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Duan H, Wang L, Li H, Wang Z, Jiao S, Liu Y, Li H, Chen J, Feng Q. The influence of WeChat education and care program on anxiety, depression, insomnia, and general state of health in parents of pediatric acute lymphoblastic leukemia patients. J Cancer Res Clin Oncol 2024; 150:138. [PMID: 38502341 PMCID: PMC10950967 DOI: 10.1007/s00432-024-05646-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 02/05/2024] [Indexed: 03/21/2024]
Abstract
PURPOSE WeChat-based education and care program serves as a promising nursing method for relieving mental stress in parents of pediatric patients. This study purposed to explore the influence of the WeChat education and care program (WECP) on mental health, insomnia, and general state of health in parents of pediatric acute lymphoblastic leukemia (ALL) patients. METHODS Totally, 146 parents of 73 primary pediatric ALL patients were randomized into the WECP group (74 parents of 37 patients) and standard care (SC) group (72 parents of 36 patients) to receive a 6-month corresponding intervention. Self-rating anxiety scale (SAS), self-rating depression scale (SDS), Athens insomnia scale (AIS), and 12-item general health questionnaire (GHQ-12) were assessed in parents of patients. RESULTS SAS scores at the third month (M3) (P = 0.041) and M6 (P = 0.032) were reduced in WECP group versus SC group. SAS-defined anxiety rate at M6 (P = 0.035) was declined in WECP group versus SC group. SDS score at M6 was descended in WECP group versus SC group (P = 0.024). However, there was no discrepancy in SDS-defined depression rate at any time point between groups (all P > 0.05). AIS scores at M1 (P = 0.015) and M6 (P = 0.021), as well as GHQ-12 scores at M3 (P = 0.007) and M6 (P = 0.001) were decreased in WECP group versus SC group. By subgroup analyses, WECP exhibited good effects at M6 in mothers, but not in fathers. CONCLUSION WECP is a feasible and efficacy intervention to improve mental stress and health status among parents of pediatric ALL patients, especially in mothers.
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Affiliation(s)
- Hui Duan
- Department of Pediatrics, Affiliated Hospital of Hebei Engineering University, No. 81 Congtai Road, Handan, 056002, China
| | - Li Wang
- Department of Pediatrics, Affiliated Hospital of Hebei Engineering University, No. 81 Congtai Road, Handan, 056002, China.
| | - Hui Li
- Department of Intensive Care Unit, Hebei Engineering University Affiliated Hospital, Handan, 056000, China
| | - Zhongyu Wang
- Department of Oncology 4, Handan Central Hospital, Handan, 056002, China
| | - Shuili Jiao
- Department of Pediatrics Ward 2, Handan Central Hospital, Handan, 056002, China
| | - Yanli Liu
- Department of Neonatology Ward 1, Handan Central Hospital, Handan, 056002, China
| | - Huihui Li
- Department of Neonatology Ward 1, Handan Central Hospital, Handan, 056002, China
| | - Jie Chen
- Department of Nephrology 2, Handan Central Hospital, Handan, 056002, China
| | - Qiang Feng
- Department of Cardiology 4, Handan Central Hospital, Handan, 056002, China
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Nekoeian S, Ferdowsian S, Asgari Y, Azizi Z. Identification of Hub Genes Associated with Resistance to Prednisolone in Acute Lymphoblastic Leukemia Based on Weighted Gene Co-expression Network Analysis. Mol Biotechnol 2023; 65:1913-1922. [PMID: 36877306 DOI: 10.1007/s12033-023-00707-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 02/18/2023] [Indexed: 03/07/2023]
Abstract
Resistance against glucocorticoids which are used to reduce inflammation and treatment of a number of diseases, including leukemia, is known as the first stage of treatment failure in acute lymphoblastic leukemia. Since these drugs are the essential components of chemotherapy regimens for ALL and play an important role in stop of cell growth and induction of apoptosis, it is important to identify genes and the molecular mechanism that may affect glucocorticoid resistance. In this study, we used the GSE66705 dataset and weighted gene co-expression network analysis (WGCNA) to identify modules that correlated more strongly with prednisolone resistance in type B lymphoblastic leukemia patients. The PPI network was built using the DEGs key modules and the STRING database. Finally, we used the overlapping data to identify hub genes. out of a total of 12 identified modules by WGCNA, the blue module was find to have the most statistically significant correlation with prednisolone resistance and Nine genes including SOD1, CD82, FLT3, GART, HPRT1, ITSN1, TIAM1, MRPS6, MYC were recognized as hub genes Whose expression changes can be associated with prednisolone resistance. Enrichment analysis based on the MsigDB repository showed that the altered expressed genes of the blue module were mainly enriched in IL2_STAT5, KRAS, MTORC1, and IL6-JAK-STAT3 pathways, and their expression changes can be related to cell proliferation and survival. The analysis performed by the WGCNA method introduced new genes. The role of some of these genes was previously reported in the resistance to chemotherapy in other diseases. This can be used as clues to detect treatment-resistant (drug-resistant) cases in the early stages of diseases.
