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Ercan AB, Aronson M, Fernandez NR, Chang Y, Levine A, Liu ZA, Negm L, Edwards M, Bianchi V, Stengs L, Chung J, Al-Battashi A, Reschke A, Lion A, Ahmad A, Lassaletta A, Reddy AT, Al-Darraji AF, Shah AC, Van Damme A, Bendel A, Rashid A, Margol AS, Kelly BL, Pencheva B, Heald B, Lemieux-Anglin B, Crooks B, Koschmann C, Gilpin C, Porter CC, Gass D, Samuel D, Ziegler DS, Blumenthal DT, Kuo DJ, Hamideh D, Basel D, Khuong-Quang DA, Stearns D, Opocher E, Carceller F, Baris Feldman H, Toledano H, Winer I, Scheers I, Fedorakova I, Su JM, Vengoechea J, Sterba J, Knipstein J, Hansford JR, Gonzales-Santos JR, Bhatia K, Bielamowicz KJ, Minhas K, Nichols KE, Cole KA, Penney L, Hjort MA, Sabel M, Gil-da-Costa MJ, Murray MJ, Miller M, Blundell ML, Massimino M, Al-Hussaini M, Al-Jadiry MF, Comito MA, Osborn M, Link MP, Zapotocky M, Ghalibafian M, Shaheen N, Mushtaq N, Waespe N, Hijiya N, Fuentes-Bolanos N, Ahmad O, Chamdine O, Roy P, Pichurin PN, Nyman P, Pearlman R, Auer RC, Sukumaran RK, Kebudi R, Dvir R, Raphael R, Elhasid R, McGee RB, Chami R, Noss R, Tanaka R, Raskin S, Sen S, Lindhorst S, Perreault S, Caspi S, Riaz S, Constantini S, Albert S, Chaleff S, Bielack S, Chiaravalli S, Cramer SL, Roy S, Cahn S, Penna S, Hamid SA, Ghafoor T, Imam U, Larouche V, Magimairajan Issai V, Foulkes WD, Lee YY, Nathan PC, Maruvka YE, Greer MLC, Durno C, Shlien A, Ertl-Wagner B, Villani A, Malkin D, Hawkins C, Bouffet E, Das A, Tabori U. Clinical and biological landscape of constitutional mismatch-repair deficiency syndrome: an International Replication Repair Deficiency Consortium cohort study. Lancet Oncol 2024; 25:668-682. [PMID: 38552658 DOI: 10.1016/s1470-2045(24)00026-3] [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] [Received: 08/28/2023] [Revised: 12/29/2023] [Accepted: 01/14/2024] [Indexed: 05/04/2024]
Abstract
BACKGROUND Constitutional mismatch repair deficiency (CMMRD) syndrome is a rare and aggressive cancer predisposition syndrome. Because a scarcity of data on this condition contributes to management challenges and poor outcomes, we aimed to describe the clinical spectrum, cancer biology, and impact of genetics on patient survival in CMMRD. METHODS In this cohort study, we collected cross-sectional and longitudinal data on all patients with CMMRD, with no age limits, registered with the International Replication Repair Deficiency Consortium (IRRDC) across more than 50 countries. Clinical data were extracted from the IRRDC database, medical records, and physician-completed case record forms. The primary objective was to describe the clinical features, cancer spectrum, and biology of the condition. Secondary objectives included estimations of cancer incidence and of the impact of the specific mismatch-repair gene and genotype on cancer onset and survival, including after cancer surveillance and immunotherapy interventions. FINDINGS We analysed data from 201 patients (103 males, 98 females) enrolled between June 5, 2007 and Sept 9, 2022. Median age at diagnosis of CMMRD or a related cancer was 8·9 years (IQR 5·9-12·6), and median follow-up from diagnosis was 7·2 years (3·6-14·8). Endogamy among minorities and closed communities contributed to high homozygosity within countries with low consanguinity. Frequent dermatological manifestations (117 [93%] of 126 patients with complete data) led to a clinical overlap with neurofibromatosis type 1 (35 [28%] of 126). 339 cancers were reported in 194 (97%) of 201 patients. The cumulative cancer incidence by age 18 years was 90% (95% CI 80-99). Median time between cancer diagnoses for patients with more than one cancer was 1·9 years (IQR 0·8-3·9). Neoplasms developed in 15 organs and included early-onset adult cancers. CNS tumours were the most frequent (173 [51%] cancers), followed by gastrointestinal (75 [22%]), haematological (61 [18%]), and other cancer types (30 [9%]). Patients with CNS tumours had the poorest overall survival rates (39% [95% CI 30-52] at 10 years from diagnosis; log-rank p<0·0001 across four cancer types), followed by those with haematological cancers (67% [55-82]), gastrointestinal cancers (89% [81-97]), and other solid tumours (96% [88-100]). All cancers showed high mutation and microsatellite indel burdens, and pathognomonic mutational signatures. MLH1 or MSH2 variants caused earlier cancer onset than PMS2 or MSH6 variants, and inferior survival (overall survival at age 15 years 63% [95% CI 55-73] for PMS2, 49% [35-68] for MSH6, 19% [6-66] for MLH1, and 0% for MSH2; p<0·0001). Frameshift or truncating variants within the same gene caused earlier cancers and inferior outcomes compared with missense variants (p<0·0001). The greater deleterious effects of MLH1 and MSH2 variants as compared with PMS2 and MSH6 variants persisted despite overall improvements in survival after surveillance or immune checkpoint inhibitor interventions. INTERPRETATION The very high cancer burden and unique genomic landscape of CMMRD highlight the benefit of comprehensive assays in timely diagnosis and precision approaches toward surveillance and immunotherapy. These data will guide the clinical management of children and patients who survive into adulthood with CMMRD. FUNDING The Canadian Institutes for Health Research, Stand Up to Cancer, Children's Oncology Group National Cancer Institute Community Oncology Research Program, Canadian Cancer Society, Brain Canada, The V Foundation for Cancer Research, BioCanRx, Harry and Agnieszka Hall, Meagan's Walk, BRAINchild Canada, The LivWise Foundation, St Baldrick Foundation, Hold'em for Life, and Garron Family Cancer Center.
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Affiliation(s)
- Ayse Bahar Ercan
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, ON, Canada
| | - Melyssa Aronson
- Zane Cohen Centre for Digestive Diseases, Sinai Health System, Toronto, ON, Canada
| | | | - Yuan Chang
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, ON, Canada
| | - Adrian Levine
- Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Zhihui Amy Liu
- Department of Biostatistics, Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada
| | - Logine Negm
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, ON, Canada
| | - Melissa Edwards
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, ON, Canada
| | - Vanessa Bianchi
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, ON, Canada
| | - Lucie Stengs
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, ON, Canada
| | - Jiil Chung
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, ON, Canada
| | - Abeer Al-Battashi
- Department of Pediatric Hematology and Oncology, The Royal Hospital, Muscat, Oman
| | - Agnes Reschke
- Division of Pediatric Hematology/Oncology, Stanford Medicine, Stanford, CA, USA
| | - Alex Lion
- Department of Pediatric Hematology/Oncology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Alia Ahmad
- University of Child Health Sciences, Children's Hospital Lahore, Lahore, Pakistan
| | - Alvaro Lassaletta
- Department of Pediatric Hematology-Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | | | - Amir F Al-Darraji
- College of Medicine, University of Baghdad, Paediatric Oncology Unit, Baghdad, Iraq
| | - Amish C Shah
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - An Van Damme
- Division of Pediatric Hematology and Oncology, Institut Roi Albert II, Cliniques Universitaires Saint-Luc, Brussels, Belgium
| | | | - Aqeela Rashid
- Department of Pediatric Oncology, Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | - Ashley S Margol
- Department of Pediatrics, Children's Hospital Los Angeles, Keck School of Medicine University of Southern California, Los Angeles, CA, USA
| | | | - Bojana Pencheva
- Alfac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - Brandie Heald
- Department of Gastroenterology, Hepatology, and Nutrition, Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Brianna Lemieux-Anglin
- Departments of Oncology and Human Genetics, McGill University Health Centre, Cancer Genetics Program, Montreal, QC, Canada
| | - Bruce Crooks
- Division of Hematology-Oncology, IWK Health, Halifax, NS, Canada
| | - Carl Koschmann
- Department of Pediatric Hematology-Oncology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Catherine Gilpin
- Children's Hospital of Eastern Ontario, Genetics, Ottawa, ON, Canada
| | - Christopher C Porter
- Alfac Cancer & Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA
| | - David Gass
- Department of Pediatric Hematology and Oncology, Atrium Health, Charlotte, NC, USA
| | | | - David S Ziegler
- Kid's Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia
| | - Deborah T Blumenthal
- Neuro-Oncology Division, Tel Aviv Medical Center, Tel Aviv University, Tel Aviv, Israel
| | - Dennis John Kuo
- Division of Pediatric Hematology/Oncology, University of California, San Diego, CA, USA
| | - Dima Hamideh
- Division of Pediatric Hematology-Oncology, American University of Beirut, Beirut, Lebanon
| | - Donald Basel
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | | | - Duncan Stearns
- UH Rainbow Babies and Children's Hospital Division of Pediatrics, Pediatric Neuro-oncology, Cleveland, OH, USA
| | - Enrico Opocher
- Pediatric Hematology, Oncology and Stem Cell Transplant Division, Padua University Hospital, Padua, Italy
| | - Fernando Carceller
- Children and Young People's Unit, Royal Marsden NHS Foundation Trust, London, UK; Division of Clinical Studies, The Institute of Cancer Research, London, UK
| | - Hagit Baris Feldman
- The Genetics Institute and Genomics Center, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel; Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Helen Toledano
- Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Department of Pediatric Hematology-Oncology, Schneider Children's Medical Center, Petah Tikva, Israel
| | - Ira Winer
- Wayne State University and Karmanos Cancer Institute, Detroit, MI, USA
| | - Isabelle Scheers
- Division of Pediatric Gastroenterology and Hepatology, Cliniques Universitaires Saint-Luc, IREC Universite Catholique de Louvain, Brussels, Belgium
| | - Ivana Fedorakova
- Clinic of Pediatric Oncology and Hematology, University Children's Hospital, Banská Bystrica, Slovakia
| | - Jack M Su
- Department of Pediatrics, Texas Children's Cancer and Hematology Centers, Baylor College of Medicine, Houston, TX, USA
| | - Jaime Vengoechea
- Associate Professor of Human Genetics, Emory University, Atlanta, GA, USA
| | - Jaroslav Sterba
- Pediatric Oncology Department, University Hospital Brno, Masaryk Univerzity, Faculty of Medicine, Brno, Czech Republic
| | - Jeffrey Knipstein
- Division of Pediatric Hematology/Oncology/Blood and Marrow Transplant, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Jordan R Hansford
- Michael Rice Children's Hematology and Oncology Centre, Women's and Children's Hospital, Adelaide, SA, Australia; South Australia Health and Medical Research Institute Adelaide, SA, Australia; South Australia Immunogenomics Cancer Institute, University of Adelaide, Adelaide, SA, Australia
| | | | - Kanika Bhatia
- Children's Cancer Centre, The Royal Children's Hospital, Melbourne, VIC, Australia
| | - Kevin J Bielamowicz
- Department of Pediatrics, Division of Hematology/Oncology, University of Arkansas for Medical Sciences/Arkansas Children's Hospital, Little Rock, AR, USA
| | - Khurram Minhas
- Division of Histopathology, Department of Pathology and Laboratory Medicine, Aga Khan University, Karachi, Pakistan
| | - Kim E Nichols
- Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Kristina A Cole
- Division of Oncology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Lynette Penney
- Division of Medical Genetics, Department of Pediatrics, IWK Health Centre, Halifax, NS, Canada
| | | | - Magnus Sabel
- Department of Pediatrics, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | | | | | - Matthew Miller
- Division of Hematology and Oncology, Oregon Health & Science University, Portland, OR, USA
| | | | - Maura Massimino
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | | | - Mazin F Al-Jadiry
- College of Medicine, University of Baghdad, Paediatric Oncology Unit, Baghdad, Iraq
| | | | - Michael Osborn
- Michael Rice Children's Hematology and Oncology Centre, Women's and Children's Hospital, Adelaide, SA, Australia
| | - Michael P Link
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Michal Zapotocky
- Department of Paediatric Haematology and Oncology, University Hospital Motol and Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | | | - Najma Shaheen
- Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, Pakistan
| | | | - Nicolas Waespe
- Division of Pediatric Oncology and Hematology, Department of Pediatrics, Inselspital, Bern University Hospital, Bern, Switzerland
| | - Nobuko Hijiya
- Pediatric Hematology Oncology and Stem Cell Transplant, Columbia University Irving Medical Center, New York, NY, USA
| | | | - Olfat Ahmad
- Hopp Children's Cancer Center, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Omar Chamdine
- Department of Pediatric Hematology Oncology, King Fahad Specialist Hospital, Dammam, Saudi Arabia
| | - Paromita Roy
- Department of Pathology, Tata Medical Center, Rajarhat, Kolkata, India
| | - Pavel N Pichurin
- Department of Clinical Genomics, Mayo Clinic, Rochester, MN, USA
| | - Per Nyman
- Crown Princess Victoria Children's Hospital, Linköping University Hospital, Linköping, Sweden; Department of Health, Medicine and Caring Sciences, Linköping University, Linköping, Sweden
| | - Rachel Pearlman
- Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH, USA
| | | | - Reghu K Sukumaran
- Department of Pediatric Hemato-oncology, Tata Medical Center, Kolkata, India
| | - Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Istanbul University, Oncology Institute, Istanbul, Türkiye
| | - Rina Dvir
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Robert Raphael
- UCSF Benioff Children's Hospital Oakland, Oakland, CA, USA
| | - Ronit Elhasid
- Department of Pediatric Hemato-Oncology, Tel Aviv Medical Center, Tel Aviv, Israel
| | - Rose B McGee
- St Jude Children's Research Hospital, Memphis, TN, USA
| | - Rose Chami
- Division of Pathology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ryan Noss
- Center for Personalized Genetic Healthcare, Cleveland Clinic, Cleveland, OH, USA
| | - Ryuma Tanaka
- Department of Pediatrics, Medical College of Wisconsin, Milwaukee, WI, USA
| | - Salmo Raskin
- Department of Pediatrics, Federal University of Parana, Curitiba, Parana
| | - Santanu Sen
- Department of Pediatric Hematology, Oncology, and Bone Marrow Transplant, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, India
| | - Scott Lindhorst
- Department of Neurosurgery, Division of Neuro-Oncology, Medical University of South Carolina, Charleston, SC, USA
| | - Sebastien Perreault
- Division of Child Neurology, Department of Pediatrics, CHU Sainte-Justine, Université de Montréal, Montreal, QC, Canada
| | - Shani Caspi
- Sheba Medical Center, Cancer Research Center, Tel Hashomer, Israel
| | - Shazia Riaz
- Department of Hematology and Oncology, The Children's Hospital and University of Child Health Sciences, Lahore, Pakistan
| | - Shlomi Constantini
- Department of Pediatric Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Sophie Albert
- Cancer Axis, Lady Davis Institute, Jewish General Hospital, Montreal, QC Canada
| | | | - Stefan Bielack
- Padiatrie 5 (Onkologie, Hamatologie, Immunologie), Zentrum fur Kinder-, Jugend- und Frauenmedizin, Stuttgart Cancer Center, Klinikum Stuttgart-Olgahospital, Stuttgart, Germany
| | - Stefano Chiaravalli
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
| | - Stuart Louis Cramer
- Department of Pediatric Hematology/Oncology, Prisma Health, Columbia, SC, USA
| | - Sumita Roy
- Central Michigan University, Mount Pleasant, MI, USA; Division of Genetics, Genomic & Metabolic Disorders, Pediatric Cancer Genetics Clinic, Children's Hospital of Michigan, Detroit, MI, USA
| | - Suzanne Cahn
- Winship Cancer Institute, Emory University Hospital, Atlanta, GA, USA
| | - Suzanne Penna
- Division of Rehabilitation Neuropsychology, Emory University School of Medicine, Atlanta, GA, USA
| | | | - Tariq Ghafoor
- Department of Hematology and Stem Cell Transplant, Armed Forces Bone Marrow Transplant Center, National Institute of Blood and Marrow Transplant, Rawalpindi, Pakistan
| | - Uzma Imam
- Pediatric Oncology Department, National Institute of Child Health, Karachi, Pakistan
| | - Valerie Larouche
- Department of Hematology-Oncology, CHU de Quebec-Universite Laval, Quebec, QC, Canada
| | | | - William D Foulkes
- Departments of Oncology and Human Genetics, McGill University Health Centre, Cancer Genetics Program, Montreal, QC, Canada
| | - Yi Yen Lee
- Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Paul C Nathan
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Yosef E Maruvka
- Faculty of Biotechnology and Food Engineering, The Lokey Center for Life Science and Engineering, TECHNION-Israel Institute of Technology, Haifa, Israel
| | - Mary-Louise C Greer
- Department of Diagnostic and Interventional Radiology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Carol Durno
- Division of Gastroenterology, Hepatology, and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada
| | - Adam Shlien
- Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Birgit Ertl-Wagner
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, ON, Canada; Department of Medical Imaging, University of Toronto, Toronto, ON, Canada
| | - Anita Villani
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - David Malkin
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Cynthia Hawkins
- Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - Eric Bouffet
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Anirban Das
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, ON, Canada; Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Uri Tabori
- Arthur and Sonia Labatt Brain Tumor Research Centre, Toronto, ON, Canada; Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada.
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Kaliki S, Vempuluru VS, Mohamed A, Al-Jadiry MF, Bowman R, Chawla B, Hamid SA, Ji X, Kapelushnik N, Kebudi R, Sthapit PR, Rojanaporn D, Sitorus RS, Yousef YA, Fabian ID. Retinoblastoma in Asia: Clinical Presentation and Treatment Outcomes in 2112 Patients from 33 Countries. Ophthalmology 2024; 131:468-477. [PMID: 37839559 DOI: 10.1016/j.ophtha.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2023] [Revised: 09/15/2023] [Accepted: 10/09/2023] [Indexed: 10/17/2023] Open
Abstract
PURPOSE To describe the clinical presentation and treatment outcomes of children who received a diagnosis of retinoblastoma in 2017 throughout Asia. DESIGN Multinational, prospective study including treatment-naïve patients in Asia who received a diagnosis of retinoblastoma in 2017 and were followed up thereafter. PARTICIPANTS A total of 2112 patients (2797 eyes) from 96 retinoblastoma treatment centers in 33 Asian countries. INTERVENTIONS Chemotherapy, radiotherapy, enucleation, and orbital exenteration. MAIN OUTCOME MEASURES Enucleation and death. RESULTS Within the cohort, 1021 patients (48%) were from South Asia (SA), 503 patients (24%) were from East Asia (EA), 310 patients (15%) were from Southeast Asia (SEA), 218 patients (10%) were from West Asia (WA), and 60 patients (3%) were from Central Asia (CA). Mean age at presentation was 27 months (median, 23 months; range, < 1-261 months). The cohort included 1195 male patients (57%) and 917 female patients (43%). The most common presenting symptoms were leukocoria (72%) and strabismus (13%). Using the American Joint Committee on Cancer Staging Manual, Eighth Edition, classification, tumors were staged as cT1 (n = 441 [16%]), cT2 (n = 951 [34%]), cT3 (n = 1136 [41%]), cT4 (n = 267 [10%]), N1 (n = 48 [2%]), and M1 (n = 129 [6%]) at presentation. Retinoblastoma was treated with intravenous chemotherapy in 1450 eyes (52%) and 857 eyes (31%) underwent primary enucleation. Three-year Kaplan-Meier estimates for enucleation and death were 33% and 13% for CA, 18% and 4% for EA, 27% and 15% for SA, 32% and 22% for SEA, and 20% and 11% for WA (P < 0.0001 and P < 0.0001), respectively. CONCLUSIONS At the conclusion of this study, significant heterogeneity was found in treatment outcomes of retinoblastoma among the regions of Asia. East Asia displayed better outcomes with higher rates of globe and life salvage, whereas Southeast Asia showed poorer outcomes compared with the rest of Asia. FINANCIAL DISCLOSURE(S) The author(s) have no proprietary or commercial interest in any materials discussed in this article.
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Affiliation(s)
- Swathi Kaliki
- The Operation Eyesight Universal Institute for Eye Cancer, L.V. Prasad Eye Institute, Hyderabad, India.
| | - Vijitha S Vempuluru
- The Operation Eyesight Universal Institute for Eye Cancer, L.V. Prasad Eye Institute, Hyderabad, India
| | - Ashik Mohamed
- The Operation Eyesight Universal Institute for Eye Cancer, L.V. Prasad Eye Institute, Hyderabad, India
| | - Mazin Faisal Al-Jadiry
- Pediatric Oncology Unit, Children Welfare Teaching Hospital, Medical City, College of Medicine, University of Baghdad, Bagdad, Iraq
| | - Richard Bowman
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Department of Ophthalmology, Great Ormond Street Children's Hospital, London, United Kingdom
| | - Bhavna Chawla
- Ocular Oncology Service, Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Syed Ahmer Hamid
- Department of Ophthalmology, The Indus Hospital, Karachi, Pakistan
| | - Xunda Ji
- Department of Ophthalmology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Noa Kapelushnik
- Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
| | - Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | | | - Duangnate Rojanaporn
- Department of Ophthalmology, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand
| | - Rita S Sitorus
- Department of Ophthalmology, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | | | - Ido Didi Fabian
- International Centre for Eye Health, London School of Hygiene & Tropical Medicine, London, United Kingdom; Goldschleger Eye Institute, Sheba Medical Center, Tel Hashomer, Tel-Aviv University, Tel-Aviv, Israel
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Challinor J, Davidson A, Chantada G, Kebudi R, Pritchard-Jones K. The role of International Society of Paediatric Oncology (SIOP) in advancing global childhood cancer care. Ecancermedicalscience 2024; 18:1678. [PMID: 38439802 PMCID: PMC10911668 DOI: 10.3332/ecancer.2024.1678] [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: 11/07/2023] [Indexed: 03/06/2024] Open
Abstract
The Société Internationale d'Oncologie Pédiatrique [International Society of Paediatric Oncology] (SIOP), founded in 1969, aims to improve the lives of children and adolescents with cancer through global collaboration, education, training, research and advocacy. The annual congress provides the opportunity to share late-breaking research, clinical experiences and debate, with experts worldwide. SIOP's six Continental Branches represent their constituent members in North America, Oceania, Latin America, Africa, Europe and Asia and bring best practices and recent research findings of value to their specific patient populations. In 1990, the SIOP Board of Directors addressed the formerly predominantly European/North American society transforming into a global association by establishing a scholarship program to bring low- and middle-income country (LMIC) paediatric oncologists and nurses to SIOP meetings. A major achievement was SIOP's acceptance as a World Health Organisation (WHO) non-state actor in official relations in 2018, joining 220 non-governmental organisations, international business associations and philanthropic foundations with this privilege. SIOP supports advocacy with WHO member states and civil society to highlight the specific needs of cancer in this age-group through key programs especially supporting the WHO Global Initiative for Childhood Cancer. Sustained improvement in childhood cancer outcomes has paralleled the integration of research with care; thus, SIOP launched a Programme for Advancing Research Capacity for funding selected clinical trial groups in LMICs. SIOP supports south-south partnerships, and the principles elegantly expressed in SIOP Africa's checklist for co-branding projects, that include the prioritisation of local needs, cultivation of local expertise and commitment to equitable partnerships. SIOP now counts approximately 3,000 members from over 128 countries; 39% are from more than 60 LMICs. SIOP members have multidisciplinary expertise on all aspects of childhood cancer care working in collaboration with key stakeholders including governments, civil society organisations and funders to improve the lives of children/adolescents with cancer everywhere in all ways.
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Affiliation(s)
- Julia Challinor
- School of Nursing, University of California San Francisco, 2 Koret Way, San Francisco, CA 94143, USA
- https://orcid.org/0000-0002-5008-8501
| | - Alan Davidson
- Pediatric Hematology-Oncology Service, Red Cross War Memorial Children’s Hospital, University of Cape Town, Rondebosch, Cape Town 7700, South Africa
- https://orcid.org/0000-0002-4646-4332
| | - Guillermo Chantada
- Department of Pediatric Oncology, Hospital Sant Joan de Deu, Pg de Sant Joan de Déu, 2, Esplugues de Llobregat, 08950 Barcelona, Spain
- Departamento de Montevideo, Fundación Perez Scremini, Bv Gral Artigas 1556, Montevideo 11600, Uruguay
- https://orcid.org/0000-0002-9375-9336
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Department of Clinical Oncology, Oncology Institute, Topkapı, Turgut Özal Millet Cd No:118, 34093 Fatih/Istanbul, Turkey
- Division of Pediatric Hematology-Oncology, Department of Preventive Oncology, Oncology Institute, Topkapı, Turgut Özal Millet Cd No:118, 34093 Fatih/Istanbul, Turkey
- https://orcid.org/0000-0003-4344-8174
| | - Kathy Pritchard-Jones
- University College London Great Ormond Street Institute of Child Health, 30 Guilford St, WC1N 1EH London, UK
- https://orcid.org/0000-0002-2384-9475
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Aydın A, Savaş EH, Bingöl H, Kebudi R. Taboo words in pediatric oncology: Communication experiences of nurses and physicians with dying children and their families. Eur J Oncol Nurs 2024; 68:102466. [PMID: 38101245 DOI: 10.1016/j.ejon.2023.102466] [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: 05/09/2023] [Revised: 10/31/2023] [Accepted: 11/08/2023] [Indexed: 12/17/2023]
Abstract
PURPOSE Despite the numerous benefits of effective communication between patients, families, and healthcare professionals, there are still substantial barriers and communication challenges. This study investigated the experiences of nurses and doctors working in different pediatric hematology-oncology units in Turkey communicating with children and their parents about end-of-life issues. METHOD This qualitative study was conducted with twenty-four physicians and nurses. A descriptive phenomenological approach was used. Data were analyzed using Braun and Clarke's six-step reflexive thematic analysis. The MAXQDA software was used to facilitate data management. RESULTS The findings revealed three main themes describing end-of-life communication experiences of physicians and nurses: Avoiding communication with a dying child, Everyone knows but nobody talks, and Complicating aspects of the setting. CONCLUSIONS Communication with dying children and their families is essential. However, multiple barriers remain for healthcare providers to do so. That issue burdens the child and their family more during the end-of-life, which is already a challenging experience to handle. Healthcare professionals need urgent training in communication with the dying children and their families.
