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Hepatitis B and C infections of are amongst important health problems. Specifically, the oncology and hematology patients receiving packed red blood cell suspensions or other blood products usually are in the high risk group for these infections. In our center, before 2000 the frequency of HBsAg and anti-HBs positivity was 11.6% and 11%, respectively. The aim of this study was to determine the trend in these frequencies after the routine application of hepatitis B vaccine and to determine the frequency of hepatitis B and C infections. A total of 95 patients diagnosed as lymphoma and solid tumors from January 2005 to December 2006 were included in this study. At baseline; only one patient had HBsAg positivity, the remaining 94 patients were determined as HBsAg negative. In addition, 58 patients (61%) were anti-HBs positive, and 37 (39%) were anti-HBs negative. At baseline, there was no anti-HCV positive patient. During the follow up, no new HBsAg positive patient was occurred, but anti-HCV became positive in one patient. As a result; compared to our previous results, we found that the incidence of HBV and HCV infections were significantly declined but 39% of our patients were seronegative for HBV. For this reason; in these patients the protective antibody levels against HBV must be followed carefully and the patients must be included in the vaccination program again, if necessary., Hepatit B ve C virüs (HBV, HCV) enfeksiyonları önemli bir sağlık sorunudur. Özellikle kan ve ürünlerinin sık transfüzyonu yapılan onkoloji- hematoloji hastaları hepatit B ve C bulaşması açısından riskli grupta yer almaktadır. Merkezimizde 2000 yılından önce, HBsAg pozitifliği %11.6, anti-HBs pozitifliği %11 hastada saptanmıştır. Ülkemizde hepatit B aşısının rutin uygulanmaya başlanmasından sonra insidans değişikliğini ve hepatit B ve C gelişme oranını değerlendirmek amacıyla bu çalışma planlanmıştır. Ocak 2005 ve Aralık 2006 tarihleri arasında lenfoma ve solid tümör tanısı almış 95 hasta çalışmaya alındı. Başvuru esnasında HBsAg 1 hastada pozitif (%1), 94 hastada negatif idi. Elli sekiz hastada (%61) Anti-HBs pozitif, 37 hastada (%39) negatif saptandı. Başvuru esnasında Anti-HCV pozitifliği saptanan hasta yoktu. Hastaların izleminde sonradan HBsAg pozitifleşen hasta olmadı, anti-HCV ise 1 hastada pozitifleşti. Sonuç olarak, merkezimizde daha önce yapılan çalışmaya göre HBV ve HCV oranlarında belirgin azalma saptanmasına rağmen, hastalarımızın %39'u HBV için seronegatiftir. Bu nedenle bu hasta gruplarında HBV'ye karşı koruyucu antikor titresinin dikkatlice izlenmesi ve gerektiğinde yeniden aşı programına alınması gerekmektedir.

WOS: 000411827200025, PubMed ID: 28961828, Background: Reed-Sternberg cells of classical Hodgkin's lymphoma (cHL) are characterized by genetic alterations at the 9p24.1 locus, leading to over-expression of programmed death-ligand 1 and 2. In a phase 1b study, nivolumab, a PD-1-blocking antibody, produced a high response in patients with relapsed or refractory cHL, with an acceptable safety profile. Patients and methods: We present a retrospective analysis of 82 patients (median age: 30 years; range: 18-75) with relapsed/refractory HL treated with nivolumab in a named patient program from 24 centers throughout Turkey. The median follow-up was 7 months, and the patients had a median of 5 (2-11) previous lines of therapy. Fifty-seven (70%) and 63 (77%) had been treated by stem-cell transplantation and brentuximab vedotin, respectively. Results: Among 75 patients evaluated after 12 weeks of nivolumab treatment, the objective response rate was 64%, with 16 complete responses (CR; 22%); after 16 weeks, it was 60%, with 16 (26%) patients achieving CR. Twenty patients underwent subsequent transplantation. Among 11 patients receiving allogeneic stem-cell transplantation, 5 had CR at the time of transplantation and are currently alive with ongoing response. At the time of analysis, 41 patients remained on nivolumab treatment. Among the patients who discontinued nivolumab, the main reason was disease progression (n = 19). The safety profile was acceptable, with only four patients requiring cessation of nivolumab due to serious adverse events (autoimmune encephalitis, pulmonary adverse event, and two cases of graft-versus-host disease aggravation). The 6-month overall and progression-free survival rates were 91.2% (95% confidence interval: 0.83-0.96) and 77.3% (0.66-0.85), respectively. Ten patients died during the follow-up; one of these was judged to be treatment-related. Conclusions: Nivolumab represents a novel option for patients with cHL refractory to brentuximab vedotin, and may serve as a bridge to transplantation; however, it may be associated with increased toxicity.