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Affiliation(s)
- Shahram Nekoeian
- Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, No. 88, School of Advanced Technologies in Medicine, Italia st, Keshavarz Blvd, Tehran, 1417755469, Iran
- Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Yazdan Asgari
- Department of Medical Biotechnology, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, No. 88, School of Advanced Technologies in Medicine, Italia st, Keshavarz Blvd, Tehran, 1417755469, Iran.
| | - Zahra Azizi
- Department of Molecular Medicine, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, No. 88, School of Advanced Technologies in Medicine, Italia st, Keshavarz Blvd, Tehran, 1417755469, Iran.
- Department of Applied Cell Sciences, School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran.
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Evaluation of health-related quality of life in childhood cancer survivors. Arch Pediatr 2023; 30:89-92. [PMID: 36526498 DOI: 10.1016/j.arcped.2022.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 03/15/2022] [Accepted: 11/11/2022] [Indexed: 12/15/2022]
Abstract
BACKGROUND Considering the high survival rates of childhood cancers and their stable incidence, concepts such as quality of life (QOL) and health-related quality of life (HRQOL) are impactful issues that have consistently retained their importance worldwide. OBJECTIVE This study aimed to evaluate HRQOL at least 5 years after treatment in childhood cancer survivors (CCSs) with the hypothesis that their QOL could be adversely affected later in their lives. Additionally, we sought to assess the parents of pediatric CCSs with respect to HRQOL. PATIENTS AND METHODS We evaluated CCSs aged 8-18 years and compared the results with healthy controls (matched for age and sex). The parents of the pediatric CCSs and control groups were also analyzed. A total of 174 cases (patients and controls) and 168 parents (of patients and controls) were included in the study. HRQOL was evaluated by applying the Pediatric Quality of Life Inventory (PedsQL). RESULTS The mean HRQOL scores of CCSs were significantly lower than those of the controls (p= 0.04). No differences were found between the parents of these groups. The physical and social functionality scores of CCSs were significantly lower when compared to healthy controls (p = 0.02 and p<0.01, respectively). In addition, according to cancer type, the HRQOL scores of those with solid tumors were found to be significantly lower than those with hematological cancers (p=0.02).(p = 0.02) CONCLUSION: This study shows that HRQOL is lower in CCSs compared to healthy controls. The most important differences in HRQOL among CCSs were found in the physical and social subdimensions compared to the controls. In this regard, it appears to be vital to provide mental support to CCSs after cancer treatment. These findings also indicate the need for health-focused social policies that can increase HRQOL in CCSs.
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Sinha R, Siddiqui T, Patel SS, Sahu C, Ghoshal U. Burkholderia vietnamiensis infection in a haematological unit: Case series and review of literature of this new emerging pathogen. Indian J Med Microbiol 2023; 41:90-92. [PMID: 36402675 DOI: 10.1016/j.ijmmb.2022.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 09/14/2022] [Accepted: 10/31/2022] [Indexed: 11/17/2022]
Abstract
Burkholderia vietnamiensis causes opportunistic infection in immunocompromised individuals. It closely resembles other non-fermentative Gram-negative bacteria. Accuracy in diagnosis has improved with the use of new modalities. Here, we describe four patients of lymphoblastic disorder on chemotherapy, who presented with fever due to blood stream infection. Multidrug resistant B. vietnaminensis was isolated in blood culture and identified using MALDI-TOF MS. All of them responded to a switch in antibiotic therapy based on sensitivity reports. This is the first case series from North India highlighting the importance of this less known organism as an important pathogen in immunocompromised patients.