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Affiliation(s)
- Ayfer Aydın
- School of Nursing, Istanbul University, Istanbul, Turkey
| | | | - Hülya Bingöl
- Istanbul University, Oncology Institute, Istanbul, Turkey
| | - Rejin Kebudi
- Istanbul University, Oncology Institute, Istanbul, Turkey
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Erdoğan ÖŞ, Ödemiş DA, Kayım ZY, Gürbüz O, Tunçer ŞB, Kılıç S, Çelik B, Tuncer S, Bay SB, Kebudi R, Yazıcı H. Investigation of the methylation changes in the promoter region of RB1 gene in retinoblastoma: Unraveling the epigenetic puzzle in retinoblastoma. Pathol Res Pract 2024; 253:154939. [PMID: 38006838 DOI: 10.1016/j.prp.2023.154939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2023] [Revised: 11/06/2023] [Accepted: 11/08/2023] [Indexed: 11/27/2023]
Abstract
Retinoblastoma is an infrequent neoplasm that arises during childhood from retinal nerve cells and is attributed to the biallelic inactivation of the RB1 gene. In conjunction with anatomical anomalies, it is widely acknowledged that epigenetic modifications play a significant role in the pathogenesis of cancer. The association between methylation of the RB1 gene promoter and tumor formation has been established; however, there is currently no scholarly evidence to substantiate the claim that it is responsible for the inheritance of retinoblastoma. The initial hypothesis posited for this work was that familial retinoblastoma disease would be similarly observed in cases with RB1 promotor gene methylation, akin to RB1 mutations. The RB1 gene promoter region was subjected to methylation screening using real-time PCR in individuals diagnosed with familial retinoblastoma but lacking RB1 mutations. The study involved a comparison of the germline methylation status of the RB1 gene in the peripheral blood samples of 50 retinoblastoma patients and 52 healthy individuals. The healthy individuals were carefully selected to match the retinoblastoma patients in terms of age, sex, and ethnicity. The data obtained from both groups were subjected to statistical analysis. The study revealed that the methylation level in a cohort of 50 individuals diagnosed with retinoblastoma and 52 healthy control participants was determined to be 36.1% and 33.9%, respectively. As a result, there was no statistically significant disparity observed in RB1 promoter methylation between the patient and control groups (p = 0.126). The methylation of the promoter region of the RB1 gene in familial retinoblastoma does not exert any influence on the hereditary transmission of the disease.
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Affiliation(s)
- Özge Şükrüoğlu Erdoğan
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Fatih, 34093 Istanbul, Turkey.
| | - Demet Akdeniz Ödemiş
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Fatih, 34093 Istanbul, Turkey
| | - Zübeyde Yalnız Kayım
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Fatih, 34093 Istanbul, Turkey
| | - Orkun Gürbüz
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Fatih, 34093 Istanbul, Turkey; İstinye University, Vocational School of Health Care Services
| | - Şeref Buğra Tunçer
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Fatih, 34093 Istanbul, Turkey
| | - Seda Kılıç
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Fatih, 34093 Istanbul, Turkey
| | - Betül Çelik
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Fatih, 34093 Istanbul, Turkey
| | - Samuray Tuncer
- Department of Ophthalmology, Istanbul Medical Faculty, Istanbul University, Fatih, 34093 Istanbul, Turkey
| | - Sema Büyükkapu Bay
- Department of Pediatric and Hematologic Oncology, Oncology Institute, Istanbul University, Fatih, 34093 Istanbul, Turkey
| | - Rejin Kebudi
- Department of Pediatric and Hematologic Oncology, Oncology Institute, Istanbul University, Fatih, 34093 Istanbul, Turkey
| | - Hülya Yazıcı
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Fatih, 34093 Istanbul, Turkey; Arel University Faculty of Medicine, Department of Basic Medical Sciences / Medical Biology
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Kroeze E, Padilla LA, Burkhardt B, Attarbaschi A, von Mersi H, Kebudi R, Nievelstein RAJ, Tolboom N, Hagleitner MM, Kuiper RP, Beishuizen A, Loeffen JLC. 18 F-FDG-PET/CT imaging in diagnostic workup of pediatric precursor B-cell lymphoblastic lymphoma. Pediatr Blood Cancer 2023; 70:e30642. [PMID: 37638834 DOI: 10.1002/pbc.30642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/29/2023]
Abstract
18 F-fluorodeoxyglucose-positron emission tomography/computed tomography (PET/CT) imaging is currently not used in standard diagnostics for B-cell precursor lymphoblastic lymphoma (BCP-LBL), and it is unknown whether PET/CT imaging would lead to agreement between detection of lesions with the gold standard imaging methods. Therefore, we performed a retrospective cohort study in which we included 32 pediatric BCP-LBL patients and determined localizations by reviewing local imaging reports. There was a disagreement between protocol-based imaging and PET/CT in 59% of the patients, and the discrepancies mostly comprise of additional lesions detected with PET/CT, typically in lymph node and bone or the absence of bone marrow involvement with PET/CT. If PET/CT was leading in determining definite stage of disease, this would lead to a different stage and therapy branch in 31% and 28% of the patients, respectively.
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Affiliation(s)
- Emma Kroeze
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Laura Arias Padilla
- NHL-BFM Study Center and Pediatric Hematology and Oncology, University Hospital Muenster, Münster, Germany
| | - Birgit Burkhardt
- NHL-BFM Study Center and Pediatric Hematology and Oncology, University Hospital Muenster, Münster, Germany
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
- St. Anna Children's Cancer Research Institute, Vienna, Austria
| | - Hannah von Mersi
- Department of Pediatric Hematology and Oncology, St. Anna Children's Hospital, Medical University of Vienna, Vienna, Austria
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Istanbul University, Oncology Institute, Istanbul, Turkey
| | - Rutger A J Nievelstein
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Nelleke Tolboom
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Radiology and Nuclear Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
| | | | - Roland P Kuiper
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Department of Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
- Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - Jan L C Loeffen
- Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
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Kebudi R, Koc B, Sozmen BO. Late Relapse in Neuroblastoma: Case Report and Review of the Literature. Curr Pediatr Rev 2023; 20:CPR-EPUB-135707. [PMID: 37929737 DOI: 10.2174/0115733963255648231024081333] [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: 04/13/2023] [Revised: 07/22/2023] [Accepted: 09/07/2023] [Indexed: 11/07/2023]
Abstract
BACKGROUND Neuroblastoma is the most common extra-cranial solid tumor in children. The survival rate of relapsed/refractory neuroblastoma is dismal. Late recurrence may occur rarely. CASE PRESENTATION We have, herein, presented a case with stage IV neuroblastoma who relapsed after 11 years and had a subsequent relapse after 15 years from the initial diagnosis, and reviewed cases with late relapsed (after >5 years) neuroblastoma in the literature. The case presented with recurrent disease at the T7 vertebra after 11 years from the initial diagnosis. The patient received surgery, chemotherapy, MIBG treatment, and antiGD2 combined with chemotherapy, and had a further local recurrence in the paravertebral area of the removed T7 vertebra after three years. The patient was operated, received anti-GD2 combined with chemotherapy, and is still alive with no symptoms for 19 months after the last relapse. CONCLUSION There is not a well-established treatment regimen for the majority of these patients. MIBG treatment and antiGD2 combined with chemotherapy may be promising options for relapsed/ refractory neuroblastoma.
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Affiliation(s)
- Rejin Kebudi
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Begum Koc
- University of Health Sciences Pediatric Hematology-Oncology, Istanbul Turkey
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Akdeniz Odemis D, Kebudi R, Bayramova J, Kilic Erciyas S, Kuru Turkcan G, Tuncer SB, Sukruoglu Erdogan O, Celik B, Kurt Gultaslar B, Buyukkapu Bay S, Tuncer S, Yazici H. RB1 gene mutations and genetic spectrum in retinoblastoma cases. Medicine (Baltimore) 2023; 102:e35068. [PMID: 37682130 PMCID: PMC10489529 DOI: 10.1097/md.0000000000035068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 08/14/2023] [Indexed: 09/09/2023] Open
Abstract
The aim of the study was to investigate the frequency and types of mutations on the retinoblastoma gene (RB1 gene) in Turkish population. RB1 gene mutation analysis was performed in a total of 219 individuals (122 probands with retinoblastoma, 14 family members with retinoblastoma and 83 clinically healthy family members). All 27 exons and close intronic regions of the RB1 gene were sequenced for small deletions and insertions using both the Sanger sequencing or NGS methods, and the large deletions and duplications were investigated using the MLPA analysis and CNV algorithm. The bilateral/trilateral retinoblastoma rate was 66% in the study population. The general frequency of RB1 gene mutation in the germline of the patients with retinoblastoma was 41.9%. Approximately 51.5% of the patients were diagnosed earlier than 12 months old, and de novo mutation was found in 32.4% of the patients. Germline small genetic rearrangement mutations were detected in 78.9% of patients and LGRs were detected in 21.1% of patients. An association was detected between the eye color of the RB patients and RB1 mutations. 8 of the mutations detected in the RB1 gene were novel in the study.
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Affiliation(s)
- Demet Akdeniz Odemis
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Istanbul, Türkiye
| | - Rejin Kebudi
- Istanbul University, Oncology Institute, Division of Pediatric Hematology-Oncology, Istanbul, Türkiye
| | - Jamila Bayramova
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Istanbul, Türkiye
| | - Seda Kilic Erciyas
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Istanbul, Türkiye
| | - Gozde Kuru Turkcan
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Istanbul, Türkiye
- Halic University, Faculty of Arts and Sciences, Department of Molecular Biology and Genetics, Istanbul, Türkiye
| | - Seref Bugra Tuncer
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Istanbul, Türkiye
| | - Ozge Sukruoglu Erdogan
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Istanbul, Türkiye
| | - Betul Celik
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Istanbul, Türkiye
| | - Busra Kurt Gultaslar
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Istanbul, Türkiye
| | - Sema Buyukkapu Bay
- Istanbul University, Oncology Institute, Division of Pediatric Hematology-Oncology, Istanbul, Türkiye
| | - Samuray Tuncer
- Istanbul University, Istanbul Medical Faculty, Department of Ophthalmology, Istanbul, Türkiye
| | - Hulya Yazici
- Istanbul University, Oncology Institute, Department of Basic Oncology, Division of Cancer Genetics, Istanbul, Türkiye
- Istanbul Arel University, Istanbul Arel Medical Faculty, Department of Medical Biology and Genetics, Istanbul, Türkiye
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Semerci R, Bingöl H, Bay Büyükkapu S, Kudubes AA, Bektaş M, Kebudi R. Comparison of Heparin and Saline for Prevention of Central Venous Catheter Occlusion in Pediatric Oncology: A Systematic Review and Meta-Analysis. Semin Oncol Nurs 2023; 39:151426. [PMID: 37147152 DOI: 10.1016/j.soncn.2023.151426] [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: 12/04/2022] [Revised: 03/15/2023] [Accepted: 03/16/2023] [Indexed: 05/07/2023]
Abstract
OBJECTIVE The management of central venous catheter (CVC) occlusion remains an area without clear evidence-based guidelines. Studies have been conducted that compare the use of heparin and normal saline for reducing thrombosis, but the evidence is not strong enough to suggest a significant advantage of one over the other. Therefore, the study aimed to assess the effectiveness of heparin and normal saline flushing in preventing CVC occlusion in pediatric patients with cancer. DATA SOURCES A comprehensive search was conducted in PubMed, Web of Science, Cochrane, MEDLINE, CINAHL, Embase, World Health Organization International Clinical Trials Registry Platform, and ClinicalTrials.gov platform using specific keywords. The search was conducted until March 2022. Five randomized controlled trials are included in this study. CONCLUSION Five studies with a total of 316 pediatric cancer patients met the inclusion criteria. The studies were found to be heterogeneous due to variations in the types of cancer, heparin concentration, flushing frequency of CVCs, and methods used to measure occlusion. Despite these differences, there was no significant difference in the effect of flushing with heparin and normal saline in preventing CVC occlusion. The analysis revealed that normal saline is as effective as heparin in preventing CVC occlusion among pediatric cancer patients. IMPLICATIONS FOR NURSING PRACTICE This systematic review and meta-analysis demonstrated that there is no significant difference between the use of heparin and normal saline flushing in preventing CVC occlusion among pediatric cancer patients. Considering the potential risks of heparin, the use of normal saline flushing may be recommended to prevent CVC obstruction.
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Affiliation(s)
| | - Hülya Bingöl
- Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, İstanbul, Turkey
| | - Sema Bay Büyükkapu
- Pediatric Hematology-Oncology, Kanuni Sultan Süleyman Education and Research Hospital, İstanbul, Turkey
| | - Aslı Akdeniz Kudubes
- Pediatric Nursing, Faculty of Health Sciences, Bilecik Şeyh Edebali University, Bilecik, Turkey
| | - Murat Bektaş
- Pediatric Nursing, Faculty of Nursing, Dokuz Eylül University, Izmir, Turkey
| | - Rejin Kebudi
- Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, İstanbul, Turkey
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Erginel B, Mustafayeva N, Karadağ ÇA, Yanar F, Kebudi R, Tanyıldız HG, Tuğcu D, Berker N, İlhan B, Soysal FG. A rare cause of intestinal obstruction in children: signet-ring cell adenocarcinoma of the colon. ULUS TRAVMA ACIL CER 2023; 29:798-805. [PMID: 37409928 PMCID: PMC10405033 DOI: 10.14744/tjtes.2023.64257] [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: 05/04/2023] [Accepted: 05/29/2023] [Indexed: 07/07/2023]
Abstract
BACKGROUND Signet-ring cell adenocarcinoma of the colon is well-recognized in adult patients who are extremely rare and not well-documented in children. Our study aims to raise awareness about this rare disease and its long-term outcomes. METHODS We retrospectively evaluated patients with signet-ring cell colon adenocarcinoma. RESULTS Six patients, three boys and three girls, with a mean age of 14.83 (range, 13-17 years), presented with signs of intesti-nal obstruction and were diagnosed with signet-ring cell colon adenocarcinoma. All patients had air-fluid levels on abdominal X-ray. Abdominal ultrasonography of all patients revealed subileus. Abdominal computed tomography was performed in five patients, and pre-operative colonoscopy was conducted in two patients before the emergency intervention. All of the patients underwent emergent exploratory laparotomy with the preliminary diagnosis of acute abdomen. In two patients, debulking surgery followed by a stoma was performed. The remaining four patients were treated with anastomosis following intestinal resection. All girls had metastases on the ovary. One of the patients died due to the burden of multiple metastases in the early period, and three died in the sixth post-operative year. We have been following the remaining two patients since then. CONCLUSION Although signet-ring cell carcinomas (SRCCs) are rare, they should be considered in the differential diagnosis of acute abdomen and intestinal obstruction in pediatric patients. Despite early diagnosis and treatment, SRCC has a poor prognosis in the pediatric population.
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Affiliation(s)
- Basak Erginel
- Department of Pediatric Surgery, Istanbul University, Istanbul Medical Faculty, İstanbul-Türkiye
| | - Naila Mustafayeva
- Department of Pediatric Surgery, Istanbul University, Istanbul Medical Faculty, İstanbul-Türkiye
| | - Çetin Ali Karadağ
- Department of Pediatric Surgery, Sisli Hamidiye Etfal Training and Research Hospital, İstanbul-Türkiye
| | - Fatih Yanar
- Department of General Surgery, Istanbul University, Istanbul Medical Faculty, İstanbul-Türkiye
| | - Rejin Kebudi
- Department of Pediatric Hematology-Oncology, İstanbul University, Oncology Institute, İstanbul-Türkiye
| | | | - Deniz Tuğcu
- Department of Pediatric Hematology-Oncology, İstanbul University, İstanbul-Türkiye
| | - Neslihan Berker
- Department of Pathology, İstanbul University, İstanbul Medical Faculty, İstanbul-Türkiye
| | - Burak İlhan
- Department of General Surgery, Istanbul University, Istanbul Medical Faculty, İstanbul-Türkiye
| | - Feryal Gün Soysal
- Department of Pediatric Surgery, Istanbul University, Istanbul Medical Faculty, İstanbul-Türkiye
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Yavaş Abalı Z, Öztürk AP, Baş F, Poyrazoğlu Ş, Akcan N, Kebudi R, İribaş Çelik A, Bundak R, Darendeliler F. Long-Term Endocrinologic Follow-Up of Children with Brain Tumors and Comparison of Growth Hormone Therapy Outcomes: A SingleCenter Experience. Turk Arch Pediatr 2023; 58:308-313. [PMID: 37144265 DOI: 10.5152/turkarchpediatr.2023.22147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/06/2023]
Abstract
OBJECTIVE Brain tumors in childhood carry a high risk for endocrine disorders due to the direct effects of the tumor and/or surgery and radiotherapy. Somatotropes are vulnerable to pressure and radiotherapy; therefore, growth hormone deficiency is one of the most frequent abnormalities. This study aimed to evaluate endocrine disorders and recombinant growth hormone treatment outcomes in brain tumor survivors. MATERIALS AND METHODS In this study, 65 (27 female) patients were classified into 3 groups as craniopharyngioma (n = 29), medulloblastoma (n = 17), and others (n = 19). "Others" group included astrocytoma, ependymoma, germinoma, pineoblastoma, and meningioma patients. Anthropometric data and endocrine parameters of patients and their growth outcome with/without recombinant growth hormone therapy were collected from medical records, retrospectively. RESULTS Mean age at the first endocrinological evaluation was 8.7 ± 3.6 years (range: 1.0- 17.1 years). Height, weight, and body mass index standard deviation score, mean ± standard deviation (median) values were -1.7 ± 1.7 (-1.5), -0.8 ± 1.9 (-0.8), and 0.2 ± 1.5 (0.4), respectively. Hypothyroidism (central 86.9%, primary 13.1%) was detected during follow-up in 81.5% of patients. Primary hypothyroidism in medulloblastoma (29.4%) was significantly higher compared to other groups (P = .002). The frequency of hypogonadotropic hypogonadism, central adrenal insufficiency, and diabetes insipidus was significantly high in the craniopharyngioma cases. CONCLUSION In our study, endocrine disorders other than growth hormone deficiency were also frequently observed. In craniopharyngioma cases, the response to recombinant growth hormone therapy was satisfactory. However, there was no improvement in height prognosis during recombinant growth hormone therapy in medulloblastoma patients. A multidisciplinary approach to the care of these patients, referral for endocrine complications, and guidelines on when recombinant growth hormone therapy is required.
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Affiliation(s)
- Zehra Yavaş Abalı
- Department of Pediatric Endocrinology and Diabetes, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Ayşe Pınar Öztürk
- Department of Pediatric Endocrinology and Diabetes, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Firdevs Baş
- Department of Pediatric Endocrinology and Diabetes, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Şükran Poyrazoğlu
- Department of Pediatric Endocrinology and Diabetes, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Neşe Akcan
- Department of Pediatric Endocrinology and Diabetes, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey; Department of Pediatric Endocrinology, Near East University Faculty of Medicine, Nicosia, Turkish Republic of Northern Cyprus
| | - Rejin Kebudi
- Department of Pediatric Hematology-Oncology, İstanbul University Institute of Oncology, İstanbul, Turkey
| | - Ayça İribaş Çelik
- Department of Radiation Oncology, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
| | - Rüveyde Bundak
- Department of Pediatric Endocrinology and Diabetes, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey; Department of Pediatric Endocrinology, University of Kyrenia Faculty of Medicine, Kyrenia, Turkish Republic of Northern Cyprus
| | - Feyza Darendeliler
- Department of Pediatric Endocrinology and Diabetes, İstanbul University İstanbul Faculty of Medicine, İstanbul, Turkey
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Toret E, Ozdemir ZC, Zengin Ersoy G, Oztunali C, Bozkurt C, Kebudi R. Tandem high-dose chemotherapy followed by autologous stem cell transplantation: An infant with trilateral retinoblastoma. Pediatr Transplant 2023; 27:e14504. [PMID: 36919672 DOI: 10.1111/petr.14504] [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: 04/28/2022] [Revised: 01/26/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Retinoblastoma (RB) is the most common intraocular malignancy in childhood. Advanced RB, associated with exceedingly poor prognosis, requires more intensive multiagent chemotherapy than conventional regimens. Rescue of the bone marrow after intensive chemotherapy is achieved with stem cell transplantation. The sequential courses (tandem transplantation) of high-dose chemotherapy followed by autologous stem cell transplantation allow for even greater dose intensity in consolidation with the potential to use different active chemotherapeutics at each transplant and have proven feasible and successful in treating children with recurrent/refractory solid tumors. CASE DESCRIPTION We report an infant with trilateral high-risk RB who received tandem high-dose chemotherapy (HDC) followed by autologous stem cell transplantation after the conventional chemotherapy. A 5-month-old female patient presented with strabismus, and the ophthalmoscopic examination showed intraocular tumoral lesions in both eyes. Magnetic resonance imaging (MRI) concluded the trilateral retinoblastoma diagnosis due to a tumoral mass in the optic chiasm. The follow-up ophthalmologic examinations and the MRI detected stable disease after six cycles of multiagent chemotherapy. CONCLUSIONS Rescue with autologous stem cell transplantation after HDC allows for an increase in chemotherapy intensity. Tandem transplantation provides the chance to perform different chemotherapeutics at each transplant and enables an increase in the chemotherapy intensity, thus providing a positive effect on disease-free survival.
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Affiliation(s)
- Ersin Toret
- Department of Pediatric Hematology-Oncology, Eskisehir Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Zeynep Canan Ozdemir
- Department of Pediatric Hematology-Oncology, Eskisehir Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Gizem Zengin Ersoy
- Department of Pediatric Hematology-Oncology, Altinbas University, School of Medicine, Medicalpark Bahcelievler Hospital, Istanbul, Turkey
| | - Cigdem Oztunali
- Department of Pediatric Radiology, Eskisehir Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Ceyhun Bozkurt
- Department of Pediatric Hematology-Oncology, Istinye University, School of Medicine, Altınbas University Medicalpark Bahcelievler Hospital, Istanbul, Turkey
| | - Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Istanbul University Oncology Institute, Cerrahpasa School of Medicine, Istanbul, Turkey
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Karaman S, Kebudi R, Kizilocak H, Karakas Z, Demirag B, Evim MS, Yarali N, Kaya Z, Karagun BS, Aydogdu S, Caliskan U, Ayhan AC, Bahadir A, Cakir B, Guner BT, Albayrak C, Karapinar DY, Kazanci EG, Unal E, Turkkan E, Akici F, Bor O, Vural S, Yilmaz S, Apak H, Baytan B, Tahta NM, Güzelkucuk Z, Kocak U, Antmen B, Tokgöz H, Fisgin T, Özdemir N, Gunes AM, Vergin C, Unuvar A, Ozbek N, Tugcu D, Bay SB, Tanyildiz HG, Celkan T. Central Nervous System Fungal Infections in Children With Leukemia and Undergoing Hematopoietic Stem Cell Transplantation: A Retrospective Multicenter Study. J Pediatr Hematol Oncol 2022; 44:e1039-e1045. [PMID: 36036521 DOI: 10.1097/mph.0000000000002499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Accepted: 05/04/2022] [Indexed: 11/26/2022]
Abstract
BACKGROUND Central nervous system fungal infections (CNSFI) are seen in patients with hematologic malignancies and have high morbidity and mortality. Because of their rarity, there is limited data on CNSFI in children with no established treatment protocols or guidelines. MATERIALS AND METHODS In this multicenter retrospective study, 51 pediatric patients with leukemia, 6 of whom had undergone bone marrow transplantation, with proven or probable CNSFI were evaluated. Fungal infections were defined as proven or probable based on European Organisation for Research and Treatment of Cancer criteria. Proven CNSFI was diagnosed by appropriate central nervous system (CNS) imaging or tissue sample findings in combination with positive microbiological results of cerebrospinal fluid. A positive culture, microscopic evidence of hyphae, a positive result of the galactomannan assays are defined as positive microbiological evidence. Probable CNSFI was defined as appropriate CNS imaging findings together with proven or probable invasive fungal infections at another focus without CNS when there is no other explanatory condition. Data was collected by using the questionnaire form (Supplemental Digital Content 1, http://links.lww.com/JPHO/A541 ). RESULTS Seventeen patients had proven, 34 patients had probable CNSFI. Headaches and seizures were the most common clinical findings. The median time between the onset of fever and diagnosis was 5 days. The most common fungal agent identified was Aspergillus . Sixteen patients received single-agent, 35 received combination antifungal therapy. Surgery was performed in 23 patients. Twenty-two patients (43%) died, 29 of the CNSFI episodes recovered with a 20% neurological sequelae. CONCLUSION CNSFIs should be considered in the differential diagnosis in patients with leukemia and refractory/recurrent fever, headache, neurologicalocular symptoms, and a radiologic-serological evaluation should be performed immediately. Early diagnosis and prompt management, both medical and surgical, are essential for improving clinical outcomes.
