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Ortaköylü MY, Özdemir Sİ, Dinçaslan H, Taçyıldız N, Ateş U, Ünal AE, Soydal Ç, Fitoz ÖS, Karabulut HG, Ruhi HI, Ünal EC. De novo germline TP53 mutation in a pediatric patient with Li-Fraumeni syndrome and diffuse peritoneal mesothelioma. Pediatr Blood Cancer 2024:e31071. [PMID: 38773723 DOI: 10.1002/pbc.31071] [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: 04/03/2024] [Revised: 04/27/2024] [Accepted: 04/29/2024] [Indexed: 05/24/2024]
Affiliation(s)
- Melek Yaman Ortaköylü
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Sonay İncesoy Özdemir
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Handan Dinçaslan
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Nurdan Taçyıldız
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Ufuk Ateş
- Department of Pediatric Surgery, Ankara University, Ankara, Turkey
| | - Ali Ekrem Ünal
- Department of General Surgery, Ankara University, Ankara, Turkey
| | - Çiğdem Soydal
- Department of Nuclear Medicine, Ankara University, Ankara, Turkey
| | - Ömer Suat Fitoz
- Division of Pediatric Radiology, Radiology Department, Ankara University, Ankara, Turkey
| | | | | | - Emel Cabi Ünal
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
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Yaman Ortaköylü M, İncesoy Özdemir S, Dinçaslan H, Taçyıldız N, Ünal AE, Soydal Ç, Fitöz ÖS, Ünal E. Nivolumab for pediatric malignant peritoneal mesothelioma. Pediatr Blood Cancer 2023; 70:e29892. [PMID: 35851543 DOI: 10.1002/pbc.29892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Accepted: 07/03/2022] [Indexed: 01/09/2023]
Affiliation(s)
- Melek Yaman Ortaköylü
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Sonay İncesoy Özdemir
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Handan Dinçaslan
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Nurdan Taçyıldız
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
| | - Ali Ekrem Ünal
- Department of General Surgery, Ankara University, Ankara, Turkey
| | - Çiğdem Soydal
- Department of Nuclear Medicine, Ankara University, Ankara, Turkey
| | - Ömer Suat Fitöz
- Division of Pediatric Radiology, Radiology Department, Ankara University, Ankara, Turkey
| | - Emel Ünal
- Division of Pediatric Oncology, Department of Pediatrics, Ankara University, Ankara, Turkey
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İsakoca M, Kahiloğulları G, Şıklar Z, Kontbay T, Ünal E, Taçyıldız N, Dinçaslan H, Berberoğlu M. Hypophyseal Dysfunction and Difficulties in Management of Pediatric Intracranial Germ Cell Tumors. Turk Arch Pediatr 2022; 57:362-364. [PMID: 35781243 PMCID: PMC9131827 DOI: 10.5152/turkarchpediatr.2022.21175] [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: 12/01/2022]
Affiliation(s)
- Mehmet İsakoca
- Department of Pediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey
| | - Gökmen Kahiloğulları
- Department of Neurosurgery, Ankara University School of Medicine, Ankara, Turkey
| | - Zeynep Şıklar
- Department of Pediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey
- Corresponding author:Zeynep Şıklar✉
| | - Tuğba Kontbay
- Department of Pediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey
| | - Emel Ünal
- Department of Pediatric Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Nurdan Taçyıldız
- Department of Pediatric Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Handan Dinçaslan
- Department of Pediatric Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Merih Berberoğlu
- Department of Pediatric Endocrinology, Ankara University School of Medicine, Ankara, Turkey
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Çakmak H, Tacyildiz N, Ünal E, Dinçaslan H, Yılmaz Y, Kartal Ö, Tanyıldız G, Özdemir S, Yavuz G. Late outcomes in children and adolescents with non-Hodgkin lymphoma: A single-center experience. J Cancer Res Ther 2022; 18:712-717. [DOI: 10.4103/jcrt.jcrt_80_21] [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: 11/04/2022]
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Özen S, Özdemir H, Evren E, Taşkın EÇ, Arga G, Konca HK, Çakmaklı HF, Haskoloğlu Ş, Okulu E, Dinçaslan H, İnce E, İleri T, Taçyıldız N, Doğu F, Us E, Karahan ZC, Fitöz S, Kendirli T, Kuloğlu Z, Tutar E, İkincioğulları A, Ünal E, Ertem M, İnce E, Çiftçi E. The role of galactomannan test results in the diagnosis of pediatric invasive aspergillosis. Infect Dis (Lond) 2021; 54:269-276. [PMID: 34842498 DOI: 10.1080/23744235.2021.2008486] [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] [Indexed: 10/19/2022] Open
Abstract
