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Aktekin EH, Erbay A, Saygı S, Yazici N. Intracranial Hemorrhage, Cerebral Venous Thrombosis, and Hypereosinophilia. Pediatr Neurol 2023; 149:134-136. [PMID: 37879137 DOI: 10.1016/j.pediatrneurol.2023.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/12/2023] [Accepted: 09/21/2023] [Indexed: 10/27/2023]
Affiliation(s)
- Elif Habibe Aktekin
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Baskent University, Adana, Turkey.
| | - Ayşe Erbay
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Baskent University, Adana, Turkey
| | - Semra Saygı
- Division of Peditric Neurology, Department of Pediatrics, Baskent University, Adana, Turkey
| | - Nalan Yazici
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Baskent University, Adana, Turkey
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Aktekin EH, Yazici N, Kozanoğlu İ, Erbay A. Is very high platelet count always associated with essential thrombocythemia? An unusual presentation in a child. Lab Med 2023; 54:e170-e176. [PMID: 37352366 DOI: 10.1093/labmed/lmad053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/25/2023] Open
Abstract
Myeloproliferative neoplasms are rare in childhood. They are categorized as Philadelphia chromosome-positive and Philadelphia chromosome-negative. Chronic myeloid leukemia (CML) is the most common myeloproliferative disease in which the Philadelphia chromosome is detected as a result of BCR-ABL rearrangements. In others, the most common genetic abnormality is JAK2V617F mutation. The coexistence of these 2 abnormalities in CML is unexpected, and rare cases have recently been reported in adults. We present a child who had a very high platelet count in which we found this coexistence. The clinical presentation, laboratory findings, management, and prognosis of this coexistence is challenging in such a rare condition.
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Affiliation(s)
- Elif Habibe Aktekin
- Department of Pediatrics Division of Pediatric Hematology-Oncology, Baskent University, Adana, Turkey
| | - Nalan Yazici
- Department of Pediatrics Division of Pediatric Hematology-Oncology, Baskent University, Adana, Turkey
| | - İlknur Kozanoğlu
- Department of Physiology and the Apheresis Unit Adult Bone Marrow Transplant Centre, Baskent University, Adana, Turkey
| | - Ayşe Erbay
- Department of Pediatrics Division of Pediatric Hematology-Oncology, Baskent University, Adana, Turkey
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Guzelkucuk Z, Karapınar DY, Gelen SA, Tokgoz H, Ozcan A, Ay Y, Bahadır A, Ozbek NY, Oren AC, Ayhan AC, Akyay A, Akıncı B, Karadas N, Unuvar A, Oren H, Fettah A, Kaya Z, Isık B, Eker İ, Karaman S, Yıldırım AT, Orhan MF, Oymak Y, Timur C, Yazici N, Simsek A, Karakurt N, Toret E, Evim MS. Central nervous system thrombosis in pediatric acute lymphoblastic leukemia in Turkey: A multicenter study. Pediatr Blood Cancer 2023:e30425. [PMID: 37194482 DOI: 10.1002/pbc.30425] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Revised: 04/22/2023] [Accepted: 04/25/2023] [Indexed: 05/18/2023]
Abstract
BACKGROUND In patients with acute lymphoblastic leukemia (ALL), the risk of thromboembolism increases due to hemostatic changes secondary to the primary disease and due to treatment-related factors. In this multicenter study, we aimed to research the frequency of central nervous system (CNS) thrombosis occurring during treatment, hereditary and acquired risk factors, clinical and laboratory features of patients with thrombosis, treatment approaches, and thrombosis-related mortality and morbidity rates in pediatric ALL patients. PROCEDURE Pediatric patients who developed CNS thrombosis during ALL treatment from 2010 to 2021 were analyzed retrospectively in 25 different Pediatric Hematology Oncology centers in Türkiye. The demographic characteristics of the patients, symptoms associated with thrombosis, the stage of the leukemia treatment during thrombosis, the anticoagulant therapy applied for thrombosis, and the final status of the patients recorded through electronic medical records were determined. RESULTS Data from 70 patients with CNS thrombosis during treatment, out of 3968 pediatric patients with ALL, were reviewed. The incidence of CNS thrombosis was 1.8% (venous: 1.5 %; arterial: 0.03%). Among patients with CNS thrombosis, 47 had the event in the first 2 months. Low molecular weight heparin (LMWH) was the most commonly used treatment with a median of 6 months (min-max: 3-28 months). No treatment-related complications occurred. Chronic thrombosis findings occurred in four patients (6%). In five (7%) patients who developed cerebral vein thrombosis, neurological sequelae (epilepsy and neurological deficit) remained. One patient died related to thrombosis, and the mortality rate was 1.4%. CONCLUSION Cerebral venous thrombosis and, less frequently, cerebral arterial thrombosis may develop in patients with ALL. The incidence of CNS thrombosis is higher during induction therapy than during other courses of treatment. Therefore, patients receiving induction therapy should be monitored carefully for clinical findings suggestive of CNS thrombosis.