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Affiliation(s)
- Serap Karaman
- Division of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Istanbul University Oncology Institute
| | - Hande Kizilocak
- Division of Pediatric Hematology-Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa
| | - Zeynep Karakas
- Division of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University
| | - Bengu Demirag
- Division of Pediatric Hematology-Oncology, University of Health Sciences Dr. Behcet Uz Children's Hospital
| | - Melike S Evim
- Division of Pediatric Hematology-Oncology, Faculty of Medicine, Uludağ University
| | - Nese Yarali
- Division of Pediatric Hematology-Oncology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital
| | - Zuhre Kaya
- Division of Pediatric Hematology-Oncology, Faculty of Medicine, Gazi University, Ankara
| | - Barbaros S Karagun
- Division of Pediatric Hematology-Oncology, Acibadem Adana Hospital, Adana
| | - Selime Aydogdu
- Division of Pediatric Hematology-Oncology, Altinbas University Bahcelievler Medical Park Hospital
| | - Umran Caliskan
- Division of Pediatric Hematology-Oncology, Meram University Faculty of Medicine, Konya
| | - Aylin C Ayhan
- Division of Pediatric Hematology-Oncology, Medeniyet University, Faculty of Medicine
| | - Aysenur Bahadir
- Division of Pediatric Hematology-Oncology, Karadeniz Technical University, Faculty of Medicine, Trabzon
| | - Betul Cakir
- Division of Pediatric Hematology-Oncology, Bezmiâlem Vakif University
| | - Burcak T Guner
- Division of Pediatric Hematology-Oncology, Izmir University of Health Sciences Tepecik Training and Research Hospital
| | - Canan Albayrak
- Division of Pediatric Hematology-Oncology, Ondokuz Mayis University, Faculty of Medicine, Samsun
| | - Deniz Y Karapinar
- Division of Pediatric Hematology-Oncology, Faculty of Medicine, Ege University
| | - Elif G Kazanci
- Division of Pediatric Hematology-Oncology, Health Sciences University Bursa High Specialist Training and Research Hospital, Bursa
| | - Ekrem Unal
- Division of Pediatric Hematology-Oncology, Erciyes University Faculty of Medicine, Kayseri
| | - Emine Turkkan
- Division of Pediatric Hematology-Oncology, University of Health Sciences, Okmeydani Training and Research Hospital
| | - Ferhan Akici
- Division of Pediatric Hematology-Oncology, University of Health Science Kanuni Sultan Süleyman Research and Training Hospital
| | - Ozcan Bor
- Division of Pediatric Hematology-Oncology, Faculty of Medicine, Eskişehir Osmangazi University, Eskişehir, Turkey
| | - Sema Vural
- Division of Pediatric Hematology-Oncology, Health Sciences University Istanbul Sariyer Hamidiye Etfal Health Practice and Research Center, Istanbul
| | - Sebnem Yilmaz
- Division of Pediatric Hematology-Oncology, Dokuz Eylul University Faculty of Medicine, Izmir
| | - Hilmi Apak
- Division of Pediatric Hematology-Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa
| | - Birol Baytan
- Division of Pediatric Hematology-Oncology, Faculty of Medicine, Uludağ University
| | - Neryal M Tahta
- Division of Pediatric Hematology-Oncology, University of Health Sciences Dr. Behcet Uz Children's Hospital
| | - Zeliha Güzelkucuk
- Division of Pediatric Hematology-Oncology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital
| | - Ulker Kocak
- Division of Pediatric Hematology-Oncology, Faculty of Medicine, Gazi University, Ankara
| | - Bulent Antmen
- Division of Pediatric Hematology-Oncology, Acibadem Adana Hospital, Adana
| | - Huseyin Tokgöz
- Division of Pediatric Hematology-Oncology, Meram University Faculty of Medicine, Konya
| | - Tunc Fisgin
- Division of Pediatric Hematology-Oncology, Altinbas University Bahcelievler Medical Park Hospital
| | - Nihal Özdemir
- Division of Pediatric Hematology-Oncology, University of Health Science Kanuni Sultan Süleyman Research and Training Hospital
| | - Adalet M Gunes
- Division of Pediatric Hematology-Oncology, Faculty of Medicine, Uludağ University
| | - Canan Vergin
- Division of Pediatric Hematology-Oncology, University of Health Sciences Dr. Behcet Uz Children's Hospital
| | - Aysegul Unuvar
- Division of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University
| | - Namik Ozbek
- Division of Pediatric Hematology-Oncology, University of Health Sciences, Ankara Child Health and Diseases Hematology Oncology Training and Research Hospital
| | - Deniz Tugcu
- Division of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University
| | - Sema B Bay
- Division of Pediatric Hematology-Oncology, Istanbul University Oncology Institute
| | - Hikmet G Tanyildiz
- Division of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University
| | - Tiraje Celkan
- Division of Pediatric Hematology-Oncology, Cerrahpasa Faculty of Medicine, Istanbul University-Cerrahpasa
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Kebudi R, Yıldırım U, Şenol B, Zulfikar B. IS A MODIFIED BFM REGIMEN WITH 1 Gram/m2 METHOTREXATE AS EFFECTIVE AS 5 Gram/m2 IN PEDIATRIC ADVANCED-STAGE NONLYMPHOBLASTIC NON-HODGKIN LYMPHOMA? Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00251-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Kroeze E, Burkhardt B, Padilla L, Attarbaschi A, von Mersi H, Kebudi R, Hagleitner M, Kuiper R, Beishuizen A, Loeffen J. FDG-PET/CT IMAGING IN PEDIATRIC PRECURSOR B-CELL LYMPHOBLASTIC LYMPHOMA (BCP-LBL) SHOWS BONE (MARROW) INVOLVEMENT IN A VAST MAJORITY OF PATIENTS. Leuk Res 2022. [DOI: 10.1016/s0145-2126(22)00317-4] [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]
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Bingöl H, Aydın A, Kebudi R, Umaç EH, Koç B, Yıldırım ÜM, Zülfikar B. Desires vs. conditions: A qualitative study exploring the factors affecting the place of death of child with cancer in Turkey. Eur J Cancer Care (Engl) 2022; 31:e13703. [PMID: 36131608 DOI: 10.1111/ecc.13703] [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: 03/12/2022] [Revised: 07/15/2022] [Accepted: 08/31/2022] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The purpose of this study was to describe factors affecting the place of death of children with cancer at the end of life. METHODS The descriptive phenomenological approach was used. Eighteen mothers who lost their children to cancer participated in in-depth interviews. Data were analysed using MAXQDA software version. Codes and categories were developed inductively from participants' narratives. RESULTS The factors affecting the place of death of children were categorised into two main themes: (1) desires and (2) conditions. Most of the mothers reported that their deceased children wanted to be with their families at the end of life and they wanted to go home. The conditions related to health services were defined as the barriers to the death of their children in the places of death preferred by the mothers. CONCLUSION The desire to be close to the child was the main factor affecting the parents' decisions. The findings revealed the prevailing circumstances in the death place decision beyond parental desires. These were the child's health conditions, physical conditions of hospitals, and the lack of home care and paediatric palliative care services, which were factors related to the system, and the lack of other options for parents.
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Affiliation(s)
- Hülya Bingöl
- Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Ayfer Aydın
- School of Nursing, Istanbul University, Istanbul, Turkey
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology & Department of Preventive Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | | | - Başak Koç
- Oncology Institute, Istanbul University, Istanbul, Turkey
| | | | - Bülent Zülfikar
- Division of Pediatric Hematology-Oncology & Department of Preventive Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
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Yıldırım ÜM, Kebudi R. Neurofibromatosis Type I and Hodgkin Lymphoma: Case Report and Review of the Literature. Turk Arch Pediatr 2022; 57:566-568. [PMID: 36062445 PMCID: PMC9524435 DOI: 10.5152/turkarchpediatr.2022.22004] [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] [Indexed: 11/22/2022]
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Kroeze E, Arias Padilla L, Bakker M, Boer JM, Hagleitner MM, Burkhardt B, Mori T, Attarbaschi A, Verdú-Amorós J, Pillon M, Anderzhanova L, Kabíčková E, Chiang AKS, Kebudi R, Mellgren K, Lazic J, Jazbec J, Meijerink JPP, Beishuizen A, Loeffen JLC. Pediatric Precursor B-Cell Lymphoblastic Malignancies: From Extramedullary to Medullary Involvement. Cancers (Basel) 2022; 14:cancers14163895. [PMID: 36010889 PMCID: PMC9405801 DOI: 10.3390/cancers14163895] [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] [Received: 06/24/2022] [Revised: 07/22/2022] [Accepted: 08/10/2022] [Indexed: 11/24/2022] Open
Abstract
B-cell lymphoblastic lymphoma (BCP-LBL) and B-cell acute lymphoblastic leukemia (BCP-ALL) are the malignant counterparts of immature B-cells. BCP-ALL is the most common hematological malignancy in childhood, while BCP-LBL accounts for only 1% of all hematological malignancies in children. Therefore, BCP-ALL has been well studied and treatment protocols have changed over the last decades, whereas treatment for BCP-LBL has stayed roughly the same. Clinical characteristics of 364 pediatric patients with precursor B-cell malignancies were studied, consisting of BCP-LBL (n = 210) and BCP-ALL (n = 154) patients. Our results indicate that based on the clinical presentation of disease, B-cell malignancies probably represent a spectrum ranging from complete isolated medullary disease to apparent complete extramedullary disease. Hepatosplenomegaly and peripheral blood involvement are the most important discriminators, as both seen in 80% and 95% of the BCP-ALL patients and in 2% of the BCP-LBL patients, respectively. In addition, we show that the overall survival rates in this cohort differ significantly between BCP-LBL and BCP-ALL patients aged 1−18 years (p = 0.0080), and that the outcome for infants (0−1 years) with BCP-LBL is significantly decreased compared to BCP-LBL patients of all other pediatric ages (p < 0.0001).
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Affiliation(s)
- Emma Kroeze
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Laura Arias Padilla
- NHL-BFM Study Center and Pediatric Hematology and Oncology, University Hospital Muenster, 48149 Muenster, Germany
| | - Max Bakker
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | - Judith M. Boer
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
| | | | - Birgit Burkhardt
- NHL-BFM Study Center and Pediatric Hematology and Oncology, University Hospital Muenster, 48149 Muenster, Germany
| | - Takeshi Mori
- Department of Hematology and Oncology, Hyogo Prefectural Kobe Children’s Hospital, Kobe 650-0047, Japan
| | - Andishe Attarbaschi
- Department of Pediatric Hematology and Oncology, St. Anna Children’s Hospital, Medical University of Vienna, 1090 Vienna, Austria
| | - Jaime Verdú-Amorós
- Pediatric Oncology Department, Hospital Clínico Universitario de Valencia, 46010 Valencia, Spain
| | - Marta Pillon
- Clinic of Pediatric Hemato-Oncology, Department of Women’s and Children’s Health, University of Padova, 46010 Padova, Italy
| | - Liliya Anderzhanova
- Dmitry Rogachev National Medical Research Center of Pediatric Hematology, Oncology and Immunology, 117198 Moscow, Russia
| | - Edita Kabíčková
- Department of Pediatric Hematology and Oncology, Charles University, 2nd Medical School and University Hospital Motol, 150 06 Prague, Czech Republic
| | - Alan K. S. Chiang
- Department of Pediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam, Hong Kong
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Istanbul University, Oncology Institute, 34452 İstanbul, Turkey
| | - Karin Mellgren
- Department of Pediatric Oncology, Sahlgrenska University Hospital, University of Gothenburg, 413 45 Gothenburg, Sweden
| | - Jelena Lazic
- Department for Hematology and Oncology, University Children’s Hospital, University of Belgrade, 11000 Belgrade, Serbia
| | - Janez Jazbec
- Division of Pediatrics, Hematology and Oncology, University Medical Center Ljubljana, SI-1000 Ljubljana, Slovenia
| | | | - Auke Beishuizen
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Erasmus Medical Center, Sophia Children’s Hospital, 3015 CN Rotterdam, The Netherlands
| | - Jan L. C. Loeffen
- Princess Máxima Center for Pediatric Oncology, 3584 CS Utrecht, The Netherlands
- Correspondence:
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Fabian ID, Abdallah E, Abdullahi SU, Abdulqader RA, Abdulrahaman AA, Abouelnaga S, Ademola-Popoola DS, Adio A, Afifi MA, Afshar AR, Aggarwal P, Aghaji AE, Ahmad A, Akib MNR, Akinsete A, Al Harby L, Al Mesfer S, Al Ani MH, Alarcón Portabella S, Al-Badri SAF, Alcasabas APA, Al-Dahmash SA, Alejos A, Alemany-Rubio E, Alfa Bio AI, Alfonso Carreras Y, Al-Haddad CE, Al-Hussaini HHY, Ali AM, Alia DB, Al-Jadiry MF, Al-Jumaily U, Alkatan HM, All-Eriksson C, Al-Mafrachi AARM, Almeida AA, Alsawidi KM, Al-Shaheen AASM, Al-Shammary EH, Amankwaa-Frempong D, Amiruddin PO, Armytasari I, Astbury NJ, Atalay HT, Ataseven E, Atchaneeyasakul LO, Atsiaya R, Autrata R, Balaguer J, Balayeva R, Barranco H, Bartoszek P, Bartuma K, Bascaran C, Bechrakis NE, Beck Popovic M, Begimkulova AS, Benmiloud S, Berete RC, Berry JL, Bhaduri A, Bhat S, Bhattacharyya A, Biewald EM, Binkley E, Blum S, Bobrova N, Boldt H, Bonanomi MTBC, Bouda GC, Bouguila H, Brennan RC, Brichard BG, Buaboonnam J, Budiongo A, Burton MJ, Calderón-Sotelo P, Calle Jara DA, Camuglia JE, Cano MR, Capra M, Caspi S, Cassoux N, Castela G, Castillo L, Català-Mora J, Cavieres I, Chandramohan A, Chantada GL, Chaudhry S, Chawla B, Chen W, Chiwanga FS, Chuluunbat T, Cieslik K, Clark A, Cockcroft RL, Comsa C, Correa Llano MG, Corson TW, Couitchere L, Cowan-Lyn KE, Csóka M, Dangboon W, Das A, Das P, Das S, Davanzo JM, Davidson A, De Francesco S, De Potter P, Quintero D K, Demirci H, Desjardins L, Díaz Coronado RY, Dimaras H, Dodgshun AJ, Donato Macedo CR, Dragomir MD, Du Y, Du Bruyn M, Du Plessis J, Dudeja G, Eerme K, Eka Sutyawan IW, El Kettani A, Elbahi AM, Elder JE, Elhaddad AM, Elhassan MMA, Elzembely MM, Ericksen C, Essuman VA, Evina TGA, Ezegwui IR, Fadoo Z, Fandiño AC, Faranoush M, Fasina O, Fernández DDPG, Fernández-Teijeiro A, Foster A, Frenkel S, Fu LD, Fuentes-Alabi SL, Garcia JL, García Aldana D, Garcia Pacheco HN, Geel JA, Ghassemi F, Girón AV, Goenz MA, Gold AS, Goldberg H, Gole GA, Gomel N, Gonzalez E, Gonzalez Perez G, González-Rodríguez L, Gorfine M, Graells J, Gregersen PA, Grigorovski NDAK, Guedenon KM, Gunasekera DS, Gündüz AK, Gupta H, Gupta S, Gupta V, Hadjistilianou T, Hamel P, Hamid SA, Hamzah N, Hansen ED, Harbour JW, Hartnett ME, Hasanreisoglu M, Muhammad H, Hassan S, Hassan S, Hautz W, Haydar H, Hederova S, Hessissen L, Hongeng S, Hordofa DF, Hubbard GB, Hummelen M, Husakova K, Hussein Al-Janabi AN, Ibanga A, Ida R, Ilic VR, Islamov Z, Jairaj V, Janjua T, Jeeva I, Ji X, Jo DH, Jones MM, Kabesha Amani TB, Kabore RL, Kaliki S, Kalinaki A, Kamsang P, Kantar M, Kapelushnik N, Kardava T, Kebudi R, Keomisy J, Kepak T, Ketteler P, Khan ZJ, Khaqan HA, Khetan V, Khodabande A, Khotenashvili Z, Kim JW, Kim JH, Kiratli H, Kivela TT, Klett A, Koç I, Kosh Komba Palet JE, Krivaitiene D, Kruger M, Kulvichit K, Kuntorini MW, Kyara A, Lam GC, Larson SA, Latinović S, Laurenti KD, Lavy Y, Lavric Groznik A, Leverant AA, Li C, Li K, Limbu B, Liu CH, Quah B, López JP, Lukamba RM, Luna-Fineman S, Lutfi D, Lysytsia L, Madgar S, Magrath GN, Mahajan A, Maitra P, Maka E, Makimbetov EK, Maktabi A, Maldonado C, Mallipatna A, Manudhane R, Manzhuova L, Martín-Begue N, Masud S, Matende IO, Mattosinho CCDS, Matua M, Mayet I, Mbumba FB, McKenzie JD, Mehrvar A, Mengesha AA, Menon V, Mercado GJV, Mets MB, Midena E, Miller A, Mishra DKC, Mndeme FG, Mohamedani AA, Mohammad MT, Moll AC, Montero MM, Moreira C, Mruthyunjaya P, Msina MS, Msukwa G, Mudaliar SS, Muma KIM, Munier FL, Murray TG, Musa KO, Mushtaq A, Musika AA, Mustak H, Mustapha T, Muyen OM, Myezo KH, Naidu G, Naidu N, Nair AG, Natarajan S, Naumenko L, Ndoye Roth PA, Nency YM, Neroev V, Ng Y, Nikitovic M, Nkanga ED, Nkumbe HE, Numbi MN, Nummi K, Nuruddin M, Nyaywa M, Nyirenda C, Obono-Obiang G, Oliver SCN, Oporto J, Ortega-Hernández M, Oscar AH, Ossandon D, Pagarra H, Paintsil V, Paiva L, Palanivelu MS, Papyan R, Parrozzani R, Pascual Morales CR, Paton KE, Pe'er J, Peralta Calvo J, Perić S, Pham CTM, Philbert R, Plager DA, Pochop P, Polania RA, Polyakov V, Ponce J, Qadir AO, Qayyum S, Qian J, Refaeli D, Rahman A, Rajkarnikar P, Ramanjulu R, Ramasubramanian A, Ramirez-Ortiz MA, Randhawa JK, Randrianarisoa HL, Raobela L, Rashid R, Reddy M, Renner LA, Reynders D, Ribadu D, Ritter-Sovinz P, Rogowska A, Rojanaporn D, Romero L, Roy SR, Saab RH, Saakyan S, Sabhan AH, Sagoo MS, Said AMA, Saiju R, Salas B, San Román Pacheco S, Sánchez GL, Sanchez Orozco AJ, Sayalith P, Scanlan TA, Schlüter S, Schwab C, Sedaghat A, Seth R, Sgroi M, Shah AS, Shakoor SA, Sharma MK, Sherief ST, Shields CL, Sia D, Siddiqui SN, Sidi cheikh S, Silva S, Singh AD, Singh U, Singha P, Sitorus RS, Skalet AH, Soebagjo HD, Sorochynska T, Ssali G, Stacey AW, Staffieri SE, Stahl ED, Steinberg DM, Stones DK, Strahlendorf C, Suarez MEC, Sultana S, Sun X, Superstein R, Supriyadi E, Surukrattanaskul S, Suzuki S, Svojgr K, Sylla F, Tamamyan G, Tan D, Tandili A, Tang J, Tarrillo Leiva FF, Tashvighi M, Tateshi B, Teh KH, Tehuteru ES, Teixeira LF, Tekavcic Pompe M, Thawaba ADM, Theophile T, Toledano H, Trang DL, Traoré F, Tripathy D, Tuncer S, Tyau-Tyau H, Umar AB, Unal E, Uner OE, Urbak SF, Ushakova TL, Usmanov RH, Valeina S, Valente P, van Hoefen Wijsard M, Vasquez Anchaya JK, Vaughan LO, Veleva-Krasteva NV, Verma N, Victor AA, Viksnins M, Villacís Chafla EG, Villegas VM, Vishnevskia-Dai V, Waddell K, Wali AH, Wang YZ, Wangtiraumnuay N, Wetter J, Widiarti W, Wilson MW, Wime ADC, Wiwatwongwana A, Wiwatwongwana D, Wolley Dod C, Wong ES, Wongwai P, Wu SQ, Xiang D, Xiao Y, Xu B, Xue K, Yaghy A, Yam JC, Yang H, Yanga JM, Yaqub MA, Yarovaya VA, Yarovoy AA, Ye H, Yee RI, Yousef YA, Yuliawati P, Zapata López AM, Zein E, Zhang Y, Zhilyaeva K, Zia N, Ziko OAO, Zondervan M, Bowman R. The Global Retinoblastoma Outcome Study: a prospective, cluster-based analysis of 4064 patients from 149 countries. The Lancet Global Health 2022; 10:e1128-e1140. [PMID: 35839812 PMCID: PMC9397647 DOI: 10.1016/s2214-109x(22)00250-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 05/06/2022] [Accepted: 05/23/2022] [Indexed: 02/01/2023] Open
Abstract
Background Retinoblastoma is the most common intraocular cancer worldwide. There is some evidence to suggest that major differences exist in treatment outcomes for children with retinoblastoma from different regions, but these differences have not been assessed on a global scale. We aimed to report 3-year outcomes for children with retinoblastoma globally and to investigate factors associated with survival. Methods We did a prospective cluster-based analysis of treatment-naive patients with retinoblastoma who were diagnosed between Jan 1, 2017, and Dec 31, 2017, then treated and followed up for 3 years. Patients were recruited from 260 specialised treatment centres worldwide. Data were obtained from participating centres on primary and additional treatments, duration of follow-up, metastasis, eye globe salvage, and survival outcome. We analysed time to death and time to enucleation with Cox regression models. Findings The cohort included 4064 children from 149 countries. The median age at diagnosis was 23·2 months (IQR 11·0–36·5). Extraocular tumour spread (cT4 of the cTNMH classification) at diagnosis was reported in five (0·8%) of 636 children from high-income countries, 55 (5·4%) of 1027 children from upper-middle-income countries, 342 (19·7%) of 1738 children from lower-middle-income countries, and 196 (42·9%) of 457 children from low-income countries. Enucleation surgery was available for all children and intravenous chemotherapy was available for 4014 (98·8%) of 4064 children. The 3-year survival rate was 99·5% (95% CI 98·8–100·0) for children from high-income countries, 91·2% (89·5–93·0) for children from upper-middle-income countries, 80·3% (78·3–82·3) for children from lower-middle-income countries, and 57·3% (52·1-63·0) for children from low-income countries. On analysis, independent factors for worse survival were residence in low-income countries compared to high-income countries (hazard ratio 16·67; 95% CI 4·76–50·00), cT4 advanced tumour compared to cT1 (8·98; 4·44–18·18), and older age at diagnosis in children up to 3 years (1·38 per year; 1·23–1·56). For children aged 3–7 years, the mortality risk decreased slightly (p=0·0104 for the change in slope). Interpretation This study, estimated to include approximately half of all new retinoblastoma cases worldwide in 2017, shows profound inequity in survival of children depending on the national income level of their country of residence. In high-income countries, death from retinoblastoma is rare, whereas in low-income countries estimated 3-year survival is just over 50%. Although essential treatments are available in nearly all countries, early diagnosis and treatment in low-income countries are key to improving survival outcomes. Funding Queen Elizabeth Diamond Jubilee Trust.
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Nussbaumer G, Benesch M, Gielen GH, Castel D, Grill J, Alonso Roldán MM, Antonelli M, Bailey S, Baugh JN, Biassoni V, Carai A, Colditz N, Colefati GS, Corbacioglu S, Crampsie S, Entz-Werle N, Eyrich M, Frühwald MC, Garrè ML, Gerber NU, Giangaspero F, Gil-da-Costa MJ, Grabovska Y, Graf N, Hargrave D, Hauser P, Hoffmann M, Hulleman E, Jacobs S, Karremann M, Kattamis A, Kebudi R, Kortmann RD, Kwiecien R, Mackay A, Massimino M, Miele E, Mastronuzzi A, Morana G, Noack CM, Pentikainen V, Perwein T, Pfister SM, Pietsch T, Roka K, Rossi S, Rutkowski S, Schiavello E, Štěrba J, Sturm D, Sumerauer D, Temelso S, van Vuurden D, Varlet P, Veldhuijzen van Zanten SEM, Vinci M, von Bueren AO, Warmuth-Metz M, Wesseling P, Wiese M, Wolff JEA, Zamecnik J, Jones DTW, Bison B, La Madrid AM, Jones C, Kramm CM. HGG-49. Gliomatosis cerebri in children: A collaborative report from the European Society for Pediatric Oncology (SIOPE). Neuro Oncol 2022. [DOI: 10.1093/neuonc/noac079.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
BACKGROUND: Gliomatosis cerebri (GC), a radiologically defined diffusely infiltrating glioma, is no longer considered a distinct entity since the 2016 WHO classification for tumors of the CNS. Due to its rarity and dismal prognosis treatment recommendations in children remain ambiguous. Using central neuroradiological review, we performed a multi-institutional, retrospective study of GC providing comprehensive radiological, clinical, and (epi)genetic characterization. RESULTS: We included 104 patients between 1-19 years. Within a median follow-up of 15.5 months (range, 2.3-138.8), 93 patients (89.4 %) had died, 4 (3.8 %) were lost to follow-up and 7 (6.8 %) were alive with stable/progressive disease. Median progression-free- (PFS) and overall survival (OS) were 8.6 months (interquartile range, 4.3-14.0) and 15.5 months (10.9-27.7), respectively. Former WHO grading correlated significantly with median OS: WHO °II: 47.8 months (25.2-55.7); WHO °III: 15.9 months (11.4-26.3); WHO °IV: 10.4 months (8.8-14.4) (p<0.001). In high-grade gliomas (HGG), radiochemotherapy showed best PFS (p=0.002). Compared to hemispheric pediatric non-GC HGG, GC phenotype was associated with decreased OS (p=0.001). Methylation-based classification and exome sequencing were possible for 49 and 45 patients, respectively. According to the 2021 WHO classification, most cases were considered as IDH-/H3-wildtype gliomas (n=37/49, 75.5 %), mostly with a pedRTK2 subtype (n=15, 30.6%), followed by pedMYCN (n=5, 10.2 %). Within the IDH-/H3-wildtype gliomas, EGFR-altered tumors (n=10) seemed overrepresented. Survival analyses revealed a better OS for IDH1-mutant tumors (n=6; 54.6 vs. 15.2 months in IDH-wildtype; p=0.015) and a worse OS for TP53-mutant tumors (n=6; p=0.001). Despite the potential overrepresentation of EGFR-altered tumors, no other specific molecular markers for GC could be identified so far. Further analyses are ongoing. CONCLUSIONS: GC in children is confirmed as a poor prognostic phenotype include various epigenetic pediatric glioma subtypes, without a proven (epi)genetic mark of its own. The relevance of overrepresented EGFR alterations has to be determined yet.