BACKGROUND Invasive aspergillosis (IA) is an important cause of morbidity and mortality in immunosuppressed children. Early detection of the infection can improve prognosis in this patient population. OBJECTIVES To investigate the utility of Aspergillus galactomannan antigen assay (GM-EIA) as a diagnostic tool for IA in at-risk paediatric patients. PATIENTS/METHODS For the study, 659 GM-EIA results from 59 patients diagnosed with IA and 3368 GM-EIA results from 351 subjects without evidence for IA (controls) were reviewed retrospectively. Three cut-off values (i.e. ≥0.5, ≥1, ≥1.5) were specified to determine GM-EIA positivity. RESULTS The median age was 6.3 years for boys and 14.5 years for girls. There was a significant difference between the girls and boys in terms of age (p < 0.01). For proven/probable/possible IA patients, sensitivity of 67.8% and specificity of 59.8% were detected when the ≥0.5 cut-off value was used for GM-EIA-positivity. The specificity increased to 80% at the cut-off of ≥1 and to 88% at the cut-off of ≥1.5. False positivity rates were 9.14, 3, and 1.45% at the ≥0.5, ≥1 and ≥1.5 cut-offs respectively. In the proven/probable IA group, sensitivity and negative predictive values were 86.9 and 97.2% at the ≥0.5 cut-off, 85.7 and 97.9%, at the ≥1 cut-off and 84.2 and 98.1% at ≥1.5 cut-off respectively. The positive likelihood ratio was 7.57 and the odds ratio was 42.67 at ≥1.5 cut-off. CONCLUSION The GM-EIA may be used for both screening and diagnostic purposes in paediatric patients using a cut-off value of ≥1.5 for GM-EIA positivity.
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Affiliation(s)
- Seval Özen
- Division of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Halil Özdemir
- Division of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ebru Evren
- Department of Medical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Esra Çakmak Taşkın
- Division of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gül Arga
- Division of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Hatice Kübra Konca
- Division of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Hasan Fatih Çakmaklı
- Division of Pediatric Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Şule Haskoloğlu
- Division of Pediatric Immunology and Allergy, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emel Okulu
- Division of Neonatology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Handan Dinçaslan
- Division of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Elif İnce
- Division of Pediatric Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Talia İleri
- Division of Pediatric Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nurdan Taçyıldız
- Division of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Figen Doğu
- Division of Pediatric Immunology and Allergy, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ebru Us
- Department of Medical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Zeynep Ceren Karahan
- Department of Medical Microbiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Suat Fitöz
- Department of Radiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Tanıl Kendirli
- Division of Pediatric Intensive Care, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Zarife Kuloğlu
- Division of Pediatric Gastroenterology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ercan Tutar
- Division of Pediatric Cardiology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aydan İkincioğulları
- Division of Pediatric Immunology and Allergy, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emel Ünal
- Division of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Mehmet Ertem
- Division of Pediatric Hematology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Erdal İnce
- Division of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ergin Çiftçi
- Division of Pediatric Infectious Diseases, Ankara University Faculty of Medicine, Ankara, Turkey
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Gündüz AK, Mirzayev I, Dinçaslan H, Özalp Ateş FS. Recurrence and new tumor development after frontline intravenous chemotherapy for retinoblastoma: Risk factors and treatment results. Eur J Ophthalmol 2021; 32:1795-1803. [PMID: 34192976 DOI: 10.1177/11206721211023311] [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] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To evaluate the risk factors leading to recurrence and new tumor (NT) development in patients with retinoblastoma after intravenous chemotherapy (IVC) and to review the treatment outcomes. MATERIALS AND METHODS The records of 166 retinoblastoma cases (having 246 affected eyes) who underwent six-cycle IVC (vincristine, etoposide, and carboplatin) as primary treatment between October 1999 and August 2020 were reviewed retrospectively. RESULTS The mean ages at presentation were 9.0 (median: 8.0) and 9.2 (median: 8.5) months in cases with recurrence and NTs respectively. Recurrence was detected in 40 (16.3%) eyes, NTs in 29 (11.8%), and both recurrence/NTs in 24 (9.8%). The mean time elapsed till recurrence and NT was 10.7 months. Multivariable analysis showed that the factors predictive of recurrence were largest tumor base diameter (LTBD) >12 mm (p = 0.039) and presence of subretinal seeds at diagnosis (p = 0.043). Multivariable risk factors for the development of NTs were bilateral familial retinoblastoma (p = 0.001) and presence of subretinal seeds at diagnosis (p = 0.010). Mean follow-up was 80.1 (median: 72.5) months. By Kaplan-Meier analysis, the 1-, 3-, and 6-year recurrence and NT rates were 21.2%, 28.1%, and 28.7% and 14.9%, 22.6%, and 23.9% respectively. The most common treatment methods used for recurrent and/or NTs included cryotherapy, transpupillary thermotherapy, and intra-arterial chemotherapy. Enucleation was eventually required in 24/93 (25.8%) eyes. No patient developed metastasis. DISCUSSION Development of recurrence and/or NT after IVC was noted in 38% of all retinoblastoma eyes. Bilateral familial disease, LTBD >12 mm, and presence of subretinal seeds at baseline were risk factors for recurrence and NTs in this study.
