40 research outputs found
Akut lenfoblastik lösemi l2 morfolojisi ile myeloid antijen pozitifliğinin ilişkisi
TEZ4707Tez (Uzmanlık) -- Çukurova Üniversitesi, Adana, 2003.Kaynakça (s. 68-82) var.viii, 82 s. ; 30 cm.
ÇOcukluk ÇA���Ndaki Akut Myeloid L�Semi Tedavisinde Azalt�Lm��� Doz İDarubisin Ve Parenteral Beslenme Tedavisi
Aim: Disease free survival rate for acute myeloid leukemia (AML) is
still below 50% for the last 30 years. Our objective was to compare the
results of two different dosages of idarubicin (12 mg/m2 versus 8
mg/m2) therapy for newly diagnosed AML patients. Method: Sixty eight
patients with AML were treated between February, 1998 and January,
2005. We designed two therapy groups comprising of 12 mg/m2/day
idarubicin therapy (group I), 8 mg/m2/day idarubicin therapy and when
oral nutrition is broken, we have given parenteral nutrition (group
II). Overall survival (OS), event free survival (EFS), disease free
survival (DFS) data were assessed and other tests were performed when
needed. Result: There were 26 patients (38.2%) in group I and 42
patients (61.8%) in group II. After the first induction therapy, 20
patients (76.9%) in group I and 36 in group II (85.7%) had CR or
partial remission. After two courses of induction, treatment-related
mortality (TRM) was 34.6% in group I and 7.1% in group II (p: 0.006).
OS of the patients in group I/II were 44/81% for 12 months, 34/54% for
24 months, 29/48% for 36 months. EFS were 43/65% for 12 months, 34/50%
for 24 months, and 29/50% for 36 months. OS and DFS rates were
statistically significant but EFS rates were not, in group I and II.
Conclusion: The protocol with idarubicin dose of 8 mg/m2/day has less
TRM in comparison to that of 12 mg/m2/day and has better OS and EFS.Amaç: Akut myeloid lösemi (AML) hastalığı
için sağkalım oranı, son 30 yıldır %
50’nin hala altındadır. Amacımız,
idarubicinin iki farklı dozları ile tedavi edilen (12 mg/m2
karşı 8 mg/m2) yeni tanı AML hastalarının
sonuçları karşılaştırmaktır. Metod:
Altmış sekiz AML hastası Şubat 1998 ve Ocak 2005
tarihleri arasında tedavi edildi. İki tedavi grubu;
idarubicin tedavisi 12 mg/m2/gün (grup I), 8 mg/m2/gün ve
oral beslenme bozulduğunda parenteral beslenme verilen hastalar
(grup II) olarak şekillendirildi. Genel sağkalım (OS),
olaysız sağkalım (EFS), hastalıksız
sağkalım (DFS) verileri değerlendirildi ve diğer
testler gerektiğinde yapıldı. Bulgular: Grup I’de
26 hasta (% 38.2) ve grup II’de 42 hasta (% 61.8) vardı.
İlk tedavi kürü sonrası grup I’deki
hastaların 20’sinde (% 76.9), grup II’deki
hastaların ise 36’sında (% 85.7) tam ya da kısmi
düzelme vardı. İki kür sonra, tedaviye
bağlı mortalite (TRM) grup I’de % 34.6 ve grup
II’de ise % 7.1 idi (p: 0.006). OS grup I/II hastalarda 12 ay, 24
ay, 36 ay için sırasıyla % 29/48, %34/54 ve % 44/81
olduğu saptandı. EFS 12 ay, 24 ay için %34/50 için
43/65 ve% 29/50% 36 ay idi. Grup I ve II için OS ve DFS
oranları istatistiksel olarak anlamlı, fakat EFS oranı
için anlamlı değildi. Sonuç: İdarubisinin 8
mg/m2/gün dozu verilen protokolü, 12 mg/m2/gün doz
verilen protokole göre daha az tedavi ilişkili mortalite
olduğu ve OS ve EFS oranlarının daha iyi olduğu
saptand
Akut Lenfoblastik Lösemili Çocuklarda Yaygın (Rinoserebral Ve Pulmoner) İnvazif Fungal Enfeksiyon Tanısında Radyolojik Bulguların Önemi: Olgu Sunumu
İnvazif mantar enfeksiyonların tanısını koyabilmek immün yetmezlikli hastalarda çok güçtür. Bu nokta da klinik
ve radyolojik bulguların tanıyı desteklemesi çok önemlidir. Biz burada akut lenfoblastik lösemi nedeniyle takipte
olan ve invazif fungal enfeksiyon gelişen bir hastayı sunarak tanıda radyolojik bulguların önemini vurgulamak
istedik
Transplantasyon ilişkili trombotik mikroanjiopati tanı kriterleri ve tedavi seçeneklerinin iki olgu nedeniyle gözden geçirilmesi