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Affiliation(s)
- Zeliha Guzelkucuk
- Department of Pediatric Hematology-Oncology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Deniz Yılmaz Karapınar
- Department of Pediatric Hematology-Oncology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Sema Aylan Gelen
- Department of Pediatric Hematology, Kocaeli University Faculty of Medicine, Kocaeli, Turkey
| | - Huseyin Tokgoz
- Department of Pediatric Hematology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Alper Ozcan
- Department of Pediatric Hematology-Oncology, Erciyes University Faculty of Medicine, Kayseri, Turkey
| | - Yılmaz Ay
- Department of Pediatric Hematology, Pamukkale University Faculty of Medicine, Denizli, Turkey
| | - Aysenur Bahadır
- Faculty of Medicine, Department of Pediatric Hematology, Karadeniz Technical University, Trabzon, Turkey
| | - Namik Yasar Ozbek
- Department of Pediatric Hematology-Oncology, Ankara Bilkent City Hospital, Ankara, Turkey
| | - Ayse Ceyda Oren
- Department of Pediatric Hematology-Oncology, Faculty of Medicine, Gaziantep University, Gaziantep, Turkey
| | - Aylin Canbolat Ayhan
- Faculty of Medicine, Department of Pediatric Hematology, Istanbul Medeniyet University, Istanbul, Turkey
| | - Arzu Akyay
- Department of Pediatric Hematology, Inonu University Faculty of Medicine, Malatya, Turkey
| | - Burcu Akıncı
- Department of Pediatric Hematology-Oncology, Acıbadem University Faculty of Medicine, Istanbul, Turkey
| | - Nihal Karadas
- Department of Pediatric Hematology-Oncology, Ege University Faculty of Medicine, İzmir, Turkey
| | - Aysegul Unuvar
- Department of Pediatric Hematology-Oncology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Hale Oren
- Department of Pediatric Hematology, Dokuz Eylul University Faculty of Medicine, Izmir, Turkey
| | - Ali Fettah
- Department of Pediatric Hematology, Dr. Sami Ulus Pediatric Health and Diseases Training and Research Hospital, Ankara, Turkey
| | - Zuhre Kaya
- Department of Pediatric Hematology-Oncology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Bilgen Isık
- Department of Pediatric Hematology-Oncology, University of Health Sciences Bursa High Specialization Hospital, Bursa, Turkey
| | - İbrahim Eker
- Department of Pediatric Hematology-Oncology, Afyonkarahisar University Faculty of Medicine, Afyon, Turkey
| | - Serap Karaman
- Department of Pediatric Hematology-Oncology, Istanbul University Faculty of Medicine, Istanbul, Turkey
| | - Aysen Turedi Yıldırım
- Department of Pediatric Hematology-Oncology, Celal Bayar University Faculty of Medicine, Manisa, Turkey
| | - Mehmet Fatih Orhan
- Department of Pediatric Hematology-Oncology, Sakarya University Faculty of Medicine, Sakarya, Turkey
| | - Yesim Oymak
- University of Health Sciences Dr. Behçet Uz Pediatric Diseases and Pediatric Surgery Department of Pediatric Hematology, İzmir, Turkey
| | - Cetin Timur
- Department of Pediatric Hematology-Oncology, Yeditepe Faculty of Medicine, Istanbul, Turkey
| | - Nalan Yazici
- Department of Pediatric Hematology, Baskent University Adana Dr. Turgut Noyan Application and Research Center, Adana, Turkey
| | - Ayse Simsek
- Department of Pediatric Hematology, Necmettin Erbakan University Meram Faculty of Medicine, Konya, Turkey
| | - Neslihan Karakurt
- Department of Pediatric Hematology Oncology, Sancaktepe Sehit Prof. Dr. İlhan Varank Training and Research Hospital, Istanbul, Turkey
| | - Ersin Toret
- Department of Pediatric Hematology-Oncology, Osmangazi University Faculty of Medicine, Eskişehir, Turkey
| | - Melike Sezgin Evim
- Department of Pediatric Hematology-Oncology, Uludag University Faculty of Medicine, Bursa, Turkey
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Affiliation(s)
- Nalan Yazici
- Department of Pediatric Oncology, Faculty of Medicine, Baskent University, Adana, Turkey -