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Affiliation(s)
- Ahmet Kaan Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.,Private Eye Clinic, Ankara, Turkey
| | - Ibadulla Mirzayev
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.,Department of Ophthalmology, Dünyagöz Hospital, Ankara, Turkey
| | - Handan Dinçaslan
- Departmant of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
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Perk O, Kendirli T, Dinçaslan H, Azapağası E, Meral G. Overlap Stevens Johnson Syndrome/Toxic Epidermal Necrolysis developed due to the use of toxic-dose vinblastine in case of Langerhans Cell Histiocytosis(Letterer-Siwe). Transfus Apher Sci 2021; 60:103173. [PMID: 34215518 DOI: 10.1016/j.transci.2021.103173] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 05/24/2021] [Accepted: 05/26/2021] [Indexed: 11/20/2022]
Abstract
Except for side effects expected standart dose use of the chemotherapeutics agents, toxic effects (poisoning) may occur if high doses of are mistakenly used in the treatment of haemato-oncological diseases and these toxic doses are usually fatal. Here, we report a case of Stevens Johnson Syndrome (SJS) / Toxic Epidermal Necrolysis (TEN) following administration of toxic dose of vinblastine by mistake. A 20-month-old male patient with a diagnosis of Langerhans Cell Histiocytosis (Letterer-Siwe) at the pediatric oncology department was admitted to intensive care unit, after having received treatment protocol consisting of vinblastine, etoposide and prednisolone, with fever, altered consciousness and decompensated shock findings. Skin biopsy which performed from bullous lesions in the perianal, neck and axillary regions was resulted compatible with SJS / TEN in the patient with multiple organ failure, at 48 h of admission. It was later determined that the patient has been mistakenly given 10 times the normal dose of vinblastine he needed (60 mg/m2), which was 6 mg/m2. Plasma exchange was performed 3 times for vinblastine toxicity, intravenous immunoglobulin was administered for SJS / TEN therapy and phenobarbital was initiated to increase drug metabolism. The patient whose clinical picture fully improved, was transferred to the oncology department on the 30th day of intensive care hospitalization. Vinblastine toxicity is a life-threatening condition that can cause multiple organ failure, SJS / TEN. Plasma exchange is an effective treatment method for the removal of vinblastine from the body and in these cases of toxicity.
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Affiliation(s)
- Oktay Perk
- Division of Pediatric Intensive Care, Department of Pediatrics, Ankara City Hospital, Ankara, Turkey.