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Affiliation(s)
- Richa Sinha
- Department of Microbiology Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
| | - Tasneem Siddiqui
- Department of Microbiology Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
| | - Sangram Singh Patel
- Department of Microbiology Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
| | - Chinmoy Sahu
- Department of Microbiology Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
| | - Ujjala Ghoshal
- Department of Microbiology Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, 226014, India.
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Yu H, Mi L, Qi F, Wang X, Ye Y, Li M, Wang D, Ding N, Wang X, Song Y, Zhu J, Xie Y. Survival and prognostic analysis of T-cell lymphoblastic lymphoma patients treated with dose-adjusted BFM-90 regimen. Aging (Albany NY) 2022; 14:3203-3215. [PMID: 35400665 PMCID: PMC9037275 DOI: 10.18632/aging.204008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 03/28/2022] [Indexed: 11/25/2022]
Abstract
We aimed to investigate the long-term prognosis and prognostic factors of T-cell lymphoblastic lymphoma (T-LBL) patients who received dose-adjusted Berlin–Frankfurt–Münster (BFM)-90 regimen as first-line therapy in our center. A total of 145 T-LBL patients who underwent first-line dose-adjusted BFM-90 was retrospectively reviewed. Conditional survival analysis was used to evaluate the long-term prognosis of patients. Receiver operating characteristic (ROC) curve was applied to determine the optimal cut-off value for neutrophil-to-lymphocyte ratio (NLR). Estimated 3-year overall survival (OS) and progression-free survival (PFS) rates for overall were 66.8% and 58.4%, respectively. Conditional survival analysis showed that for patients having survived 3 and 5 years or more after the completion of the treatment, the estimated subsequent 3-year OS thereafter increased to 85.7% and 94.3, respectively. Patients receiving consolidation APBSCT (Autologous peripheral blood stem cell transplantation) after BFM-90 regimen had superior 3-year OS than those with non-APBSCT (79.1% vs. 33.4%, p<0.001). We also discovered that baseline NLR ≥4.95 was negatively associated with OS (HR=2.75, 95% CI 1.55-4.89, p=0.015) and PFS (HR=2.07, 95% CI 1.25-4.96, p=0.021) via multivariable analysis. Conclusions: The survival probability of T-LBL patients treated with first-line dose-adjusted BFM-90 has improved significantly as patients have survived for every additional year. The addition of consolidation APBSCT following dose-adjusted BFM-90 therapy bring further survival benefits for those patients. Baseline NLR ≥4.95 was an independent risk factor for T-LBL patients in our study.
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Affiliation(s)
- Hui Yu
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Lan Mi
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Fei Qi
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Xing Wang
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Yingying Ye
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Miaomiao Li
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Dedao Wang
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Ning Ding
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Xiaogan Wang
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Yuqin Song
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Jun Zhu
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
| | - Yan Xie
- Key Laboratory of Carcinogenesis and Translational Research, Ministry of Education, Department of Lymphoma, Peking University Cancer Hospital and Institute, Beijing, China
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Tüfekçi Ö, Evim MS, Güneş AM, Celkan T, Karapinar DY, Kaya Z, Baysal B, Baytan B, Koçak Ü, Yilmaz Ş, Çinar S, Ören H. Assessment of Minimal Residual Disease in Childhood Acute Lymphoblastic Leukemia: A Multicenter Study From Turkey. J Pediatr Hematol Oncol 2022; 44:e396-e402. [PMID: 35129146 DOI: 10.1097/mph.0000000000002419] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 01/04/2022] [Indexed: 10/19/2022]
Abstract
Assestment of minimal residual disease (MRD) in childhood acute lymphoblastic leukemia (ALL) is of utmost importance both for risk classification and tailoring of the therapy. The data of pediatric ALL patients that received treatment with Berlin-Frankfurt-Münster (BFM) protocols were retrospectively collected from 5 university hospitals in Turkey. Of the 1388 patients enrolled in the study 390 were treated according to MRD-based protocols. MRD assestment was with real time quantitative polymerase chain reaction (qPCR) in 283 patients and with multiparametric flow cytometry (MFC)-MRD in 107 patients. MRD monitoring had upstaged a total of 8 patients (2%) from intermediate risk group to high-risk group. Univariate analysis revealed age 10 years or above, prednisone poor response, PCR-MRD ≥10-3 on day 33 and on day 78 as poor prognostic factors affecting event-free survival (EFS). Detection of >10% blasts on day 15 with MFC (MFC-high-risk group) was not shown to affect EFS and/or overall survival (log-rank P=0.339). Multiple logistic regression analysis revealed PCR-MRD ≥10-3 on day 78 as the only poor prognostic factor affecting EFS (odds ratio: 8.03; 95% confidence interval: 2.5-25; P=0.000). It is very important to establish the infrastructure and ensure necessary standardization for both MRD methods for optimal management of children with ALL.