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Affiliation(s)
- Gunther Nussbaumer
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz , Graz , Austria
| | - Martin Benesch
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz , Graz , Austria
| | - Gerrit H Gielen
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn , Bonn , Germany
| | - David Castel
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Center, Paris-Saclay University , Villejuif , France
| | - Jacques Grill
- Department of Pediatric and Adolescent Oncology, Gustave Roussy Cancer Center, Paris-Saclay University , Villejuif , France
| | | | - Manila Antonelli
- Department of Radiological, Oncological and Anatomo-Pathological Sciences , Rome , Italy
| | - Simon Bailey
- Department of Paediatric Oncology, Sir James Spence Institute of Child Health, Royal Victoria Infirmary Queen, Newcastle upon Tyne, United Kingdom
| | - Joshua N Baugh
- Princess Máxima Center for Pediatric Oncology , Utrecht , Netherlands
| | - Veronica Biassoni
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori , Milano , Italy
| | - Andrea Carai
- Department of Neuroscience and Neurorehabilitation, Bambino Gesù Children's Hospital , Rome , Italy
| | - Niclas Colditz
- Division of Pediatric Hematology and Oncology, University Medical Center Goettingen , Goettingen , Germany
| | | | - Selim Corbacioglu
- Department of Pediatric Hematology, Oncology and Stem Cell Transplantation, University of Regensburg , Regensburg , Germany
| | - Shauna Crampsie
- Division of Cancer Therapeutics and Department of Molecular Pathology, Institute of Cancer Research , London , United Kingdom
| | - Natacha Entz-Werle
- Pediatric Onco-Hematology department - Pediatrics III, University Hospital of Strasbourg , Strasbourg , France
- UMR CNRS 7021, Laboratory of Bioimaging and pathologies , Illkirch , France
| | - Matthias Eyrich
- Children's Department of Oncology, Hematology and Stem Cell Transplantation, University Children's Hospital , Wuerzburg , Germany
| | - Michael C Frühwald
- Swabian Children's Cancer Center, University Children's Hospital Augsburg , Augsburg , Germany
| | - Maria Luisa Garrè
- Neuro-Oncology Unit, IRCSS Istituto Giannina Gaslini , Genoa , Italy
| | - Nicolas U Gerber
- Department of Oncology and Children's Research Centre, University Children's Hospital , Zurich , Switzerland
| | - Felice Giangaspero
- Department of Radiological, Oncological and Anatomo-Pathological Sciences, Sapienza University , Rome , Italy
| | | | - Yura Grabovska
- Division of Molecular Pathology, The Institute of Cancer Research , London , United Kingdom
| | - Norbert Graf
- Department of Pediatric Oncology and Hematology, Saarland University , Homburg , Germany
| | - Darren Hargrave
- Paediatric Oncology, Great Ormond Street Hospital for Children , London , United Kingdom
| | - Peter Hauser
- Second Department of Pediatrics, Semmelweis University , Budapest , Hungary
| | - Marion Hoffmann
- Division of Pediatric Hematology and Oncology, University Medical Center Goettingen , Goettingen , Germany
| | - Esther Hulleman
- Princess Máxima Center for Pediatric Oncology , Utrecht , Netherlands
| | - Sandra Jacobs
- Department of Microbiology and Immunology, Laboratory of Pediatric Immunology, KU Leuven , Leuven , Belgium
| | - Michael Karremann
- Department of Pediatric and Adolescent Medicine, University Medical Center Mannheim, Medical Faculty Mannheim, Heidelberg University , Mannheim , Germany
| | - Antonis Kattamis
- Division of Pediatric Hematology-Oncology, First Department of Pediatrics, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital , Athen , Greece
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University , Istanbul , Turkey
| | | | - Robert Kwiecien
- Institute of Biostatistics and Clinical Research, University of Muenster , Muenster , Germany
| | - Alan Mackay
- Division of Cancer Therapeutics and Department of Molecular Pathology, Institute of Cancer Research , London , United Kingdom
| | - Maura Massimino
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori , Milano , Italy
| | - Evelina Miele
- Department of Onco-haematology, Gene and Cell Therapy, Bambino Gesù Children's Hospital - IRCCS , Rome , Italy
| | - Angela Mastronuzzi
- Department of Onco-haematology, Gene and Cell Therapy, Bambino Gesù Children's Hospital - IRCCS , Rome , Italy
| | - Giovanni Morana
- Department of Radiology, Santa Maria di Ca' Foncello Hospital , Treviso , Italy
| | - Claudia M Noack
- Center of Radiology, Department of Diagnostic and Interventional Radiology and Neuroradiology, Hospital of Fulda , Fulda , Germany
| | - Virve Pentikainen
- Division of Hematology-Oncology and Stem Cell Transplantation, Children's Hospital, Helsinki University Hospital , Helsinki , Finland
| | - Thomas Perwein
- Division of Pediatric Hematology and Oncology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz , Graz , Austria
| | - Stefan M Pfister
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Neurooncology, German Cancer Research Center (DKFZ) and German Consortium for Translational Cancer Research (DKTK) , Heidelberg , Germany
| | - Torsten Pietsch
- Department of Neuropathology, DGNN Brain Tumor Reference Center, University of Bonn , Bonn , Germany
| | - Kleoniki Roka
- Division of Pediatric Hematology-Oncology, First Department of Pediatrics, National and Kapodistrian University of Athens, "Aghia Sophia" Children's Hospital , Athen , Greece
| | - Sabrina Rossi
- Pathology Unit-Department of Laboratories, Bambino Gesù Children's Hospital - IRCCS , Roma , Italy
| | - Stefan Rutkowski
- Departement of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Elisabetta Schiavello
- Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori , Milano , Italy
| | - Jaroslav Štěrba
- Department of Pediatric Oncology, University Hospital Brno and Faculty of Medicine, Masaryk University , Brno , Czech Republic
| | - Dominik Sturm
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - David Sumerauer
- Department of Pediatric Hematology and Oncology, Motol University Hospital, Charles University , Prague , Czech Republic
| | - Sara Temelso
- Division of Cancer Therapeutics and Department of Molecular Pathology, Institute of Cancer Research , London , United Kingdom
| | | | - Pascale Varlet
- Department of Neuropathology, GHU Paris - Sainte-Anne Hospital , Paris , France
| | | | - Maria Vinci
- Department of Onco-haematology, Gene and Cell Therapy, Bambino Gesù Children's Hospital - IRCCS , Rome , Italy
| | - André O von Bueren
- Department of Pediatrics, Obstetrics and Gynecology, Division of Pediatric Hematology and Oncology, University Hospital Geneva , Geneva , Switzerland
| | - Monika Warmuth-Metz
- Institute of Diagnostic and Interventional Neuroradiology, University of Wuerzburg , Wuerzburg , Germany
| | - Pieter Wesseling
- Princess Máxima Center for Pediatric Oncology , Utrecht , Netherlands
- Department of Pathology, Amsterdam UMC , Amsterdam , Netherlands
| | - Maria Wiese
- Division of Pediatric Hematology and Oncology, University Medical Center Goettingen , Goettingen , Germany
| | | | - Josef Zamecnik
- Department of Pathology and Molecular Medicine, 2nd Faculty of Medicine, Charles University in Prague and University Hospital Motol , Prague , Czech Republic
| | - David T W Jones
- Hopp Children's Cancer Center (KiTZ) , Heidelberg , Germany
- Division of Pediatric Glioma Research, German Cancer Research Center (DKFZ) , Heidelberg , Germany
| | - Brigitte Bison
- Institute of Diagnostic and Interventional Neuroradiology, University Hospital Augsburg , Augsburg , Germany
| | - Andrés Morales La Madrid
- Pediatric Neuro-Oncology, Department of Pediatric Oncology, Hospital Sant Joan de Deu , Barcelona , Spain
| | - Chris Jones
- Division of Cancer Therapeutics and Department of Molecular Pathology, Institute of Cancer Research , London , United Kingdom
| | - Christof M Kramm
- Division of Pediatric Hematology and Oncology, University Medical Center Goettingen , Goettingen , Germany
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Kebudi R, Akdeniz D, Bayramova J, Erciyas SK, Turkcan GK, Tuncer BS, Sukruoglu O, Celik B, Gultaslar BK, Buyukkapu SB, Tuncer S, Yazici H. RB1 gene mutations in Turkish retinoblastoma patients. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e22007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22007 Background: Retinoblastoma (RB) is the most common intraocular malignancy in children, caused by mutations in the tumor suppressor RB1 gene. Patients with bilateral/trilateral/familial RB are considered to have hereditary RB (1 germline, 1 somatic mutation); although most unilateral RB are nonhereditary (2 somatic mutations), some have germline RB1 mutation. Identification of RB1 mutations and genetic counseling is essential to assess the risk of developing RB in the patients´ relatives and to prevent the disease. The aim of this study is to assess the frequency/type of RB1 gene mutations in a large cohort of Turkish RB cases. Methods: RB1 gene mutation screening was performed in peripheral blood samples of 219 individuals (122 children with RB/14 family members with RB/83 healthy family members of 47 probands with RB1 mutations) followed in the Istanbul University, Oncology Institute. All 27 exons and close intronic regions of the RB1 gene were sequenced for small deletions and insertions using the Sanger sequencing (2013-2018) or Next Generation Sequencing (2019-2021); large deletions and duplications were investigated both by Multiplex Ligation Probe Amplification (MLPA) and copy number variation (CNV). Correlation with demographic and clinical data were evaluated. Results: After RB1 mutation screening, mutations were detected in 57 (41.9%) of 136 patients. RB1 mutations was observed in 23/84 (27.4%) patients with unilateral RB, in 30/47 (63.8%) bilateral RB, in 3/3 trilateral RB, and1/2 unilateral retinoma. Of these mutations, 45 (78.9%) were small genetic rearrangements and 12 (21.1%) large genetic rearrangements. Frameshift mutations were found in 11, nonsense in 18, splice error in 11, and missense mutation in 1, synonymous substitution in 2, upstream substitution in 2 patients. Ten novel mutations were found. Three of 83 healthy family members also had germline RB1 mutation. The disease was hereditary in 13 (22.8%); and de novo (77.2 %) in 44 of the 57 patients with mutations. Three siblings were found to have RB1 mutation, while their parents did not. Patients diagnosed as infants (RB1 mutation found in 63.2% of 70 infants vs in 36.8% of older ones, p:0.021); those with bilateral/trilateral RB (66 vs 27.4%, p:0.0001); those with light (green-blue) iris color vs dark color (71.4% vs 36.5%. p:0.003) had higher frequency of RB1 gene mutation. There was no significant correlation regarding gender or ICRB stage and RB1 mutation frequency. Conclusions: RB1 gene mutation was found in 41.9% of Turkish children with RB, in 63.8% of bilateral and 27.4% of unilateral RB. 10 novel mutations of the RB1 gene were found according to the Leiden Open Variation Database and the Human Gene Mutation Database.The mutation frequency was significantly higher in patients with bilateral/trilateral RB, in infants, in those with light iris color. In bilateral RB with no RB1 mutation, other genes/RB1 gene methylation and expression status may play a role in the pathogenesis.
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Affiliation(s)
- Rejin Kebudi
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Demet Akdeniz
- Istanbul University, Oncology Institute, Division of Cancer Genetics, Istanbul, Turkey
| | - Jamila Bayramova
- Istanbul University, Oncology Institute, Division of Cancer Genetics, Istanbul, Turkey
| | - Seda Kilic Erciyas
- Istanbul University, Oncology Institute, Division of Cancer Genetics, Istanbul, Turkey
| | - Gozde Kuru Turkcan
- Istanbul University, Oncology Institute, Division of Cancer Genetics, Istanbul, Turkey
| | - Bugra Seref Tuncer
- Istanbul University, Oncology Institute, Division of Cancer Genetics, Istanbul, Turkey
| | - Ozge Sukruoglu
- Istanbul University, Oncology Institute, Division of Cancer Genetics, Istanbul, Turkey
| | - Betul Celik
- Istanbul University, Oncology Institute, Division of Cancer Genetics, Istanbul, Turkey
| | - Busra Kurt Gultaslar
- Istanbul University, Oncology Institute, Division of Cancer Genetics, Istanbul, Turkey
| | - Sema Bay Buyukkapu
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Samuray Tuncer
- Istanbul Faculty of Medicine, Department of Ophthalmology, Ocular Oncology Service, Istanbul University, Istanbul, Turkey
| | - Hulya Yazici
- Istanbul University, Oncology Institute, Division of Cancer Genetics, Istanbul, Turkey
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22
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Kebudi R, Yıldırım UM, Iribas A, Tuncer S. Optic pathway gliomas in children: Demographic, clinical characteristics, and results of an adapted protocol. J Clin Oncol 2022. [DOI: 10.1200/jco.2022.40.16_suppl.e22016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22016 Background: Optic pathway gliomas (OPG) constitute 1-5% of childhood brain tumors. The presence of neurofibromatosis type 1 (NF-1) is generally associated with more indolent disease. The aim of this study is to evaluate patients with optic pathway gliomas diagnosed/treated/ followed in a single center over 32 years. Methods: The medical files of 85 patients with OPG diagnosed/treated between 1990-2021 in the Istanbul University, Oncology Institute were retrospectively assessed for demographic, clinical characteristics, treatment and outcome. Results: The median age of the 85 patients (42 male, 43 female) was 60 (1-216) months, 53 (62.4%) had NF-1. Seven had diencephalic syndrome (8.2%). According to Dodge classification, 23 (27.1%) had Dodge 1, 30 (35.3%) Dodge 2 and 32 (37.6%) Dodge 3 disease. Median follow up time was 10.5 years (1-31 years). Twenty (23.5%) patients had stable disease and were followed without treatment, 14 patients underwent surgery (5 gross total tumor resection, 2 subtotal resection, 3 ventriculoperitoneal shunt operation, 4 excision/biopsy). 7 patients recieved radiotherapy (RT), none had NF1. 56 patients received chemotherapy (CT) due to severe/progressive clinical symptoms (such as diencephalic syndrome, visual impairment, nystagmus) or radiologic progressive disease. Chemotherapy consisted of an adapted SIOP-LGG regimen: vincristine (VCR) 1.5 mg/m²/dose and carboplatinum 550 mg/m²/dose every 21 days for three courses with weekly VCR, followed by VCR and carboplatinum every 28 days for a total of 12 cycles (3 cycles induction, 9 cycles consolidation). Vinblastin or cisplatinum with etoposide were used for second line or further treatment in progressive disease. One of the seven patients who had diencephalic syndrome and two of the 3 patients with leptomeningeal metastasis died. Ocular findings were recorded in 47 patients: vision was stable in 30 (63.8%), improved in 15 (31.9%), detoriated in 2 (4.3%). Radiology (MRI) revealed stable disease/regression of tumor in 41 patients, and complete regression of spinal metastasis in 1 patient. Endocrinologic follow-up was done and 13(15.2%) recieved hormonal treatment. Ten year overall survival(S) in all patients, in patients with NF1 and without NF1 were 96.5%, 96.1% and 95%, respectively; 10 year event free survival (EFS) in all patients, in patients with NF1 and without NF1 were 80.6%, 90.5% and 60% (p:0.001) respectively. Conclusions: OPG may remain indolent for many years after diagnosis, especially in patients with NF 1. However, these tumors develop progressive characteristics and can cause visual disturbances, endocrine dysfunction, blindness and even death among some of the patients. In young children who are symptomatic/have progressive disease, chemotherapy with an adapted regimen consisting of vincristine and carboplatinum seems to be effective and provides a relatively good quality of life.
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Affiliation(s)
- Rejin Kebudi
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Ulku Miray Yıldırım
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Ayca Iribas
- Istanbul University Institute of Oncology, Radiation Oncology, Istanbul, Turkey
| | - Samuray Tuncer
- Istanbul Faculty of Medicine, Department of Ophthalmology, Ocular Oncology Service, Istanbul University, Istanbul, Turkey
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Silbermann M, Calimag MM, Eisenberg E, Futerman B, Fernandez-Ortega P, Oliver A, Monje JPY, Guo P, Charalambous H, Nestoros S, Pozo X, Bhattacharyya G, Katz GJ, Tralongo P, Fujisawa D, Kunirova G, Punjwani R, Ayyash H, Ghrayeb I, Manasrah N, Bautista MJS, Kotinska-Lemieszek A, de Simone G, Cerutti J, Gafer N, Can G, Terzioglu F, Kebudi R, Tuncel-Oguz G, Aydin A, Şenel GO, Mwaka AD, Youssef A, Brant J, Alvarez GP, Weru J, Rudilla D, Fahmi R, Hablas M, Rassouli M, Mula-Hussain L, Faraj S, Al-Hadad S, Al-Jadiry M, Ghali H, Fadhil SA, Abu-Sharour L, Omran S, Al-Qadire M, Hassan A, Khader K, Alalfi N, Ahmed G, Galiana L, Sansó N, Abe A, Vidal-Blanco G, Rochina A. Evaluating Pain Management Practices for Cancer Patients among Health Professionals: A Global Survey. J Palliat Med 2022; 25:1243-1248. [PMID: 35442772 DOI: 10.1089/jpm.2021.0596] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Background: Cancer incidence in the world is predicted to increase in the next decade. While progress has been in diagnosis and treatment, much still remains to be done to improve cancer pain therapy, mainly in underserved communities in low-income countries. Objective: To determine knowledge, beliefs, and barriers regarding pain management in both high- and low-income countries (according to the WHO classification); and to learn about ways to improve the current state of affairs. Design: Descriptive survey. Setting/Subjects: Fifty-six countries worldwide; convenience sample of 1639 consisted of 36.8% physicians; 45.1% nurses, and 4.5% pharmacists employed in varied settings. Results: Improved pain management services are key elements. Top barriers include religion factors, lack of appropriate education and training at all levels, nonadherence to guidelines, patients' reluctance to report on pains, over regulation associated with prescribing and access to opioid analgesics, fear of addiction to opioids, and lack of discussions around prognosis and treatment planning. Conclusion: The majority of patients with cancer in low-income countries are undertreated for their pain. Promoting cancer pain accredited program of training and education on pain management for physicians and nurses is crucial, as well as advocating policymakers and the public at large.
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Affiliation(s)
| | | | - Elon Eisenberg
- Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Boris Futerman
- Bruce and Ruth Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | | | - Amparo Oliver
- Catedrática de Metodología de las CC del Comportamiento, University of Valencia, Valencia, Spain
| | | | - Ping Guo
- Cecily Saunders Institute of Pediatric Care, King's College, London, United Kingdom
| | - Haris Charalambous
- Department of Medical Oncology, Bank of Cyprus Oncology Center, Nicosia, Cyprus
| | | | - Ximena Pozo
- Pontifical Catholic University of Ecuador, Faculty of Medicine, Quito, Ecuador
| | - Gouri Bhattacharyya
- Department of Medical Oncology, Chittaranjan National Cancer Institute, Kolkata, India
| | - Glynis J Katz
- Department of Information and Control, Sabar Health, Haifa, Israel
| | - Paolo Tralongo
- Department of Medical Oncology, Umberto I Hospital-RAO, Siracuse, Sicily, Italy
| | - Daisuke Fujisawa
- Department of Neuropsychiatry and Palliative Care, Keio University School of Medicine, Tokyo, Japan
| | | | - Rehana Punjwani
- Indus Research Centre, Indus Hospital and Health Network, Karachi, Pakistan
| | - Hani Ayyash
- Department of Clinical Hemato-Oncology, European Gaza Hospital, Khan Yunis, Gaza, Palestine
| | - Ibtisam Ghrayeb
- Intensive Care Unit, Makassed Islamic Charitable Hospital, East Jerusalem
| | - Nemeh Manasrah
- Faculty of Nursing, Hebron University, Hebron, West Bank, Palestinian Authority
| | | | | | - Gustavo de Simone
- Department of Palliative Care, Bonorino Udaondo Public Hospital, Buenos Aires, Argentina
| | - Julie Cerutti
- Department of Pediatric Oncology, Child Cancer Institute, Porto Alegre, Brazil
| | - Nahla Gafer
- Department of Palliative Care, Radiation and Isotope Center, Khartoum, Sudan
| | - Gulbeyaz Can
- Florence Nightingale Faculty of Nursing, Istanbul University, Cerrahpasa, Istanbul
| | - Fusun Terzioglu
- Faculty of Health Science, Kocaeli University of Health Sciences, Turkey
| | - Rejin Kebudi
- Cerrahpasa Medical Faculty, Istanbul University Oncology Institute, Istanbul, Turkey
| | - Gonca Tuncel-Oguz
- Dr. AY Ankara Oncology Education and Research Hospital, Ankara, Turkey
| | - Ayfer Aydin
- Faculty of Nursing, Koç University, Istanbul, Turkey
| | | | | | - Alexey Youssef
- Queens College, University of Oxford, Oxford, United Kingdom
| | - Jeannine Brant
- Billings Clinic Collaborative Science and Innovation, Billings, Montana, USA
| | | | - John Weru
- Department of Palliative Medicine, Aga Khan University Hospital, Nairobi, Kenya
| | - David Rudilla
- Department of Clinical Psychology, La Princesa University Hospital, Madrid, Spain
| | - Rasha Fahmi
- Department of Clinical Oncology, El-Salam Oncology Center Cairo, Cairo, Egypt
| | - Mohamed Hablas
- Saudi German Hospital Cairo, Gharbiah Cancer Society, Tanta, Egypt
| | - Maryam Rassouli
- Cancer Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Layth Mula-Hussain
- Sultan Qaboos Comprehensive Cancer Care and Research Center, Muscat, Oman and the University of Sulaimani, Sulaimani, Kurdistan, Iraq
| | - Safa Faraj
- Department of Pediatric Oncology, Children Welfare Teaching Hospital, Medical City, Baghdad, Iraq
| | - Salma Al-Hadad
- Department of Pediatric Oncology, Children Welfare Teaching Hospital, Medical City, Baghdad, Iraq
| | - Mazin Al-Jadiry
- Department of Pediatric Oncology, Children Welfare Teaching Hospital, Medical City, Baghdad, Iraq
| | - Hasanein Ghali
- Department of Pediatric Oncology, Children Welfare Teaching Hospital, Medical City, Baghdad, Iraq
| | - Samaher A Fadhil
- Department of Pediatric Oncology, Children Welfare Teaching Hospital, Medical City, Baghdad, Iraq
| | | | - Suha Omran
- Department of Adult Health, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad Al-Qadire
- Al-Bayt University, Mafraq, The Hashemite Kingdom of Jordan and Sultan Qaboos University, Muscat, Sultanate of Oman
| | - Azza Hassan
- Department of Palliative Medicine, National Center for Cancer Care and Research, Doha, Qatar
| | - Khaled Khader
- Department of Nursing and Midwifery, Taif University, Taif, Saudi Arabia
| | | | - Gamila Ahmed
- Department of Psycho-Oncology, National Cancer Center, Aden, Yemen
| | - Laura Galiana
- Catedrática de Metodología de las CC del Comportamiento, University of Valencia, Valencia, Spain
| | - Noemi Sansó
- Department of Sociology, Gender, and Health, University of the Balearic Islands, Palmade Mallorca, Spain
| | - Akiko Abe
- Department of Neuropsychiatry and Palliative Care, Keio University School of Medicine, Tokyo, Japan
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Dundar M, Fahrioglu U, Yildiz SH, Bakir-Gungor B, Temel SG, Akin H, Artan S, Cora T, Sahin FI, Dursun A, Sezer O, Gurkan H, Erdogan M, Gunduz CNS, Bisgin A, Ozdemir O, Ulgenalp A, Percin EF, Yildirim ME, Tekes S, Bagis H, Yuce H, Duman N, Bozkurt G, Yararbas K, Yildirim MS, Arman A, Mihci E, Eraslan S, Altintas ZM, Aymelek HS, Ruhi HI, Tatar A, Ergoren MC, Cetin GO, Altunoglu U, Caglayan AO, Yuksel B, Ozkul Y, Saatci C, Kenanoglu S, Karasu N, Dundar B, Ozcelik F, Demir M, Siniksaran BS, Kulak H, Kiranatlioglu K, Baysal K, Kazimli U, Akalin H, Dundar A, Boz M, Bayram A, Subasioglu A, Colak FK, Karaduman N, Gunes MC, Kandemir N, Aynekin B, Emekli R, Sahin IO, Ozdemir SY, Onal MG, Senel AS, Poyrazoglu MH, Kisaarslan ANP, Gursoy S, Baskol M, Calis M, Demir H, Zararsiz GE, Erdogan MO, Elmas M, Solak M, Ulu MS, Thahir A, Aydin Z, Atasever U, Sag SO, Aliyeva L, Alemdar A, Dogan B, Erguzeloglu CO, Kaya N, Ozkinay F, Cogulu O, Durmaz A, Onay H, Karaca E, Durmaz B, Aykut A, Cilingir O, Aras BD, Gokalp EE, Arslan S, Temena A, Haziyeva K, Kocagil S, Bas H, Susam E, Keklikci AR, Sarac E, Kocak N, Nergiz S, Terzi YK, Dincer SA, Baskin ES, Genc GC, Bahadir O, Sanri A, Yigit S, Tozkir H, Yalcintepe S, Ozkayin N, Kiraz A, Balta B, Gonen GA, Kurt EE, Ceylan GG, Ceylan AC, Erten S, Bozdogan ST, Boga I, Yilmaz M, Silan F, Kocabey M, Koc A, Cankaya T, Bora E, Bozkaya OG, Ercal D, Ergun MA, Ergun SG, Duman YS, Beyazit SB, Uzel VH, Em S, Cevik MO, Eroz R, Demirtas M, Firat CK, Kabayegit ZM, Altan M, Mardan L, Sayar C, Tumer S, Turkgenc B, Karakoyun HK, Tunc B, Kuru S, Zamani A, Geckinli BB, Ates EA, Clark OA, Toylu A, Coskun M, Nur B, Bilge I, Bayramicli OU, Emmungil H, Komesli Z, Zeybel M, Gurakan F, Tasdemir M, Kebudi R, Karabulut HG, Tuncali T, Kutlay NY, Kahraman CY, Onder NB, Beyitler I, Kavukcu S, Tulay P, Tosun O, Tuncel G, Mocan G, Kale H, Uyguner ZO, Acar A, Altinay M, Erdem L. Clinical and molecular evaluation of MEFV gene variants in the Turkish population: a study by the National Genetics Consortium. Funct Integr Genomics 2022; 22:291-315. [PMID: 35098403 DOI: 10.1007/s10142-021-00819-3] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2021] [Revised: 10/22/2021] [Accepted: 10/25/2021] [Indexed: 02/08/2023]
Abstract
Familial Mediterranean fever (FMF) is a monogenic autoinflammatory disorder with recurrent fever, abdominal pain, serositis, articular manifestations, erysipelas-like erythema, and renal complications as its main features. Caused by the mutations in the MEditerranean FeVer (MEFV) gene, it mainly affects people of Mediterranean descent with a higher incidence in the Turkish, Jewish, Arabic, and Armenian populations. As our understanding of FMF improves, it becomes clearer that we are facing with a more complex picture of FMF with respect to its pathogenesis, penetrance, variant type (gain-of-function vs. loss-of-function), and inheritance. In this study, MEFV gene analysis results and clinical findings of 27,504 patients from 35 universities and institutions in Turkey and Northern Cyprus are combined in an effort to provide a better insight into the genotype-phenotype correlation and how a specific variant contributes to certain clinical findings in FMF patients. Our results may help better understand this complex disease and how the genotype may sometimes contribute to phenotype. Unlike many studies in the literature, our study investigated a broader symptomatic spectrum and the relationship between the genotype and phenotype data. In this sense, we aimed to guide all clinicians and academicians who work in this field to better establish a comprehensive data set for the patients. One of the biggest messages of our study is that lack of uniformity in some clinical and demographic data of participants may become an obstacle in approaching FMF patients and understanding this complex disease.