| | - Tanıl Kendirli
- Division of Pediatric Intensive Care, Department of Pediatrics, Medical School, Ankara University, Ankara, Turkey
| | - Handan Dinçaslan
- Division of Pediatric Oncology, Department of Pediatric, Medical School, Ankara University, Ankara, Turkey
| | - Ebru Azapağası
- Division of Pediatric Intensive Care, Department of Pediatrics, Dr. Sami Ulus Maternity and Children's Training and Research Hospital, Ankara, Turkey
| | - Gokcen Meral
- Department of Pediatrics, Ankara City Hospital, Ankara, Turkey
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Gündüz AK, Mirzayev I, Temel E, Ünal E, Taçyıldız N, Dinçaslan H, Köse SK, Özalp Ateş FS, Işık MU. A 20-year audit of retinoblastoma treatment outcomes. Eye (Lond) 2020; 34:1916-1924. [PMID: 32376976 PMCID: PMC7608123 DOI: 10.1038/s41433-020-0898-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Revised: 04/10/2020] [Accepted: 04/15/2020] [Indexed: 11/17/2022] Open
Abstract
Objectives To evaluate the long-term treatment outcomes in intraocular retinoblastoma (RB) including the associated factors for eventual treatment with external beam radiotherapy (EBRT) and enucleation as well as to analyse the risk factors for metastasis and death in extraocular RB. Methods Retrospective analysis of 390 eyes from 256 (89.8%) intraocular RB and 29 (10.2%) extraocular RB cases diagnosed and treated between October 1998 and May 2018 at one of the largest tertiary care centers in Turkey. Results Of 351 intraocular RB eyes, 53.3% had group D/E disease at presentation. 75 (21.4%) of 351 eyes underwent primary enucleation. Of the remaining 276 eyes undergoing eye-conserving treatments, 201 (72.8%) were salvaged. Most of these eyes were treated using intravenous chemotherapy and/or focal treatments [transpupillary thermotherapy (TTT) and cryotherapy] initially. EBRT was eventually required in 48 (17.4%) eyes and secondary enucleation in 75 (27.2%) eyes. At mean follow-ups of 76.7 and 39.7 months for intraocular and extraocular RB cohorts, respectively, 180 (46.2%) eyes underwent primary/secondary enucleation and exenteration. Overall, 13 cases developed metastasis and 9 died. Two patients with trilateral RB also expired. Multivariable risk factors for enucleation were the presence of vitreous seeds (p < 0.001), absence of EBRT administration (p = 0.033), 5–9 TTT applications compared with no TTT (p = 0.031), and each 1 mm increase in tumour base diameter (p < 0.001). Univariate factors predictive of metastasis were the presence of extraocular RB detected by imaging methods (p < 0.001) and extrascleral/optic nerve cut end involvement at histopathological examination (p < 0.001). Conclusions In our series, 72.8% of the intraocular RB eyes undergoing eye-conserving treatments were saved. The globe salvage rate for all intraocular and extraocular RB eyes was 53.8% and the overall survival rate was 96.1%.
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Affiliation(s)
- Ahmet Kaan Gündüz
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey.
| | - Ibadulla Mirzayev
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emine Temel
- Department of Ophthalmology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emel Ünal
- Departmant of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nurdan Taçyıldız
- Departmant of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Handan Dinçaslan
- Departmant of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Serdal Kenan Köse
- Department of Biostatistics, Ankara University Faculty of Medicine, Ankara, Turkey
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Taçyıldız N, Ünal E, Dinçaslan H, Çakmak HM, Köse K, Tanyıldız G, Kartal Ö. Muramyl Tripeptide Plus Chemotherapy Reduces Metastasis in Non-Metastatic Osteosarcoma: A Single-Center Experience. Asian Pac J Cancer Prev 2020; 21:715-720. [PMID: 32212798 PMCID: PMC7437342 DOI: 10.31557/apjcp.2020.21.3.715] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Accepted: 03/13/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The immunomodulator mifamurtide plus a chemotherapy regimen has been shown to significantly improve the outcome in non-metastatic osteosarcoma patients. We report the results of the addition of mifamurtide to chemotherapy in newly diagnosed patients with osteosarcoma. METHODS A total of 36 children with osteosarcoma without detectable metastasis were treated between November 2010 and April 2018 at the Ankara University Department of Pediatric Oncology. Mifamurtide was added to the chemotherapy regimen in 17 patients while the remaining 19 did not receive mifamurtide. The probabilities of metastasis and overall survival were compared between the groups. RESULTS The 43-month survival rate was 87.5% and 89.9% in the patients who received and did not receive mifamurtide, respectively (p=0.65). Common side effects of mifamurtide were chills and fever. The addition of mifamurtide in the high-risk group with ≤95% necrosis tended to decrease the probability of distant metastasis (36.4% vs. 58.3%) (p=0.39). The time to metastasis in the group with positive surgical margins (4 months in one patient in the non-mifamurtide group, 7 and 20 months in the mifamurtide group) was also longer in the mifamurtide group. During the 43-month follow up period, median time to metastasis was longer in the mifamurtide group (20 vs. 5 months). In addition, mifamurtide plus chemotherapy decreased the risk of metastasis in the cases with primary site relapse. CONCLUSIONS The addition of mifamurtide to chemotherapy might improve event-free survival by decreasing the probability of distant metastasis in bad histologic responders, and also by increasing the time to distant metastasis in the surgical margin positive group. Additional clinical studies are necessary to determine the long-term effects of mifamurtide on metastatic disease. .
