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Copyright of Journal of Behcet Uz Children's Hospital 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.)

Objectives: We aimed to evaluate the impact of pretreatment folate and vitamin B12 deficiencies on the frequency of complications and peripheral blood recovery, in children with acute lymphoblastic leukemia (ALL). Methods: Pre-induction serum folate and vitamin B12 levels of 88 newly diagnosed ALL patients were evaluated retrospectively. Folate < 3 ng/mL and vitamin B12 < 200 pg/mL were accepted as deficiency. Median hemoglobin, absolute neutrophil count (ANC), and platelet counts, transfusion needs, and complications such as mucositis, febrile neutropenia (FN), bleeding at diagnosis, at 15th and 33rd day of induction, were assessed. Recovery of peripheral blood count, which was defined as an ANC > 1.0 × 109/L and platelet count > 100 × 109/L at 33rd day of chemotherapy were also evaluated. Results: Folate or vitamin B12 deficiencies were observed in 21 (23%) and 40 (45%) children, respectively. Peripheral blood counts, complications rates, and transfusion needs were not statistically different between deficient and normal level groups during induction. The number of febrile days, though not statistically significant, was higher in the both deficient groups. Seventeen of 40 (42.5%) patients with vitamin B12-deficient and 12 of 21 (57.1%) folate-deficient patients experienced at least one episode of FN during induction. FN was more common in folate-deficient group, but that was not statistically significant. Complete peripheral blood recovery at 33rd day of induction was seen in 40% in the vitamin B12-deficient group and 28.6% in folate-deficient group. Peripheral blood recovery rate at day 33 was also similar in both deficient and normal level groups. Conclusion: Although pre-induction low serum levels of vitamin B12 and folate did not have statistically significant impact on disease-/treatment-related complications and peripheral blood recovery at induction, the frequency of FN and number of febrile day were higher in both deficiencies and folate-deficient patients, respectively. [ABSTRACT FROM AUTHOR]

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 Journal of Dr. Behcet Uz Children's Hospital 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.)