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Affiliation(s)
- Munis Dundar
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.
| | - Umut Fahrioglu
- Department of Medical Biology, Faculty of Medicine, Near East University, 99138, Nicosia, Cyprus. .,DESAM Institute, Near East University, 99138, Nicosia, Cyprus. .,Genetics and Cancer Diagnosis-Research Centre, Centre of Excellence, Near East University, 99138, Nicosia, Cyprus.
| | - Saliha Handan Yildiz
- Department of Medical Genetics, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey
| | - Burcu Bakir-Gungor
- Department of Computer Engineering, Faculty of Engineering and Natural Sciences, Abdullah Gul University, Kayseri, 38080, Turkey
| | - Sehime Gulsun Temel
- Department of Medical Genetics, Faculty of Medicine, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey.,Department of Histology and Embryology, Faculty of Medicine, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey.,Department of Translational Medicine, Health Sciences Institute, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey
| | - Haluk Akin
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, 35100, Turkey
| | - Sevilhan Artan
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Tulin Cora
- Department of Medical Biology and Genetics, Faculty of Medicine, Selcuk University, Konya, 42131, Turkey
| | - Feride Iffet Sahin
- Department of Medical Genetics, Faculty of Medicine, Baskent University, Ankara, 06490, Turkey
| | - Ahmet Dursun
- Department of Medical Genetics, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, 67600, Turkey
| | - Ozlem Sezer
- Department of Medical Genetics, Samsun Education and Research Hospital, Samsun, 55090, Turkey
| | - Hakan Gurkan
- Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, 22130, Turkey
| | - Murat Erdogan
- Division of Medical Genetics, Kayseri City Education and Research Hospital, Kayseri, 38080, Turkey
| | - C Nur Semerci Gunduz
- Department of Medical Genetics, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, 06800, Turkey.,Ataturk Training and Research Hospital, Genetic Diseases Diagnosis Center, Ankara, 06230, Turkey
| | - Atil Bisgin
- Department of Medical Genetics, Faculty of Medicine, Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center and Medical Genetics), Adana, 01790, Turkey
| | - Ozturk Ozdemir
- Department of Medical Genetics, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, 17100, Turkey
| | - Ayfer Ulgenalp
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey.,Department of Pediatric Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey
| | - E Ferda Percin
- Department of Medical Genetics, Faculty of Medicine, Gazi University, Besevler Ankara, 06560, Turkey
| | - Malik Ejder Yildirim
- Department of Medical Genetics, Faculty of Medicine, Cumhuriyet University, Sivas, 58140, Turkey
| | - Selahaddin Tekes
- Department of Medical Genetics, Faculty of Medicine, Dicle University, Diyarbakir, 21280, Turkey
| | - Haydar Bagis
- Department of Medical Genetics, Faculty of Medicine, Adiyaman University, Adiyaman, 02040, Turkey
| | - Huseyin Yuce
- Department of Medical Genetics, Faculty of Medicine, Duzce University, Duzce, 81620, Turkey
| | - Nilgun Duman
- Department of Medical Genetics, Faculty of Medicine, Dragos Hospital, Bezmi Alem Vakif University, Istanbul, 34844, Turkey
| | - Gokay Bozkurt
- Department of Medical Genetics, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, 09010, Turkey
| | - Kanay Yararbas
- Acibadem Labgen Genetic Diagnosis Center, Acibadem University, Istanbul, 34755, Turkey
| | - Mahmut Selman Yildirim
- Department of Medical Genetics, Meram Medical Faculty, Necmettin Erbakan University, Konya, 42080, Turkey
| | - Ahmet Arman
- Department of Medical Genetics, Faculty of Medicine, Marmara University, Istanbul, 34854, Turkey
| | - Ercan Mihci
- Department of Medical Genetics, Faculty of Medicine, Akdeniz University, Antalya, 07070, Turkey.,Department of Pediatric Genetics, Faculty of Medicine, Akdeniz University, Antalya, 07070, Turkey
| | - Serpil Eraslan
- Diagnostic Center for Genetic Diseases, Koc University Hospital, Koc University, Istanbul, 34010, Turkey
| | - Zuhal Mert Altintas
- Department of Medical Genetics, Faculty of Medicine, Mersin University, Mersin, 33343, Turkey
| | - Huri Sema Aymelek
- Department of Medical Genetics, Faculty of Medicine, Van Yuzuncu Yil University, Van, 65080, Turkey.,Division of Medical Genetics, Bursa City Hospital, Bursa, 16110, Turkey
| | - Hatice Ilgin Ruhi
- Department of Medical Genetics, Faculty of Medicine, Ankara University, Ankara, 06590, Turkey
| | - Abdulgani Tatar
- Department of Medical Genetics, Faculty of Medicine, Ataturk University, Erzurum, 25240, Turkey
| | - Mahmut Cerkez Ergoren
- DESAM Institute, Near East University, 99138, Nicosia, Cyprus.,Department of Medical Genetics, Faculty of Medicine, Near East University, 99138, Nicosia, Cyprus
| | - G Ozan Cetin
- Department of Medical Genetics, Faculty of Medicine, Pamukkale University, Denizli, 20070, Turkey
| | - Umut Altunoglu
- Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Istanbul, 34093, Turkey.,Department of Medical Genetics, Faculty of Medicine (KUSOM), Koc University, Istanbul, 34010, Turkey
| | - Ahmet Okay Caglayan
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey.,Department of Medical Genetics, Faculty of Medicine, Istanbul Bilim University, Istanbul, 34394, Turkey
| | - Berrin Yuksel
- Department of Medical Genetics, Faculty of Medicine, Usak University, Usak, 64050, Turkey
| | - Yusuf Ozkul
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Cetin Saatci
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Sercan Kenanoglu
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Nilgun Karasu
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Bilge Dundar
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Firat Ozcelik
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Mikail Demir
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Medical Genetics, Faculty of Medicine, Van Yuzuncu Yil University, Van, 65080, Turkey
| | - Betul Seyhan Siniksaran
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Hande Kulak
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Medical Genetics, Faculty of Medicine, Van Yuzuncu Yil University, Van, 65080, Turkey
| | - Kubra Kiranatlioglu
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Kubra Baysal
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Ulviyya Kazimli
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Hilal Akalin
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Ayca Dundar
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Mehmet Boz
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Arslan Bayram
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Medical Genetics, Etlik Zubeyde Hanim Women's Diseases Education and Research Hospital, Ankara, 06050, Turkey
| | - Asli Subasioglu
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Medical Genetics, Faculty of Medicine, Izmir Katip Celebi University, Izmir, 35620, Turkey
| | - Fatma Kurt Colak
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Medical Genetics, Faculty of Medicine, Kahramanmaras Sutcu Imam University, Kahramanmaras, 46040, Turkey
| | - Neslihan Karaduman
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Division of Medical Genetics, Kirikkale High Specialization Hospital, Kirikkale, 71300, Turkey
| | - Meltem Cerrah Gunes
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Medical Genetics, Faculty of Medicine, Kocaeli University, Kocaeli, 41001, Turkey
| | - Nefise Kandemir
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Medical Genetics, Diskapi Yildirim Beyazit Training and Research Hospital, Ankara, 06110, Turkey
| | - Busra Aynekin
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Rabia Emekli
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Izem Olcay Sahin
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Sevda Yesim Ozdemir
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Medical Genetics, Faculty of Medicine, Uskudar University, Istanbul, 34662, Turkey
| | - Muge Gulcihan Onal
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | | | - Muammer Hakan Poyrazoglu
- Department of Pediatrics, Division of Nephrology, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Ayse Nur Pac Kisaarslan
- Department of Child Health and Diseases, Division of Pediatric Rheumatology, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Sebnem Gursoy
- Department of Gastroenterology, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Mevlut Baskol
- Department of Gastroenterology, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Mustafa Calis
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Huseyin Demir
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Gozde Erturk Zararsiz
- Department of Biostatistics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey
| | - Mujgan Ozdemir Erdogan
- Department of Medical Genetics, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey
| | - Muhsin Elmas
- Department of Medical Genetics, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey
| | - Mustafa Solak
- Department of Medical Genetics, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey
| | - Memnune Sena Ulu
- Department of Internal Medicine, Faculty of Medicine, Afyonkarahisar Health Sciences University, Afyonkarahisar, 03030, Turkey
| | - Adam Thahir
- Department of Computer Engineering, Faculty of Engineering and Natural Sciences, Abdullah Gul University, Kayseri, 38080, Turkey
| | - Zafer Aydin
- Department of Computer Engineering, Faculty of Engineering and Natural Sciences, Abdullah Gul University, Kayseri, 38080, Turkey
| | - Umut Atasever
- Department of Computer Engineering, Faculty of Engineering and Natural Sciences, Abdullah Gul University, Kayseri, 38080, Turkey
| | - Sebnem Ozemri Sag
- Department of Medical Genetics, Faculty of Medicine, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey
| | - Lamiya Aliyeva
- Department of Medical Genetics, Faculty of Medicine, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey
| | - Adem Alemdar
- Department of Translational Medicine, Health Sciences Institute, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey
| | - Berkcan Dogan
- Department of Medical Genetics, Faculty of Medicine, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey.,Department of Translational Medicine, Health Sciences Institute, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey
| | - Cemre Ornek Erguzeloglu
- Department of Translational Medicine, Health Sciences Institute, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey
| | - Niyazi Kaya
- Department of Medical Genetics, Faculty of Medicine, Bursa Uludag University, Gorukle, Bursa, 16059, Turkey
| | - Ferda Ozkinay
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, 35100, Turkey.,Department of Pediatrics and Health, Genetics and Teratology, Faculty of Medicine, Ege University, Izmir, 35100, Turkey
| | - Ozgur Cogulu
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, 35100, Turkey.,Department of Pediatrics and Health, Genetics and Teratology, Faculty of Medicine, Ege University, Izmir, 35100, Turkey
| | - Asude Durmaz
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, 35100, Turkey
| | - Huseyin Onay
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, 35100, Turkey
| | - Emin Karaca
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, 35100, Turkey
| | - Burak Durmaz
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, 35100, Turkey
| | - Ayca Aykut
- Department of Medical Genetics, Faculty of Medicine, Ege University, Izmir, 35100, Turkey
| | - Oguz Cilingir
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Beyhan Durak Aras
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Ebru Erzurumluoglu Gokalp
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Serap Arslan
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Arda Temena
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Konul Haziyeva
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Sinem Kocagil
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Hasan Bas
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Ezgi Susam
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Ali Riza Keklikci
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Elif Sarac
- Department of Medical Genetics, Faculty of Medicine, Eskisehir Osmangazi University, Eskisehir, 26040, Turkey
| | - Nadir Kocak
- Department of Medical Biology and Genetics, Faculty of Medicine, Selcuk University, Konya, 42131, Turkey
| | - Suleyman Nergiz
- Department of Medical Biology and Genetics, Faculty of Medicine, Selcuk University, Konya, 42131, Turkey
| | - Yunus Kasim Terzi
- Department of Medical Genetics, Faculty of Medicine, Baskent University, Ankara, 06490, Turkey
| | - Selin Akad Dincer
- Department of Medical Genetics, Faculty of Medicine, Baskent University, Ankara, 06490, Turkey
| | - Esra Sidika Baskin
- Department of Pediatric Nephrology, Faculty of Medicine, Baskent University, Ankara, 06490, Turkey
| | - Gunes Cakmak Genc
- Department of Medical Genetics, Faculty of Medicine, Zonguldak Bulent Ecevit University, Zonguldak, 67600, Turkey
| | - Oguzhan Bahadir
- Department of Medical Genetics, Faculty of Medicine, Erciyes University, Kayseri, 38039, Turkey.,Department of Medical Genetics, Samsun Education and Research Hospital, Samsun, 55090, Turkey
| | - Aslihan Sanri
- Department of Medical Genetics, Samsun Education and Research Hospital, Samsun, 55090, Turkey
| | - Serbulent Yigit
- Department of Genetics, Faculty of Veterinary, Ondokuz Mayis University, Samsun, 55270, Turkey.,Department of Medical Biology, Faculty of Medicine, Gaziosmanpasa University, Tokat, 60030, Turkey
| | - Hilmi Tozkir
- Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, 22130, Turkey
| | - Sinem Yalcintepe
- Department of Medical Genetics, Faculty of Medicine, Trakya University, Edirne, 22130, Turkey
| | - Nese Ozkayin
- Department of Pediatrics, Division of Nephrology, Faculty of Medicine, Trakya University, Edirne, 22130, Turkey
| | - Aslihan Kiraz
- Division of Medical Genetics, Kayseri City Education and Research Hospital, Kayseri, 38080, Turkey
| | - Burhan Balta
- Division of Medical Genetics, Kayseri City Education and Research Hospital, Kayseri, 38080, Turkey
| | - Gizem Akinci Gonen
- Division of Medical Genetics, Kayseri City Education and Research Hospital, Kayseri, 38080, Turkey
| | - E Emre Kurt
- Department of Medical Genetics, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, 06800, Turkey.,Ataturk Training and Research Hospital, Genetic Diseases Diagnosis Center, Ankara, 06230, Turkey
| | - Gulay Gulec Ceylan
- Department of Medical Genetics, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, 06800, Turkey.,Ataturk Training and Research Hospital, Genetic Diseases Diagnosis Center, Ankara, 06230, Turkey
| | - Ahmet Cevdet Ceylan
- Department of Medical Genetics, Faculty of Medicine, Ankara Yildirim Beyazit University, Ankara, 06800, Turkey.,Ataturk Training and Research Hospital, Genetic Diseases Diagnosis Center, Ankara, 06230, Turkey
| | - Sukran Erten
- Department of Rheumatology, Ataturk Training Research Hospital, Ankara Yildirim Beyazit University, Ankara, 06230, Turkey
| | - Sevcan Tug Bozdogan
- Department of Medical Genetics, Faculty of Medicine, Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center and Medical Genetics), Adana, 01790, Turkey
| | - Ibrahim Boga
- Department of Medical Genetics, Faculty of Medicine, Cukurova University AGENTEM (Adana Genetic Diseases Diagnosis and Treatment Center and Medical Genetics), Adana, 01790, Turkey
| | - Mustafa Yilmaz
- Division of Pediatric Rheumatology, Faculty of Medicine, Cukurova University, Adana, 01790, Turkey
| | - Fatma Silan
- Department of Medical Genetics, Faculty of Medicine, Canakkale Onsekiz Mart University, Canakkale, 17100, Turkey
| | - Mehmet Kocabey
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey
| | - Altug Koc
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey
| | - Tufan Cankaya
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey
| | - Elcin Bora
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey
| | - Ozlem Giray Bozkaya
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey.,Department of Pediatric Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey
| | - Derya Ercal
- Department of Medical Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey.,Department of Pediatric Genetics, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey
| | - Mehmet Ali Ergun
- Department of Medical Genetics, Faculty of Medicine, Gazi University, Besevler Ankara, 06560, Turkey
| | - Sezen Guntekin Ergun
- Department of Medical Genetics, Faculty of Medicine, Gazi University, Besevler Ankara, 06560, Turkey.,Department of Medical Biology, Faculty of Medicine, Hacettepe University, Ankara, 06100, Turkey
| | - Yesim Sidar Duman
- Department of Medical Genetics, Faculty of Medicine, Cumhuriyet University, Sivas, 58140, Turkey
| | - Serife Busra Beyazit
- Department of Medical Genetics, Faculty of Medicine, Cumhuriyet University, Sivas, 58140, Turkey
| | - Veysiye Hulya Uzel
- Department of Pediatric Hematology, Faculty of Medicine, Dicle University, Diyarbakir, 21280, Turkey
| | - Serda Em
- Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Dicle University, Diyarbakir, 21280, Turkey
| | - Muhammer Ozgur Cevik
- Department of Medical Genetics, Faculty of Medicine, Adiyaman University, Adiyaman, 02040, Turkey
| | - Recep Eroz
- Department of Medical Genetics, Faculty of Medicine, Duzce University, Duzce, 81620, Turkey
| | - Mercan Demirtas
- Department of Medical Genetics, Faculty of Medicine, Dragos Hospital, Bezmi Alem Vakif University, Istanbul, 34844, Turkey
| | - Cem Koray Firat
- Department of Child Health and Diseases, Faculty of Medicine, Dragos Hospital, Bezmi Alem Vakif University, Istanbul, 34844, Turkey
| | - Zehra Manav Kabayegit
- Department of Medical Genetics, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, 09010, Turkey
| | - Mustafa Altan
- Department of Medical Genetics, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, 09010, Turkey
| | - Lamiya Mardan
- Department of Medical Genetics, Faculty of Medicine, Aydin Adnan Menderes University, Aydin, 09010, Turkey
| | - Ceyhan Sayar
- Acibadem Labgen Genetic Diagnosis Center, Acibadem University, Istanbul, 34755, Turkey
| | - Sait Tumer
- Acibadem Labgen Genetic Diagnosis Center, Acibadem University, Istanbul, 34755, Turkey
| | - Burcu Turkgenc
- Acibadem Labgen Genetic Diagnosis Center, Acibadem University, Istanbul, 34755, Turkey
| | | | - Betul Tunc
- Acibadem Labgen Genetic Diagnosis Center, Acibadem University, Istanbul, 34755, Turkey
| | - Seda Kuru
- Acibadem Labgen Genetic Diagnosis Center, Acibadem University, Istanbul, 34755, Turkey
| | - Aysegul Zamani
- Department of Medical Genetics, Meram Medical Faculty, Necmettin Erbakan University, Konya, 42080, Turkey
| | - Bilgen Bilge Geckinli
- Department of Medical Genetics, Faculty of Medicine, Marmara University, Istanbul, 34854, Turkey
| | - Esra Arslan Ates
- Department of Medical Genetics, Marmara Teaching and Research Hospital, Marmara University, Istanbul, 34899, Turkey
| | - Ozden Altiok Clark
- Department of Medical Genetics, Faculty of Medicine, Akdeniz University, Antalya, 07070, Turkey
| | - Asli Toylu
- Department of Medical Genetics, Faculty of Medicine, Akdeniz University, Antalya, 07070, Turkey
| | - Mert Coskun
- Department of Medical Genetics, Faculty of Medicine, Akdeniz University, Antalya, 07070, Turkey
| | - Banu Nur
- Department of Pediatric Genetics, Faculty of Medicine, Akdeniz University, Antalya, 07070, Turkey
| | - Ilmay Bilge
- Department of Pediatric Nephrology, Koc University Hospital, Istanbul, 34010, Turkey
| | - Oya Uygur Bayramicli
- Department of Gastroenterology and Hepatology, Med American Ambulatory Care Center, Istanbul, 34724, Turkey
| | - Hakan Emmungil
- Department of Rheumatology, Faculty of Medicine, Trakya University, Edirne, 22100, Turkey
| | - Zeynep Komesli
- Department of Internal Medicine, Koc University Hospital, Istanbul, 34010, Turkey
| | - Mujdat Zeybel
- Department of Gastroenterology and Hepatology, Faculty of Medicine, Koc University, Istanbul, 34010, Turkey
| | - Figen Gurakan
- Department of Pediatrics, VKV American Hospital, Istanbul, 34365, Turkey
| | - Mehmet Tasdemir
- Division of Pediatric Nephrology, Department of Pediatrics, Faculty of Medicine, Koc University, Istanbul, 34010, Turkey
| | - Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, 34093, Turkey
| | - Halil Gurhan Karabulut
- Department of Medical Genetics, Faculty of Medicine, Ankara University, Ankara, 06590, Turkey
| | - Timur Tuncali
- Department of Medical Genetics, Faculty of Medicine, Ankara University, Ankara, 06590, Turkey
| | - Nuket Yurur Kutlay
- Department of Medical Genetics, Faculty of Medicine, Ankara University, Ankara, 06590, Turkey
| | - Cigdem Yuce Kahraman
- Department of Medical Genetics, Faculty of Medicine, Ataturk University, Erzurum, 25240, Turkey
| | - Nerin Bahceciler Onder
- Department of Pediatrics, Faculty of Medicine, Near East University, 99138, Nicosia, Cyprus
| | - Ilke Beyitler
- Department of Pediatrics, Faculty of Medicine, Near East University, 99138, Nicosia, Cyprus
| | - Salih Kavukcu
- Department of Pediatric Nephrology, Faculty of Medicine, Dokuz Eylul University, Izmir, 35340, Turkey
| | - Pinar Tulay
- DESAM Institute, Near East University, 99138, Nicosia, Cyprus.,Department of Medical Genetics, Faculty of Medicine, Near East University, 99138, Nicosia, Cyprus
| | - Ozgur Tosun
- Department of Biostatistics, Faculty of Medicine, Near East University, 99138, Nicosia, Cyprus
| | - Gulten Tuncel
- DESAM Institute, Near East University, 99138, Nicosia, Cyprus
| | - Gamze Mocan
- Department of Pathology, Faculty of Medicine, Near East University, 99138, Nicosia, Cyprus
| | - Hamdi Kale
- Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Istanbul, 34093, Turkey
| | - Zehra Oya Uyguner
- Department of Medical Genetics, Istanbul Medical Faculty, Istanbul University, Istanbul, 34093, Turkey
| | - Aynur Acar
- Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Demiroglu Bilim University, Sisli, Istanbul, 34394, Turkey
| | - Mert Altinay
- Department of Molecular Biology and Genetics, Faculty of Arts and Sciences, Demiroglu Bilim University, Sisli, Istanbul, 34394, Turkey
| | - Levent Erdem
- Department of Internal Medicine, Faculty of Medicine, Demiroglu Bilim University, Sisli, Istanbul, 34394, Turkey
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Görgün Ö, Koç B, Kebudi R, Wolff JE, Kebudi A, Darendeliler E. Clinical characteristics, late effects and outcomes in pineoblastomas in children: a single center experience. Turk J Pediatr 2022; 63:955-961. [PMID: 35023643 DOI: 10.24953/turkjped.2021.06.002] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Pineoblastomas (PB) are rare tumors of the central nervous system and are more common in children. There is no consensus about standard of care. The objective of this study is to analyze the outcome of children with PB. METHODS Six patients with PB who were diagnosed between 1990-2012 were evaluated retrospectively. Demographics, age of diagnosis, first complaint, tumor region, diagnosis type, seeding metastasis to the spinal axis or cerebrospinal fluid (CSF), treatment and survival of these patients were recorded. RESULTS Three patients had subtotal resection and all patients received chemotherapy and craniospinal irradiation (CSI) after diagnosis. Median follow-up after treatment was 5.5 (range:1-19) years. Two patients are alive with no evidence of disease for 7.5 and 10 years, one of whom was diagnosed with papillary thyroid carcinoma 9.5 years after treatment. One of the patients who died had lived for 19 years after diagnosis. CONCLUSIONS Pineoblastomas are rare but very aggressive tumors; more effective treatment strategies are needed. Survivors should be followed up for late effects such as second malignancies and endocrine deficiencies.
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Affiliation(s)
- Ömer Görgün
- Division of Pediatric Hematology-Oncology, İstanbul University Oncology Institute, İstanbul, Turkey
| | - Başak Koç
- Division of Pediatric Hematology-Oncology, İstanbul University Oncology Institute, İstanbul, Turkey
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, İstanbul University Oncology Institute, İstanbul, Turkey
| | - Johannes E Wolff
- Division of Pediatric Hematology- Oncology, MD Anderson Cancer Center, Houston, TX, USA
| | - Abut Kebudi
- Division of Surgical Oncology, Okan University Medical Faculty, İstanbul, Turkey
| | - Emin Darendeliler
- Department of Radiation Oncology, İstanbul University Oncology Institute, İstanbul, Turkey
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26
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Kebudi R, Chantada G, Kurucu N, Tuğcu D, Mukkada S, C Moreira D. COVID-19: Consequences for Children With Cancer in Turkey and Globally. Turk Arch Pediatr 2022; 56:295-299. [PMID: 35005722 PMCID: PMC8655955 DOI: 10.5152/turkarchpediatr.2021.21134] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 04/26/2021] [Accepted: 05/04/2021] [Indexed: 12/11/2022]
Affiliation(s)
- Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Guillermo Chantada
- Hemato-oncology Service, Hospital Pereira Rossell, Montevideo, Uruguay.,Hemato-oncology Service, Hospital Universitario Austral, Buenos Aires, Argentina.,Hospital Sant Joan de Deu, Hemato-oncology Service, Barcelona, Spain
| | - Nilgün Kurucu
- Department of Pediatric Oncology, Institute of Cancer, Hacettepe University School of Medicine, Ankara, Turkey
| | - Deniz Tuğcu
- Department of Pediatric Hematology-Oncology, Istanbul University School of Medicine,Istanbul,Turkey
| | - Sheena Mukkada
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
| | - Daniel C Moreira
- Department of Global Pediatric Medicine, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
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27
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Ödemiş DA, Kebudi R, Hassani M, Çelik B, Tuncer ŞB, Erciyas SK, Erdoğan ÖŞ, Bay SB, Yazıcı H. Identification of candidate genes in a family with cancer overload by whole-exome sequencing. Turk J Pediatr 2022; 64:451-465. [PMID: 35899558 DOI: 10.24953/turkjped.2021.4872] [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] [Indexed: 06/15/2023]
Abstract
BACKGROUND Approximately 120 out of every 1 million children in the world develop cancer each year. In Turkey, 2500-3000 children are diagnosed with new cancer each year. The causes of childhood cancer have been studied for many years. It is known that many cancers in children, as in adults, cause uncontrolled cell growth, and develop as a result of mutations in genes that cause cancer. METHODS The investigation of family history within this context in the study, a total of 13 individuals consisting of all children and adults in the family were examined using the whole-exome sequencing (WES) with the individuals who were diagnosed with cancer in the family, who were detected to have different cancer profiles, and defined as high risk and to determine the gene or genes through which the disease has developed. RESULTS At the end of the study, a total of 30 variants with a pathogenic record in the family were identified. A total of 10 pathogenic variants belonging to 8 different genes from these variants have been associated with various cancer risks. CONCLUSIONS A significant scientific contribution has been made to the mechanism of disease formation by studying a family with a high cancer burden and by finding the genes associated with the disease. In addition, by the results obtained, family members with cancer predisposition were selected after a risk analysis conducted in this family, and the necessary examinations and scans were recommended to provide an early diagnostic advantage.
