 12/11/2007] [Accepted: 12/13/2007] [Indexed: 10/22/2022]
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İrken G, Ören H, Öniz H, Çetingül N, Vergin C, Atabay B, Gülen H, Türker M, Kantar M, Yılmaz Ş. Hyperleukocytosis in childhood acute lymphoblastic leukemia: complications and treatment outcome. Turk J Haematol 2006; 23:142-146. [PMID: 27265481] [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
Hyperleukocytosis, defined as a peripheral leukocyte count ≥ 100x109/L, is seen in 5-20% of newly diagnosed cases of childhood leukemia and is a poor prognostic factor. In this study, we aimed to examine the presenting clinical and laboratory features, complications, and treatment outcome of 47 children with acute lymphoblastic leukemia (ALL) and hyperleukocytosis who were diagnosed and treated in four medical centers of İzmir between January 1990 and January 2001. The median age was 5.0 years (range: 0.1-16.3 years). Median white blood cell count was 495x109/L (range: 107x109/L- 794x109/L). Forty-two of 47 patients (90%) had hepatosplenomegaly, 5 (11%) had respiratory distress, 3 (6%) had neurologic symptoms, 3 (6%) had diffuse cervical lymphadenopathy, and 3 (6%) had acute renal failure at admission. Ten of 47 patients (21%) had central nervous system involvement, and 17 (36%) had mediastinal mass. Ten patients (21%) had coagulopathy and 15 patients (32%) had metabolic complications (8 patients had hyperuricemia, 4 had hyperphosphatemia, 2 had hyperuricemia, hyperphosphatemia and hypercalcemia, and 1 had hypocalcemia) before the initiation of therapy. Forty of 47 patients (85%) with hyperleukocytosis were effectively managed with intravenous hydration, alkalinization, and allopurinol therapy. Early death during remission induction therapy occurred in 5 patients (11%) with respiratory distress and sepsis. Kaplan-Meier estimates of event free survival and overall survival were 37.0% and 40.5%, respectively.
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Ören H. Autoimmune lymphoproliferative syndrome. Turk J Haematol 2006; 23:125-135. [PMID: 27265479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2023] Open
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Ören H, Gülen H, Uçar C, Duman M, İrken G. Successful Treatment of Infection- Associated Hemophagocytic Syndrome with Intravenous Immunoglobulin. Turk J Haematol 2003; 20:95-99. [PMID: 27265439] [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
Hemophagocytic syndrome is a rare disorder characterized by a group of clinical, laboratory and histopathological findings such as fever, hepatosplenomegaly, cytopenia, hypertriglyceridemia, and hemophagocytosis in the bone marrow, spleen, and lymph nodes. Hemophagocytic syndrome may occur as a primary or secondary disease. Primary type of hemophagocytic syndrome is also known as familial erythrophagocytic lymphohistiocytosis and secondary type is mostly associated with an viral infection and known as infection-associated hemophagocytic syndrome (IAHS). Rapid diagnosis is very important in these patients since suggested treatment strategies for the two types have been different and mortality rate is very high. In this report we present the clinical and laboratory findings and the outcome of two children with IAHS to emphasize the importance of early diagnosis and the effectiveness of intravenous immunoglobulin therapy in these patients.
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