Hearing status in vitamin B12-deficient children

Aim The aim of this study is to investigate the effects of vitamin B12 deficiency on hearing in school-aged children by pure-tone audiometry. Methods Forty-three vitamin B12-deficient children and 37 age-matched control subjects were enrolled in the study. Tympanometric evaluations and pure-tone audiometry including high frequencies were performed on the subjects. The results were compared between the two groups. Results Both right and left ear pure-tone hearing thresholds (PTHTs) at 0.25-4 kHz, and four-frequency pure-tone average values were significantly better in the control group compared with the patient group (P 0.05). Vitamin B12 level also did not show any significant correlation with the PTHTs at 0.25-16 kHz (P > 0.05). Conclusion This study indicates that vitamin B12 deficiency may contribute to hearing impairment at low frequencies as a possible aetiological factor in children

Two Acute Myeloblastic Leukemia Cases Concomitant with Hemophagocytic Lymphohistiocytosis and Review of the Literature

We present two patients with acute myeloblastic leukemia (FAB AML-M7 and AML-M2) complicated by hemophagocytic lymphohistiocytosis (HLH) and relevant literature review. To our knowledge, our first case is the first and youngest patient having AML-M7 associated with HLH reported in the literature. Our cases and cases in the literature highlight the high mortality rate of leukemia associated with HLH and the need for further investigation for the most appropriate therapy

H1N1 associated encephalitis in a child with acute myeloblastic leukemia and bacteremia due to Klebsiella pneumonia

Herein, a neutropenic 16-year-old girl with acute myeloblastic leukemia who developed recurrent generalized seizures when she was on antimicrobial therapy including oseltamivir also due to pneumonia, bacteremia of Klebsiella pneumonia and H1N1 infection, in November 2009 is presented. Seizures could be controlled by assisted ventilation. Electroencephalography revealed encephalopathy. Cranial computed tomography, magnetic resonance imaging (MRI) and MRI angiography were normal. She recovered completely with no sequele. Our case highlights that during pandemias, H1N1 should always be kept in mind

Central nervous system thrombosis in pediatric acute lymphoblastic leukemia in Turkey: A multicenter study

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

COVID-19 infection in children with cancer and stem cell transplant recipients in Turkey: A nationwide study

To the Editor: Adults with cancer are reported to have a higher risk for coronavirus disease (COVID-19) infection and more severe disease and mortality than the general population.1, 2 Although children seem to be at a lower risk for COVID-19 than adults,3-5 data specifically addressing children with cancer are limited

Clinical Characteristics and Outcomes of COVID-19 in Turkish Patients with Hematological Malignancies

Objective: Patients with solid malignancies are more vulnerable to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection than the healthy population. The outcome of SARS-CoV-2 infection in highly immunosuppressed populations, such as in patients with hematological malignancies, is a point of interest. We aimed to analyze the symptoms, complications, intensive care unit admissions, and mortality rates of patients with hematological malignancies infected with SARS-CoV-2 in Turkey. Materials and Methods: In this multicenter study, we included 340 adult and pediatric patients diagnosed with SARS-CoV-2 from March to November 2020. Diagnosis and status of primary disease, treatment schedules for hematological malignancies, time from last treatment, life expectancy related to the hematological disease, and comorbidities were recorded, together with data regarding symptoms, treatment, and outcome of SARS-CoV-2 infection. Results: Forty four patients were asymptomatic at diagnosis of SARSCoV-2 infection. Among symptomatic patients, fever, cough, and dyspnea were observed in 62.6%, 48.8%, and 41.8%, respectively. Sixtynine (20%) patients had mild SARS-CoV-2 disease, whereas moderate, severe, and critical disease was reported in 101 (29%), 71 (20%), and 55 (16%) patients, respectively. Of the entire cohort, 251 (73.8%) patients were hospitalized for SARS-CoV-2. Mortality related to SARS-CoV-2 infection was 26.5% in the entire cohort; this comprised 4.4% of those patients with mild disease, 12.4% of those with moderate disease, and 83% of those with severe or critical disease. Active hematological disease, lower life expectancy related to primary hematological disease, neutropenia at diagnosis of SARS-CoV-2, ICU admission, and first-line therapy used for coronavirus disease-2019 treatment were found to be related to higher mortality rates. Treatments with hydroxychloroquine alone or in combination with azithromycin were associated with a higher rate of mortality in comparison to favipiravir use. Conclusion: Patients with hematological malignancy infected with SARS-CoV-2 have an increased risk of severe disease and mortality