| | - Faik Sarialioglu
- Department of Pediatric Oncology, Faculty of Medicine, Baskent University, Ankara, Turkey
| | - Ayşe Erbay
- Department of Pediatric Oncology, Faculty of Medicine, Baskent University, Adana, Turkey
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Doğruel D, Erbay A, Yazici N, Arslan A, Hasbay Biçen B. A Case of Idiopathic Pulmonary Hemosiderosis Presenting With Signs and Symptoms Mimicking Hemolytic Anemia. J Pediatr Hematol Oncol 2017; 39:e15-e17. [PMID: 27918350 DOI: 10.1097/mph.0000000000000722] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Idiopathic pulmonary hemosiderosis is primarily a disorder of childhood, which is characterized by hemoptysis, iron deficiency anemia, and diffuse parenchymal infiltrates on chest x-ray secondary to recurrent attacks of alveolar hemorrhage. It can be diagnosed by showing hemosiderin laden macrophages in bronchoalveolar lavage fluid after other specific causes of diffuse alveolar hemorrhage are definitely excluded. A 5-year-old male patient was admitted to our clinic with sudden-onset pallor during iron therapy given for anemia. While he was being investigated for clinical and laboratory signs mimicking hemolytic anemia, he developed cough and dyspnea. He had infiltrates on chest x-ray and scattered patchy infiltrates in both lungs on high-resolution computed tomography. Hemosiderin laden macrophages were identified in fasting gastric juice and bronchoalveolar lavage fluid. The patient was diagnosed with idiopathic pulmonary hemosiderosis and started corticosteroid therapy.
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Affiliation(s)
- Dilek Doğruel
- Departments of *Pediatric Allergy and Immunology †Pediatric Hematology and Oncology ‡Pediatric Cardiology §Pathology, Adana Teaching and Medical Research Center, Baskent University Faculty of Medicine, Adana, Turkey
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Yazici N, Sarialioglu F, Alkan Ö, Erol İ, Erbay A. Variability of Dose and Level of Sirolimus in a Patient With Tuberous Sclerosis Complex and Subependymal Giant Cell Astrocytoma. Pediatr Blood Cancer 2016; 63:1497-8. [PMID: 27082208 DOI: 10.1002/pbc.25992] [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: 02/29/2016] [Accepted: 03/01/2016] [Indexed: 11/07/2022]
Affiliation(s)
- Nalan Yazici
- Department of Pediatric Hematology and Oncology, Baskent University Adana Medical and Research Center, Adana, Turkey
| | - Faik Sarialioglu
- Department of Pediatric Hematology and Oncology, Baskent University Adana Medical and Research Center, Adana, Turkey
| | - Özlem Alkan
- Department of Radiology, Baskent University Adana Medical and Research Center, Adana, Turkey
| | - İlknur Erol
- Department of Pediatric Neurology, Baskent University Adana Medical and Research Center, Adana, Turkey
| | - Ayse Erbay
- Department of Pediatric Hematology and Oncology, Baskent University Adana Medical and Research Center, Adana, Turkey
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Asilsoy S, Yazici N, Demir S, Erbay A, Koçer E, Sarıalioğlu F. A different cause for respiratory disorder in children: cases with pulmonary Langerhans cell histiocytosis. Clin Respir J 2015; 11:193-199. [PMID: 26083968 DOI: 10.1111/crj.12324] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2014] [Revised: 04/27/2015] [Accepted: 05/14/2015] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND AIMS In children, complaints of a respiratory disorder are very frequent. Etiology of respiratory illness is a broad spectrum that varies from a simple viral infection to a malignant disorder. Pulmonary Langerhans cell histiocytosis (PLCH) is one of these entities and it is truly rare in children. The aim of this study is to evaluate our patients with PLCH. METHODS Patients who had