No abstract

The main purpose of this study is to determine the current status of long-term follow-up (LTFU) for childhood cancer survivors and the challenges of LTFU for pediatric cancer survivors at pediatric oncology institutions in Turkey. Material and methods:A questionnaire was e-mailed to the directors of 33 pediatric oncology centers (POCs) registered in the Turkish Pediatric Oncology Group (TPOG). Of these 33 active TPOG institutions, 21 participated in the study and returned their completed questionnaires.Results: Only 1 of the 21 participating centers had a separate LTFU clinic. The remaining centers provided LTFU care for childhood cancer survivors at the pediatric oncology outpatient clinic. Of these centers, 17 (80.9%) reported difficulty in transition from the pediatric clinic to the adult clinic, 14 (66.6%) reported insufficient care providers, and 12 (57.1%) reported insufficient time and transportation problems. As neglected late effects, 16 (76.1%) centers reported psychosocial and getty job problems and 11 (52.3%) reported sexual and cognitive problems. None of the centers had their own LTFU guidelines for their daily LTFU practice. Conclusion:This study was the first to gain an overview of the needs of POCs and the gaps in survivorship services in Turkey. The results from this study will help to develop a national health care system and national guidelines for pediatric cancer survivors.

No abstract

The COVID-19 outbreak has caused anxiety among children with hematology-oncology disease and their families, as it has in every segment of society. In this study, we aimed to detect the anxiety levels of children with hematologic or oncologic disease and of their parents after the COVID-19 outbreak. The sample consisted of 15 patients 12 to 18 years of age receiving treatment in the Pediatric Hematology and Oncology Unit in Altinbaş University Medical Faculty Bahçelievler Medikalpark Hospital and 33 parents of the same unit patients between 6 and 18 years of age, and their 35 healthy peers and their parents. The State-Trait Anxiety Inventory was applied to participant children and their parents to evaluate their general anxiety and pandemic-related anxiety levels. Children with a hematology-oncology disease and their families were compared with healthy peers and their families. No significant difference was observed for pandemic-related anxiety levels (P>0.05). Both parent groups exhibited higher anxiety levels with regard to the pandemic than did their children (P<0.05). Children with hematology-oncology disease reported significantly higher trait anxiety levels when compared with healthy peers (P=0.01). The families of children who had not received stem cell transplantation had higher state and trait anxiety scores than the families of children who had received the transplantation (P<0.05). Even though they were in the high-risk group, children with a hematology-oncology disease and their families had pandemic-related anxiety levels comparable with those of healthy peers and their families.

Background: Post-transplant relapse has a dismal prognosis in children with acute leukemia undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT).Data on risk factors, treatment options, and outcomes are limited. Procedure:In this retrospective multicenter study in which a questionnaire was sent to all pediatric transplant centers reporting relapse after allo-HSCT for a cohort of 938 children with acute leukemia, we analyzed 255 children with relapse of acute leukemia after their first allo-HSCT. Results:The median interval from transplantation to relapse was 180 days, and the median follow-up from relapse to the last follow-up was 1844 days. The 3-year overall survival (OS) rate was 12.0%. The main cause of death was disease progression or subsequent relapse (82.6%). The majority of children received salvage treatment with curative intent without a second HSCT (67.8%), 22.0% of children underwent a second allo-HSCT, and 10.2% received palliative therapy. Isolated extramedullary relapse (hazard ratio (HR): 0.607, P = .011) and relapse earlier than 365 days post-

Amaç: Bu çalışmada ultrasonografi ve floroskopi eşliğinde yerleştirilen subkutanöz venöz port olgularının bulgu ve sonuçlarının değerlendirilmesi amaçlanmıştır. Gereç ve Yöntem: Haziran 2012-Mayıs 2013 tarihleri arasında subkutanöz venöz port yerleştirilen 40 (17 kadın, 23 erkek; ortalama yaş: 57.63 ± 12.28) olgu retrospektif olarak değerlendirildi. Olguların demografik özellikleri, primer tanıları, port yerleştirilme endikasyonları, işlem tekniği, portun implantasyonu sonrası kullanım süresi, işlem sırasında ve kullanım sırasında gelişen komplikasyonlar ve çıkarılan port sayısı ile çıkarılma nedenleri araştırıldı. Bulgular: Otuz yedi olguda sağ internal juguler ven ve 3 olguda sol internal juguler ven ponksiyonu yapıldı. Hiçbir hastada hematom, hemotoraks ve pnömotoraks ile arteriyel ponksiyon gibi erken dönem gelişmedi. Tüm hastalarda port kateterin ucu atriokaval bileşke ya da sağ atrium üst kısmında olacak şekilde yerleştirildi. Portların kullanım süresi 3-327 (Ortalama: 141.5 ± 97.32) gün arasında değişmekteydi. Sonuç: Subkutanöz venöz port yerleştirilmesi, oluşabilecek sorunların bilinmesi ve bunlara yönelik gerekli önlemler alınarak ultrasonografi ve floroskopinin sağladığı kolaylıkla radyoloji ünitelerinde güvenli olarak yapılabilir. 40 patients (17 female, 23 male; mean age: 57,63 ± 12.28) who underwent subcutaneous venous port implantations were evaluated retrospectively. The demographic features, primary diagnosis, indications of implantation, technique of the implantation process, mean duration of port usage, the complications during the implantation process and during the port usage, the number of cases in which the port was removed, and the causes of the port removal were investigated. Results: Right internal jugular venous access was used in 37 patients, while left internal jugular venous access was used in 3 patients. There were no early period complications such as hematoma, pneumothorax, hemothorax, and arterial puncture. The tip of the port was placed in the junction of the right atrium and superior cava vein or in the proximal right atrium in all patients. The duration of the port usage was 3-327 days (mean: 141.5 ± 97.32 days). Conclusion: The ultrasound and floroscopy guided implantation of the venous ports can be safely performed with the knowledge of the probable complications, and when taking some preventions at radiology departments.

The mutation detection of β thalassemia is absolutely necessary for molecular diagnosis, as well as any genetic epidemiological study. The β globin gene has 3 exons and 2 introns, involved in β-thalassemic pathogenesis. The study aim of the study is to characterize the spectrum of β globin gene mutations in 136 Turkish, Northern Iraqi and Albanian pediatric β thalassemia major patients. After genomic DNA extraction from venous blood and amplification of the target DNA regions with PCR, genotyping was achieved by Sanger based DNA sequencing. The IVSI-110 G>A mutation was the most frequent allele in the Turkish and Albanian patients. In Northern Iraqi patients IVSI-1 G>A was is the most frequent. There are two mutations are firstly reported for Albania [c.*111 A>G 3’ UTR (rs63751128) and c.113 G>A (p.Trp38Ter, p.W38*) (rs35887507)] with this study. These findings may be of value for genetic counseling, premarital diagnosis, prenatal diagnosis and prevention programs.

No abstract