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Affiliation(s)
- Demet Akdeniz Ödemiş
- Departments of Cancer Genetics, İstanbul University Oncology Institute, İstanbul, Turkey
| | - Rejin Kebudi
- Departments of Pediatric Hematology-Oncology, İstanbul University Oncology Institute, İstanbul, Turkey
| | - Masoumeh Hassani
- Departments of Pathology, Laboratory Techniques, Vocational School of Health Services, İstanbul Gelisim University, İstanbul, Turkey
| | - Betül Çelik
- Departments of Cancer Genetics, İstanbul University Oncology Institute, İstanbul, Turkey
| | - Şeref Buğra Tuncer
- Departments of Cancer Genetics, İstanbul University Oncology Institute, İstanbul, Turkey
| | - Seda Kılıç Erciyas
- Departments of Cancer Genetics, İstanbul University Oncology Institute, İstanbul, Turkey
| | - Özge Şükrüoğlu Erdoğan
- Departments of Cancer Genetics, İstanbul University Oncology Institute, İstanbul, Turkey
| | - Sema Büyükkapu Bay
- Departments of Pediatric Hematology-Oncology, İstanbul University Oncology Institute, İstanbul, Turkey
| | - Hülya Yazıcı
- Department of Basic Medical Sciences, İstanbul Arel University, İstanbul, Turkey
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28
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Aras Y, Dölen D, İribas Çelik A, Kılıç G, Kebudi R, Ünverengil G, Sabancı PA, İzgi AN. Effects of different molecular subtypes and tumor biology on the prognosis of medulloblastoma. Childs Nerv Syst 2021; 37:3733-3742. [PMID: 34550414 DOI: 10.1007/s00381-021-05350-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 08/27/2021] [Indexed: 12/20/2022]
Abstract
PURPOSE Medulloblastoma is one of the most common malignant brain tumors in the pediatric population. Recent studies identified four distinct medulloblastoma subgroups with different molecular alterations and pathways, and natural courses and outcomes. To evaluate the results of surgical and medical treatments of patients with medulloblastoma and compare them among the medulloblastoma subgroups. METHODS The clinical and radiological features, medical and surgical management and treatment outcomes and their correlation with molecular subgroups of 58 patients treated for medulloblastoma in the last 20 years were evaluated. RESULTS Fifty-eight patients, of whom 35 were male and 23 were female, were evaluated. The median age was 6 years (range, 1-19 years). The most common symptoms were nausea and vomiting (60%). Forty-three percent of the patients had headache and 40% had ataxia. Previous pathology reports revealed that 43 (74%), eight (14%), five (8%), and two (3%) had classic, desmoplastic, desmoplastic/nodular, and anaplastic morphologies, respectively. After the subgroup analyses, five patients (12%) were attributed to the wingless subgroup (WNT) group; 14 (32.5%), to the sonic hedgehog subgroup (SHH) group; and 24 (56%), to the non-WNT non-SHH group. On the basis of immunohistochemical analysis results, 15 patients could not be attributed to any subgroups. The clinical risk groups (average vs high-risk) and age at diagnosis (≥ 3 years vs < 3 years of age) were significant for 5-year event free survival (86% vs 43%, p:0.011 and 59% vs 36%, p:0.039). There was no significant difference in survival or event free survival according to molecular subtypes in this cohort. CONCLUSION In corporation of molecular features to the clinicopathologic classification leads to risk-adapted treatment. Although the molecular subgroups did not affect outcome significantly in this study, more studies with larger numbers of patients are needed to understand the tumor pathophysiology of medulloblastoma and design the future medical practice.
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Affiliation(s)
- Yavuz Aras
- Istanbul Faculty of Medicine, Neurosurgery Department, Istanbul University, Istanbul, Turkey
| | - Duygu Dölen
- Istanbul Faculty of Medicine, Neurosurgery Department, Istanbul University, Istanbul, Turkey.
| | - Ayca İribas Çelik
- Istanbul Faculty of Medicine, Radiation Oncology Department, Istanbul University, Istanbul, Turkey
| | - Gozde Kılıç
- Istanbul Faculty of Medicine, Pathology Department, Istanbul University, Istanbul, Turkey
| | - Rejin Kebudi
- Institute of Oncology, Pediatric Hematology-Oncology Department, Istanbul University, Istanbul, Turkey
| | - Gökçen Ünverengil
- Istanbul Faculty of Medicine, Pathology Department, Istanbul University, Istanbul, Turkey
| | - Pulat Akın Sabancı
- Istanbul Faculty of Medicine, Neurosurgery Department, Istanbul University, Istanbul, Turkey
| | - Ali Nail İzgi
- Istanbul Faculty of Medicine, Neurosurgery Department, Istanbul University, Istanbul, Turkey
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29
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Kebudi R, Buyukkapu SB, Gorgun O, Ozkaya K, Meral R, Ayan I, Altun M. Nasopharyngeal carcinoma in children: Multimodal treatment and long-term outcome of 92 patients in a single center over a 28-year period. Pediatr Blood Cancer 2021; 68:e29372. [PMID: 34582092 DOI: 10.1002/pbc.29372] [Citation(s) in RCA: 2] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Revised: 09/07/2021] [Accepted: 09/11/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVES The aim of the study was to evaluate the long-term outcome and late effects in pediatric patients with nasopharyngeal carcinoma (NPC) treated with neoadjuvant chemotherapy (NACT), followed by radiotherapy (RT). METHODS Ninety-two children (65 male, 27 female) diagnosed with NPC between 1989 and 2017 in the Istanbul University, Institute of Oncology were evaluated retrospectively. NACT consisted of three cycles of cisplatin-containing regimen every 3 weeks, followed by RT. RESULTS The median age was 13 years (5-18 years). Most had locoregionally advanced disease (stage III/IVA/IVB) and five had distant metastases at presentation. At a median follow-up of 108 months (3-332 months), 5- and 10-year overall survival rates and event-free survival rates were 87.5%, 79.7% and 82.1%, 78.9%, respectively. Three patients with distant metastasis are long-term survivors. Thirteen patients relapsed at a median of 8 months (2-23 months). Hypothyroidism (36%) and xerostomia (25%) were the most frequent long-term treatment-related toxicities. Nine second malignancies developed in eight patients, eight in the irradiated field at a median of 14 years (range 5-26 years), five of whom are long-term survivors after curative surgery. CONCLUSIONS Three courses of cisplatin-containing NACT, followed by RT lead to high survival and locoregional control rate in advanced stage NPC in children. Patients with distant metastasis should also be treated with curative intent by systemic chemotherapy and locoregional radiotherapy. Patients should be followed closely for recurrences and long-term morbidities including second malignancies, which may be treated with curative surgeries if diagnosed early.
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Affiliation(s)
- Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Sema Bay Buyukkapu
- Division of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Omer Gorgun
- Division of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Kübra Ozkaya
- Division of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Rasim Meral
- Division of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Inci Ayan
- Division of Pediatric Hematology-Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey
| | - Musa Altun
- Division of Radiation Oncology, Institute of Oncology, Istanbul University, Istanbul, Turkey.,Department of Radiation Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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30
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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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31
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Vural S, Genç DB, Kebudi R, Doğan Ö, Karaman S. Treatment results of modified BFM protocol in pediatric high-risk Burkitt lymphoma. Turk J Pediatr 2021; 63:639-647. [PMID: 34449146 DOI: 10.24953/turkjped.2021.04.011] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Chemotherapy with high dose methotrexate is the mainstay of treatment for Burkitt lymphoma (BL), especially to manage central nervous system (CNS) disease. However, methotrexate administration requires close drug level monitoring for appropriate folinic acid rescue, which might not be readily available in all centers. In this study, we assessed the long-term treatment outcomes of a modified Non-Hodgkin lymphoma (NHL)-Berlin-Frankfurt-Munster (BFM) 90 regimen in pediatric high-risk BL without CNS involvement. METHODS Between 1999 and 2011, 42 patients (median age: 7 years) with advanced-stage BL were treated with modified NHL-BFM 90 regimen (methotrexate at a dose of 1 g/m2). Demographic data, stage, lactate dehydrogenase (LDH) and treatment results were retrospectively evaluated. The patients were assessed for toxicity, survival and CNS recurrence. RESULTS Thirty-six patients had Stage III and six had Stage IV disease, respectively. The median LDH level was 1,432 IU/L. Four patients died of infectious and metabolic complications. One patient had local recurrence at the 48 < sup > th < /sup > month of the follow-up and he is in the second remission for 72 months. In Kaplan-Meier analysis, the overall survival and event-free survival rates at 10 years were found as 90 % and 88 %, respectively. None of our patients died of treatment failure. CONCLUSIONS The administration of the reduced dose of methotrexate seems to not compromise treatment success nor increase the risk of CNS recurrence in high-risk BL without CNS involvement. The limitation of the study is that it is not randomized. Our treatment scheme might be considered for centers without methotrexate measurement facility.
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Affiliation(s)
- Sema Vural
- Department of Pediatric Oncology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Dildar Bahar Genç
- Department of Pediatric Oncology, University of Health Sciences, Sisli Hamidiye Etfal Training and Research Hospital, İstanbul
| | - Rejin Kebudi
- Department of Pediatric Hematology/Oncology, Istanbul University Institute of Oncology, İstanbul
| | - Öner Doğan
- Department of Pathology, İstanbul University Medical Faculty, İstanbul, Turkey
| | - Serap Karaman
- Department of Pediatric Hematology/Oncology, Istanbul University Institute of Oncology, İstanbul
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32
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Kebudi R, Dural O, Bay SB, Gorgun O, Onder S, Bilgic B, Yilmaz I, Iribas A, Arndt CA, Harris AK, Field A, Schultz KAP, Hill DA. Childhood Rhabdomyosarcoma of the Female Genital Tract: Association with Pathogenic DICER1 Variation, Clinicopathological Features, and Outcomes. J Pediatr Adolesc Gynecol 2021; 34:449-453. [PMID: 33484847 DOI: 10.1016/j.jpag.2021.01.011] [Citation(s) in RCA: 5] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 12/23/2020] [Accepted: 01/14/2021] [Indexed: 12/17/2022]
Abstract
STUDY OBJECTIVE Rhabdomyosarcomas (RMSs) of the female genital tract (FGT) have been recently shown to be associated with germline pathogenic variation in DICER1, which can underlie a tumor predisposition disorder. We sought to determine the incidence of a pathogenic variation in DICER1 in a cohort of RMSs of the FGT, as well as to evaluate the clinicopathological features and outcomes of the patients. DESIGN, SETTING, PARTICIPANTS, INTERVENTIONS, AND MAIN OUTCOME MEASURES: We retrospectively reviewed medical records of the patients diagnosed with RMS of the FGT between 1990 and 2019. Molecular genetic sequencing of the tumor to detect an RNase IIIb domain hot spot mutation in DICER1 samples was performed in 7 patients. Individuals with a missense mutation in the tumor were also screened for a loss of function germline mutation in DICER1. RESULTS Of 210 cases of pediatric RMS, 11 arose from the FGT. Molecular genetic sequencing of the tumor samples revealed a somatic missense mutation in the RNase IIIb domain of DICER1 in a total of 3 patients, 2 patients with embryonal RMS of the cervix/uterus, and 1 patient with ovarian embryonal RMS. As a result of genetic testing for the loss of function germline mutation in DICER1, a heterozygous pathogenic variant was also found in 2 of these patients. CONCLUSION Despite the limited number of patients, our findings suggest that it is important to be aware of the possible association between RMS of FGT and pathogenic germline DICER1 variants because the detection of this mutation in a patient or relatives can provide the opportunity for surveillance of related conditions that might improve long-term outcomes and survival.
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Affiliation(s)
- Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey.
| | - Ozlem Dural
- Department of Obstetrics and Gynecology, Istanbul University, School of Medicine, Istanbul, Turkey
| | - Sema Buyukkapu Bay
- Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Omer Gorgun
- Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Semen Onder
- Department of Pathology, Istanbul University, School of Medicine, Istanbul, Turkey
| | - Bilge Bilgic
- Department of Pathology, Istanbul University, School of Medicine, Istanbul, Turkey
| | - Ismail Yilmaz
- University of Health Sciences, Department of Pathology, Sultan Abdulhamid Han Training and Research Hospital, Istanbul, Turkey
| | - Ayca Iribas
- Radiation Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Carola A Arndt
- Department of Pediatric and Adolescent Medicine, Mayo Clinic and Foundation, Rochester, Minnesota
| | - Anne K Harris
- International Pleuropulmonary Blastoma/DICER1 Registry, Minneapolis, Minnesota; International Ovarian and Testicular Stromal Tumor (OTST) Registry, Minneapolis, Minnesota; Cancer and Blood Disorders, Children's Minnesota, Minneapolis, Minnesota
| | | | - Kris Ann P Schultz
- International Pleuropulmonary Blastoma/DICER1 Registry, Minneapolis, Minnesota; International Ovarian and Testicular Stromal Tumor (OTST) Registry, Minneapolis, Minnesota; Children's Minnesota, Minneapolis, Minnesota
| | - D Ashley Hill
- ResourcePath, Sterling, Virginia; Department of Pathology, Children's National Health System, Washington, DC; George Washington University School of Medicine and Health Sciences, Washington, DC
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33
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Kebudi R, Kurucu N, Tuğcu D, Hacısalihoğlu Ş, Fışgın T, Ocak S, Tokuç G, Nihal Özdemir G, Bozkurt C, İnce D, Aras S, Ayçiçek A, Aksoy BA, Karadaş N, Öztürk G, Orhan MF, Ataseven E, Akbayram S, Yılmaz E, Tüfekçi Ö, Vural S, Akyay A, Ayhan AC, Kılıç S, Uzel VH, Düzenli Y, Kazancı EG, Acıpayam C, Elli M, Tanyeli A, Karakas Z, Somer A, Kara A. COVID-19 infection in children with cancer and stem cell transplant recipients in Turkey: A nationwide study. Pediatr Blood Cancer 2021; 68:e28915. [PMID: 33538100 PMCID: PMC7995085 DOI: 10.1002/pbc.28915] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 12/19/2020] [Accepted: 01/07/2021] [Indexed: 01/08/2023]
Affiliation(s)
- Rejin Kebudi
- Pediatric Hematology‐OncologyInstitute of OncologyIstanbul UniversityIstanbulTurkey
| | - Nilgün Kurucu
- Department of Pediatric OncologyCancer InstituteHacettepe University Faculty of MedicineAnkaraTurkey
| | - Deniz Tuğcu
- Department of Pediatric Hematology‐Oncologyİstanbul University Faculty of MedicineIstanbulTurkey
| | - Şadan Hacısalihoğlu
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Kanuni Sultan Süleyman Training and Research HospitalIstanbulTurkey
| | - Tunç Fışgın
- Department of Pediatric Hematology Pediatric Stem Cell TransplantationAltınbaş University Medical Park HospitalIstanbulTurkey
| | - Süheyla Ocak
- Department of Pediatric Hematology‐OncologyCerrahpaşa University Faculty of MedicineIstanbulTurkey
| | - Gülnur Tokuç
- Department of Pediatric OncologyMarmara University Faculty of MedicineIstanbulTurkey
| | - Gül Nihal Özdemir
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Kanuni Sultan Süleyman Training and Research HospitalIstanbulTurkey
| | - Ceyhun Bozkurt
- Department of Pediatric Hematology Pediatric Stem Cell TransplantationAltınbaş University Medical Park HospitalIstanbulTurkey
| | - Dilek İnce
- Department of Pediatric OncologyDokuz Eylül University Faculty of MedicineİzmirTurkey
| | - Seda Aras
- Department of Pediatric OncologyMarmara University Faculty of MedicineIstanbulTurkey
| | - Ali Ayçiçek
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Kanuni Sultan Süleyman Training and Research HospitalIstanbulTurkey
| | - Başak Adaklı Aksoy
- Department of Pediatric Hematology Pediatric Stem Cell TransplantationAltınbaş University Medical Park HospitalIstanbulTurkey
| | - Nihal Karadaş
- Department of Pediatric HematologyEge University Faculty of MedicineİzmirTurkey
| | - Gülyüz Öztürk
- Department of Pediatric Hematology and Pediatric Stem Cell TransplantationAcıbadem Altunizade HospitalIstanbulTurkey
| | - Mehmet Fatih Orhan
- Department of Pediatric Hematology‐OncologySakarya University Faculty of MedicineSerdivanTurkey
| | - Eda Ataseven
- Department of Pediatric OncologyEge University Faculty of MedicineİzmirTurkey
| | - Sinan Akbayram
- Department of Pediatric Hematology‐OncologyGaziantep University Faculty of MedicineGaziantepTurkey
| | - Ebru Yılmaz
- Department of Pediatric Hematology‐OncologyErciyes University Faculty of MedicineKayseriTurkey
| | - Özlem Tüfekçi
- Department of Pediatric HematologyDokuz Eylül University Faculty of MedicineİzmirTurkey
| | - Sema Vural
- Department of Pediatric OncologySağlık Bilimleri University Hamidiye Şişli Etfal Training and Research HospitalIstanbulTurkey
| | - Arzu Akyay
- Department of Pediatric Hematology‐Oncologyİnönü University Faculty of MedicineMalatyaTurkey
| | - Aylin Canbolat Ayhan
- Department of Pediatric Hematologyİstanbul Medeniyet University Faculty of MedicineIstanbulTurkey
| | - Suar Kılıç
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Ümraniye Training and Research HospitalIstanbulTurkey
| | - Veysiye Hülya Uzel
- Department of Pediatric Hematology‐OncologyDicle University Faculty of MedicineTurkey
| | - Yeter Düzenli
- Department of Pediatric Hematology‐OncologySağlık Bakanlığı Erzurum Training and Research HospitalErzurumTurkey
| | - Elif Güler Kazancı
- Department of Pediatric Hematology‐OncologySağlık Bilimleri University Bursa Yüksek İhtisas Training and Research HospitalBursaTurkey
| | - Can Acıpayam
- Department of Pediatric Hematolology‐OncologyKahramanmaraş Sütçü İmam University Faculty of MedicineKahramanmaraşTurkey
| | - Murat Elli
- Department of Pediatric Hematology‐Oncology and Bone Marrow Transplantationİstanbul Medipol UniversityIstanbulTurkey
| | - Atilla Tanyeli
- Department of Pediatric Stem Cell TransplantationMemorial Şişli HospitalIstanbulTurkey
| | - Zeynep Karakas
- Department of Pediatric Hematology‐Oncologyİstanbul University Faculty of MedicineIstanbulTurkey
| | - Ayper Somer
- Department of Pediatric Infectious Diseaseİstanbul University Faculty of MedicineIstanbulTurkey
| | - Ateş Kara
- Department of Pediatric Infectious DiseaseHacettepe University Faculty of MedicineAnkaraTurkey
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Kebudi R, Oflaz Sozmen B, Bahar M, Paker T, Hacı I, Ekinci A, Egeli D, Eren Ö, Inel Y. Prolonged extracorporeal membrane oxygenation in pediatric leukemia with severe acute respiratory distress syndrome and persistent fungemia. Pediatr Blood Cancer 2021; 68:e28966. [PMID: 33629444 DOI: 10.1002/pbc.28966] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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: 01/31/2021] [Revised: 02/02/2021] [Accepted: 02/03/2021] [Indexed: 01/05/2023]
Affiliation(s)
- Rejin Kebudi
- Oncology Institute, Pediatric Hematology-Oncology, Istanbul University, Istanbul, Turkey.,Pediatrics, Pediatric Hematology Oncology, American Hospital, Istanbul, Turkey
| | - Banu Oflaz Sozmen
- School of Medicine, Pediatric Hematology Oncology, Koç University, Istanbul, Turkey
| | - Mois Bahar
- Intensive Care Unit, American Hospital, Istanbul, Turkey
| | - Tufan Paker
- Cardiovascular Surgery, American Hospital, Istanbul, Turkey
| | - Ismail Hacı
- Intensive Care Unit, American Hospital, Istanbul, Turkey
| | - Alim Ekinci
- Intensive Care Unit, American Hospital, Istanbul, Turkey
| | - Demet Egeli
- Intensive Care Unit, American Hospital, Istanbul, Turkey
| | - Özge Eren
- Intensive Care Unit, American Hospital, Istanbul, Turkey
| | - Yalçın Inel
- Intensive Care Unit, American Hospital, Istanbul, Turkey
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Kebudi R, Bay Buyukkapu S, Gorgun O, Iribas A, Yaman Agaoglu F, Kebudi A, Tuncer S, Altun M. Second malignancies in children with head and neck primary tumors. J Clin Oncol 2021. [DOI: 10.1200/jco.2021.39.15_suppl.e22014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
e22014 Background: Children with primaries in the head and neck region, especially those who recieve radiotherapy (RT) are at increased risk for second malignancies (SM). This study aims to assess the incidence and outcome of SM in children with head and neck primary tumors. Methods: During 1990-2017, 3214 children with cancer were treated in theIstanbul University, Oncology Institute. The primary tumor was in the head and neck region in 1414 (651 brain tumors,289 retinoblastoma,474 other). Survivors followed up for at least 3 years from diagnosis were evaluated for second malignancies. Results: 30 SM were identified in 28 survivors (18 male,10 female) at a median of 12 years (2-26) from diagnosis. The primary diagnosis was nasopharyngeal carcinoma (NPC) in 8, bilateral retinoblastoma (RBS) in 7, embryonal brain tumors (CNST) in 8, Hodgkin lymphoma (HD) in 3, rhabdomyosarcoma(RMS) in 2. Two RBS patients who did not recieve radiotherapy developed pilocytic astrocytoma (at 2 years) and osteosarcoma of the extremity (at 4 years) each, both are alive with no evidence of disease (NED) for 3.5 and 10 years. 26 patients recieved RT: one with CNST developed MDS (at 8 years) and died due to complications after stem cell transplantation (SCT). One with NPC developed PNET of the bladder (at 5 years) and died of disease (DOD). One with relapse HD developed Langerhans cell histiocytosis 2 years after SCTand is with NED for 10 years. The other 23 developed SM in the/proximity of the RT field. These SM were 7 sarcomas (in 4 retinoblastoma,2 NPC, 1 RMS), 6 thyroid cancer (in 2 CNST, 1 RMS, 1 HD, 1 NPC), 3 meningiomas (in 2 CNST, 1 RBS), 5 carcinomas (in 4 NPC, 1 RBS), 1 basal cell carcinoma (in a recurrent re-irradiated CNST, is with NED), 1 peripheral nerve sheath tumor (in 1 HD, DOD), glioblastoma multiforme and non Hodgkin's lymphoma (in the same CNST case, DOD at 6 months). One of the NPC case developed both sarcoma (at 18 years) and carcinoma (at 25 years, NED). The RT dose (20-70 Gy) differed according to diagnosis. All survivors of thyroid cancer are with NED except one who died in an accident; of 3 meningiomas, the one with retinoblastoma who developed malignant meningioma died. Of five carciinomas as SM, two with NPC who developed carcinomas died. Of sarcomas as SM, two with fibrosarcomas are with NED at 10 years each (1NPC, 1 RMS). All patients survived for a median of 3 (0.5-16) years after SM; 16/28 (57%) are with NED at a median of 8 (1-16) years; 12 died at a median of 1.8 (0.5-4.75) years after SM. (1 CNST due to accident, 1 NPC due to infectious complications after a reconstructive surgery, 10 DOD). All SM were detected early during regular surveillance. Conclusions: Children with head and neck primaries are at risk for SM which may occur many years later, especially in RT sites. RT should be avoided when possible such as currently in RBS. Patients need regular surveillance lifelong, for early detection of SM. SM should be treated with curative intent, to achieve long term survival.
