1
|
Arslantaş E, Ayçiçek A, Akpınar Tekgündüz S, Özkorucu Yıldırgan D, Özkan Karagenç A, Tahtakesen Güçer TN, Kaçar AG, Bayram C, Özdemir N. Switching from Deferasirox Dispersible Tablets to Deferasirox Film-Coated Tablets: Is There an Effect on Ferritin Levels in Children and Adolescents with Transfusion-Dependent Anemia? Turk Arch Pediatr 2024; 59:193-199. [PMID: 38454229 PMCID: PMC11059524 DOI: 10.5152/turkarchpediatr.2024.23262] [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: 10/30/2023] [Accepted: 02/06/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVE To investigate the effect of switching from deferasirox dispersible tablet (DT) to deferasirox film-coated tablet (FCT) on serum ferritin (SF) levels in transfusion-dependent patients. MATERIALS AND METHODS Patients who received regular erythrocyte transfusion and whose treatment was switched from DT to FCT were included in the study. FCT start date was taken as the index date. Patients were followed over 2 equal and long periods, both before and after index date. RESULTS Thirty-two patients were included, and the comparison periods ranged from 4 to 12 months. The SF values increased from a median of 1723 ng/mL (range 717-5369 ng/mL) to 1.853 ng/mL (range 924-5478 ng/mL) after switching from DT to FCT (P = .036). While there was a significant increase in median SF after switching in Turkish patients (1467 ng/mL to 1778 ng/ mL, P = .010) and patients ≥12 years (1598-1848 ng/mL, P = .009), there was an insignificant (P = .859) decrease in SF in immigrant children. Considering only the post-switch period, there was a non-significant increase in median SF in the entire cohort, while SF decreased significantly in immigrant children (P = .026). No serious side effects were observed in any patient that would cause discontinuation of treatment. CONCLUSION Overall, higher SF value was observed with FCT compared to DT in short term. There were different results between patient groups. Our results suggest that FCT is more effective than DT in patients with high basal ferritin and who are actually incompatible with treatment and should be preferred first in these patients.
Collapse
Affiliation(s)
- Esra Arslantaş
- Department of Pediatric Hematology and Oncology, Health Sciences University, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Ali Ayçiçek
- Department of Pediatric Hematology and Oncology, Health Sciences University, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Sibel Akpınar Tekgündüz
- Department of Pediatric Hematology and Oncology, Health Sciences University, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Duygu Özkorucu Yıldırgan
- Department of Pediatric Hematology and Oncology, Health Sciences University, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Ayşe Özkan Karagenç
- Department of Pediatric Hematology and Oncology, Health Sciences University, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Tuba Nur Tahtakesen Güçer
- Department of Pediatric Hematology and Oncology, Health Sciences University, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Ayşe Gonca Kaçar
- Department of Pediatric Hematology and Oncology, Health Sciences University, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Cengiz Bayram
- Department of Pediatric Hematology and Oncology, Health Sciences University, Başakşehir Çam and Sakura City Hospital, İstanbul, Turkey
| | - Nihal Özdemir
- Department of Pediatric Hematology and Oncology, Health Sciences University, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey
| |
Collapse
|
2
|
Arslantaş E, Ayçiçek A, Esen Akkas B, Tahtakesen Güçer TN, Okur Acar S, Özkan Karagenc A, Akpınar Tekgündüz S, Bayram C. The Role of FDG- PET/CT in Detecting Bone Marrow Involvement in Childhood Solid Tumors. Nuklearmedizin 2024. [PMID: 38190995 DOI: 10.1055/a-2224-9441] [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: 01/10/2024]
Abstract
PURPOSE To compare the results of 18F-Fluorodeoxy positron emission tomography/computed tomography (18 F-FDG-PET/CT) and bone marrow biopsy (BMB) procedures in the initial evaluation of bone marrow involvement (BMI) in pediatric solid tumors. METHODS We conducted a retrospective analysis of newly diagnosed pediatric cases with lymphoma, neuroblastoma, Ewing sarcoma, rhabdomyosarcoma. Each case underwent both PET-CT imaging and BMB. Presence of tumor infiltration in BMB specimens and/or positive FDG-PET/CT findings indicate as BMI were regarded as true positive results. RESULTS Sixty-four patients were included in the study. BMI was detected in 23/64 (36%) patients, FDG-PET/CT imaging and BMB results were concordant in 54/64 patients. In 9/64 patients the finding was FDG-PET/CT (+), BMB (-) indicating a false negative BMB result. In only 1/64 patients FDG- PET/CT (-), BMB (+), indicating a false negative FDG-PET/CT result. In the whole patient group, the sensitivity, specificity, positive predictive value and negative predictive value of PET/CT and BMB in detecting bone marrow involvement were 95.6%, 100%, 100% and 97.6% and 60.8 %, 100%, 100% and 82%, respectively. CONCLUSION PET/CT has a high sensitivity and specificity for the assessing marrow involvement in pediatric solid tumors. We believe that PET/CT imaging should be performed as the first step in diagnostic staging, and BMB may not be necessary in every patient, only in patients with suspicious PET/CT results for bone marrow involvement. Additionally, for a more precise determination of bone marrow involvement, it is reasonable to perform BMB from FDG-retaining areas, using PET/CT as a guide tool.
