Browsing by Author "Emir, Suna"

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Citation Count: 0
Autologous peripheral blood stem cell mobilization and apheresis in pediatric patients with cancer: A single-center report of 64 procedures
(Wiley, 2024) Erdem, Arzu Yazal; Ozyoruk, Derya; Bozkaya, Ikbal Ok; Cakmakci, Selma; Emir, Suna; Demir, Haci Ahmet; Ozbek, Namik Yasar
Background The published experience concerning autologous peripheral blood stem cell collection in children is very limited. Methods The data of pediatric patients who underwent autologous stem cell mobilization and apheresis between January 2011 and April 2020 were analyzed retrospectively. Results We studied retrospectively 64 mobilization and apheresis procedures in 48 pediatric patients (34 males, 14 females), mean age of 7.31 +/- 5.38 (range, 1.5-19.7) years, the underlying disease was mostly neuroblastoma (NBL). The body weight of 21 patients (43.75%) was 15 kg or less. The targeted autologous peripheral stem cell apheresis (APSCA) was successfully achieved in 98% of patients. Neuroblastoma patients were younger than the rest of the patients and underwent apheresis after receiving fewer chemotherapy cycles than others and all of them mobilized within the first session successfully. Plerixafor was added to mobilization in nine heavily pretreated patients (18.7%), median two doses (range, 1-4 doses). 11 patients (22.9%) underwent radiotherapy (RT) before mobilization with doses of median 24 Gy (range, 10.8-54.0 Gy). Patients with RT were older at the time of apheresis and had received more chemotherapy courses than patients without RT. As a result, patients with a history of RT had significantly lower peripheral CD34+ cells and CD34+ yields than those without RT. In 17 patients (35.4%), 22 different complications were noted. The most common complications were catheter-related infections (n:10, 20.8%), followed by catheter-related thrombosis in eight patients (16.7%). Conclusions Patients who had far less therapy before apheresis were more likely to mobilize successfully. Our study provides a detailed practice approach including complications during APSCA aiming to increase the success rates of apheresis in transplantation centers.
Citation Count: 2
Clinical and Demographic Characteristics of Cutaneous Mastocytosis in Childhood: Single-center Experience
(Lippincott Williams and Wilkins, 2022) Erdem,A.Y.; Özyörük,D.; Emir,S.; Çakmakçı,S.; Ceylan,G.G.; Toyran,M.; Mısırlıoğlu,E.D.
Introduction: Mastocytosis is a rare and heterogenous disease, and in children it is generally limited to the skin and tends to regress spontaneously in adolescence. Aim: In this study, demographic, clinical, and laboratory characteristics of pediatric patients with mastocytosis, and also coexisting diseases were investigated. Results: A total of 61 pediatric patients were included in the study. The male-to-female ratio was 2.2, the median age was 2 years (range, 0.25 to 19 y), and the median follow-up period was 2.0 years (range, 0.25 to 19 y). Types of clinical presentation at diagnosis consisted of mainly urticaria pigmentosa (45.9%). Seven patients were further investigated with suspicion of systemic mastocytosis, they were followed up, median of 9 years (range, 2.5 to 16 y), and none of them developed systemic disease. Coexisting allergic diseases were recorded in total 5 patients (8.2%). Three patients had immunoglobulin A deficiency, 1 patient had elevated immunoglobulin E level. A patient developed mature B-cell lymphoma with a heterozygous mutation in c-KIT exon 11. Discussion: Cutaneous mastocytosis in children may present as a complex disease with different clinical signs and symptoms. Standardized clinical criteria and guidelines for the follow-up of children with mastocytosis are required. Copyright © 2021 Wolters Kluwer Health, Inc. All rights reserved.