been diagnosed with PLCH were retrospectively evaluated. Features of medical history, onset of the complaints, date of the diagnosis, chest X-Ray and computed tomography (CT) findings, histopathology and other laboratory investigations were considered. RESULTS There were four cases with PLCH. All of them were male, ages were between 5 months and 16 years. In three cases, major complaints were chronic respiratory problems whereas in one of them there was acute respiratory distress beginning with cough and leading to pneumothorax. In all of the cases, multisystemic involvement was prominent. The diagnosis was proven by histopathology in all of the cases. In two children with smaller age, skin involvement was detected. Time from complaint to diagnosis was minimum 3 months and maximum 3 years. CONCLUSION PLCH is a rare disorder in children. Pulmonary involvement is generally a component of systemic involvement but in many cases it might have been detected with early respiratory complaints. So, children with chronic respiratory problems should be carefully evaluated and should be followed up for rare entities like PLCH.
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Affiliation(s)
- Suna Asilsoy
- Pediatric Allergy, Dokuz Eylul University, Faculty of Medicine, Izmir, Turkey
| | - Nalan Yazici
- Pediatric Oncology, Baskent University, Faculty of Medicine, Adana, Turkey
| | - Senay Demir
- Pediatic Radyology, Baskent University, Faculty of Medicine, Adana, Turkey
| | - Ayse Erbay
- Pediatric Oncology, Baskent University, Faculty of Medicine, Adana, Turkey
| | - Emrah Koçer
- Pathology, Baskent University, Faculty of Medicine, Adana, Turkey
| | - Faik Sarıalioğlu
- Pediatric Oncology, Baskent University Faculty of Medicine, Adana, Turkey
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Abbasoglu A, Sarialioglu F, Yazici N, Bayraktar N, Haberal A, Erbay A. Serum neuron-specific enolase levels in preterm and term newborns and in infants 1-3 months of age. Pediatr Neonatol 2015; 56:114-9. [PMID: 25315754 DOI: 10.1016/j.pedneo.2014.07.005] [Citation(s) in RCA: 7] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2014] [Revised: 06/27/2014] [Accepted: 07/28/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Elevated serum levels of neuron-specific enolase (NSE) was initially assumed to be specific to neuronal tumors (particularly neuroblastoma), but is now known to accompany nontumoral conditions and tumors other than neuroblastomas. There is a need to establish normal ranges for NSE, especially in early infancy. The aims of this study were to determine reference values for NSE in newborns and young infants and to assess whether NSE levels in early infancy (i.e., preterm infants and term infants) differ from the adult reference range for this enzyme. METHODS We enrolled 140 healthy babies, which included 40 preterm newborns (3-15 days old and born at 28-42 weeks gestation), 40 term newborns (< 1 month old and born at term), and 60 young infants 1-3 months old (n = 20 per subgroup of 1-, 2-, and 3-month-old infants). The determination of NSE levels was performed by the electrochemiluminescence immunoassay (ECLIA) method using the Elecysys 2010 device (Roche Diagnostics, Mannheim, Germany). The mean serum NSE levels for the preterm newborns was 21.83 ± 15.06 ng/mL [95% confidence interval (95%CI), 16.95-26.71 ng/mL]; term newborns, 18.06 ± 12.83 ng/mL (95%CI, 13.94-22.19 ng/mL); and young infants, 9.09 ± 4.38 ng/mL (95%CI, 7.96-10.23 ng/mL). The mean serum NSE level for infants 1-3 months old was within the ECLIA kit's normal range (4.7-18 ng/mL for adults), whereas the corresponding means for the preterm and term newborns were higher (p < 0.001, for both). CONCLUSION Our findings suggest that adult reference values should not be applied to the preterm and term age groups.