Catheter-associated bloodstream infections (CABSIs) are common complications encountered with cancer treatment. The aims of this study were to analyze the factors associated with recurrent infection and catheter removal in pediatric hematology-oncology patients. All cases of CABSIs in patients attending the Department of Pediatric Hematology-Oncology between January 2008 and December 2010 were reviewed. A total of 44 episodes of CABSIs, including multiple episodes involving the same catheter, were identified in 31 children with cancer. The overall CABSIs rate was 7.4 infections per 1000 central venous catheter (CVC) days. The most frequent organism isolated was coagulase-negative Staphylococcus (CONS). The CVC was removed in nine (20.4%) episodes. We found that hypotension, persistent bacteremia, Candida infection, exit-side infection, neutropenia, and prolonged duration of neutropenia were the factors for catheter removal. There were 23 (52.2%) episodes of recurrence or reinfection. Mortality rate was found to be 9.6% in children with CABSIs. In this study, we found that CABSIs rate was 7.4 infections per 1000 catheter-days. CABSIs rates in our hematology-oncology patients are comparable to prior reports. Because CONS is the most common isolated microorganism in CABSIs, vancomycin can be considered part of the initial empirical regimen.

The objective of the present study was to determine the type, frequency, the reason why complementary and alternative medicine (CAM) treatments are used, the factors related with their use, and the effects of CAM usage on long-term survival. Families of a total of 120 children with cancer between 0-18 years of age, including 50 (41.7%) girls and 70 (58.3%) boys, participated in our study. The authors found that 88 patients (73.3%) used at least one CAM method, the most common (95.5%) of which was biologically based therapies. Most frequently used biologically based therapies were dietary supplements and herbal products. The most commonly used dietary supplement or herbal product was honey (43.2%) or stinging nettle (43.2%), respectively. We found that patients used such CAM methods as complementary to, but not instead of, conventional therapy. Sixty-nine out of 88 patient families (78.4%) shared the CAM method they used with their physicians. No statistically significant relation was found between socioeconomic, sociodemographic, or other factors or items and CAM use. The mean follow-up period of the CAM users and nonusers groups was 79.4 +/- 36.7 (21.3-217.9) and 90.9 +/- 50.3 (27.4-193.7) months, respectively. Five-year survival rates for CAM users and nonusers were found as 81.5% and 86.5%, respectively (P > .05). In conclusion, families of children with cancer use complementary and alternative treatment frequently. They do not attempt to replace conventional treatment with CAM. Higher rates of CAM use was found in families with higher educational level. CAM usage did not affect the long-term survival.