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Affiliation(s)
- Nurdan Taçyıldız
- Division of Pediatric Hematology and Oncology, Department of Pediatrics,
| | - Emel Ünal
- Division of Pediatric Hematology and Oncology, Department of Pediatrics,
| | - Handan Dinçaslan
- Division of Pediatric Hematology and Oncology, Department of Pediatrics,
| | - H Mine Çakmak
- Division of Pediatric Hematology and Oncology, Department of Pediatrics,
| | - Kenan Köse
- Department of Biostatistics, Medical University of Ankara,
| | - Gülşah Tanyıldız
- Division of Pediatric Hematology and Oncology, Department of Pediatrics,
| | - Ömer Kartal
- Division of Pediatric Hematology and Oncology, Department of Pediatrics, Gülhane Training and Research Hospital, Ankara, Turkey.
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Taçyıldız N, Tanyıldız HG, Ünal E, Dinçaslan H, Asarcıklı F, Aksoy BA, Vatansever G, Yavuz G. A targeted salvage therapy with Brentuximab vedotin in heavily treated refractory or relapsed pediatric Hodgkin lymphoma patients before and after stem cell transplantation. Turk J Pediatr 2020; 61:671-676. [PMID: 32104998 DOI: 10.24953/turkjped.2019.05.005] [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] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Taçyıldız N, Tanyıldız HG, Ünal E, Dinçaslan H, Asarcıklı F, Adaklı Aksoy B, Vatansever G, Yavuz G. A targeted salvage therapy with Brentuximab vedotin in heavily treated refractory or relapsed pediatric Hodgkin lymphoma patients before and after stem cell transplantation. Turk J Pediatr 2019; 61: 671-676. Hodgkin`s lymphoma (HL) is highly curable disease in its early stages, but in advanced stages, it presents a dilemma when it becomes refractory or relapses after several rounds of chemotherapy. Brentuximab vedotin (BV) is an antibody-drug conjugate that targets the tumor necrosis receptor family protein member CD30 positive malignancies via an anti-CD30 monoclonal antibody linked to monomethyl auristatin-E. In adult and pediatric studies, it has been shown to be an effective salvage therapy for primary refractory HL or relapse after autologous stem cell transplant (ASCT). Between July 2012 and August 2017, we administered BV (1.8 mg/m2 every three weeks; 12 cycles totally) with doxorubucin, vinblastin, dacarbazine (AVD), rituximab + ifosfamide + carboplatin + etoposide (RICE), or bendamustine combination treatment in pediatric HL patients, who were previosuly treated for refractory or relapsed advanced stage HL before (seven patients) or after (one patient) ASCT in our center. After eight BV courses, one patient was able to undergo match unrelated donor (MUD) SCT. Another seven pediatric HL patients, who were not able to go into remission with any other classical HL chemotherapy protocols, received 4-6 courses of BV-AVD and/or RICE/bendamustine. All were able to undergo ASCT after negative positron emission tomography (PET) imaging results. After ASCT, we switched to BV as consolidation therapy until a total of 12 cycles was completed. Patients went into remission after a median 34 (range: 12-42) months from the start of BV treatment. BV is an encouraging, well- tolerated, and effective targeted therapy especially when combined with AVD or when alternated with another targeted therapy combination, including RICE, when needed.
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Affiliation(s)
- Nurdan Taçyıldız
- Divisions of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | | | - Emel Ünal
- Divisions of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Handan Dinçaslan
- Divisions of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Fikret Asarcıklı
- Divisions of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Başak Adaklı Aksoy
- Divisions of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Göksel Vatansever
- Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gülsan Yavuz
- Divisions of Pediatric Oncology, Ankara University Faculty of Medicine, Ankara, Turkey
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Ödek Ç, Kendirli T, Pekpak E, Yaman A, Adaklı-Aksoy B, Dinçaslan H, Taçyıldız N, Ünal E, İnce E, Yavuz G. An unusual case of neuroblastoma: a 17-year-old adolescent presented with bilateral diffuse lung metastasis at initial diagnosis. Turk J Pediatr 2017; 58:86-89. [PMID: 27922241 DOI: 10.24953/turkjped.2016.01.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Neuroblastoma (NB) is the most frequently diagnosed neoplasm during infancy and its incidence declines within the first 3-5 years of life. It can be rarely diagnosed in adolescents and young adults. Adolescents have advanced stage of disease, higher frequency of uncommon metastatic sites such as lungs, and worse outcomes. Herein, we describe an unusual case of NB in a 17-year-old adolescent presented with lung metastasis at diagnosis. The patient was diagnosed with stage IV NB. Thorax high-resolution computed tomography (HRCT) scan revealed irregular septal thickening with ground glass opacity consistent with pulmonary parenchymal metastases. After the first cycle of chemotherapy he developed pulmonary hemorrhage and respiratory distress. He required ventilation support and mechanical ventilation was started. Metastatic nodules were determined on second thorax HRCT. We lost the patient due to septic shock and multiple organ failure 2 months after diagnosis. In conclusion, adolescents with NB have unfavorable prognosis. These patients may have lung metastases at diagnosis. Therefore, detailed chest imaging at initial diagnosis is crucial.
