Browsing by Author "Ayhan A.C."

Now showing 1 - 3 of 3
  • No Thumbnail Available
    Item
    Central nervous system thrombosis in pediatric acute lymphoblastic leukemia in Turkey: A multicenter study
    (John Wiley and Sons Inc, 2023) Guzelkucuk Z.; Karapınar D.Y.; Gelen S.A.; Tokgoz H.; Ozcan A.; Ay Y.; Bahadır A.; Ozbek N.Y.; Oren A.C.; Ayhan A.C.; Akyay A.; Akıncı B.; Karadas N.; Unuvar A.; Oren H.; Fettah A.; Kaya Z.; Isık B.; Eker İ.; Karaman S.; Yıldırım A.T.; Orhan M.F.; Oymak Y.; Timur C.; Yazici N.; Simsek A.; Karakurt N.; Toret E.; Evim M.S.
    Background: In patients with acute lymphoblastic leukemia (ALL), the risk of thromboembolism increases due to hemostatic changes secondary to the primary disease and due to treatment-related factors. In this multicenter study, we aimed to research the frequency of central nervous system (CNS) thrombosis occurring during treatment, hereditary and acquired risk factors, clinical and laboratory features of patients with thrombosis, treatment approaches, and thrombosis-related mortality and morbidity rates in pediatric ALL patients. Procedure: Pediatric patients who developed CNS thrombosis during ALL treatment from 2010 to 2021 were analyzed retrospectively in 25 different Pediatric Hematology Oncology centers in Türkiye. The demographic characteristics of the patients, symptoms associated with thrombosis, the stage of the leukemia treatment during thrombosis, the anticoagulant therapy applied for thrombosis, and the final status of the patients recorded through electronic medical records were determined. Results: Data from 70 patients with CNS thrombosis during treatment, out of 3968 pediatric patients with ALL, were reviewed. The incidence of CNS thrombosis was 1.8% (venous: 1.5 %; arterial: 0.03%). Among patients with CNS thrombosis, 47 had the event in the first 2 months. Low molecular weight heparin (LMWH) was the most commonly used treatment with a median of 6 months (min–max: 3–28 months). No treatment-related complications occurred. Chronic thrombosis findings occurred in four patients (6%). In five (7%) patients who developed cerebral vein thrombosis, neurological sequelae (epilepsy and neurological deficit) remained. One patient died related to thrombosis, and the mortality rate was 1.4%. Conclusion: Cerebral venous thrombosis and, less frequently, cerebral arterial thrombosis may develop in patients with ALL. The incidence of CNS thrombosis is higher during induction therapy than during other courses of treatment. Therefore, patients receiving induction therapy should be monitored carefully for clinical findings suggestive of CNS thrombosis. © 2023 Wiley Periodicals LLC.
  • No Thumbnail Available
    Item
    Common viral respiratory infections in children with cancer during the COVID-19 pandemic: a multicenter study from Türkiye
    (Turkish National Pediatric Society, 2024) Kaçar D.; Kebudi R.; Özyörük D.; Tuğcu D.; Bahadır A.; Özdemir Z.C.; Özgüven A.A.; Orhan M.F.; Yıldırım A.T.; Albayrak C.; Kartal İ.; Sarı N.; Tokgöz H.; Albayrak M.; Ayhan A.C.; Eroğlu N.; Aydın S.; Üzel V.H.; Zülfikar B.; Yıldırım Ü.M.; Büyükavcı M.; Gülen H.; Töret E.; Bör Ö.; Özbek N.Y.; İlhan İ.E.; Yaralı N.
    Background. Microbiologic confirmation of respiratory tract infections gained importance during the coronavirus disease 2019 (COVID-19) pandemic. This study retrospectively evaluated seasonal distribution, clinical presentation, and complications of respiratory viral infections (RVIs) other than COVID-19 in children with cancer during and after the pandemic lockdown. Methods. Two hundred and sixty-five inpatient and outpatient RVI episodes in 219 pediatric cancer patients confirmed by multiplex reverse transcriptase polymerase chain reaction (RT-PCR) panels from 13 centers were enrolled. Results. Eighty-six (32.5%) of the total 265 episodes occurred in 16 months corresponding to the lockdowns in Türkiye, and the remaining 67.5% in 10 months thereafter. Human rhinovirus/enterovirus (hRE) (48.3%) was the most common agent detected during and after lockdown. Parainfluenza virus (PIV) (23.0%), influenza virus (9.8%), and respiratory syncytial virus (RSV) (9.1%) were the other common agents. The 28.7% of episodes were lower respiratory tract infections (LRTIs), and complications and mortality were higher than upper respiratory tract infections (URTIs) (25.0% vs 5.3%). Bacteremia was identified in 11.5% of culture-drawn episodes. Treatment delay in one-third and death within four weeks after RVI in 4.9% of episodes were observed. Conclusion. During the pandemic, fewer episodes of RVIs occurred during the lockdown period. Respiratory viruses may cause complications, delays in treatment, and even death in children with cancer. Therefore, increased awareness of RVIs and rapid detection of respiratory viruses will benefit the prevention and, in some cases, abrupt supportive and some antiviral treatment of RVI in children with cancer. © 2024, Turkish National Pediatric Society. All rights reserved.
  • No Thumbnail Available
    Item
    Sirolimus is effective and safe in childhood relapsed-refractory autoimmune cytopenias: A multicentre study
    (John Wiley and Sons Inc, 2024) Acar S.O.; Tahta N.; Al I.O.; Erdem M.; Gözmen S.; Karapınar T.H.; Kılınç B.; Celkan T.; Kirkiz S.; Koçak Ü.; Ören H.; Yıldırım A.T.; Arslantaş E.; Ayhan A.C.; Oymak Y.
    Autoimmune cytopenias are a heterogeneous group of disorders characterized by immune-mediated destruction of haematopoietic cell lines. Effective and well-tolerated treatment options for relapsed-refractory immune cytopenias are limited. In this study, the aim was to evaluate the efficacy and safety of sirolimus in this disease group within the paediatric age group. The study enrolled patients in the paediatric age group who used sirolimus with a diagnosis of immune cytopenia between December 2010 and December 2020, followed at six centres in Turkey. Of the 17 patients, five (29.4%) were treated for autoimmune haemolytic anaemia (AIHA), six (35.2%) for immune thrombocytopenic purpura (ITP) and six (35.2%) for Evans syndrome (ES). The mean response time was 2.7 months (range, 0–9 months). Complete response (CR) and partial response (PR) were obtained in 13 of 17 patients (76.4%) and nonresponse (NR) in four patients (23.5%). Among the 13 patients who achieved CR, three of them were NR in the follow-up and two of them had remission with low-dose steroid and sirolimus. Thus, overall response rate (ORR) was achieved in 12 of 17 patients (70.5%). In conclusion, sirolimus may be an effective and safe option in paediatric patients with relapsed-refractory immune cytopenia. © 2024 The Scandinavian Foundation for Immunology.