This study aimed to examine the incidence, clinical characteristics, and outcome of hyperuricemia and tumor lysis syndrome (TLS) in children with non-Hodgkin's lymphoma (NHL) and acute lymphoblastic leukemia (ALL).This retrospective study included data from 327 patients (113 NHL and 214 ALL).Hyperuricemia occurred in 26.5% and 12.6% of the patients with NHL and ALL, respectively. The corresponding figures for TLS were 15.9% and 0.47% (p=0.001). All hyperuricemic NHL patients had advanced disease and renal involvement was present in 53%. All hyperuricemic ALL patients had a leukocyte count50,000 mm3 at the time of diagnosis. Among the hyperuricemic NHL and ALL patients, 96.6% and 66.6% had LDH ≥500 UI/L, respectively. Treatment consisted of hydration and allopurinol; none of the patients received urate oxidase. Among the patients that developed TLS, 26.3% had laboratory TLS, 42.1% had grade I or II TLS, and 31.6% had grade III or IV TLS. Uric acid levels returned to normal after a mean period of 3.5±2.5 and 3.05±0.8 d in NHL and ALL groups, respectively. In all, 7% of the patients with hyperuricemia required hemodialysis. None of the patients died.In this series the factors associated with a high-risk for TLS were renal involvement in NHL and high leucocyte count in ALL. Management with allopurinol and hydration was effective in this group of patients with high tumor burden.AMAÇ: Çalışmanın amacı NHL ve ALL’li çocuklarda hiperürisemi ve TLS sıklığını, klinik özellikleri ve sonuçlarını tanımlamaktır. YÖNTEMLER: Bu retrospektif çalışmada 113 NHL ve 214 ALL’li toplam 327 hastanın verileri değerlendirildi.NHL olgularının %26.5’inde, ALL olgularının %12.6’sında hiperürisemi görüldü. TLS insidansı NHL ve ALL gruplarında %15.9 ve %0.47 bulundu (p=0.001). Hiperürisemi görülen NHL olgularının tümü ileri evrede olup, %53’ünde renal tutulum vardı. Tüm hiperürisemili ALL olgularında tanıda lökosit sayımı 50.000/mm3’den yüksekti. Hiperürisemik NHL grubunun %96.6’sında, ALL grubunun %66.6’sında LDH ≥500 UI/L idi. Tedavide hidrasyon ve allopürinol uygulandı, ürat oksidaz verilen hasta olmadı. TLS gelişen olguların %26.3’ünde laboratuvar TLS, %42,1’inde grade I ve grade II TLS, %31.6’sında grade III ve IV TLS saptandı. Ürik asit düzeyleri NHL ve ALL hastalarında ortalama 3.5±2.5 ve 3.05±0.8 günde normale döndü. Hiperürisemili hastaların %7’sinde hemodiyaliz gerekti. Mortalite olmadı. SONUÇ: Bu seride en yüksek TLS riski renal tutulumu olan NHL olgularında saptandı. Allopürinol ve hidrasyonun tümör yükü yüksek olan bu grupta etkili olduğu gözlendi.

Aim: The objective of this study is to evaluate the febrile neutropenia attacks in the children who have been treated for cancer in our center. Material and Method: Between January 2000 and December 2005, 57 patients with lymphoma and solid organ tumors who, had a total of 206 attacks of febril neutropenia were evaluated retrospectively. Results: The mean absolute neutrophil count (ANC), absolute lymphocyte count (ALC), absolute monocyte count (AMC) levels at the time of febril neutropenia attacks were 296 +/- 342/mm(3), 518 +/- 896/mm(3), 144 +/- 262/mm(3), respectively. The mean C-reactive protein (CRP) level was 7.63 +/- 7.06 mg/dL, Hb level was 8.67 +/- 1.74 g/dL and fever was 38.5 +/- 0.2 degrees C. There were no infection focus in the 57.3% of the attacks (n=118) and the most common infection focuses were pharyngitis and mucositis and they were seen in the 14% and 12.1% of the attacks, respectively. Combination of third generation cephalosporins and aminoglycosides were given in 87.8% (n=181) of the attacks. Bacteremia was found in 14.6% (n=30). The rate of isolated gram negative bacteria (60%) was higher than the others. The most common agents isolated were E.coli, Enterobacter cloaca and S.epidermidis in 16.7%, 13.3% and 13.3%, respectively. The success rate of therapy was found as 67.5%. There were no correlations between the infection focus and AMC, ANC, CRP levels, and mucositis and bacteremia. The presence of mucositis prolonged the duration of hospitalization. There were no significant differences between therapy regimens according to success of therapy, bacteremia and duration of hospitalization. The duration of neutropenia was longer in neuroblastoma and brain tumors. The mortality rate was found as 1.45%. Conclusions: The rate of gram negative bacteremia was higher in our study. None of our patients had central venous catheters, so we thought that this could be the reason to the lower rate of isolated gram positive bacteria. The response rate to the treatment was good and mortality rate was low with the empirical treatment by cephalosporin and aminoglycoside combination.

Myeloid/lymphoid leukemia (MLL) gene rearrangements are high risk cytogenetic characteristics of acute lymphoblastic leukemia (ALL). Translocations of this gene are well defined, and their impact on the patient's prognosis is well known, but deletions of the same region are rare, and little is known about their prognostic significance and the significance of their accompanying translocations. Here we present a case of childhood ALL with a deletion of the 5' region of the MILL gene detected by fluorescence in situ hybridization (FISH) analysis, This result also confirmed the sensitivity and efficiency of FISH analysis.

