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The number of studies evaluating teicoplanin lock therapy in coagulase-negative staphylococcus-associated catheter infection in pediatric malignancies is limited. The aim of this study was to evaluate the efficacy of teicoplanin lock therapy in pediatric cancer cases. Twenty-two patients with coagulase-negative staphylococcus-associated totally implantable venous access device infection, who had undergone teicoplanin closure treatment, were included in the study. Demographic data, number of lock treatment days, and treatment success data were obtained from the medical files of the patients. Fourteen of the patients (63.6%) had acute lymphocytic leukemia, 3 (13.6%) had acute myelocytic leukemia, and 5 (22.7%) had solid cancer. The median neutrophil count was 240×10 3 /μL (interquartile range: 0 to 1195×10 3 /μL). Between patients with and without catheter removal, no statistically significant difference was found in terms of baseline C-reactive protein, absolute neutrophil count, and the day of starting systemic teicoplanin treatment ( P0.05). The overall port survival rate of teicoplanin lock therapy was 72.7%. Within an average of 4 days, negative cultures of 16 (72.7%) patients whose catheters had not been removed were obtained. In conclusion, we suggest that teicoplanin lock therapy is an effective and safe treatment for catheter-related infections, caused by methicillin-resistant coagulase-negative staphylococcus.

The prevalence of intracardiac thrombus (ICT) is gradually increasing, though it is rare among children. Data related to the occurrence of ICT among children are limited, and treatment recommendations have been made utilizing adult guidelines. The primary objective of this study is to determine associated factors, management, and outcomes of intracardiac thrombosis in children. Between January 2013 and January 2020, patients diagnosed with ICT at the Pediatric Hematology-Oncology and Pediatric Cardiology departments in our hospital were included in the study. Demographic characteristics, clinical and laboratory findings, treatment protocols, and outcomes were analyzed retrospectively. The median age at diagnosis was 10.5 months (2 days to 14.5 years), and the median follow-up period was 6.5 months (1 month to 3.1 years). The most common primary diagnoses of the patients, in order of frequency, were heart disease (n: 8), metabolic disease (n: 3), prematurity and RDS (n: 3), burns (n: 2), pneumonia (n: 2), and asphyxia (n: 2). CVC was present in 19/23 of the patients. The reasons for CVC insertion were the need for plasmapheresis in one patient with a diagnosis of HUS and the need for well tolerated vascular access because of long-term hospitalization in others. LMWH was administered to all patients as first-line therapy. Complete response was achieved in 19 (79%) of 24 patients and 4 patients (16.6%) were unresponsive to medical treatment. It was found out that the thrombus location, type, sepsis, and hemoculture positivity, as well as the presence of CVC, had no impact on treatment response (chi-square P = 0.16, 0.12, 0.3, 0.49, 0.56). Moreover, no correlation was determined between thrombus size and treatment response (Mann Whitney U test P = 0.47). The mortality rate was determined to be 12.5% (3/24). Spontaneous occurrence of ICT is rare in childhood, without any underlying primary disease or associated factor. The presence of CVC, sepsis, and heart disease are factors associated with ICT. The success rate is increased with medical treatment. There was no significant difference in treatment response between the newborn and 1 month to 18-year-old patient group. It has been demonstrated that thrombus size, type, localization; sepsis, and hemoculture positivity had no impact on the treatment response.

There are a limited number of studies evaluating iron overload in childhood leukemia by magnetic resonance imaging (MRI). The aim of this study was to determine liver iron content (LIC) by MRI in children with acute lymphoblastic leukemia (ALL) who had completed treatment and to compare those values with serum iron parameters.A total of 30 patients between the ages of 7 and 18 who had completed ALL treatment were included in the study. Serum iron parameters (serum iron, serum ferritin [SF], and total iron-binding capacity) and liver function tests were studied. R2 MRI was performed for determining LIC.Normal LIC was detected in 22 (63.4%) of the cases. Seven (23.3%) had mild and 1 (3.3%) had moderate liver iron deposition. In contrast, severe iron overload was not detected in any of the cases. LIC levels were correlated with the numbers of packed red blood cell (pRBC) transfusions (r=0.637, p0.001), pRBC transfusion volume (r=0.449, p0.013), SF levels (r=0.561, p=0.001), and transferrin saturation (r=0.353, p=0.044). In addition, a positive correlation was found between the number of pRBC transfusions and SF levels (r=0.595, p0.001).We showed that the frequency of liver iron deposition was low and clinically less significant after the end of treatment in childhood ALL patients. LIC was demonstrated to be related to SF and transfusion history. These findings support that SF and transfusion history may be used as references for monitoring iron accumulation or identifying cases for further examinations such as MRI.Çocukluk çağı lösemisinde aşırı demir yükünü manyetik rezonans görüntüleme (MRG) ile değerlendiren sınırlı sayıda çalışma vardır. Bu çalışmanın amacı, akut lenfoblastik lösemisi (ALL) olan ve tedavisini tamamlamış olan çocuklarda R2 MRI yöntemiyle karaciğer demir içeriğini (LIC) belirlemek ve serum demir parametreleriyle karşılaştırmaktır.Çalışmaya ALL tedavisini tamamlayan 7-18 yaşları arasında toplam 30 hasta alındı. Serum demir parametreleri (serum demir, serum ferritin [SF] ve toplam demir bağlama kapasitesi), karaciğer fonksiyon testleri çalışıldı. LIC’yi belirlemek için R2 MRG yöntemi kullanıldı.Olguların 22’sinde (%63,4) normal LIC saptandı. Yedi (%23,3) olguda hafif ve 1 (%3,3) olguda orta derecede karaciğerde demir birikimi mevcuttu. Buna karşılık, hiçbir olguda ciddi derecede demir birikimi tespit edilmedi. LIC seviyeleri, pRBC transfüzyonu sayısı (r=0,637, p0,001), pRBC transfüzyon miktarı (r=0,449, p0,013), SF seviyeleri (r=0,561, p=0,001) ve transferrin (r=0,353, p=0,044) ile korele saptandı. Ek olarak, pRBC transfüzyonlarının sayısı ile SF seviyeleri arasında pozitif korelasyon bulundu (r=0,595, p0,001).Çocukluk çağı ALL hastalarında tedavi bitiminden sonra karaciğer demir birikiminin sıklığının düşük ve klinik olarak daha az önemli olduğunu gösterdik. Ayrıca, LIC’nin SF ve transfüzyon öyküsü ile ilişkili olduğunu gösterdik. Bu bulgular, SF ve transfüzyon geçmişinin demir birikimini izlemek veya MRG gibi ileri tetkikin gerekli olduğu olguları belirlemek açısından referans olarak kullanılabileceğini desteklemektedir.