Hematopoietic stem cell transplantation and high dose chemotherapy in recurrent and/or chemotherapy resistant hodgkin lymphoma cases: A single center experience

Giriş: Standart tedavi alan Hodgkin Lymphoma (HL) hastalarının yaklaşık %20’sinde hastalık dirençli seyredebilir veya tekrar edebilir. Tekrar eden/ dirençli HL’da standart tedavi yüksek doz kemoterapi ve takip eden otolog kök hücre naklidir (OKHN). Otolog KHN sonrası tekrar eden hastalarda ise allojeneik kök hücre nakli (AKHN) önemli bir kurtarma tedavisi olarak görülmektedir. Amaç: Medipol Üniversitesi Tıp Fakültesi çocuk kemik iliği nakil ünitesinde OKHN ve AKHN yapılan hastalarda sonuçları değerlendirmek. Yöntem: Tekrar eden/dirençli HL nedeniyle 2014 Kasım ile Temmuz 2019 tarihleri arasında merkezimizde OKHN yapılan 18 olgu retrospektif olarak değerlendirilmiştir. Otolog KHN sonrası hastalığı tekrar eden ve AKHN yapılan hastalarda ayrıca değerlendirilmiştir. Bulgular: Onaltı hasta halen hayattadır. Onbir hastada OKHN sonrası has talık tekrar etmiştir. Relaps eden hastalardan 10’una AKHN yapılmıştır. Bu hastalardan üçünde tekrar görülmüş olup, sekizi nakil sonrası hayattadır lar.Background: Nearly 20% of patients with Hodgkin Lymphoma (HL) who receive standard treatment will relapse or have a refractory disease. Standard treatment for the Relapsed/Refractory (RR) HL is salvage high dose chemotherapy followed by autologous stem cell transplantation (AuSCT). Management of RR HL after AuSCT with allogeneic stem cell transplantation (ASCT) is also considered as an important salvage therapy. Objective: To describe the outcome in pediatric patients with RR HL who underwent AuHSCT and ASCT in Medipol University hematopoietic stem cell transplantation center. Method: We retrospectively evaluated 18 pediatric patients with RR HL who underwent AHSCT between November 2014 and July 2019. The evaluation of ASCT after RR HL AuSCT is also done. Results: Sixteen patients are still alive. Eleven of them relapsed after AuHSCT. AllogeneicHSCT was performed on 10 patients who relapsed. Relapse was seen in three patients after AHSCT. Eight of them are still alive

The effect of early warning scoring system in pediatric intensive care unit on mortality after pediatric hematopoietic stem cell transplantation

...European Society for Blood and Marrow Transplantatio

Follow-up results in children with tracheostomy

Amaç: Çocuklarda trakeostomi; en sık uzamış entübasyon, santral hipoventilasyon, nöromuskuler hastalıklar, ileri derecede laringomalazi ya da trakeomalazi varlığı gibi birçok farklı endikasyonla yapılmaktadır.Gereçler ve Yöntem: Kliniğimizden takipli trakeostomi ile izlenen hastaların demografik özellikleri ve takip süreçlerinin değerlendirilmesi amaçlanmıştır. 48 hastanın verileri geriye dönük olarak incelenmiştir.Bulgular: Toplam hasta sayısı 48 olup, bunlardan 19’u kız, 29’u erkek idi. Hastaların yaş ortalaması 2,5±1,8 yaş idi. Trakeostomi açılma yaşı median değeri 6 ay (25P: 3 ay, 75P:15 ay) idi. Trakeostomi endikasyonları sıklık sırasıyla uzamış entübasyon, nöromuskuler hastalıklar, üst havayolu anomalileri ve travma idi. Uzamış entübasyon ihtiyacı olan hastalarda altta yatan en sık nedenler bronkopulmoner displazi ve konjenital kalp hastalığı idi. Hastaların tümü trakeostomi öncesi mekanik ventilasyon (MV) desteği almış, 32 hastanın izlemde (% 66,7) solunum desteği ihtiyacı kalmamıştı. Yirmi bir hasta (% 43,8) hala trakeostomize olarak izlenirken 19 hastamız (% 39,6) dekanüle edilmişti. Trakeostomize olarak izlenen 21 hastamızdan 14’ü, dekanüle edilen 19 hastadan 2’si halen evde solunum desteği almaktaydı. İki hasta (% 4,2) takipten çıkarken, 6 hasta ise (% 12,4) kaybedilmişti.Sonuç: Uzamış entübasyon ihtiyacı olan hastaların trakeostomi ile izlemi, yoğun bakım yatış sürelerinin azalmasına, hastaların evde takibine, daha normal günlük yaşantı ve daha düşük hasta bakım maliyetine olanak sağlamaktadır. Ancak mümkün olan en kısa sürede bu hastaların trakeostomileri kapatılmalıdır.Objective: Tracheostomy is applied for many different indications in children. The most comman indications are prolonged intubation, central hypoventilation, neuromuscular disorders, severe laryngomalacia or tracheomalacia. Material and Methods: Our aim was to evaluate the demographic features and follow-up processes of patients with tracheostomy at our clinic. The data of 48 patients were retrospectively reviewed. Results: Forty eight patients were enrolled, 19 of them were girls, 29 of them were boys. The mean age of the patients was 2.5 ± 1.8 years. The median age of tracheostomy operations was 6 months (25P: 3 months, 75P: 15 months). Tracheostomy indications were prolonged intubation, neuromuscular disorders, upper airway anomalies and trauma, respectively. The most common underlying causes in patients with prolonged intubation were bronchopulmonary dysplasia and congenital heart disease. All patients received mechanical ventilation (MV) support before prosecure, and for 32 patients (66.7%) there were no need for respiratory support at follow up. Twenty-one patients (43.8%) were still tracheostomized and 19 patients (39.6%) were decannulated. Fourteen of twentyone patients who were tracheostomized and 2 of 19 patients who were decannulated were still receiving respiratory support at home during the study period. Two patients (4.2%) were lost during follow up and 6 patients (12.4%) died. Conclusion: Tracheostomy is a voluable prosecure for patients who need prolonged intubation by shortening intensive care stay, allowing the follow up at home in normal life, and low cost. However, successful decanulation as soon as possible, is the final goal of management

Eltrombopag use for post hematopoetic stem cell transplantation thrombocytopenia in pediatric patients

Conference: 45th Annual Meeting of the European-Society-for-Blood-and-Marrow-Transplantation (EBMT) Location: Frankfurt, GERMANY Date: MAR 24-27, 2019...European Soc Blood & Marrow Transplanta

Staphylococcal scalded skin syndrome in a preterm infant

WOS: 000418094200002A male infant was delivered by cesarean section at 26 weeks and 3 days gestational age and weighed 1020 grams. Apgar scores were 7 and 8 at 1st and 5th minutes, respectively. The baby was hospitalized for prematurity, and given one dose of surfactant therapy on the first day of life. Empirical ampicillin and gentamicin therapy was started on the first day of life and continued for ten days. He also received high-flow oxygen through nasal cannula. The patient had neither clinical nor culture-proven sepsis attacks. On the 25th day of his life, the patient developed diffuse blanching erythema which started around the nose followed by appearance of bullous lesions on the extremities, neck and upper back regions (Figure 1)