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Affiliation(s)
- Özlem Tüfekçi
- Department of Pediatric Hematology, Dokuz Eylül University Medical Faculty, İzmir
| | - Melike Sezgin Evim
- Department of Pediatric Hematology, Uludağ University Medical Faculty, Bursa
| | - Adalet Meral Güneş
- Department of Pediatric Hematology, Uludağ University Medical Faculty, Bursa
| | - Tiraje Celkan
- Department of Pediatric Hematology-Oncology, İstanbul University Cerrahpaşa Medical Faculty
| | | | - Zühre Kaya
- Department of Pediatric Hematology, Gazi University Medical Faculty, Ankara, Turkey
| | - Birsen Baysal
- Department of Pediatric Hematology, Dokuz Eylül University Medical Faculty, İzmir
| | - Birol Baytan
- Department of Pediatric Hematology, Uludağ University Medical Faculty, Bursa
| | - Ülker Koçak
- Department of Pediatric Hematology, Gazi University Medical Faculty, Ankara, Turkey
| | - Şebnem Yilmaz
- Department of Pediatric Hematology, Dokuz Eylül University Medical Faculty, İzmir
| | - Suzan Çinar
- İstanbul University Institute of Experimental Medicine, İstanbul
| | - Hale Ören
- Department of Pediatric Hematology, Dokuz Eylül University Medical Faculty, İzmir
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Sunamak EÇ, Özdemir N, Koka A, Yantiri L, Apak H, Celkan T. Comparison of outcomes of children with acute lymphoblastic leukemia treated with BMF protocol across 2 decades. Pediatr Hematol Oncol 2021; 38:134-146. [PMID: 33170046 DOI: 10.1080/08880018.2020.1825573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Acute lymphoblastic leukemia is the most common malignancy of childhood. The aim of this study is to compare the outcome of children with acute lymphoblastic leukemia treated with BFM protocol over two decades at our center. We retrospectively examined the files of 421 patients by dividing them into two groups by decade of treatment, 1995-2005 and 2006-2015. After excluding 117 patients, overall, 304 patients were included in the analysis. From the first to the second decade, the proportion of patients over 12 years of age increased from 7.1% to 16.8% (p < 0.04), the high-risk group increased from 15.5% to 19.5% and patients with central nervous system leukemia increased from 5.2% to 11.4%. The relapse rate remained relatively unchanged during this period (from 12.9% to 12.7%), while the mortality rate decreased from 18.7% to 15.4% (p > 0.05) and the death rate during remission induction treatment decreased from 3.9% to 0.7%. The mortality rate of high-risk and standard-risk patients decreased from 62.5% to 34.5% (p < 0.05) and 11.1% to 3.0% (p > 0.05), respectively. The 5-year overall survival and event-free survival rates for standard-, medium- and high-risk patients were 92.7% ± 6.0%, 87.9% ± 4.7%, and 54.7% ± 13.3% and 92.5% ± 6.3%, 83.2% ± 5.5%, and 48.7% ± 14.7%, respectively. For the cohort, the 5-year overall survival rate was 83.2% ± 4.1% and the event-free survival rate was 79.9% ± 4.7%. These results demonstrate the impact of a standard protocol, experience of staff, achieving better risk stratification on treatment success.