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Affiliation(s)
- Aslihan Abbasoglu
- Division of Neonatology, Department of Pediatrics, Baskent University Faculty of Medicine, Ankara, Turkey.
| | - Faik Sarialioglu
- Division of Pediatric Oncology, Department of Pediatrics, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Nalan Yazici
- Division of Pediatric Oncology, Department of Pediatrics, Baskent University Faculty of Medicine, Adana, Turkey
| | - Nilufer Bayraktar
- Department of Biochemistry, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Aysegul Haberal
- Department of Biochemistry, Baskent University Faculty of Medicine, Ankara, Turkey
| | - Ayse Erbay
- Division of Pediatric Oncology, Department of Pediatrics, Baskent University Faculty of Medicine, Adana, Turkey
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Ince E, Oğuzkurt P, Temiz A, Ezer SS, Gezer HÖ, Yazici N, Hiçsönmez A. Complications of total implantable access ports and efficacy of Taurolidine-citrate lock solution against catheter-related infections. Afr J Paediatr Surg 2014; 11:138-42. [PMID: 24841014 DOI: 10.4103/0189-6725.132806] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Totally, implantable access ports (TIAPs) are used for long standing venous catheterization. This study was designed to present our experiences of the TIAPs applications and efficacy of Taurolidine-citrate lock solution (TCLS) against catheter-related infections. MATERIALS AND METHODS We evaluated records of the 108 patients implanted with 112 TIAPs, which had been performed using heparin solution or TCLS between 2005 and 2013. RESULTS Duration of exposure to TIAPs was 17-2051 days (median: 411 days). The primary diagnoses were solid tumours (n = 57), lymphoma (n = 23), haematologic diseases (n = 23), nephrotic syndrome (n = 4), Hirschsprung disease (n = 1). The right external jugular vein was most frequently used vascular access route (72.3%). Mechanical complications were observed in four cases. TIAPs were removed due to remission in 19 cases and infection in 19 cases. Median time from implantation and to the development of infection was 60 days. Heparin solution had been used for care in 33 ports, whereas heparin and TCLS had been used in 79 ports. Based on statistical comparison, use of TCLS was considered to be an important factor for preventing infection (P = 0.03). CONCLUSION We consider that TCLS reduces infection prevalence so TIAPs would be used more extensively and effectively to prevent infections.
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Affiliation(s)
- Emine Ince
- Department of Paediatric Surgery, Başkent University, Faculty of Medicine, Ankara, Turkey
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Yegingil Z, Nur N, Dogan T, Yazici N, Topaksu M. Effects of annealing and high radiation dose on the thermoluminescence characteristics of natural fluorite. RADIAT MEAS 2012. [DOI: 10.1016/j.radmeas.2012.08.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Varan A, Yazici N, Akalan N, Yalcin B, Akyüz C, Kutluk T, Büyükpamukçu M. Primitive neuroectodermal tumors of the central nervous system associated with genetic and metabolic defects. J Neurosurg Sci 2012; 56:49-53. [PMID: 22415382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM To evaluate the genetic, congenital and metabolic disorders which were detected concurrently with primitive neuroectodermal tumors (PNET) of the central nervous system in children. METHODS Medical records of 1030 children who were admitted to our department with diagnosis of brain tumor between 1975 and 2005 were reviewed retrospectively. Medulloblastoma and supratentorial PNETs were detected in 289 patients. They were reviewed for associated metabolic conditions, genetic and congenital defects. RESULTS One of the following conditions were detected in 10 patients with medulloblastoma and supratentorial PNETs: Neurofibromatosis type 1, Gorlin syndrome, juvenile polyposis coli, cancer prone syndrome of total premature chromatid separation and Fanconi anemia, bilateral retinoblastoma, L-2-hydroxyglutaric aciduria, Gilbert syndrome, gray platelet syndrome, cleft lip-palate and left renal agenesis. In the patients with multiple malignant diseases, cancer prone syndrome of total premature chromatid separation and Fanconi anemia, Gorlin syndrome and juvenile polyposis coli were diagnosed after diagnosis of the malignant tumors. Medulloblastoma was the first manifestation in the case with Gorlin syndrome. In case with retinoblastoma, pineal PNET was detected 2 months after diagnosis of retinoblastoma. Cleft lip-palate and L-2-Hydroxyglutaric aciduria were detected previously in the patients before their brain tumors whereas Gray platelet, Gilbert syndrome and left renal agenesis were diagnosed during treatment of medulloblastoma. CONCLUSION Associated genetic, metabolic and congenital conditions were detected in 3.5% of the cases. Thus the patients with PNET should be followed for these defects.