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Affiliation(s)
- Çağlar Ödek
- Divisions of Pediatric Critical Care , Ankara University Faculty of Medicine, Ankara, Turkey
| | - Tanıl Kendirli
- Divisions of Pediatric Critical Care , Ankara University Faculty of Medicine, Ankara, Turkey
| | - Esra Pekpak
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Ayhan Yaman
- Divisions of Pediatric Critical Care , Ankara University Faculty of Medicine, Ankara, Turkey
| | - Başak Adaklı-Aksoy
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Handan Dinçaslan
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nurdan Taçyıldız
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emel Ünal
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Erdal İnce
- Divisions of Pediatric Critical Care , Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gülsan Yavuz
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
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12
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Kutlay NY, Pekpak E, Altıner S, Ileri T, Vicdan AN, Dinçaslan H, Ince EU, Tukun FA. Prognostic impact of RUNX1 and ETV6 gene copy number on pediatric B-cell precursor acute lymphoblastic leukemia with or without hyperdiploidy. Int J Hematol 2016; 104:368-77. [PMID: 27393278 DOI: 10.1007/s12185-016-2034-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 05/26/2016] [Accepted: 05/26/2016] [Indexed: 10/21/2022]
Abstract
The ETV6/RUNX1 fusion gene is a valuable prognostic marker that is frequently observed in B-cell precursor acute lymphoblastic leukemia (B-cell ALL). However, the clinical significance of copy number aberrations in these genes remains unclear. In this study, the effects of various aberrations inETV6 and RUNX1 gene copy number on disease prognosis were evaluated in 21 pediatric patients diagnosed with B-cell ALL with/without t(12;21). The prognostic significance of changes in gene copy number of ETV6 or RUNX1 in the presence or absence of hyperdiploidy, trisomy 21, and t(12;21) translocation were also evaluated. RUNX1 gene copy number amplifications were detected in 83 % of the patients who lacked t(12;21) and in all of the patients with hyperdiploidy. Trisomy 21 was detected in 78 % of the patients with hyperdiploidy. Changes in ETV6 gene copy number were detected in patients who lacked both the t(12;21) translocation and RUNX1 gene copy number amplifications. However, RUNX1 gene copy number amplification and ETV6 deletion were observed in all of the patients with t(12;21). RUNX1 gene copy number amplification was associated with hyperdiploidy, but not with t(12;21). Thus, the evaluation of distinct FISH and cytogenetic patterns in patients with B-cell ALL may strengthen the prognostic significance of changes in gene copy number.
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Affiliation(s)
| | - Esra Pekpak
- Ankara University School of Medicine, Pediatric Hematology and Oncology, Ankara, Turkey
| | - Sule Altıner
- Ankara University School of Medicine, Medical Genetics, Ankara, Turkey
| | - Talia Ileri
- Ankara University School of Medicine, Pediatric Hematology and Oncology, Ankara, Turkey
| | | | - Handan Dinçaslan
- Ankara University School of Medicine, Pediatric Hematology and Oncology, Ankara, Turkey
| | - Elif Unal Ince
- Ankara University School of Medicine, Pediatric Hematology and Oncology, Ankara, Turkey
| | - Fatma Ajlan Tukun
- Ankara University School of Medicine, Medical Genetics, Ankara, Turkey
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13
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Yılmaz S, Özçakar ZB, Taktak A, Kiremitçi S, Ensari A, Dinçaslan H, Yalçınkaya F. Anti-VEGF-related thrombotic microangiopathy in a child presenting with nephrotic syndrome. Pediatr Nephrol 2016; 31:1029-32. [PMID: 26928310 DOI: 10.1007/s00467-016-3355-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 11/03/2015] [Revised: 02/08/2016] [Accepted: 02/15/2016] [Indexed: 12/15/2022]
Abstract
BACKGROUND Targeting the vascular endothelial growth factor (VEGF) signaling pathway has become an important approach to current cancer therapy. Anti-VEGF therapy-related renal adverse effects may present as hypertension, non-nephrotic proteinuria, and rarely as nephrotic syndrome (NS) and acute kidney injury. CASE-DIAGNOSIS/TREATMENT In this report, we present a 15-year-old boy who had developed nephrotic syndrome and thrombotic microangiopathy 26 months after administration of anti-VEGF therapy. Treatment was discontinued and nephrotic syndrome remitted spontaneously within 3 months. CONCLUSIONS Nephrologists should be aware of the side effects of anti-VEGF therapy. Early diagnosis and prompt management with withdrawal of the agents will result in spontaneous remission.