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Affiliation(s)
- Evrim Çifçi Sunamak
- Department of Pediatric Hematology and Oncology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Nihal Özdemir
- Department of Pediatric Hematology and Oncology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Aida Koka
- Department of Pediatric Hematology and Oncology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Leman Yantiri
- Department of Pediatric Hematology and Oncology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Hilmi Apak
- Department of Pediatric Hematology and Oncology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
| | - Tiraje Celkan
- Department of Pediatric Hematology and Oncology, Cerrahpaşa Faculty of Medicine, İstanbul University, İstanbul, Turkey
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İçöz K, Eken A, Çınar S, Murat A, Özcan S, Ünal E, Deniz G. Immunomagnetic separation of B type acute lymphoblastic leukemia cells from bone marrow with flow cytometry validation and microfluidic chip measurements. SEP SCI TECHNOL 2020. [DOI: 10.1080/01496395.2020.1835983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Affiliation(s)
- Kutay İçöz
- BioMINDS (Bio Micro/Nano Devices and Sensors) Lab, Department of Electrical and Electronics Engineering, Abdullah Gül University, Kayseri, Turkey
- Bioengineering Department, Abdullah Gül University, Kayseri, Turkey
| | - Ahmet Eken
- Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey
| | - Suzan Çınar
- Department of Immunology, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
| | - Ayşegül Murat
- Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey
| | - Servet Özcan
- Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey
- Biology Department, Erciyes University, Kayseri, Turkey
| | - Ekrem Ünal
- Genome and Stem Cell Center (GENKOK), Erciyes University, Kayseri, Turkey
- Pediatric Hematology & Oncology Department, Erciyes University, Kayseri, Turkey
| | - Günnur Deniz
- Department of Immunology, Aziz Sancar Institute of Experimental Medicine, Istanbul University, Istanbul, Turkey
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Öztürk AP, Koç B, Zülfikar B. Acute Complications and Survival Analysis of Childhood Acute Lymphoblastic Leukemia: A 15-year Experience. CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 2020; 21:e39-e47. [PMID: 33046422 DOI: 10.1016/j.clml.2020.08.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/18/2020] [Revised: 08/22/2020] [Accepted: 08/27/2020] [Indexed: 01/19/2023]
Abstract
BACKGROUND We evaluated the acute complications that occurred during the treatment of childhood acute lymphoblastic leukemia (ALL) and documented the survival rates of children with ALL. MATERIALS AND METHODS We retrospectively evaluated 110 children with a diagnosis of ALL treated with the Children's Oncology Group protocol from 1999 to 2014. The demographic, clinical, and laboratory data of 110 patients and acute complications of eligible and evaluable 105 patients were recorded. RESULTS Of the 110 patients, 65 were male and 45 were female. The mean age at admission was 8.3 ± 5.2 years. Ninety-seven patients (88.2%) had been diagnosed with pre-B-cell ALL, 11 (10%) with T-cell ALL, 1 (0.9%) with mixed phenotype acute leukemia, and 1 (0.9%) with mature B-cell acute leukemia. Of the 110 patients, 40 (36.3%) were in the standard-risk group and 70 (63.7%) were in high-risk group. Of the 110 patients, 105 had been followed up regularly and evaluated for acute complications. Infection was the most common complication (n = 93; 88.5%), followed by gastrointestinal (n = 29; 27.6%), neurologic (n = 28; 26.6%), metabolic/endocrine (n = 16; 15.2%), drug-related hypersensitivity (n = 16; 15.2%), avascular necrosis (n = 13; 12.3%), thrombotic (n = 11; 10.4%), severe psychiatric (n = 2; 1.9%), and various other (n = 12; 11.4%) complications. Of the 110 patients, 98 were assessed in terms of survival analysis. The 5- and 10-year overall survival rates were both 85.9% (standard error [SE], 3.6%). The relapse-free survival rates at 1, 3, and 5 years were 97.9% (SE, 1.5%), 91.3% (SE, 3%), and 86.3% (SE, 3.7%), respectively. CONCLUSION Childhood ALL, although categorized as curable malignancy owing to the improvements in treatment strategies in recent years, can cause acute complications affecting various systems. Thus, patients should be treated and followed up by multidisciplinary medical teams with high expertise.
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Affiliation(s)
- Ayşe Pınar Öztürk
- Department of Pediatrics, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.
| | - Başak Koç
- Department of Pediatric Hematology-Oncology, Istanbul University Oncology Institute, Istanbul, Turkey
| | - Bülent Zülfikar
- Department of Pediatric Hematology-Oncology, Istanbul University Oncology Institute, Istanbul, Turkey
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10
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Kızmazoğlu D, Sarı S, Evim Sezgin M, Kantarcıoğlu A, Tüfekçi Ö, Demir Yenigürbüz F, Baytan B, Yılmaz Ş, Güneş AM, Ören H. Assessment of Health-Related Quality of Life in Pediatric Acute Lymphoblastic Leukemia Survivors: Perceptions of Children, Siblings, and Parents. Turk J Haematol 2018; 36:112-116. [PMID: 30401658 PMCID: PMC6516105 DOI: 10.4274/tjh.galenos.2018.2018.0351] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
Objective We investigated the health-related quality of life (HRQL) in survivors of pediatric acute lymphoblastic leukemia (ALL) and evaluated the perceptions of the children, their siblings, and their parents. Materials and Methods Seventy ALL survivors, who were between 7 and 17 years of age and had completed therapy ≥2 years, were included. The control group consisted of their healthy siblings. HRQL was assessed by the age-specific KINDLR questionnaire. Results No significant differences could be found among HRQL scores of ALL survivors with respect to variables such as sex, risk group, and having chronic illness. HRQL scores for physical well-being, emotional well-being, family, and social functioning of the patient and sibling self-reports and parent proxy reports were lower than the expected values for healthy and chronically ill children. Conclusion These results demonstrate that both ALL survivors and their families need help via psychological counseling programs to improve their HRQL even after completion of therapy.