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Affiliation(s)
- A Varan
- Department of Pediatric Oncology, Hacettepe University Faculty of Medicin, Ankara, Turkey
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Akyuz C, Aydin GB, Cila A, Akalan N, Soylemezoglu F, Cengiz M, Yazici N, Buyukpamukcu M. Successful use of intraventricular and intravenous rituximab therapy for refractory primary CNS lymphoma in a child. Leuk Lymphoma 2009; 48:1253-5. [PMID: 17577799 DOI: 10.1080/10428190601142831] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Abstract
Pineal region tumors are a relatively uncommon, deep-seated heterogeneous group of mass lesions of the brain. Their management is much more complicated in children with cancer, both in terms of survival and sequelae, due to primary location of the tumor and treatment modality. The goal of this retrospective study was to report the presentation, treatment, and outcome of tumors that arose from this region in 24 children treated at our institution between March 1975 and May 2006. In all, 15 (62.5%) of the 24 children were initially treated with partial or complete resection, adjuvant radiotherapy was given to 18 (75%) patients, and chemotherapy was given to 15 (62.5%) of the patients. Overall survival was 44.5%. Although statistically insignificant, the most favorable outcome were obtained in patients with grossly resected tumors (66%) and in children >10 years of age (80%). Long-term sequelae occurred at a high rate in this study due to the primary location of the tumors and treatment modalities, which warrants further investigation.
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Affiliation(s)
- N Yazici
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, Ankara, Turkey
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Yazici N, Yalçin B, Soylemezoğlu F, Cila A, Akalan N, Koksal Y, Buyukpamukçu M. Intracranial desmoid tumor with familial adenomatous polyposis coli. Pediatr Neurosurg 2008; 44:140-3. [PMID: 18230929 DOI: 10.1159/000113117] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2006] [Accepted: 12/04/2006] [Indexed: 12/31/2022]
Abstract
Intracranial desmoid tumors are extremely rare. The association of desmoid tumors with familial adenomatous polyposis coli was reported previously, with the tumors involving trunk and extremities. We report a 3.5-year-old girl with intracranial desmoid tumor with familial adenomatous polyposis coli. This condition in a child is rarely reported. Follow-up of the patient after cranial surgery and of the family for this premalignant inherited condition is necessary.
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Affiliation(s)
- Nalan Yazici
- Department of Pediatric Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey.
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Abstract
We report an extremely rare occurrence of ameloblastic carcinoma located in the maxilla of a pediatric patient. Wide surgical resection was done along with adjuvant radiotherapy because of involved surgical margins. Histopathological diagnosis was established with morphological features of both ameloblastoma and carcinoma.
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Affiliation(s)
- Nalan Yazici
- Department of Pediatric Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey.