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Affiliation(s)
- Rejin Kebudi
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Sema Bay Buyukkapu
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Omer Gorgun
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Ayca Iribas
- Istanbul University Institute of Oncology, Radiation Oncology, Istanbul, Turkey
| | - Fulya Yaman Agaoglu
- Istanbul University, Institute of Oncology, Radiation Oncology, Istanbul, Turkey
| | - Abut Kebudi
- Okan University, Department of General Surgery and Oncologic Surgery, Istanbul, Turkey
| | - Samuray Tuncer
- Istanbul Faculty of Medicine, Department of Ophthalmology, Ocular Oncology Service, Istanbul University, Istanbul, Turkey
| | - Musa Altun
- Istanbul University, Istanbul Faculty of Medicine, Department of Radiation Oncology, Istanbul, Turkey
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36
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Durno C, Ercan AB, Bianchi V, Edwards M, Aronson M, Galati M, Atenafu EG, Abebe-Campino G, Al-Battashi A, Alharbi M, Azad VF, Baris HN, Basel D, Bedgood R, Bendel A, Ben-Shachar S, Blumenthal DT, Blundell M, Bornhorst M, Bronsema A, Cairney E, Rhode S, Caspi S, Chamdin A, Chiaravalli S, Constantini S, Crooks B, Das A, Dvir R, Farah R, Foulkes WD, Frenkel Z, Gallinger B, Gardner S, Gass D, Ghalibafian M, Gilpin C, Goldberg Y, Goudie C, Hamid SA, Hampel H, Hansford JR, Harlos C, Hijiya N, Hsu S, Kamihara J, Kebudi R, Knipstein J, Koschmann C, Kratz C, Larouche V, Lassaletta A, Lindhorst S, Ling SC, Link MP, Loret De Mola R, Luiten R, Lurye M, Maciaszek JL, MagimairajanIssai V, Maher OM, Massimino M, McGee RB, Mushtaq N, Mason G, Newmark M, Nicholas G, Nichols KE, Nicolaides T, Opocher E, Osborn M, Oshrine B, Pearlman R, Pettee D, Rapp J, Rashid M, Reddy A, Reichman L, Remke M, Robbins G, Roy S, Sabel M, Samuel D, Scheers I, Schneider KW, Sen S, Stearns D, Sumerauer D, Swallow C, Taylor L, Thomas G, Toledano H, Tomboc P, Van Damme A, Winer I, Yalon M, Yen LY, Zapotocky M, Zelcer S, Ziegler DS, Zimmermann S, Hawkins C, Malkin D, Bouffet E, Villani A, Tabori U. Survival Benefit for Individuals With Constitutional Mismatch Repair Deficiency Undergoing Surveillance. J Clin Oncol 2021; 39:2779-2790. [PMID: 33945292 PMCID: PMC8407605 DOI: 10.1200/jco.20.02636] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [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: 12/26/2022] Open
Abstract
Constitutional mismatch repair deficiency syndrome (CMMRD) is a lethal cancer predisposition syndrome characterized by early-onset synchronous and metachronous multiorgan tumors. We designed a surveillance protocol for early tumor detection in these individuals.
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Affiliation(s)
- Carol Durno
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada.,Mount Sinai Hospital, The Familial Gastrointestinal Cancer Registry at the Zane Cohen Centre for Digestive Disease, Toronto, ON, Canada
| | - Ayse Bahar Ercan
- The Hospital for Sick Children, The Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, ON, Canada.,University of Toronto, Institute of Medical Science, Toronto, ON, Canada
| | - Vanessa Bianchi
- The Hospital for Sick Children, The Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, ON, Canada
| | - Melissa Edwards
- The Hospital for Sick Children, The Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, ON, Canada
| | - Melyssa Aronson
- Mount Sinai Hospital, The Familial Gastrointestinal Cancer Registry at the Zane Cohen Centre for Digestive Disease, Toronto, ON, Canada
| | - Melissa Galati
- The Hospital for Sick Children, The Arthur and Sonia Labatt Brain Tumour Research Centre, Toronto, ON, Canada.,University of Toronto, Institute of Medical Science, Toronto, ON, Canada
| | - Eshetu G Atenafu
- Department of Biostatistics, Princess Margaret Cancer Centre, University of Toronto, Toronto, ON, Canada
| | - Gadi Abebe-Campino
- Department of Pediatric Hematology-Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - Abeer Al-Battashi
- Ministry of Health Oman, Child Health Specialist Muscat, Muscat, Oman
| | - Musa Alharbi
- Department of Pediatric Hematology Oncology, King Fahad Medical City, Riyadh, Saudi Arabia
| | - Vahid Fallah Azad
- MAHAK Pediatric Cancer Treatment and Research Center (MPCTRC), Tehran, Iran
| | - Hagit N Baris
- Rambam Health Care Campus, The Genetics Institute, Haifa, Israel
| | - Donald Basel
- Medical College of Wisconsin, Pediatrics, Milwaukee, WI
| | | | - Anne Bendel
- Department of Pediatric Hematology-Oncology, Children's Hospitals and Clinics of Minnesota, Minneapolis, MN
| | - Shay Ben-Shachar
- Tel Aviv Sourasky Medical Center, Genetic Institute, Tel Aviv, Israel
| | - Deborah T Blumenthal
- Oncology Division, Tel Aviv University Sackler Faculty of Medicine, Tel Aviv, Israel
| | | | - Miriam Bornhorst
- Children's National Medical Center, Brain Tumor Institute, Washington, DC
| | - Annika Bronsema
- Department of Pediatric Hematology and Oncology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Elizabeth Cairney
- Department of Pediatrics, London Health Sciences Centre, London, ON, Canada
| | - Sara Rhode
- Department of Hematology and Oncology, Cleveland Clinic, Cleveland, OH
| | - Shani Caspi
- Sheba Medical Center, Cancer Research Center, Tel Hashomer, Israel
| | - Aghiad Chamdin
- Michigan State University, College of Human Medicine, Center for Bleeding and Clotting Disorders, East Lansing, MI
| | - Stefano Chiaravalli
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Shlomi Constantini
- Department of Pediatric Neurosurgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Bruce Crooks
- Division of Hematology-Oncology, IWK Health Centre, Halifax, NS, Canada
| | - Anirban Das
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Rina Dvir
- Department of Pediatric Hemato-Oncology, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Roula Farah
- Lebanese American University Medical Center-Rizk, Beirut, Lebanon
| | - William D Foulkes
- Deparments of Oncology and Human Genetics, McGill University Health Centre, Cancer Genetics Program, Montreal, QC, Canada
| | | | - Bailey Gallinger
- Division of Clinical and Metabolic Genetics, The Hospital for Sick Children, Toronto, ON, Canada
| | - Sharon Gardner
- Department of Pediatric Hematology-Oncology, NYU Langone Health, New York, NY
| | - David Gass
- Department of Pediatric Hematology and Oncology, Atrium Health, Charlotte, NC
| | - Mithra Ghalibafian
- MAHAK Pediatric Cancer Treatment and Research Center (MPCTRC), Tehran, Iran
| | - Catherine Gilpin
- Children's Hospital of Eastern Ontario, Genetics, Ottawa, ON, Canada
| | - Yael Goldberg
- Department of Oncology, Hadassah Medical Center, Jerusalem, Israel
| | - Catherine Goudie
- Division of Oncology, McGill University Health Centre, Montreal, QC, Canada
| | | | - Heather Hampel
- The Ohio State University Comprehensive Cancer Center, Internal Medicine, Columbus, OH
| | - Jordan R Hansford
- The Royal Children's Hospital Melbourne, Children's Cancer Centre, Parkville, Victoria, Australia
| | - Craig Harlos
- Department of Medical Oncology and Hematology, CancerCare Manitoba, Winnipeg, MB, Canada
| | - Nobuko Hijiya
- Pediatric Hematology Oncology and Stem Cell Transplant, Columbia University Irving Medical Center, New York, NY
| | - Saunders Hsu
- Department of Pediatric Hematology-Oncology, Sutter Health, Sacramento, CA
| | - Junne Kamihara
- Dana-Farber Children's Hospital Cancer Center, Pediatric Oncology, Boston, MA
| | - Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Istanbul University, Fatih, Istanbul, Turkey
| | - Jeffrey Knipstein
- Department of Pediatric Neurology, Medical College of Wisconsin, Milwaukee, WI
| | - Carl Koschmann
- Department of Pediatric Hematology-Oncology, University of Michigan Medical School, Ann Arbor, MI
| | - Christian Kratz
- Department of Pediatric Haematology and Oncology, Hospital of the Goethe University Frankfurt, Frankfurt am Main, Hessen, Germany
| | - Valerie Larouche
- Department of Hematology-Oncology, CHU de Quebec-Universite Laval, Quebec, QC, Canada
| | - Alvaro Lassaletta
- Department of Pediatric Hematology-Oncology, Hospital Infantil Universitario Nino Jesus, Madrid, Spain
| | - Scott Lindhorst
- Department of Hematology-Medical Oncology, Medical University of South Carolina, Charleston, SC
| | - Simon C Ling
- Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada
| | - Michael P Link
- Department of Pediatrics, Stanford Medicine, Stanford, CA
| | | | - Rebecca Luiten
- Department of Clinical Cancer Genetics, Banner MD Anderson Cancer Center, Gilbert, AZ
| | - Michal Lurye
- Sheba Medical Center at Tel Hashomer, Tel Hashomer, Israel
| | | | | | - Ossama M Maher
- Department of Pediatric Hematology-Oncology, Nicklaus Children's Hospital, Miami, FL
| | - Maura Massimino
- Pediatric Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milano, Lombardia, Italy
| | - Rose B McGee
- Saint Jude Children's Research Hospital, Memphis, TN
| | | | - Gary Mason
- Children's Hospital of Pittsburgh of UPMC, Pittsburgh, PA
| | - Monica Newmark
- Ann and Robert H Lurie Children's Hospital of Chicago, Chicago, IL
| | - Garth Nicholas
- Division of Medical Oncology, University of Ottawa, Ottawa, ON, Canada
| | - Kim E Nichols
- Department of Oncology, Saint Jude Children's Research Hospital, Memphis, TN
| | - Theodore Nicolaides
- Department of Pediatric Hematology-Oncology, NYU Langone Health, New York, NY
| | - Enrico Opocher
- Department of Pediatrics, University of Padua, Padova, Veneto, Italy
| | - Michael Osborn
- Paediatric Haematology, Womens and Childrens Hospital (WCH), North Adelaide, South Australia, Australia
| | - Benjamin Oshrine
- Johns Hopkins All Children's Hospital, Cancer and Blood Disorders Institute, Saint Petersburg, FL
| | - Rachel Pearlman
- Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH
| | | | - Jan Rapp
- West Virginia University Cancer Institute, Morgantown, WV
| | | | - Alyssa Reddy
- University of California San Francisco, San Francisco, CA
| | - Lara Reichman
- McGill University Health Centre, Montreal, QC, Canada
| | - Marc Remke
- University Hospital Dusseldorf, Dusseldorf, Nordrhein-Westfalen, Germany
| | - Gabriel Robbins
- Department of Pediatric Hematology-Oncology, NYU Langone Health, New York, NY
| | | | - Magnus Sabel
- Department of Pediatrics, University of Gothenburg Sahlgrenska Academy, Goteborg, Sweden
| | | | - Isabelle Scheers
- Universite Catholique de Louvain La Faculte de Medecine, Bruxelles, Belgium
| | - Kami Wolfe Schneider
- Department of Pediatric Hematology-Oncology, Children's Hospital Colorado, Aurora, CO
| | - Santanu Sen
- Department of Pediatrics, Kokilaben Dhirubhai Ambani Hospital and Medical Research Institute, Mumbai, Maharashtra, India
| | - Duncan Stearns
- UH Rainbow Babies and Children's Hospital Division of Pediatrics, Pediatric Neuro-oncology, Cleveland, OH
| | - David Sumerauer
- Department of Pediatric Hematology and Oncology, 2nd Faculty of Medicine, University Hospital Motol, Charles University, Prague, Czechia
| | - Carol Swallow
- Department of Surgery, Mount Sinai Hospital, Toronto, ON, Canada
| | - Leslie Taylor
- Saint Jude Children's Research Hospital, Memphis, TN
| | | | - Helen Toledano
- Department of Pediatric Hematology Oncology, Schneider Children's Medical Center of Israel, Petah Tikva, Israel
| | - Patrick Tomboc
- Department of Pediatrics, West Virginia University, Morgantown, WV
| | - An Van Damme
- Department of Pediatric Hematology and Oncology, Universite Catholique de Louvain, Louvain-la-Neuve, Walloon Brabant, Belgium
| | | | - Michal Yalon
- Department of Pediatric Hematology-Oncology, Sheba Medical Center, Tel Hashomer, Israel
| | - Lee Yi Yen
- Department of Neurosurgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | | | - Shayna Zelcer
- Department of Pediatrics, London Health Sciences Centre, London, ON, Canada
| | - David S Ziegler
- Sydney Children's Hospital Randwick, Kids Cancer Centre, Randwick, New South Wales, Australia
| | - Stefanie Zimmermann
- Department of Pediatric Hematology and Oncology, Hannover Medical School, Hannover, Niedersachsen, Germany
| | - Cynthia Hawkins
- Department of Pediatric Laboratory Medicine, The Hospital for Sick Children, Toronto, ON, Canada
| | - David Malkin
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Eric Bouffet
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Anita Villani
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Uri Tabori
- Division of Hematology and Oncology, The Hospital for Sick Children, Toronto, ON, Canada
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Kebudi R, Kurucu N, Tuğcu D. Delays in Treatment Because of COVID-19 Infection in Children With Cancer and Stem-Cell Transplant Recipients in Turkey. JCO Oncol Pract 2021; 17:363-364. [PMID: 33881924 DOI: 10.1200/op.21.00047] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Rejin Kebudi
- Rejin Kebudi, MD, Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey; Nilgün Kurucu, MD, Department of Pediatric Oncology, Faculty of Medicine, Cancer Institute, Hacettepe University, Ankara, Turkey; and Deniz Tuğcu, MD, Department of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Nilgün Kurucu
- Rejin Kebudi, MD, Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey; Nilgün Kurucu, MD, Department of Pediatric Oncology, Faculty of Medicine, Cancer Institute, Hacettepe University, Ankara, Turkey; and Deniz Tuğcu, MD, Department of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Deniz Tuğcu
- Rejin Kebudi, MD, Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey; Nilgün Kurucu, MD, Department of Pediatric Oncology, Faculty of Medicine, Cancer Institute, Hacettepe University, Ankara, Turkey; and Deniz Tuğcu, MD, Department of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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38
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Güneş N, Yeşil G, Geyik F, Kasap B, Celkan T, Kebudi R, Tüysüz B. Neurofibromatosis type 1: Expanded variant spectrum with multiplex ligation-dependent probe amplification and genotype-phenotype correlation in 138 Turkish patients. Ann Hum Genet 2021; 85:155-165. [PMID: 33877690 DOI: 10.1111/ahg.12422] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/31/2021] [Accepted: 04/01/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To investigate the variant spectrum and genotype-phenotype correlations in a Turkish cohort with Neurofibromatosis Type-1 (NF1). MATERIALS AND METHODS We retrospectively investigated the clinical and molecular data of 138 NF1 patients from 129 families who had been followed-up for a median of 3.9 (1.25-18.5) years. RESULTS NF1 sequencing revealed 73 different intragenic variants, 19 of which were novel. Seven large deletions were detected by multiplex ligation-dependent probe amplification (MLPA) analyses. The total detection rate of pathogenic NF1 variants was found to be 87.1%. Comparing age groups, cutaneous neurofibromas, freckling, and Lisch nodules were more prevalent in patients older than 12 years (p > .05). Optic glioma detected in 17.3% of the patients and was significantly more common before the age of 6 (p > .001). Other solid tumors developed in 5% of the patients. There was no genotype-phenotype correlation between patients with truncating and nontruncating variants. However, six out of seven patients with large deletions had significant developmental delay, one patient with the c.2970_2972delAAT (p.Met992del) variant had only typical pigmentary features, and another patient with the c.4267A > G (p.Lys1423Glu) variant had CALMs, freckling, neurofibromas, and Noonan-like phenotype. CONCLUSIONS We described 19 novel variants and seven large deletions in NF1. Applying MLPA assay in NF1 is useful in expanding the molecular diagnosis. Although very limited genotype-phenotype correlation has been reported in NF1, the fact that specific phenotypic findings were observed in our patients with large deletions and two intragenic variants supports the studies published recently.
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Affiliation(s)
- Nilay Güneş
- Cerrahpaşa Medical Faculty, Department of Pediatric Genetics, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Gözde Yeşil
- Faculty of Medicine, Department of Medical Genetics, Bezmialem Vakif University, Istanbul, Turkey
| | - Filiz Geyik
- Cerrahpaşa Medical Faculty, Department of Pediatric Genetics, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Büşra Kasap
- Cerrahpaşa Medical Faculty, Department of Pediatric Genetics, Istanbul University-Cerrahpaşa, Istanbul, Turkey
| | - Tiraje Celkan
- Cerrahpaşa Medical Faculty, Department of Pediatric Oncology, Istanbul University-Cerrahpaşa, Istanbul
| | - Rejin Kebudi
- Department of Pediatric Oncology, Istanbul University, Oncology Institute, Istanbul, Turkey
| | - Beyhan Tüysüz
- Cerrahpaşa Medical Faculty, Department of Pediatric Genetics, Istanbul University-Cerrahpaşa, Istanbul, Turkey
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39
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Kebudi R. Acute invasive fungal sinusitis in immunocompromised children. Hematol Transfus Cell Ther 2021; 44:128-129. [PMID: 33773957 PMCID: PMC8885361 DOI: 10.1016/j.htct.2021.01.012] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Accepted: 01/27/2021] [Indexed: 10/31/2022] Open
Affiliation(s)
- Rejin Kebudi
- Istanbul University, Oncology Institute, Istanbul, Turkey.
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40
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Bay SB, Kebudi R. Respiratory viral panel testing in children with cancer and respiratory tract infections. Pediatr Blood Cancer 2021; 68:e28773. [PMID: 33058455 DOI: 10.1002/pbc.28773] [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: 10/04/2020] [Accepted: 10/05/2020] [Indexed: 11/10/2022]
Affiliation(s)
- Sema Buyukkapu Bay
- Department of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey.,Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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Kebudi R, Alkaya DU. Epidemiology and survival of childhood cancer in Turkey. Pediatr Blood Cancer 2021; 68:e28754. [PMID: 33034155 DOI: 10.1002/pbc.28754] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [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: 11/17/2019] [Revised: 09/13/2020] [Accepted: 09/22/2020] [Indexed: 11/10/2022]
Abstract
INTRODUCTION The aim of this study is to evaluate demographics, clinical data, and survival rates of children with cancer over 22 years, and to compare the outcomes, before and after a national health reform was performed. MATERIAL AND METHODS Files of patients, aged 0-19 years, diagnosed with cancer at the Istanbul University Oncology Institute during 1990-2012 were evaluated retrospectively. RESULTS The mean age at diagnosis of 2413 patients was 7.5 ± 5.1 years (range 3 days to 19 years). Male/female ratio was 1.26. After 2002, the number of patients diagnosed at a localized/low-risk stage compared to advanced stage significantly increased (60.7% vs 65.1%, P = .03). Comparing the period before 2002 to after 2002, a lower percentage of patients were diagnosed with advanced stage non-Hodgkin lymphoma (62.1% vs 45.1%, P = .03), retinoblastoma (9.5% vs 1.4%, P = .005), soft tissue sarcomas (52.1% vs 38.3%, P = .01), neuroblastoma (82.4% vs 56.2%, P = .005), and carcinomas (72.9% vs 65.4%, P = .04) after 2002. The 5-year survival rate of all patients during the entire period was 74.4%. The survival rate significantly increased for non-Hodgkin lymphoma (63.7% vs 91.8%, P < .0001), neuroblastoma (46.8% vs 70.5%, P = .025), and renal tumors (70% vs 92.3%, P = .013) after 2002. CONCLUSIONS The increase in patients diagnosed at a localized/low-risk stage and the increase in survival of some types of cancer over years is promising. The national health care reform, enabling patients to easily access free health services, increased awareness, improvement in oncological treatment, and supportive care may have contributed to the progress achieved, and may be a model for other developing countries.
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Affiliation(s)
- Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Department of Clinical Oncology & Department of Preventive Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Dilek Uludag Alkaya
- Department of Pediatrics, Cerrahpasa Medical Faculty, Istanbul University-Cerrahpasa, Istanbul, Turkey
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Mulder RL, Font-Gonzalez A, Hudson MM, van Santen HM, Loeffen EAH, Burns KC, Quinn GP, van Dulmen-den Broeder E, Byrne J, Haupt R, Wallace WH, van den Heuvel-Eibrink MM, Anazodo A, Anderson RA, Barnbrock A, Beck JD, Bos AME, Demeestere I, Denzer C, Di Iorgi N, Hoefgen HR, Kebudi R, Lambalk C, Langer T, Meacham LR, Rodriguez-Wallberg K, Stern C, Stutz-Grunder E, van Dorp W, Veening M, Veldkamp S, van der Meulen E, Constine LS, Kenney LB, van de Wetering MD, Kremer LCM, Levine J, Tissing WJE. Fertility preservation for female patients with childhood, adolescent, and young adult cancer: recommendations from the PanCareLIFE Consortium and the International Late Effects of Childhood Cancer Guideline Harmonization Group. Lancet Oncol 2021; 22:e45-e56. [PMID: 33539753 DOI: 10.1016/s1470-2045(20)30594-5] [Citation(s) in RCA: 78] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Revised: 09/10/2020] [Accepted: 09/16/2020] [Indexed: 01/05/2023]
Abstract
Female patients with childhood, adolescent, and young adult cancer are at increased risk for fertility impairment when treatment adversely affects the function of reproductive organs. Patients and their families desire biological children but substantial variations in clinical practice guidelines reduce consistent and timely implementation of effective interventions for fertility preservation across institutions. As part of the PanCareLIFE Consortium, and in collaboration with the International Late Effects of Childhood Cancer Guideline Harmonization Group, we reviewed the current literature and developed a clinical practice guideline for fertility preservation in female patients who were diagnosed with childhood, adolescent, and young adult cancer at age 25 years or younger, including guidance on risk assessment and available methods for fertility preservation. The Grading of Recommendations Assessment, Development and Evaluation methodology was used to grade the available evidence and to form the recommendations. This clinical practice guideline leverages existing evidence and international expertise to develop transparent recommendations that are easy to use to facilitate the care of female patients with childhood, adolescent, and young adult cancer who are at high risk for fertility impairment. A complete review of the existing evidence, including a quality assessment, transparent reporting of the guideline panel's decisions, and achievement of global interdisciplinary consensus, is an important result of this intensive collaboration.
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Affiliation(s)
- Renée L Mulder
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands.
| | - Anna Font-Gonzalez
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control and Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
| | - Hanneke M van Santen
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, UMC Utrecht, Utrecht, Netherlands
| | - Erik A H Loeffen
- Department of Pediatric Oncology/Hematology, Beatrix Children's Hospital, UMC Groningen, University of Groningen, Groningen, Netherlands
| | - Karen C Burns
- Cancer and Blood Disease Institute, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA; Department of Pediatrics, University of Cincinnati College of Medicine, University of Cincinnati, Cincinnati, OH, USA
| | - Gwendolyn P Quinn
- Department of Obstetrics and Gynecology, Department of Population Health, and Division of Medical Ethics, New York University School of Medicine, New York University, New York, NY, USA
| | - Eline van Dulmen-den Broeder
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | | | - Riccardo Haupt
- Epidemiology and Biostatistics Unit and DOPO Clinic, IRCCS Istituto Giannina Gaslini, Genova, Italy
| | - W Hamish Wallace
- Department of Paediatric Haematology and Oncology, Royal Hospital for Sick Children, Edinburgh, UK
| | - Marry M van den Heuvel-Eibrink
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Hematology and Oncology, Sophia Children's Hospital, Erasmus MC, Rotterdam, Netherlands
| | - Antoinette Anazodo
- Kids Cancer Centre, Sydney Children's Hospital, Sydney, NSW, Australia; Nelune Comprehensive Cancer Centre, Prince of Wales Hospital, Sydney, NSW, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, NSW, Australia
| | - Richard A Anderson
- Medical Research Council Centre for Reproductive Health, University of Edinburgh, Edinburgh, UK
| | - Anke Barnbrock
- Division for Stem Cell Transplantation and Immunology, Department for Children and Adolescents, University Hospital, Goethe University, Frankfurt, Germany
| | - Joern D Beck
- Hospital for Children and Adolescents, University of Erlangen-Nürnberg, Erlangen, Germany; LESS Group, Hospital for Children and Adolescents, University of Lübeck, Lübeck, Germany
| | - Annelies M E Bos
- Department of Reproductive Medicine and Gynaecology, UMC Utrecht, Utrecht, Netherlands
| | - Isabelle Demeestere
- Research Laboratory on Human Reproduction and Fertility Clinic, Department of Obstetrics and Gynecology, CUB-Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Christian Denzer
- Division of Pediatric Endocrinology and Diabetes, Department of Pediatrics and Adolescent Medicine, Ulm University Medical Center, Ulm, Germany
| | - Natascia Di Iorgi
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genova, Genova, Italy
| | - Holly R Hoefgen
- Division of Pediatric and Adolescent Gynecology, Washington University School of Medicine, Washington University, St Louis, MO, USA
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Cerrahpasa Medical Faculty, Istanbul University Cerrahpasa, Istanbul, Turkey; Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Cornelis Lambalk
- Department of Obstetrics and Gynecology, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Thorsten Langer
- Division Pediatric Hematology and Oncology, University Hospital of Schleswig-Holstein, Lübeck, Germany
| | - Lillian R Meacham
- Aflac Cancer and Blood Disorders Center, Children's Healthcare of Atlanta, Atlanta, GA, USA; Division of Hematology/Oncology and Division of Endocrinology, Department of Pediatrics, Emory University School of Medicine, Emory University, Atlanta, GA, USA
| | - Kenny Rodriguez-Wallberg
- Division of Gynecology and Reproduction, Department of Reproductive Medicine, Karolinska University Hospital, Stockholm, Sweden; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Catharyn Stern
- Melbourne IVF, East Melbourne, VIC, Australia; Reproductive Services, Royal Women's Hospital, Melbourne, VIC, Australia
| | - Eveline Stutz-Grunder
- Department of Pediatric Oncology, Children's Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Wendy van Dorp
- Division of Reproductive Medicine, Department of Obstetrics and Gynaecology, Erasmus MC, Rotterdam, Netherlands
| | - Margreet Veening
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Saskia Veldkamp
- Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Louis S Constine
- Department of Radiation Oncology and Department of Pediatrics, University of Rochester Medical Center, University of Rochester, Rochester, NY, USA
| | - Lisa B Kenney
- Boston Children's Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Harvard University, Boston, MA, USA
| | | | - Leontien C M Kremer
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Pediatric Oncology, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Jennifer Levine
- Division of Pediatric Hematology and Oncology, Weill Cornell Medicine, Cornell University, New York, NY, USA
| | - Wim J E Tissing
- Princess Máxima Center for Pediatric Oncology, Utrecht, Netherlands; Department of Pediatric Oncology/Hematology, Beatrix Children's Hospital, UMC Groningen, University of Groningen, Groningen, Netherlands
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Kebudi R, Cakir FB, Silbermann M. Palliative Care in High and Low Resource Countries. Curr Pediatr Rev 2021; 17:220-224. [PMID: 33820519 DOI: 10.2174/1573396317666210405143649] [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: 07/26/2020] [Revised: 01/10/2021] [Accepted: 01/22/2021] [Indexed: 11/22/2022]
Abstract
Palliative Care (PC) is defined by the World Health Organization (WHO) as a support provided by multiple disciplines in order to improve the quality of life of both patients and their caregivers, throughout the disease course, from diagnosis to end-of-life. PC aims to prevent and treat symptoms and side effects of the disease and its treatment. PC is well developed in most high- -income countries; however in most low-income settings, where approximately 80% of patients with cancer requiring PC care for advanced disease live, PC services are still uncommon. Health indicators monitoring global PC development are policy, education, use of medicines, service provision and professional activity. Globally, PC development may be categorized as Group 1 (no known hospice-PC activity), Group 2 (capacity-building activity), Groups 3a Isolated PC provided, 3b Generalized PC provided, 4a hospice-PC services at a stage of integration into regular service provision, and 4b hospice-PC services at a stage of advanced integration into regular service provision. Spirituality is an essential element of patient-centered PC. The use of Complementary and Traditional Medicine (CTM) in Middle Eastern countries is widespread. There are wide discrepancies in cancer care and PC in many regions of the world. The Individualized Care Planning and Coordination (ICPC) Model is designed to facilitate the advance care planning with continuity of all the measures like symptom control or emotional, social and spiritual care of both the patient and the family during the disease steps like relapse or end of life.