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Affiliation(s)
- Deniz Kızmazoğlu
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Seher Sarı
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Melike Evim Sezgin
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Arzu Kantarcıoğlu
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Özlem Tüfekçi
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Fatma Demir Yenigürbüz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Birol Baytan
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Şebnem Yılmaz
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
| | - Adalet Meral Güneş
- Uludağ University Faculty of Medicine, Department of Pediatric Hematology, Bursa, Turkey
| | - Hale Ören
- Dokuz Eylül University Faculty of Medicine, Department of Pediatric Hematology, İzmir, Turkey
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Abstract
OBJECTIVE To explore the clinical features and outcomes of relapsed childhood acute lymphoblastic leukemia (ALL) at our center, achieve the early detection of risk factors for recurrence and assess the risk-stratified Guangdong (GD)-2008 ALL protocol. MATERIALS AND METHODS In total, 59 Chinese childhood ALL patients treated with the GD-2008 ALL protocol who relapsed between July 2008 and March 2015 were enrolled in this study. Their clinical features and outcomes were retrospectively analyzed and compared with those of 218 patients who achieved continuous complete remission. RESULTS Of the 285 study participants, 8 died of treatment-related infections or other complications before remission, 218 achieved continuous complete remission, and 59 patients relapsed, yielding a relapse rate of 20.7%. The number of relapsed patients in the standard-risk, intermediate-risk, and high-risk groups were 15 (17.0%), 27 (19.7%), and 17 (32.7%), respectively. Risk factors included age 10 years and above at first diagnosis, white blood cell (WBC) count ≥50×10/L, poor prednisone response, failure to achieve bone marrow complete remission at day 15 of induction chemotherapy. High-risk stratification and a high level (≥0.1%) of minimal residual disease at day 33 were the risk factors for relapse. Multivariate analysis showed that a high WBC at first diagnosis was an independent risk factor for relapse (P=0.000). CONCLUSION For the GD-2008 ALL risk stratification based on age and initial WBC, 10 years of age and WBC 50×10/L can be used as cut-offs. Patients at high risk benefited from the GD-2008 ALL protocol. In addition, the impact of minimal residual disease on prognosis should be considered.
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Jaime-Pérez JC, Jiménez-Castillo RA, Pinzón-Uresti MA, Cantú-Rodríguez OG, Herrera-Garza JL, Marfil-Rivera LJ, Gómez-Almaguer D. Real-world outcomes of treatment for acute lymphoblastic leukemia during adolescence in a financially restricted environment: Results at a single center in Latin America. Pediatr Blood Cancer 2017; 64. [PMID: 27957789 DOI: 10.1002/pbc.26396] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2016] [Revised: 10/27/2016] [Accepted: 11/14/2016] [Indexed: 02/05/2023]
Abstract
OBJECTIVE There is a paucity of the studies of adolescents with acute lymphoblastic leukemia (ALL). This is more noticeable in low- and middle-income countries. The international 5-year event-free survival (EFS) and overall survival (OS) for this age group is around 80%, with pediatric-inspired protocols offering better results. METHODS A retrospective analysis of adolescents aged 16-20 diagnosed with ALL during the period 2004-2015 treated with a high-risk pediatric protocol at an academic center from a middle-income country was performed. Five-year OS and EFS were estimated by the Kaplan-Meier analysis. Hazard ratios of relapse and death were estimated by the Cox regression model. RESULTS Five-year EFS and OS for 57 adolescents were 23.3% and 48.9%, respectively. From the 41 patients who achieved complete remission, 24 (58.5%) relapsed. Bone marrow and central nervous system were the most frequent sites of relapse. Hazard ratio of treatment failure and death for patients with organomegaly at diagnosis was 2.026 and 2.970, respectively. Treatment-related toxicity developed in 31 (54.4%) patients and febrile neutropenia was the most frequent in 14 (24.6%) cases. Twelve patients (21.1%) had poor adherence to treatment. CONCLUSIONS High relapse rate and low 5-year EFS compared with international standards, was documented. Use of intensified pediatric regimens, adherence to proven effective medications, improved supportive care, and prevention of abandonment are necessary to improve survival rates in these patients.