Collapse
Affiliation(s)
- Esra Arslantaş
- Pediatric Hematology Oncology, Başakşehir Çam ve Sakura Şehir Hastanesi, Istanbul, Turkey
| | - Ali Ayçiçek
- Pediatric Hematology Oncology, Başakşehir Çam ve Sakura Şehir Hastanesi, Istanbul, Turkey
| | - Burcu Esen Akkas
- Department of Nuclear Medicine, Başakşehir Çam ve Sakura Şehir Hastanesi, Istanbul, Turkey
| | | | - Sultan Okur Acar
- Pediatric Hematology Oncology, Başakşehir Çam ve Sakura Şehir Hastanesi, Istanbul, Turkey
| | - Ayse Özkan Karagenc
- Pediatric Hematology Oncology, Başakşehir Çam ve Sakura Şehir Hastanesi, Istanbul, Turkey
| | | | - Cengiz Bayram
- Pediatric Hematology Oncology, Başakşehir Çam ve Sakura Şehir Hastanesi, Istanbul, Turkey
| |
Collapse
|
3
|
Atik T, Işık E, Onay H, Akgün B, Shamsali M, Kavaklı K, Evim M, Tüysüz G, Özbek NY, Şahin F, Salcıoğlu Z, Albayrak C, Oymak Y, Ünal E, Belen FB, Yılmaz Keskin E, Balkan C, Baytan B, Küpesiz A, Culha V, Tahtakesen Güçer TN, Güneş AM, Özkınay F. Factor 8 Gene Mutation Spectrum of 270 Patients with Hemophilia A: Identification of 36 Novel Mutations. Turk J Haematol 2020; 37:145-153. [PMID: 32026663 PMCID: PMC7463214 DOI: 10.4274/tjh.galenos.2020.2019.0262] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective Hemophilia A (HA) is the most severe X-linked inherited bleeding disorder caused by hemizygous mutations in the factor 8 (F8) gene. The aim of this study is to determine the mutation spectrum of the F8 gene in a large HA cohort from Turkey, and then to establish a phenotype-genotype correlation. Materials and Methods All HA cases (270 patients) analyzed molecularly in the Ege University Pediatric Genetics Molecular Laboratory between March 2017 and March 2018 were included in this study. To identify intron 22 inversion (Inv22), intron 1 inversion (Inv1), small deletion/insertions, and point mutations, molecular analyses of F8 were performed using a sequential application of molecular techniques. Results The mutation detection success rate was 95.2%. Positive Inv22 was found in 106 patients (39.3%), Inv1 was found in 4 patients (1.5%), and 106 different disease-causing sequence variants were identified in 137 patients (50.6%). In 10 patients (3.7%), amplification failures involving one or more exonic regions, considered to be large intragenic deletions, were identified. Of 106 different F8 mutations, 36 were novel. The relationship between F8 genotype and inhibitor development was considered significant. Conclusion A high mutation detection rate was achieved via the broad molecular techniques applied in this study, including 36 novel mutations. With regard to mutation types, mutation distribution and their impact on clinical severity and inhibitor development were found to be similar to those previously reported in other hemophilia population studies.
Collapse
Affiliation(s)
- Tahir Atik
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey,Equal contributors
| | - Esra Işık
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey,Equal contributors
| | - Hüseyin Onay
- Ege University, School of Medicine, Department of Medical Genetics, Izmir, Turkey
| | - Bilçağ Akgün
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey
| | - Moharram Shamsali
- Ege University, Institute of Health Sciences, Division of Health Bioinformatics, Izmir, Turkey
| | - Kaan Kavaklı
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Izmir, Turkey
| | - Melike Evim
- Uludag University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Gülen Tüysüz
- Akdeniz University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Antalya, Turkey
| | - Namık Yaşar Özbek
- Health Sciences University Ankara Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Hematology, Ankara, Turkey
| | - Fahri Şahin
- Ege University, School of Medicine, Department of Internal Medicine, Division of Hematology, Izmir, Turkey
| | - Zafer Salcıoğlu
- Istanbul Kanuni Sultan Suleyman Education and Research Hospital, Department of Pediatric Hematology and Oncology, Istanbul, Turkey
| | - Canan Albayrak
- Ondokuz Mayis University, Faculty of Medicine, Department of Pediatric Hematology and Oncology, Samsun, Turkey
| | - Yeşim Oymak
- Dr. Behcet Uz Children’s Hospital, Division of Pediatric Hematology, Izmir, Turkey
| | - Ekrem Ünal
- Erciyes University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Kayseri, Turkey
| | - Fatma Burcu Belen
- Katip Celebi University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Izmir, Turkey
| | - Ebru Yılmaz Keskin
- Suleyman Demirel University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Isparta, Turkey
| | - Can Balkan
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Izmir, Turkey
| | - Birol Baytan
- Uludag University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Alphan Küpesiz
- Akdeniz University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Antalya, Turkey
| | - Vildan Culha
- Health Sciences University Ankara Pediatric Hematology Oncology Training and Research Hospital, Department of Pediatric Hematology, Ankara, Turkey
| | - Tuba Nur Tahtakesen Güçer
- Istanbul Kanuni Sultan Suleyman Education and Research Hospital, Department of Pediatric Hematology and Oncology, Istanbul, Turkey
| | - Adalet Meral Güneş
- Uludag University, School of Medicine, Department of Pediatrics, Division of Pediatric Hematology, Bursa, Turkey
| | - Ferda Özkınay
- Ege University, School of Medicine, Department of Pediatrics, Division of Pediatric Genetics, Izmir, Turkey
| |
Collapse
|