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Köksal Y, Varan A, Aydin GB, Sari N, Yazici N, Yalcin B, Kutluk T, Akyuz C, Büyükpamukçu M. Comparison of accelerated and rapid schedules for monovalent hepatitis B and combined hepatitis A/B vaccines in children with cancer. Pediatr Hematol Oncol 2007; 24:587-94. [PMID: 18092249 DOI: 10.1080/08880010701703511] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The aim of this study was to determine the efficacy of immunization against hepatitis A and B infections with "rapid" or "accelerated" schedules in children with cancer receiving chemotherapy. Fifty-one children were recruited to receive either vaccination schedule, in the "rapid vaccination schedule"; hepatitis B (group I) or combined hepatitis A/B vaccines (group III) were administered at months 0, 1, 2, and 12; in the "accelerated vaccination schedule," hepatitis B (group II) or combined hepatitis A/B (group IV) vaccines were administered on days 0, 7, 21, and 365 intramuscularly. The seroconversion rates at months 1 and 3 were 35.7 and 57.1% in group I and 25 and 18.8% in group II, respectively. Group I developed higher seroconversion rates at month 3. In group III the seroconversion rates for hepatitis B at months 1 and 3 were 54.5 and 60% and in group IV 50 and 70%, respectively. For hepatitis A, the seroconversion rates at months 1 and 3 were 81.8 and 90% in group III and 80 and 88.9% in group IV, respectively. The accelerated vaccination schedule seems to have no advantage in children receiving cancer chemotherapy except for high antibody levels at month 1. In conclusion, the accelerated vaccination schedules are not good choices for cancer patients. The combined hepatitis A/B vaccine is more effective than monovalent vaccine in cancer patients, which probably can be explained by an adjuvant effect of the antigens. The seroconversion of hepatitis A by the combined hepatitis A/B vaccination is very good in cancer patients.
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Affiliation(s)
- Yavuz Köksal
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, Ankara, Turkey.
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Yağci B, Kandemir N, Yazici N, Yalçin B, Varan A, Akyüz C, Büyükpamukçu M. Thyroid involvement in Langerhans cell histiocytosis: a report of two cases and review of the literature. Eur J Pediatr 2007; 166:901-4. [PMID: 17443347 DOI: 10.1007/s00431-007-0487-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2007] [Revised: 03/20/2007] [Accepted: 03/21/2007] [Indexed: 11/25/2022]
Abstract
Langerhans cell histiocytosis (LCH) is a disorder with unclear etiology and pathogenesis characterized by abnormal clonal proliferation and accumulation of antigen presenting Langerhans' cells at various tissues and organs. Almost all organs or systems may be involved, and the prognosis depends on the involved sites and the presence of organ dysfunction. Thyroid tissue is a rarely affected site in children, and without histopathological evaluation it may be difficult to distinguish from other thyroid disorders because of the similar physical examination, laboratory and imaging findings. Here we report on two patients with histopathologically proven thyroid involvement of LCH. Additionally, the differential diagnosis of diffusely enlarged or multinodular thyroid glands in children is discussed, and a review of the literature of thyroid involvement in LCH is given. In the differential diagnosis of enlarged thyroid glands, especially in the presence of other endocrinological manifestations, LCH must be taken into consideration.
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Affiliation(s)
- Begül Yağci
- Department of Pediatric Oncology, Hacettepe University Institute of Oncology, Ankara, Turkey.
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Varan A, Yazici N, Aksoy C, Gedikoğlu G, Yalçin B, Akyüz C, Kutluk T, Büyükpamukçu M. Treatment results of pediatric osteosarcoma: twenty-year experience. J Pediatr Orthop 2007; 27:241-6. [PMID: 17314654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
The objectives of the study were to compare the results of surgical procedures, amputation and limb-sparing surgery, and to assess the influence of preoperative chemotherapeutic regimens on the survival of pediatric patients with osteosarcoma. We retrospectively analyzed 69 patients treated at our institution between January 1985 and April 2004. The primary treatment modalities were limb-sparing surgery or amputation with or without preoperative chemotherapy. The need for postoperative chemotherapy was determined by the histological response, the tumor margins, and the burdens created by the metastatic disease. The age range was 5.3 to 18.6 years (median, 13.3 years); with a male-female ratio of 0.9. The most common lesion site was the femur, found in 39 patients. Fourteen of the patients had metastases involving the lungs or other bones at the time of diagnosis. Preoperative chemotherapy was done in 45 patients. Most of the patients were treated with cisplatin + adriamycin (27/69, 39.1%). Forty-two patients were surgically treated by amputation and 19 with limb-sparing surgery. Four patients had surgical resection of masses located at sites other than the extremities, and in 4 patients, surgery was not possible. The overall survival rate for the whole group was 32.6%. The overall survival rates were 27.2% and 66.9% for the patients treated with amputation and limb-sparing surgery, respectively. Osteosarcoma has a poor prognosis. Based on our 20-year experience, limb-sparing surgery as surgical management and the cisplatin + adriamycin preoperative chemotherapy regimen seem to be a promising modality for the patients with osteosarcoma.