Citation Count: 0
Çocukluk Çağı Kanser Yaşayanlarında Nefrotoksisitenin İncelenmesi ve Glomerüler Filtrasyon Hızı Yöntemlerinin Karşılaştırılması
(Dr Behcet Uz Cocuk Hastaliklari ve Cerrahisi, 2021) Erdem, Arzu Yazal; Emir, Suna; Çakar, Nilgün; Demir, Ahmet; Özyörük, Derya
Amaç: Çocukluk çağı kanserlerinde artan sağkalım oranları, uzun süreli tedaviye bağlı yan etkilere ve geç nefrotoksisite için olası risk faktörlerine odaklanmaya yol açmıştır. Amacımız kanser tedavisi alıp iyileşen çocuklarda nefrotoksisiteyi belirlemek ve glomerül filtrasyon hızının hesaplanmasında tahmini glomeruler filtrasyon hızı ile kreatinin klirensinin birbiri ile uyumunu araştırmaktır. Yöntem: Sisplatin, karboplatin, ifosfamid ve/veya yüksek doz metotreksat ile kanser tedavileri tamamlanmış 59 çocuğun glomerüler ve tübüler disfonksiyonları değerlendirildi. Bulgular: Ortalama tanı yaşı 10,7±5,5 yıl (2,5-23), ortalama takip süresi 2,6±2,1 yıl (0,5-8) olan 59 hastanın %65’inde böbrek fonksiyon bozukluğu tespit edildi. Böbrek fonksiyon bozukluğunun en yaygın bulgusu azalmış glomeruler filtrasyon hızı (n:19, %32,2), artmış üriner β2-mikroglobulin atılımı (n:12, %20,4), ardından mikroalbuminuri (n:6, %10,1) idi. Kombine kemoterapi ile tedavi edilenlerde, yüksek doz metotreksat ile tedavi edilenlere göre istatistiksel anlamlı düşük tubüler fosfor reabsorbsiyonu saptandı. Serum sistatin-C ve Schwarz formülü ile hesaplanan tahmini glomeruler filtrasyon hızının birbiri ile tutarlı olduğu (r=0,563, p=0,00) bulundu. Sonuç: Çocukluk çağında kanser tedavisi alıp iyileşenlerde yüksek oranda böbrek komplikasyonlarının geliştiği gösterilmiştir. Çocukluk çağı kanser yaşayanlarında, Schwartz formülü veya sistatin-C ile tahmini glomerüler filtrasyon hızının hesaplanmasının kreatinin klirensiyle uyumlu olduğunu gösterdik. 24 saatlik idrar toplayamayan çocuklarda tahmini glomeruler filtrasyon hızı hesaplaması pratik bir yaklaşımdır.
Citation Count: 0
Retrospective Evaluation of Childhood Central Nervous System Tumors Followed in a Pediatric Hematology Oncology Center: A Single Center Experience
(Akad Doktorlar Yayinevi, 2024) Genc, Asli; Yazal Erdem, Arzu; Emir, Suna; Ozyoruk, Derya
Central nervous system (CNS) tumors are one of the main causes of cancer -related deaths in childhood. Although approximately 60% of all patients are alive 5 years after diagnosis, a sequela due to the disease and treatments are common. In this study, we aimed to evaluate the demographic, clinical characteristics, and outcomes of the childhood CNS tumors in our center. A total of 141 patients between 0-18 years who were followed up and completed their treatment in our pediatric oncology center were included. The files were reviewed retrospectively. The median age of patients was 7 years (range 1 month -17.6 years). The male/female ratio was 1.1: 1. The most common presenting symptom was headache. The median time from the first symptom to diagnosis was 1.4 months. Medulloblastoma was the most common diagnosis (n= 28, 19.9%), followed by pilocytic astrocytoma (18.4%, n= 26) respectively. Out of 141 patients, a sequela was seen in 55 (39%) patients. The relationship between high -dose radiotherapy and the development of short stature was statistically significant (p= 0.009). The patients with metastatic disease were likely to have lower survival rates than nonmetastatic disease (p= 0.001). The presence of metastasis increased the death status 6.482 times (OR: 6,482, p= 0.001). The overall 5 -year survival rate of all patients was found 80%. There was an association between the histopathological subtypes and overall survival rates (p= 0.001). In the multivariate analysis, metastasis was the most important factor in survival. According to Cox regression analysis, the two most important factors affecting overall survival were the histopathological subtype and the presence of metastasis.
Citation Count: 0
Role of surveillance screening in detecting tumor recurrence after treatment of childhood cancers
(Aves, 2021) Kısa, Pelin Teke; Emir, Suna
Objective: As the survival rates in children with cancer reach up to 80%, this improvement in survival increases the number of patients under follow-up. After cancer treatment is completed, patients are taken to follow-up surveillance to ensure the early detection of recurrence and the late effects of treatments. The frequency and necessity of surveillance screening tests are controversial. This study aimed to assess the efficacy of surveillance screening in the detection of recurrence. Material and methods: The files of 533 children who were diagnosed as having cancer at our pediatric oncology clinic between 2004 and 2013 were retrospectively evaluated. We looked at outcomes after recurrence, the timing and pattern of recurrence, the presence of symptoms during recurrence, physical examination findings, tumor marker levels, laboratory findings, and radiologic tests. Results: Of the 63 patients with recurrence, 23 were symptomatic and 40 were asymptomatic at the time of the recurrence. Tumor location and time of the recurrence did not affect the post recurrence survival. The median post-recurrence survival for patients was 13 (range, 1-98) months. The median post-relapse survival was 10 (range, 1-73) months in patients with symp-tomatic recurrence, and 16 (range, 1-98) months in patients with asymptomatic recurrence. It was determined that patients in whom recurrence was identified with surveillance tests had longer post-relapse survival time. The 5-year survival rate of 23 patients with symptomatic recurrence was 12.2%; this rate was 49.5% in asymptomatic patients (p<0.05).Conclusions: It should be considered that surveillance testing offers the benefit of prolonging post recurrence survival.