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Objective: The aim of this study was to explore adolescent survivors' views and expectations about long‐term follow‐up care. Methods: Semi‐structured, in‐depth interviews were conducted with 16 adolescent survivors of childhood acute lymphoblastic leukaemia. Survivors who had completed treatment at least 2 years ago were involved in the study. Interviews were audio‐recorded and transcribed verbatim. An inductive thematic approach was used to analyse the data. Results: Four main themes and sub‐themes were identified from the analysis as follows: information needs with three sub‐themes 'long‐term follow‐up, healthy life and social life', support needs with three sub‐themes 'psychosocial (peer relations etc.), school related and social–emotional (fear of relapse, body image, self‐esteem, etc.)', perceived benefits with two sub‐themes 'social–emotional and related to long‐term follow‐up' and perceived barriers 'medical‐hospital related and social life'. Conclusions: Adolescent survivors mainly need support in terms of psychosocial aspects: self‐esteem–body image, school, peer relations and social activities during follow‐up. Identified barriers related to follow‐up were school absence and not able to participate social activities. Adolescents specify health promotion approaches as benefits aspects of follow‐up. The findings of this study will guide nurses in the long‐term follow‐up care of adolescent survivors of acute lymphoblastic leukaemia and provide an opportunity to plan individualised follow‐up care. [ABSTRACT FROM AUTHOR]

Objective: Anthracyclines are widely used in the treatment of acute lymphoblastic leukemia (ALL). However, cardiotoxicity is the most critical side effect that requires dose limitation. It is thought to occur at first exposure, but the clinical presentation may occur years later. In this study, we aimed to determine the time of initial damage and cardiotoxicity that develops in children with ALL. Methods: In this prospective study, 13 patients with newly diagnosed intermediate-risk precursor B cell ALL treated with the ALL-IC BFM 2009 protocol were included. Conventional echocardiography, tissue Doppler imaging (TDI), and speckle-tracking echocardiography (STE) were performed in all the patients before chemotherapy, after completing the induction phase, and at the end of the reinduction phase. Results: The mean age of the patients was 7.8±4.6 (3.1–16.3) years. Myocardial velocity during systole (Sm) determined by TDI at the interventricular septum significantly decreased during the induction phase. Despite a decrease in STE parameters, a statistically significant reduction was determined in the global longitudinal strain rate at both left and right ventricles at the end of the induction. Nevertheless, a statistically significant increase was observed among the conventional echocardiographic findings in the left ventricular end-diastolic diameter at the end of the reinduction. Conclusion: During the treatment of ALL, subclinical anthracycline-associated cardiotoxicity develops in the early stages of treatment. The findings detected by TDI and STE could be missed by conventional echocardiography. We recommend evaluating patients with these newly developed techniques to detect subclinical cardiotoxicity at an early stage and starting appropriate therapy on time. [ABSTRACT FROM AUTHOR]

Copyright of Journal of Pediatric Disease / Türkiye Çocuk Hastalıkları Dergisi is the property of Turkish Journal of Pediatric Disease and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Despite improvements in diagnosis and treatment, invasive fungal infection (IFI) is still a major cause of morbidity and mortality in immunocompromised patients. In patients with hematologic malignancy, the most invasive fungal infections are caused by Candida and Aspergillus fumigatus. This study was designed retrospectively to summarize data in pediatric patients with acute lymphoblastic leukemia (ALL) and acute myeloblastic leukemia (AML) including risk factors for IFI, epidemiological and clinical features and treatment choices involving combination therapy from January 2006 through December 2014. We analyzed the records of 154 pediatric patients (125 ALL and 29 AML) receiving chemotherapy for hematologic malignancy. During follow-up 60 IFI episodes were observed. IFI episodes were observed more common in AML, compared to ALL (p=0.002). Among 60 IFI episodes, eight were proven, seven were probable and 45 were possible IFI episodes. Galactomannan antigen was investigated in 37 IFI episodes and found positive in seven probable IFI episodes. Fungemia was detected in seven patients with proven IFI and the most common microorganism was non-albicans candida spp. The most common antifungal drug was fluconazole (14.8%). A total of 29 patients (48%) had received empirically liposomal amphotericin B and 10 patients (16.6%) had received caspofungin. Crude mortality was 10.3% and attributable mortality was 6.4% during the study period. Invasive fungal infections continue to be a major cause of morbidity and mortality in children with hematologic cancer. The most common isolated agent from hemoculture was non-albicans Candida spp. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Journal of Pediatric Disease / Türkiye Çocuk Hastalıkları Dergisi is the property of Turkish Journal of Pediatric Disease and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

PH is a rare condition with high mortality rate after pediatric HSCT. As clinical presentation is non-specific and may mimic other conditions, a high degree of suspicion is required for diagnosis. Here, we present a patient with stage- IV neuroblastoma who developed PAH after autologous HSCT. After exclusion of other causes of PH, we regarded that this condition was secondary to HSCT. [ABSTRACT FROM AUTHOR]

Copyright of Turkish Journal of Hematology is the property of Galenos Yayinevi Tic. LTD. STI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Acquired aplastic anemia (AAA) is a rare and potentially life threatening disorder. We retrospectively compared the outcomes of 29 children with AAA who received immunosuppressive therapy (IST) or underwent hematopoietic stem cell transplantation (HSCT). Median age at diagnosis was 9.0 years (range, 2–18 years) and median follow-up period was 36 months (range, 3–108 months). Viral infection associated/post hepatitis AAA was in 6 patients (20.6%). According to the initial laboratory findings, 8 patients were classified as very severe AA (vSAA), 8 as severe AA (SAA), and 13 patients as transfusion-dependent moderate AA (MAA). Out of 13, 5 transfusion-dependent MAA patients progressed SAA in median one month (range, 1–5 months), another 6 MAA patients developed remission or became transfusion free during follow-up. Eight patients underwent upfront matched family donor (MFD) HSCT at median 6 months (range, 1–9 months) and achieved complete response (100%). Fifteen cycles of IST were given to 10 (34%) patients lacking MFD at median 3 months (range, 2–6 months). Fifty percent of patients had complete/partial response after IST protocol. Three patients who were unresponsive to IST, proceeded to alternative donor HSCT, in 2nd or 3rd year after the diagnosis and only 1 patient was sustained remission. Several drugs such as mycophenolatemofetil, high-dose cyclophosphamide, levamisole and eltrombopag have been investigated in order to improve the outcome of patients with AAA. Early intervention in AAA patients results in significantly better outcomes. [ABSTRACT FROM AUTHOR]