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Affiliation(s)
- Ali Varan
- Department of Pediatric Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey.
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Yazici N, Yalçin B, Yilmaz T, Akyüz C, Karli Oguz K, Sungur A, Büyükpamukçu M. Surgery and calcitonin therapy in childhood central giant cell granuloma. ACTA ACUST UNITED AC 2006. [DOI: 10.1016/j.pedex.2006.09.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Abstract
This study evaluated the immuned response of the hepatitis A vaccine in children with cancer who were receiving chemotherapy. Twenty-eight patients with lymphomas or solid tumors and who had negative serology for hepatitis A were enrolled. The median age was 4.7 years (range 2-16). The patients received 1440 IU hepatitis A vaccine at 0 and 6 months. Seroconversion rates at the first and seventh months were 60% (n = 17/28 patients) and 89% (n = 24/27 patients). No adverse effects were observed. The hepatitis A vaccine was found to be effective and safe in children with cancer.
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Affiliation(s)
- Yavuz Köksal
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100, Ankara, Turkey.
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Büyükpamukçu M, Varan A, Yazici N, Akalan N, Söylemezoğlu F, Zorlu F, Akyüz C, Kutluk MT. Second malignant neoplasms following the treatment of brain tumors in children. J Child Neurol 2006; 21:433-6. [PMID: 16901454 DOI: 10.1177/08830738060210050901] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
We investigated retrospectively 992 children with central nervous system tumors who were treated at our center between 1970 and 2004. All of the patients were treated by surgery, chemotherapy, and/or radiotherapy. Six patients developed second malignant neoplasms, and their clinical and histopathologic characteristics are reviewed in this article. The second malignant neoplasms were diagnosed as non-Hodgkin lymphoma, myelodysplastic syndrome, basal cell carcinoma, malignant melanoma, Kaposi sarcoma, and high-grade neuroectodermal tumor. The initial diagnoses were ependymoblastoma in one, medulloblastoma in three, and low-grade astrocytoma in two patients. The median latency time was 3.03 years (range 0.39-22.93 years). The outcome varied according to the histopathologic type of the second tumor. The patients who developed non-Hodgkin lymphoma and myelodysplastic syndrome died of progressive disease. The patients with second skin neoplasms are alive as of the time of this writing. The patient with Kaposi sarcoma developed one of the rare reported second malignant neoplasms following a primary brain tumor in childhood. A wide spectrum of second malignant neoplasms was detected after treatment of primary brain tumors with surgery, radiotherapy, and chemotherapy. Long-term follow-up is therefore necessary for the child who has survived a primary central nervous system tumor.
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Affiliation(s)
- Münevver Büyükpamukçu
- Department of Pediatric Oncology, Institute of Oncology, Hacettepe University, Ankara, Turkey
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Abstract
Discitis in children is a rare disorder of intervertebral disc and vertebral end plate. Infection or trauma, like lumbar puncture, may be the possible causes. Low-back pain and gait disturbance are the main symptoms. The most appropriate diagnostic procedure is MRI. Treatment is mainly empirical. Here a case with non-Hodgkin lymphoma is discussed. Treatment consisted of strict bed rest and antibiotics. Safe and sterile technique is important in patients with invasive procedures like intrathecal chemotherapy. Although discitis is a self-healing condition, it might cause vertebral osteomyelitis. In this regard, physicians should be aware of this probable complication after lumbar puncture and manage it earlier in children with cancer.
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Affiliation(s)
- Nalan Yazici
- Department of Pediatric Oncology, Hacettepe University, Institute of Oncology, 06100 Ankara, Turkey.
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