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Affiliation(s)
- Songül Yılmaz
- Department of Pediatrics, Division of Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey. .,Çocuk Sağlığı ve Hastalıkları AD, Çocuk Nefroloji Ünitesi, Ankara Üniversitesi Tıp Fakültesi, Dikimevi, Ankara, Turkey.
| | - Z Birsin Özçakar
- Department of Pediatrics, Division of Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey
| | - Aysel Taktak
- Department of Pediatric Nephrology, Ankara Child Health Hematology and Oncology Education Research Hospital, Ankara, Turkey
| | - Saba Kiremitçi
- Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
| | - Arzu Ensari
- Department of Pathology, Ankara University School of Medicine, Ankara, Turkey
| | - Handan Dinçaslan
- Department of Pediatrics, Division of Pediatric Oncology, Ankara University School of Medicine, Ankara, Turkey
| | - Fatoş Yalçınkaya
- Department of Pediatrics, Division of Pediatric Nephrology, Ankara University School of Medicine, Ankara, Turkey
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Özyörük D, Yavuz G, Dinçaslan H, Cabı-Unal E, Taçyıldız N, Karataş D, Doğu F, İkincioğulları A. Serum IL-13 levels at diagnosis and remission in children with malignant lymphoma. Turk J Pediatr 2016; 58:246-253. [PMID: 28266188 DOI: 10.24953/turkjped.2016.03.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Interleukin (IL)-13 has been reported to have a role in the pathogenesis of lymphoma through recent molecular studies predominantly in adult patients. As malignant lymphomas in children differ from adult counterparts in terms of histology and response to treatment, we aimed to determine the serum IL-13 levels of patients with lymphoma; its relation with clinical-laboratory parameters and to look for any correlation of serum IL-13 levels with different prognostic factors in children. Twenty-eight patients with malignant lymphoma and 20 age-matched healthy controls were included in the study. The median serum IL-13 level at diagnosis (range 0.59-68 pg/ml, median 3.40 pg/ml) was higher than that in remission (range 0.14-12.2 pg/ml, median 1.60 pg/ml) in the HL group (p < 0.05). Remarkably, median serum IL-13 level of patients with nodular sclerosis at diagnosis was higher than those with mixed-cellularity (p < 0.05) and declined to normal limits during remission (p < 0.05). In Burkitt's lymphoma (BL) subgroup, the median (range 2.94-154 pg/ml, median 4.5 pg/ml) was high and declined to normal levels during remission (range 0.55-11.30 pg/ml, median 1.57 pg/ml) and the difference was significant (p < 0.05). In terms of prognostic factors, serum IL-13 levels were found to be associated with white blood cells counts only in HL group. Although the number of patients is limited in our study, we found that the serum IL-13 levels exhibit variances in different histopathologic groups. IL-13 might have a role in histopathogenesis of lymphoma, but seems to have no prognostic significance. Nevertheless, more molecular studies are needed to evaluate the pathogenesis of HL.