Transplantasyon ilişkili trombotik mikroanjiopati, hematopoetik kök hücre naklinin en ciddi komplikasyonlarındandır. Tanı kriterleri açısından fikir birliğine varılmış olmasına rağmen tedavi konusunda henüz bir uzlaşı bulunmamaktadır. Bu nedenle biz burada, hematopoetik kök hücre nakli sonrası transplantasyon ilişkili trombotik mikrianjiopati gelişen 5 ve 13 yaşındaki hastalarımızı sunarak, transplantasyon ilişkili trombotik mikroanjiopati tanı kriterleri ve tedavi seçeneklerini gözden geçirmek istedik.Transplantation associated thrombotic microangiopathy has been considered to be a severe complication of hematopoietic stem cell transplantation. Although there has been an agreement in terms of transplantation associated thrombotic microangiopathy criteria, treatment options has not been clarified yet. Therefore we want to present two patients aged 5 years and 13 years who developed transplantation associated thrombotic microangiopathy after allogenic peripheric stem cell transplantation and to discuss both diagnostic criteria and treatment options of transplantation associated thrombotic microangiopathy
Diagnostic criteria of transplantation associated microangiopathy and treatment options: 2 cases report from Turkey
6th Meeting of the EBMT Paediatric Diseases Working Party/1st Meeting of the EBMT Paediatric Nurses -- JUN 02-04, 2008 -- Poznan, POLANDWOS: 000261232600070…European Grp Blood & Marrow Transplantat, Paediat Dis Working Part
Hematopoietic Stem Cell Transplantation and History
Attemps to employ marrow stem cell for therapeutic purpose began in 1940’s. Marrow transplantation might be of use not only in irradiation protection, but also with therapeutic aim to marrow aplasia, leukemia and other diseases. The use and defining tissue antigens in humans were crucial to the improving of transplantation. The administration of methotrexate for GVHD improved the long term survival. Conditioning regimens for myeloablation designed according to diseases. Cord blood and peripheral blood stem cells were used for transplantion after 1980’s. Cord blood and bone marrow stem cell banks established to find HLA matched donor
CAN ANY CEREBRAL MASS OR HEMATOMA BE LEUKEMIA? CHLOROMA
WOS: 000307988400022Granulocytic sarcoma (chloroma) is a malignant extra-medullary neoplasm of myeloid precursor cells. It is seen usually concurrent with or follows the diagnosis of acute myelogenous leukemia or other myeloproliferative disorders. Granulocytic sarcomas usually involve bones, periosteum, lymph nodes and shin. Involvement of the head and neck region is uncommon. Chloroma should be considered in the differential diagnosis of intracranial lesions. The computed tomography (CT) appearance of a cranial granulocytic sarcoma can be indistinguishable from a cerebral hematoma. We present a 12 year-old girl with scalp chloroma that was initially misdiagnosed as subdural effusion and later cerebral hematoma. An accurate and early diagnosis of this rare condition can prevent treatment delay and lead to good prognosis
Oral health status in children with acute lymphoblastic leukemia and lymphoma
We evaluated the oral health status of 85 acute lymphoblastic leukemia (ALL)/lymphoma pediatric patients who received remission-induction and maintenance chemotherapy and 85 age and sex-matched healthy children with the criteria of World Health Organization (WHO) and to determine the prevalence and distribution of dental problems in order to constitute preventive dentistry precautions in this study. The gingival tissues were scored with Community Index of Periodontal Treatment Necessity (CPITN) and dmf-t and DMF-T indices were used for caries evaluation. In the study group, malocclusion was found in 24 patients (28.2%). CPITN was scored as follows in the study group; 11% of the patients had healthy gingiva (Grade 0), the presence of plaque (Grade I) 79% of the patients, the presence of calculus (Grade II) 10% of patients were observed. Nevertheless, mucositis was found with various grades in 9 patients who received chemotherapy. Decayed teeth were found in the 76 patients and in 45 healthy children. 