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Affiliation(s)
- José C Jaime-Pérez
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Raúl A Jiménez-Castillo
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Mónica A Pinzón-Uresti
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Olga G Cantú-Rodríguez
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - José L Herrera-Garza
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - Luis J Marfil-Rivera
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
| | - David Gómez-Almaguer
- Internal Medicine Division, Department of Hematology, "Dr. José E. González" University Hospital of the School of Medicine of the Universidad Autónoma de Nuevo León, Monterrey, México
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Yalcinbayir O, Baytan B, Gelisken O, Can B, Sezgin Evim M, Yildiz M, Meral Gunes A. Spectral domain optical coherence tomography findings of patients under treatment for pediatric acute lymphoblastic leukemia. J AAPOS 2017; 21:131-135.e1. [PMID: 28315402 DOI: 10.1016/j.jaapos.2016.12.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Revised: 11/23/2016] [Accepted: 12/16/2016] [Indexed: 11/16/2022]
Abstract
PURPOSE To investigate the use of spectral domain optical coherence tomography (SD-OCT) findings in pediatric acute lymphoblastic leukemia (ALL) patients. METHODS Children that were diagnosed with precursor B-cell ALL and classified as belonging to the medium-risk group for relapse were selected for this study. Individuals who were in continuous remission and on maintenance therapy were included in the study group. Cases that had central nervous system involvement were excluded. Age-matched, otherwise healthy children were selected for the control group. Each study participant underwent a comprehensive eye examination and SD-OCT evaluation. Thickness measurements were made within the retinal nerve fiber layer (RNFL), central macula, posterior polar, and peripapillary choroid. RESULTS A total of 112 eyes of 56 children were included: 54 eyes in the study group and 58 in the control group. Compared to the control group, subfoveal and temporal choroidal thicknesses of the posterior pole were significantly thinner in the study group (P < 0.005). Similarly, peripapillary choroidal thicknesses were significantly thinner in most sectors of the study group (P < 0.005). There were no major differences between groups in terms of central macular thicknesses and overall RNFL thicknesses. CONCLUSIONS Evidence of choroidal attenuation was found in this subgroup of pediatric ALL patients. Further studies are warranted to clarify the utility of SD-OCT in detecting subclinical ocular involvement and monitoring treatment response and risk of relapse in patients with pediatric leukemia.
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Affiliation(s)
- Ozgur Yalcinbayir
- Department of Ophthalmology. Uludag University School of Medicine, Bursa, Turkey.
| | - Birol Baytan
- Department of Pediatric Hematology, Uludag University School of Medicine, Bursa, Turkey
| | | | - Basak Can
- Department of Ophthalmology. Uludag University School of Medicine, Bursa, Turkey
| | - Melike Sezgin Evim
- Department of Pediatric Hematology, Uludag University School of Medicine, Bursa, Turkey
| | - Meral Yildiz
- Department of Ophthalmology. Uludag University School of Medicine, Bursa, Turkey
| | - Adalet Meral Gunes
- Department of Pediatric Hematology, Uludag University School of Medicine, Bursa, Turkey
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Mu Y, Qin M, Wang B, Li S, Zhu G, Zhou X, Yang J, Wang K, Lin W, Zheng H. Haploidentical hematopoietic stem cell transplantation without total body irradiation for pediatric acute leukemia: a single-center experience. Onco Targets Ther 2016; 9:2557-63. [PMID: 27217774 PMCID: PMC4860998 DOI: 10.2147/ott.s102286] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Abstract
Hematopoietic stem cell transplantation (HSCT) is a promising method for therapy of pediatric patients with acute leukemia. However, less availability of matched donors limited its wide application. Recently, haploidentical HSCT has become a great resource. Here, we have retrospectively reported our experience of 20 pediatric patients with acute leukemia who underwent haploidentical HSCT without total body irradiation (TBI) myeloablative regimen in our center from November 2007 to June 2014. All the patients attained successful HSCT engraftment in terms of myeloid and platelet recovery. Thirteen patients developed grade I–IV acute graft-versus-host disease (a-GVHD). The incidence of grade I–II a-GVHD, grade III–IV a-GVHD, and chronic GVHD (c-GVHD) was 45%, 20%, and 25%, respectively. The mean myeloid and platelet recovery time was 13.20±2.41 and 19.10±8.37 days. The median follow-up time was 43.95±29.26 months. During the follow-up, three patients died. The overall survival (OS) rate was 85%. The present study indicated that haploidentical HSCT without TBI myeloablative regimen significantly improved the OS rate of pediatric patients with acute leukemia.