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Affiliation(s)
- Derya Özyörük
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Gülsan Yavuz
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Handan Dinçaslan
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Emel Cabı-Unal
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Nurdan Taçyıldız
- Divisions of Pediatric Oncology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Deniz Karataş
- Divisions of Pediatric Immunology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Figen Doğu
- Divisions of Pediatric Immunology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
| | - Aydan İkincioğulları
- Divisions of Pediatric Immunology, Department of Pediatrics, Ankara University Faculty of Medicine, Ankara, Turkey
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15
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Tacyildiz N, Ozyörük D, Yavuz G, Unal EC, Dinçaslan H, Tanyıldız GO, Gördü Z, Sıklar Z, Berberoğlu M, Ocal G. Rare childhood tumors in a Turkish pediatric oncology center. Indian J Med Paediatr Oncol 2014; 34:264-9. [PMID: 24604955 PMCID: PMC3932593 DOI: 10.4103/0971-5851.125241] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Background: It has been estimated that rare tumor rate is about 15% of all childhood cancer in United States. According to Turkish Pediatric Oncology Group (TPOG) datas, 8889 children were diagnosed between 2002 and 2008 in our country and 3.7% of them were diagnosed as rare tumors. Aim: To investigate the frequency and clinical features of rare tumors in our pediatric oncology center. Materials and Methods: A total of 43 cases that have diagnosed as rare tumor in 574 cancer patients between the yaer 2002 and 2012 were reviewed retrospectively. All cases definitive diagnosis were established by histopathological and immunohistochemical studies. Results: Frequency of rare tumors was 7.4% in our center. Benign and border line rare tumors were 27 (62.7%) cases, malignant rare tumor were 16 (37.2%) cases. Median follow-up period was 48 months (between 1 and 110 months). Six of the malignant rare tumors were died with progressive disease (synovial sarcoma, mixed malignant mesenchymal tumor, undifferentiated sarcoma, plexus choroideus carcinoma, renal peripheral primitive neuroectodermal tumor, adrenocortical carcinoma). Malignant rare tumor mortality rate was found 37.5% in our clinic. Conclusion: We have found that our rare tumor rate (7.4%) was higher than Turkish rare tumor rate (3.7%) according to TPOG's datas. However, it was still lower than rare tumor rates of western countries (15%), probably due to difficulties of diagnosis and referral problems.
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Affiliation(s)
- Nurdan Tacyildiz
- Department of Pediatric Oncology, Ankara University, Ankara, Turkey
| | - Derya Ozyörük
- Department of Pediatric Oncology, Ankara University, Ankara, Turkey
| | - Gülsan Yavuz
- Department of Pediatric Oncology, Ankara University, Ankara, Turkey
| | - Emel Cabı Unal
- Department of Pediatric Oncology, Ankara University, Ankara, Turkey
| | - Handan Dinçaslan
- Department of Pediatric Oncology, Ankara University, Ankara, Turkey
| | | | - Zülfikar Gördü
- Department of Pediatric Oncology, Ankara University, Ankara, Turkey
| | - Zeynep Sıklar
- Department of Pediatric Endocrinology, Ankara University, Ankara, Turkey
| | - Merih Berberoğlu
- Department of Pediatric Endocrinology, Ankara University, Ankara, Turkey
| | - Gönül Ocal
- Department of Pediatric Endocrinology, Ankara University, Ankara, Turkey
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Gündüz K, Köse K, Kurt RA, Süren E, Taçyildiz N, Dinçaslan H, Ünal E, Erden E, Heper AO. Retinoblastoma in Turkey: results from a tertiary care center in Ankara. J Pediatr Ophthalmol Strabismus 2013; 50:296-303. [PMID: 23937863 DOI: 10.3928/01913913-20130730-02] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Accepted: 04/25/2013] [Indexed: 11/20/2022]
Abstract
PURPOSE To evaluate the presentation patterns and results of management of retinoblastoma at a tertiary care center in Ankara, Turkey, with special emphasis on globe conservation rate in unilateral and bilateral intraocular retinoblastoma. METHODS Patients were grouped according to the International Classification of Retinoblastoma. For intraocular retinoblastoma, group E and some group D eyes underwent primary enucleation. Secondary enucleation was performed after failure of chemoreduction, focal treatments, external beam radiotherapy (EBRT), and intra-arterial chemotherapy used in various combinations. For extraocular retinoblastoma cases, treatment consisted of enucleation/exenteration or orbital biopsy, high-dose chemotherapy, and EBRT to the orbit and metastatic sites. RESULTS During the study period from October 1998 to May 2010, 165 of 192 (85.9%) patients had intraocular disease and 27 (14.1%) patients had extraocular disease. In total, primary or secondary enucleation was performed in 70 of 94 eyes with unilateral retinoblastoma (74.5%) and in 34 of 142 eyes with bilateral retinoblastoma (23.9%). The overall globe conservation rate was 69.6%. Only one patient in the intraocular retinoblastoma group died of metastatic retinoblastoma to the central nervous system. Twenty of 27 patients (74.1%) with extraocular retinoblastoma were found to have metastasis to the central nervous system, bone, bone marrow, and/or lymph nodes. At a mean follow-up of 28.0 months (median: 12 months; range: 1 to 120 months), survival was 33.3% despite intensive treatment. CONCLUSIONS The overall risk of enucleation was 75% in eyes with unilateral retinoblastoma and 24% in eyes with bilateral retinoblastoma. Extraocular retinoblastoma carries a 75% risk of systemic metastasis and 67% risk of death.
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