91.7% of patients and 52.9% of children needed dental treatment were determined. The DMF-T and dmf-t scores showed that ALL/lymphoma patients had more decayed and needed more dental treatment, missing or filled teeth both in their deciduous (<0.001) and permanent (<0.05) dentition when compared to systemically healthy children.We evaluated the oral health status of 85 acute lymphoblastic leukemia (ALL)/lymphoma pediatric patients who received remission-induction and maintenance chemotherapy and 85 age and sex-matched healthy children with the criteria of World Health Organization (WHO) and to determine the prevalence and distribution of dental problems in order to constitute preventive dentistry precautions in this study. The gingival tissues were scored with Community Index of Periodontal Treatment Necessity (CPITN) and dmf-t and DMF-T indices were used for caries evaluation. In the study group, malocclusion was found in 24 patients (28.2%). CPITN was scored as follows in the study group; 11% of the patients had healthy gingiva (Grade 0), the presence of plaque (Grade I) 79% of the patients, the presence of calculus (Grade II) 10% of patients were observed. Nevertheless, mucositis was found with various grades in 9 patients who received chemotherapy. Decayed teeth were found in the 76 patients and in 45 healthy children. 91.7% of patients and 52.9% of children needed dental treatment were determined. The DMF-T and dmf-t scores showed that ALL/lymphoma patients had more decayed and needed more dental treatment, missing or filled teeth both in their deciduous (<0.001) and permanent (<0.05) dentition when compared to systemically healthy children
Kanserli çocuklardaki ateşli nötropenik hastalar için sefoperazon- sulbaktam + amikasin ampirik tedavisi
Amaç: Bu prospektif çalışmanın amacı kanserli çocuklardaki febril nötropenin cefaperazone- sulbactam ve amikasin kombinasyonunun etkinliğini saptamaktır. Yöntem ve Gereç: Bu çalışmaya, toplam 26 febril nötropeni gelişmiş olan 20 hasta dahil edildi. Hasta seçimi; Amerika İnfeksiyon Hastalıkları Topluluğu tarafından yayınlanmış olan kılavuzdaki tarif edilmiş olan kriterlere uygun yapıldı. Bulgular: Teşhis edilen ve kayıt yapılan hastalar akut lösemi (% 58) ve solid tümörlü (% 42) hastalardır. Primer hastalığa refrakter olgu sayısı 12 (% 46,2) idi. Mikrobiyolojik ve klinik olarak saptanan infeksiyon sayısı sırasıyla 10 (% 38,5) ve 12 (% 46,1) idi. Nedeni bilinmeyen ateş sadece 4 vakada (% 15,4) vardı. Ampirik tedavinin başarısı diğer modifikasyon olmaksızın % 42,3 (11 FEN olayı). 4 FEN’li (% 15,4) hastada ateşin devam etmesi, yan etki ve/veya klinik olarak bozulma meydana gelmesi nedeniyle ampirik tedavi değiştirilme ihtiyacı oldu. Relaps yada tedaviye cevap vermediği için üç hasta kaybedildi. Klinik olarak durumu bozulan ve ateşi olan 15 hastaya (% 57,7) 48-72 saat sonra glikopeptid antibiyotik verildi. Tedavinin sonundaki tam cevap oranı, modifikasyonlu ve modifikasyonsuz olarak % 80,8’dir. Sonuç: Sulbactam/sefoperazon ve amikasin kombinasyonu çocuk kanser hastalarındaki febril nötropeni olaylarının tedavisinde etkili ve emniyetlidir.Aim: To determine the efficacy and safety of cefoperazone-sulbactam combined with amikacin in the treatment of febrile neutropenia in children with cancer. Materials and Methods: The study included 20 cancer cases with 26 febrile neutropenia (FEN) episodes. Patient selection criteria were defined according to the guidelines issued by the Infectious Disease Society of America (IDSA). Results: Patients diagnosed with acute leukemia (58%) and solid tumors (42%) were recorded. Twelve (46.2%) of the primary disease cases were refractory. The number of infection episodes identified microbiologically and clinically was 10 (38.5%) and 12 (46.1%), respectively. Fever of unknown origin was observed in only 4 cases (15.4%). The success rate of the empirical treatment without additional modification was 42.3% (11 FEN episodes). Four episodes (15.4%) needed a replacement for sulbactam/cefoperazone because of persistent fever, adverse reactions, and/or clinical deterioration. Three patients died because of relapse or because they were refractory. As 15 (57.7%) of the patients deteriorated clinically and had fever, glycopeptide antibiotics were given after 48-72 h. The overall response rate at the end of the therapy was 80.8%, with/without modification. Conclusions: The combination of sulbactam/cefoperazone plus amikacin was effective and safe in the treatment of febrile episodes in neutropenic pediatric cancer patients
Mesenchymal stem cell experience in acute GVHD: a case report
6th Meeting of the EBMT Paediatric Diseases Working Party/1st Meeting of the EBMT Paediatric Nurses -- JUN 02-04, 2008 -- Poznan, POLANDWOS: 000261232600069…European Grp Blood & Marrow Transplantat, Paediat Dis Working Part