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Affiliation(s)
- Yanshun Mu
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, Key Laboratory of Major Diseases in Children, Ministry of Education, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Maoquan Qin
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, Key Laboratory of Major Diseases in Children, Ministry of Education, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Bin Wang
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, Key Laboratory of Major Diseases in Children, Ministry of Education, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Sidan Li
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, Key Laboratory of Major Diseases in Children, Ministry of Education, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Guanghua Zhu
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, Key Laboratory of Major Diseases in Children, Ministry of Education, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Xuan Zhou
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, Key Laboratory of Major Diseases in Children, Ministry of Education, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Jun Yang
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, Key Laboratory of Major Diseases in Children, Ministry of Education, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Kai Wang
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, Key Laboratory of Major Diseases in Children, Ministry of Education, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Wei Lin
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, Key Laboratory of Major Diseases in Children, Ministry of Education, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Huyong Zheng
- Beijing Key Laboratory of Pediatric Hematology Oncology, National Key Discipline of Pediatrics, Ministry of Education, Key Laboratory of Major Diseases in Children, Ministry of Education, Hematology Oncology Center, Beijing Children's Hospital, Capital Medical University, Beijing, People's Republic of China
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Baytan B, Evim MS, Güler S, Güneş AM, Okan M. Acute Central Nervous System Complications in Pediatric Acute Lymphoblastic Leukemia. Pediatr Neurol 2015. [PMID: 26202590 DOI: 10.1016/j.pediatrneurol.2015.03.006] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND The outcome of childhood acute lymphoblastic leukemia has improved because of intensive chemotherapy and supportive care. The frequency of adverse events has also increased, but the data related to acute central nervous system complications during acute lymphoblastic leukemia treatment are sparse. The purpose of this study is to evaluate these complications and to determine their long term outcome. PATIENTS AND METHODS We retrospectively analyzed the hospital reports of 323 children with de novo acute lymphoblastic leukemia from a 13-year period for acute neurological complications. The central nervous system complications of leukemic involvement, peripheral neuropathy, and post-treatment late-onset encephalopathy, and neurocognitive defects were excluded. RESULTS Twenty-three of 323 children (7.1%) suffered from central nervous system complications during acute lymphoblastic leukemia treatment. The majority of these complications (n = 13/23; 56.5%) developed during the induction period. The complications included posterior reversible encephalopathy (n = 6), fungal abscess (n = 5), cerebrovascular lesions (n = 5), syndrome of inappropriate secretion of antidiuretic hormone (n = 4), and methotrexate encephalopathy (n = 3). Three of these 23 children (13%) died of central nervous system complications, one from an intracranial fungal abscess and the others from intracranial thrombosis. Seven of the survivors (n = 7/20; 35%) became epileptic and three of them had also developed mental and motor retardation. CONCLUSIONS Acute central neurological complications are varied and require an urgent approach for proper diagnosis and treatment. Collaboration among the hematologist, radiologist, neurologist, microbiologist, and neurosurgeon is essential to prevent fatal outcome and serious morbidity.
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Affiliation(s)
- Birol Baytan
- Department of Pediatric Hematology, Uludag University Medical Faculty, Bursa, Turkey.
| | - Melike Sezgin Evim
- Department of Pediatric Hematology, Uludag University Medical Faculty, Bursa, Turkey
| | - Salih Güler
- Department of Pediatric Hematology, Uludag University Medical Faculty, Bursa, Turkey
| | - Adalet Meral Güneş
- Department of Pediatric Hematology, Uludag University Medical Faculty, Bursa, Turkey
| | - Mehmet Okan
- Department of Pediatric Neurology, Uludag University Medical Faculty, Bursa, Turkey
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