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Affiliation(s)
- Rejin Kebudi
- Pediatric Hematology and Oncology, Istanbul University, Oncology Institute, Istanbul, Turkey
| | - Fatma Betul Cakir
- Pediatric Hematology and Oncology, Bezmialem Vakif University, Istanbul, Turkey
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Kebudi R, N NA, Abedalthagafi M, Rana AN, Kirmani S, Musthaq N, Lamki ZA, El Houdzi J, Yazıcı H, El-Naggar S, Edwards M, Bianchi V, Durno C, Tabori U, Bouffet E. RARE-55. CHALLENGES AND SPECIFIC STRATEGIES FOR CONSTITUTIONAL MISMATCH REPAIR DEFICIENCY SYNDROME IN LOW RESOURCE SETTINGS. ON BEHALF OF THE INTERNATIONAL RRD CONSORTIUM IN LOW RESOURCE SETTINGS PANEL. Neuro Oncol 2020. [PMCID: PMC7715099 DOI: 10.1093/neuonc/noaa222.765] [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: 11/16/2022] Open
Abstract
Germline biallelic mutations in one of the mismatch repair genes (MSH2/MSH6/MLH1/PMS2 results in constitutional mismatch repair deficiency (CMMRD), a condition associated with multiple tumors arising from multiple organs during childhood, and these individuals rarely reach adulthood. The paucity of information with respect to these conditions leads to mismanagement and may be a factor in the high mortality of patients with CMMRD. Two international consortia, the European CARE4CMMRD, and the international replication repair deficiency (RRD) consortium, are addressing the many challenges associated with this condition. To address specific issues surrounding the management of CMMRD in low and middle income countries (LMIC), a multidisciplinary taskforce of 11 specialists from nine countries was formed. Preliminary conclusions are: 1) Immunohistochemistry for CMMRD should be considered for all patients with suggestive clinical features. In countries where CMMRD is common, malignant gliomas, colon cancers and T cell lymphomas should be stained routinely as the prevalence of CMMRD in these tumors can exceed 40%. 2) Temozolomide should not be used in the management of malignant glioma. By contrast, preclinical studies have suggested increased sensitivity to nitrosoureas. For the management of CMMRD related lymphoma and leukemia, mercaptopurines should not be avoided or discontinued as a part of the standard of care before more data are collected. 3) Management with checkpoint inhibitors should be limited to centers with intensive care units and expertise in complex supportive care to manage side effects of immune therapy. 4) Surveillance protocols have demonstrated long term survival benefits and should be implemented in LMIC.
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Affiliation(s)
- Rejin Kebudi
- Istanbul University Oncology Institute, Istanbul, Turkey
| | - Nisreen Amayiri N
- King Hussein Cancer Center, Department of Pediatrics, Hematology/Oncology, Amman, Jordan
| | - Malak Abedalthagafi
- King Fahad Medical City, King Abdulaziz City for Science and Technology, Riyad, Saudi Arabia
| | - Asim Noor Rana
- Department of Pediatrics, Division of Hematology-Oncology, Dubai, UAE
| | | | - Naureen Musthaq
- Department of Pharmaceutical Sciences, MM College of Pharmacy, MM University, Mullana, Hryana, India
| | | | | | - Hulya Yazıcı
- Istanbul University, Oncology Institute, Cancer Genetics, Istanbul, Turkey
| | - S El-Naggar
- Children’s Cancer Hospital in Egypt 57357, Cairo, Egypt
| | - Melissa Edwards
- Department of Pediatrics, Division of Hematology-Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Vanessa Bianchi
- Department of Pediatrics, Division of Hematology-Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Carol Durno
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, The Hospital for Sick Children, Toronto, ON, Canada
| | - Uri Tabori
- Department of Pediatrics, Division of Hematology-Oncology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Eric Bouffet
- Department of Pediatrics, Division of Hematology-Oncology, The Hospital for Sick Children, Toronto, ON, Canada
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Khodzhaev K, Bay SB, Kebudi R, Altindirek D, Kaya A, Erbilgin Y, Ng OH, Kiykim A, Erol FC, Zengin FS, Firtina S, Ng YY, Aksoy BA, Sayitoglu M. Lymphoma Predisposing Gene in an Extended Family: CD70 Signaling Defect. J Clin Immunol 2020; 40:883-892. [PMID: 32620996 DOI: 10.1007/s10875-020-00816-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 02/18/2020] [Accepted: 06/26/2020] [Indexed: 12/31/2022]
Abstract
Genome-wide sequencing studies in pediatric cancer cohorts indicate that about 10% of patients have germline mutations within cancer predisposition genes. Within this group, primary immune deficiencies take the priority regarding the vulnerability of the patients to infectious agents and the difficulties of cancer management. On the other hand, early recognition of these diseases may offer specific targeted therapies and hematopoietic stem cell transplantation as an option. Besides therapeutic benefits, early diagnosis will provide genetic counseling for the family members. Within this context, an extended family with multiple consanguineous marriages and affected individuals, who presented with combined immune deficiency (CID) and/or Hodgkin lymphoma phenotype, were examined by exome sequencing. A pathogenic homozygous missense CD70 variation was detected (NM_001252.5:c332C>T) in concordance with CD70 phenotype and familial segregation was confirmed. CD70 variations in patients with CID and malignancy have very rarely been reported. This paper reports extended family with multiple affected members with CID and malignancy carrying a missense CD70 variation, and reviews the rare cases reported in the literature. Primary immune deficiencies appear to be a potential cause for pediatric cancers. Better focusing on these inborn disorders to prevent or make an early diagnosis of malignant transformation and reduce mortalities is important.
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Affiliation(s)
- Khusan Khodzhaev
- Aziz Sancar Institute of Experimental Medicine, Genetics Department, Istanbul University, Istanbul, Turkey
- Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Sema Buyukkapu Bay
- Oncology Institute, Division of Pediatric Hematology-Oncology, Istanbul University, Istanbul, Turkey
| | - Rejin Kebudi
- Oncology Institute, Division of Pediatric Hematology-Oncology, Istanbul University, Istanbul, Turkey.
| | - Didem Altindirek
- Aziz Sancar Institute of Experimental Medicine, Genetics Department, Istanbul University, Istanbul, Turkey
- Institute of Health Sciences, Istanbul University, Istanbul, Turkey
| | - Aysenur Kaya
- Faculty of Medicine, Department of Pediatric Allergy Immunology, Istinye University, Istanbul, Turkey
| | - Yucel Erbilgin
- Aziz Sancar Institute of Experimental Medicine, Genetics Department, Istanbul University, Istanbul, Turkey
| | - Ozden Hatirnaz Ng
- Department of Medical Biology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey
| | - Ayca Kiykim
- Faculty of Medicine, Division of Pediatric Allergy Immunology, Istanbul University Cerrahpasa, Istanbul, Turkey
| | - Funda Cipe Erol
- Faculty of Medicine, Department of Pediatric Allergy Immunology, Istinye University, Istanbul, Turkey
| | - Feride Sen Zengin
- Intensive Care Unit, Erzurum Education and Research Hospital, Erzurum, Turkey
| | - Sinem Firtina
- Faculty of Art and Science, Department of Molecular Biology and Genetics, Istinye University, Istanbul, Turkey
| | - Yuk Yin Ng
- Genetics and Bioengineering Department, Istanbul Bilgi University, Istanbul, Turkey
| | - Basak Adakli Aksoy
- Department of Pediatric Hematology Oncology, Altınbaş University, Istanbul, Turkey
| | - Muge Sayitoglu
- Aziz Sancar Institute of Experimental Medicine, Genetics Department, Istanbul University, Istanbul, Turkey
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Kebudi R, Amayiri N, Abedalthagafi M, Rana AN, Kirmani S, Musthaq N, Lamki ZA, Houdzi JE, Yazici H, El-Naggar S, Edwards M, Bianchi VJ, Durno C, Tabori U, Bouffet E. Position paper: Challenges and specific strategies for constitutional mismatch repair deficiency syndrome in low-resource settings. Pediatr Blood Cancer 2020; 67:e28309. [PMID: 32472748 DOI: 10.1002/pbc.28309] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 01/01/2020] [Revised: 03/18/2020] [Accepted: 03/19/2020] [Indexed: 01/25/2023]
Abstract
Germline biallelic mutations in one of the mismatch repair genes, mutS homolog 2, mutS homolog 6, mutL homolog 1, or postmeiotic segregation increased 2, result in one of the most aggressive cancer syndromes in humans termed as constitutional mismatch repair deficiency (CMMRD). Individuals with CMMRD are affected with multiple tumors arising from multiple organs during childhood, and these individuals rarely reach adulthood without specific interventions. The most common tumors observed are central nervous system, hematological, and gastrointestinal malignancies. The incidence of CMMRD is expected to be high in low-resource settings due to a high rate of consanguinity in these regions, and it is thought to be underrecognized and consequently underdiagnosed. This position paper is therefore important to provide a summary of the current situation, and to highlight the necessity of increasing awareness, diagnostic criteria, and surveillance to improve survival for patients and family members.
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Affiliation(s)
- Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Nisreen Amayiri
- Department of Pediatrics, King Hussein Cancer Center, Hematology/Oncology, Amman, Jordan
| | - Malak Abedalthagafi
- Genomics Research Department, Saudi Human Genome Project, King Fahad Medical City, King Abdulaziz City for Science and Technology, Riyadh, Saudi Arabia
| | - Asım Noor Rana
- Department of Pediatrics, Division of Hematology-Oncology, Dubai Hospital, Dubai, UAE
| | - Salman Kirmani
- Department of Pediatrics & Child Health, Aga Khan University, Karachi, Pakistan
| | - Naureen Musthaq
- Department of Pharmaceutical Sciences, M.M. College of Pharmacy, M.M. University, Mullana, Ambala, Haryana, India
| | - Zakiya Al Lamki
- College of Medicine & Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Jamila El Houdzi
- Hematology and Pediatric Oncology Unit, Centre d'Oncologie et d'Hematologie, Mohammed VI University Hospital, Marrakech, Morocco
| | - Hulya Yazici
- Division of Cancer Genetics, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - Shahenda El-Naggar
- Tumor Biology Research Program, Department of Research, Basic Research Unit, Children's Cancer Hospital in Egypt 57357, Cairo, Egypt
| | - Melissa Edwards
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Vanessa J Bianchi
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Carol Durno
- The Zane Cohen Center, Mount Sinai Hospital, Toronto, Canada.,Division of Gastroenterology, Hepatology and Nutrition, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Uri Tabori
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
| | - Eric Bouffet
- Division of Hematology-Oncology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Canada
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Sullivan M, Bouffet E, Rodriguez‐Galindo C, Luna‐Fineman S, Khan MS, Kearns P, Hawkins DS, Challinor J, Morrissey L, Fuchs J, Marcus K, Balduzzi A, Basset‐Salom L, Caniza M, Baker JN, Kebudi R, Hessissen L, Sullivan R, Pritchard‐Jones K. The COVID-19 pandemic: A rapid global response for children with cancer from SIOP, COG, SIOP-E, SIOP-PODC, IPSO, PROS, CCI, and St Jude Global. Pediatr Blood Cancer 2020; 67:e28409. [PMID: 32400924 PMCID: PMC7235469 DOI: 10.1002/pbc.28409] [Citation(s) in RCA: 85] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 04/24/2020] [Indexed: 12/16/2022]
Abstract
The COVID-19 pandemic is one of the most serious global challenges to delivering affordable and equitable treatment to children with cancer we have witnessed in the last few decades. This Special Report aims to summarize general principles for continuing multidisciplinary care during the SARS-CoV-2 (COVID-19) pandemic. With contributions from the leadership of the International Society for Pediatric Oncology (SIOP), Children's Oncology Group (COG), St Jude Global program, and Childhood Cancer International, we have sought to provide a framework for healthcare teams caring for children with cancer during the pandemic. We anticipate the burden will fall particularly heavily on children, their families, and cancer services in low- and middle-income countries. Therefore, we have brought together the relevant clinical leads from SIOP Europe, COG, and SIOP-PODC (Pediatric Oncology in Developing Countries) to focus on the six most curable cancers that are part of the WHO Global Initiative in Childhood Cancer. We provide some practical advice for adapting diagnostic and treatment protocols for children with cancer during the pandemic, the measures taken to contain it (e.g., extreme social distancing), and how to prepare for the anticipated recovery period.
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Affiliation(s)
- Michael Sullivan
- Children's Cancer CentreRoyal Children's Hospital and Department of PaediatricsFaculty of Medicine Dentistry and Health SciencesUniversity of MelbourneMelbourneAustralia
| | - Eric Bouffet
- Division of Haematology/OncologyHospital for Sick ChildrenTorontoOntarioCanada
| | | | - Sandra Luna‐Fineman
- Hematology/Oncology/SCT Children's Hospital ColoradoUniversity of ColoradoAuroraColorado
| | | | - Pam Kearns
- Birmingham Children's Hospital and Institute of Cancer and Genomic SciencesUniversity of BirminghamEdgbastonBirminghamUK
| | - Douglas S. Hawkins
- Pediatric Hematology/OncologySeattle Children's HospitalSeattleWashington
| | - Julia Challinor
- School of NursingUniversity of California San FranciscoSan FranciscoCalifornia
| | - Lisa Morrissey
- Division of NursingHematology/OncologyBoston Children's HospitalBostonMassachusetts
| | - Jörg Fuchs
- Department of Pediatric Surgery Children's HospitalUniversity of TuebingenTuebingenGermany
| | - Karen Marcus
- Dana‐Farber/Boston Children's Cancer and Blood Disorders CenterBrigham and Women's HospitalHarvard Medical School, Boston, Massachusetts
| | - Adriana Balduzzi
- Paediatric DepartmentMBBM FoundationASST Monza Ospedale San GerardoUniversity of Milano BicoccaMonzaItaly
| | - Luisa Basset‐Salom
- Childhood Cancer International (www.childhoodcancerinternational.org) and International representative of FedEspañola de Padres de NIÑOS CON Cáncer (www.cancerinfantil.org)MadridSpain
| | - Miguela Caniza
- Departments of Global Pediatric Medicine and Infectious DiseasesSt Jude Children's Research HospitalMemphisTennessee
| | - Justin N. Baker
- Division of Quality of Life and Palliative CareDepartment of OncologySt Jude Children's Research HospitalMemphisTennessee
| | - Rejin Kebudi
- Pediatric Hematology OncologyOncology InstituteIstanbul UniversityIstanbulTurkey
| | - Laila Hessissen
- Pediatric Hematology and OncologyMohammed V University of Rabat, RabatMorocco
| | - Richard Sullivan
- School of Cancer ScienceKing's College London, UKInstitute of Cancer Policy and Conflict and Health Research Groupand Research for Health Care in Conflict (https://r4hc‐mena.org/), London, UK
| | - Kathy Pritchard‐Jones
- International Society of Paediatric Oncology (SIOP)UCL Great Ormond Street Institute of Child HealthUniversity College LondonLondonUK
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Kebudi R, Bay Buyukkapu S, Gorgun O, Dural O, Onder S, Bilgic B, Yilmaz I, Iribas A, Arndt CAS, Harris A, Field A, Schultz KAP, Hill A, Darendeliler E. Rhabdomyosarcoma of the female genital tract: Long-term outcome and association with DICER1 variation. J Clin Oncol 2020. [DOI: 10.1200/jco.2020.38.15_suppl.10538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
10538 Background: Rhabdomyosarcoma (RMS) of the female genital tract is rare, accounting for 3.5% of cases of rhabdomyosarcomas. Germline DICER1 mutations are associated with predisposition to pleuropulmonary blastoma and other tumors including sarcomas. Recently DICER1-associated RMS of the uterus/ovary has ben reported.. The aim of this study is to evaluate demographic characteristics, molecular pathogenesis, treatment and long term outcome of female genital tract rhabdomyosarcoma. Methods: Files of children with RMS of the female genital tract diagnosed at the Istanbul University, Oncology Institute during 1990-2019 were reviewed. Molecular genetic sequencing was performed by polymerase chain reaction amplification of genomic DNA extracted from the formalin-fixed, paraffin embedded tumors, followed by Sanger sequencing. Genetic testing for DICER1 variants of the proband and family members was performed if DICER1 mutation was detected in the tumor of the proband. Results: Of 210 RMS cases, 11 arose from the female genital tract. The median age at diagnosis was 52 months (10 months-15 years). Primary sites were vaginal (n = 5), uterus (n = 4), and ovary(n = 2). Presenting symptoms included vaginal mass (n = 6), vaginal bleeding (n = 5), and abdominal pain (n = 3). Four had group 1, five group 3, two group 2 disease and all received chemotherapy (vincristine, actinomycinD + cyclophosphamide).Three received radiotherapy; three underwent hysterectomy. DICER1 mutation was detected in tumor tissue in three patients:[ c.5113G > A (p.E1705K); c.5428G > T (p.D1810Y); c.1870C > T (p.Arg624Ter)] Genetic testing revealed germline DICER1 pathogenic variation in two patients and their family members, one of whom had cystic nephroma in infancy and history of Wilms tumor in an uncle. They were referred for surveillance for the DICER1 related diseases. A patient with metachronous bilateral ovarian RMS died. Two are married, one has children. The 5 year survival for RMS of the female genital tract was 85.7 % at a median follow-up of 34 (4-298) months. Conclusions: Rhabdomyosarcoma of the female genital tract is associated with a favorable prognosis, however some individuals undergo aggressive local therapies. Individuals with RMS of the female genital tract should be tested for DICER1 pathogenic variation. The detection of a DICER1 mutation in an individual or family members is important to facilitate surveillance for related tumors, so that they may be detected at the earliest possible stage, potentially increasing survival and decreasing risks of late effects.
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Affiliation(s)
- Rejin Kebudi
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Sema Bay Buyukkapu
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Omer Gorgun
- Istanbul University, Oncology Institute, Pediatric Hematology-Oncology, Istanbul, Turkey
| | - Ozlem Dural
- Istanbul University, Istanbul Medical Faculty, Dept.of Obstetrics and Gynecology, Istanbul, Turkey
| | - Semen Onder
- Istanbul University, Istanbul Medical Faculty, Dept. of Pathology, Istanbul, Turkey
| | - Bilge Bilgic
- Istanbul University, Istanbul Medical Faculty, Dept. of Pathology, Istanbul, Turkey
| | - Ismail Yilmaz
- Sultan Abdulhamid Han Training and Research Hospital, Dept. of Pathology, Istanbul, Turkey
| | - Ayca Iribas
- Istanbul University, Oncology Institute, Radiation Oncology, Istanbul, Turkey
| | | | - Anne Harris
- Children's Hospitals and Clinics of Minnesota, Minneapolis, MN
| | | | | | - Ashley Hill
- George Washington University School of Medicine and Health Sciences, Dept. of Pathology, Washington, WA
| | - Emin Darendeliler
- Istanbul University, Oncology Institute, Radiation Oncology, Istanbul, Turkey
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49
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Yazici H, Wu HC, Tigli H, Yilmaz EZ, Kebudi R, Santella RM. High levels of global genome methylation in patients with retinoblastoma. Oncol Lett 2020; 20:715-723. [PMID: 32565997 PMCID: PMC7286142 DOI: 10.3892/ol.2020.11613] [Citation(s) in RCA: 4] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Accepted: 09/26/2019] [Indexed: 02/07/2023] Open
Abstract
Retinoblastoma is a tumor of the embryonic neural retina in young children. The DNA methyltransferase 1 (DNMT1) gene has been demonstrated to be transcriptionally activated in cells lacking retinoblastoma 1 (RB1). Thus, there is a direct interaction between DNMT1 and RB1 in vivo. The present study hypothesized that uncontrolled DNMT1, DNMT2 and DNMT3 expression may lead to a high level of global genome methylation causing a second hit or where both alleles are altered, in RB1 and/or inactivation of other genes in retinal cells. To test this, the global genome methylation levels were analyzed in 69 patients with retinoblastoma, as well as 26 healthy siblings and 18 healthy unrelated children as the control groups. Peripheral blood and tumor tissue samples were obtained from 32 patients. The expression levels of DNMT genes were also determined in cell lines. Based on the median levels of global genome methylation in patients, higher genome-wide methylation levels in peripheral blood were associated with a 3.33-fold increased risk for retinoblastoma in patients compared with all healthy controls (95% confidence interval, 0.98–11.35; P<0.0001). The level of global genome methylation and the expression of DNMT genes were increased in the WERI-RB-1 cell line, which has a mutated RB1 gene, compared with a wild-type RB1-expressing cell line. These results supported the hypothesis that epigenetic alterations, as well as mutations in RB1, may be associated with the oncogenesis and inheritance of retinoblastoma. The repression of genes that interact with RB1, such as the DNMT gene family, may be important in patients with retinoblastoma with alterations in RB1, and may serve a role in the treatment and regression of retinoblastoma.
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Affiliation(s)
- Hülya Yazici
- Department of Environmental Health Sciences, Mailman School of Public Health of Columbia University, New York, NY 10032, USA.,Department of Basic Oncology, Division of Cancer Genetics, Oncology Institute, Istanbul University, Fatih, Istanbul 34093, Turkey
| | - Hui-Chen Wu
- Department of Environmental Health Sciences, Mailman School of Public Health of Columbia University, New York, NY 10032, USA
| | - Hulya Tigli
- Department of Basic Oncology, Division of Cancer Genetics, Oncology Institute, Istanbul University, Fatih, Istanbul 34093, Turkey.,Department of Molecular Biology, Gelişim University, Avcilar, Istanbul 34315, Turkey
| | - Elif Z Yilmaz
- Department of Basic Oncology, Division of Cancer Genetics, Oncology Institute, Istanbul University, Fatih, Istanbul 34093, Turkey.,Faculty of Medicine, Medipol University, Beykoz, Istanbul 34810, Turkey
| | - Rejin Kebudi
- Division of Pediatric Hematology-Oncology, Cerrahpaşa Medical Faculty, Istanbul University, Fatih, İstanbul 34098, Turkey.,Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Fatih, Istanbul 34093, Turkey
| | - Regina M Santella
- Department of Environmental Health Sciences, Mailman School of Public Health of Columbia University, New York, NY 10032, USA
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50
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Hurdogan O, Yilmaz I, Bay SB, Vural S, Tugcu D, Kebudi R, Gun F, Ozkan B, Bilgic B, Firat P, Yilmazbayhan D, Ozluk Y. DICER1 Hotspot Mutations in Pleuropulmonary Blastoma: A Case Series From a Tertiary Center. Pediatr Dev Pathol 2020; 23:204-209. [PMID: 31603374 DOI: 10.1177/1093526619878602] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Pleuropulmonary blastoma (PPB) is a potentially aggressive, rare childhood neoplasia. We investigated histopathological features, survival, and DICER1 hotspot mutations among PPB patients. Archive records at our institution were reviewed, covering a 20-year period. Thirteen children (6 males and 7 females) with a mean age of 30.5 (range 6-83) months were included. The tumor subtypes were type I in 6 (46%), type II in 4 (31%), and type III in 3 (23%). Only tumors with type II and type III histology showed anaplasia (4/7, 57%). Median follow-up was 28 (range 9-216) months. Three-year overall survival rate was 83.3% and 3-year progression-free survival rate was 25%. Progression was seen in 60% (3/5) of type I and 66.7% (4/6) of type II and type III cases. Two patients died of disseminated disease at 9 and 44 months. Hotspot missense mutations on DICER1 gene were detected in all 11 patients with available tumor tissue. We found an additional novel germline loss-of-function mutation (c.5436dupT; p.E1813*) in 1 case. To the best of our knowledge, this is the first study to investigate hotspot missense mutations on DICER1 gene among the largest series of Turkish children with PPB.
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Affiliation(s)
- O Hurdogan
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - I Yilmaz
- Department of Pathology, Sultan Abdulhamid Han Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - S B Bay
- Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey
| | - S Vural
- Department of Pediatric Oncology, Sisli Etfal Training and Research Hospital, Istanbul, Turkey
| | - D Tugcu
- Department of Pediatric Hematology-Oncology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - R Kebudi
- Division of Pediatric Hematology-Oncology, Oncology Institute, Istanbul University, Istanbul, Turkey.,Department of Pediatric Oncology, Cerrahpasa Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - F Gun
- Department of Pediatric Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - B Ozkan
- Department of Thoracic Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - B Bilgic
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - P Firat
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - D Yilmazbayhan
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Y Ozluk
- Department of Pathology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
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