Bu çalışma, 11-15 Ekim 2020 tarihleri arasında Selanik[Yunanistan]'de düzenlenen 2. Balkan Symposium on Vegetables and Potatoes'da bildiri olarak sunulmuştur. The effects of hydration (priming and humidification) treatments at 15degreesC on the germination of onion seeds (i.e., long-day cvs Valencia and Corum; short-day cvs TEG-502 and Banko) with reduced viability were investigated. Osmotic solutions of PEG-8000 at -0.5 and -1.0 MPa were used for 1, 2 and 3 days. Humidification treatments were also conducted for 1, 2 and 3 days, considering the results of preliminary experiments. At the end of the experiments, in cv. Valencia, all the priming treatments leaded to a decline in the germination percentages of the seeds. Priming treatment with -0.5 MPa for 1 and 2 days decreased the germination percentage in cv. Corum, while the other treatments increased it. Nevertheless, all the priming treatments increased the germination percentage in cvs TEG-502 and Banko. As far as the mean germination time is concerned, there was no significant difference compared with control, following the priming treatments with PEG-8000 in cvs Valencia and Corum. However, all the treatments increased the mean germination time in cvs TEG-502 and Banko. Humidification treatments increased the germination percentages of seeds in all cultivars. Moreover, all humidification treatments shortened the mean germination time. Humidification treatments gave better results compared with priming treatments, in terms of both germination percentage and mean germination time. The best results were obtained from 1-day and 3-day humidification treatments in long-day and short-day onion seeds, respectively. Municipal Thermi Hellen Minist Agr N AG RE F Agr Res Ctr Macedonia & Thrace Minist Macedonia & Thrace Afg Bank Greece Hellen Sugar Indu S A Elga Bios AgrSyst Geotherm Greenhouses - Equipment Rockwool Grodan MED S A Scientact S A Plastika Kritis Psyllakis Nikolaos Ypsilon Rigas Labs Agribous Asteriadis S A Ferror Plast

Bone mineral density (BMD) and anthropometric measurements in pediatric cancer patients were evaluated and compared at early and late posttreatment periods. Sixty-six pediatric cancer patients who recovered completely following treatment longer than at least a 6-month period were included in the study. Patients were evaluated cross-sectionally and prospectively with regard to anthropometric measurements and BMD twice; the first being at a mean period of 2.62 +/- 1.44 years and the second of 6.55 +/- 1.71 years after the completion of treatment. Rates of osteoporosis and osteopenia at first or second evaluation were 25.8% and 39.4% or 10.6% and 19.7%, respectively. Mean BMD z-scores were (-1.26) +/- 1.12 [(-4.3)-2.0] and (-0.48) +/- 1.25 [(-3.30)-3.40] at first and second evaluations, respectively. BMD findings obtained at second evaluation revealed statistically significant recovery compared with those obtained at first evaluation (P = .001). BMD z-scores were significantly lower in patients who received, as opposed to those who did not receive, radiotherapy (RT) at both evaluations. Anthropometric parameters of patients such as height, weight, and body mass index (BMI) were increased at both evaluations compared with values obtained at diagnosis (P < .05). Height standard deviation score (SDS) decreased at first evaluation compared with that measured at diagnosis, whereas it increased at second evaluation. Conversely, weight SDS and BMI SDS increased (P < .05) at first evaluation compared with that measured at diagnosis, whereas they decreased at second evaluation. The authors conclude that early impairments in anthropometric measurements recover in the long term, whereas BMD is continually reduced in children who recovered from cancer.

Reversible posterior leukoencephalopathy, defined by both clinical and neuroimaging findings, can affect children receiving chemotherapy. The syndrome is characterized by hypertension, alterations in mental status, seizures, hallucinations, and acute visual changes and is associated with abnormalities seen in magnetic resonance imaging of symmetric white matter lesions, especially in the parietal and occipital lobes. The etiology of reversible posterior leukoencephalopathy is as yet unknown. Presented here are four cases of reversible posterior leukoencephalopathy induced by chemotherapy, with a brief review of the literature and consideration of possible mechanisms. A diagnosis of reversible posterior leukoencephalopathy should be considered when patients receiving cancer chemotherapy suddenly develop hypertension followed by neurologic complications, especially if presenting with seizures.