Search PubMed⌕ Search

Biomedical subjects

Mualla Cetin

Publications and source records attributed to Mualla Cetin.

31 records · Page 2Linked to original sources
PubMed2004

Parvovirus B19 infection presenting as pre-B-cell acute lymphoblastic leukemia: a transient and progressive course in two children.

Parvovirus B19 is the causative agent of various forms of hematologic diseases such as aplastic crisis in patients with hemolytic anemia, aplastic anemia, hypoplastic anemia, and idiopathic thrombocytopenic purpura. In addition, parvovirus B19 infection may precede or be associated with acute lymphoblastic leukemia (ALL). The authors present two cases of parvovirus B19 infection and bone marrow infiltration with pre-B-cell lymphoblasts; one patients was diagnosed as having ALL, and the other patient, with neurologic findings, showed total resolution of the blastic morphology and phenotype.

Antibodies, Viral↗
PubMed2004

A child with vitamin B12 deficiency presenting with pancytopenia and hyperpigmentation.

The authors describe a 16-month-old infant presenting with neurologic developmental regression, severe pancytopenia, excessive skin pigmentation, and tremor resulting from nutritional vitamin B12 deficiency. She had been exclusively breast-fed and had refused to take any other food. Laboratory studies showed severe pancytopenia, a decrease in serum B12 levels, and an increase in urinary methylmalonic acid levels. Bone marrow aspiration was compatible with megaloblastic changes. Schilling test was normal. The serum B12 level of the mother was also low. Megaloblastic anemia resulting from inadequate B12 intake was diagnosed. Parenteral B12 therapy was initiated. The neurologic picture did not completely resolve, but pancytopenia, tremor, and hyperpigmentation of the extremities recovered completely.

Anemia, Megaloblastic↗
PubMed2003

Hypophosphatemia and hypouricemia in pediatric allogeneic bone marrow transplant recipients.

Increased phosphate (P) uptake by the replicating neutrophils during engraftment syndrome has been described to play a role in the development of hypophosphatemia (HP) in bone marrow transplantation patients, and suggested as a measure of neutrophil recovery. Here, the relationship of serum P with engraftment was determined in 56 children who underwent allogeneic bone marrow transplantation (BMT). Uric acid (UA) levels were also analyzed to study the contribution of cytolysis on P levels. HP and hypouricemia (HU) developed at least once in 63 and 57% of patients respectively, before and until day +20 after transplantation. The minimal values of P and UA were observed at day +10 and were significantly lower than the baseline values (p < 0.01). The mean neutrophil engraftment was at day +13, following the P and UA nadir by 3 days. In addition there was a significant correlation between P and UA levels (p = 0.01). The levels of of both P and UA returned to pretransplant values at day +20. A significant correlation (p < 0.05) between platelet engraftment and P levels was also demonstrated. HP and HU seen in pediatric patients undergoing BMT reflects a combination of pathophysiologic mechanisms.

Adolescent↗
PubMed2003

The dose related effect of steroids on blast reduction rate and event free survival in children with acute lymphoblastic leukemia.

We examined the effect of high-dose methylprednisolone (HDMP) on blast reduction rate and compared it to conventional dose steroid treatment, administered during the first 7+ days of the induction remission period in patients with acute lymphoblastic leukemia (ALL). In our previous randomized study, the event free survival (EFS) was found to be higher in patients treated with HDMP (Group B) than in patients treated with a conventional dose of steroids (Group A). We used the chemotherapy protocol for ALL patients according to the St Jude Total XI study group. Medical records of all 194 patients who achieved complete remission were reviewed to determine the absolute blast count (ABC) in peripheral blood smears from day 0 of treatment until day 8. A target response of 1,000 blast/mm3 was employed. The time in which ABC remained > or = 1,000/mm3 and the EFS rates were assessed in group A (n = 44) and B (n = 51) of high risk patients. Group A and B patients were branched to chemotherapy schedules (A1, B1: steroid + vincristine + daunorubicine + intrathecal + 3 doses L-asparaginase; A2, B2: steroid + vincristine + daunorubicine + intrathecal; A3, B3: only steroid monotherapy). Number of patients from whom the ABC remained > or = 1,000/mm3 during all 7 days of induction treatment and the median number of days for blasts to reach the target level were significantly lower in group B1 than A1 (p < 0.05), concordantly the 8-year EFS was higher in group B1 (p = 0.01). In comparison of the subgroups, results of A2 and A3 were worse than of group B2 and B3. These findings strongly suggest that the effects of HDMP on blast cytoreduction and EFS are more potent than conventional dose steroids.

Adolescent↗
PubMed2003

The potential effect of short-course high-dose steroid on the maturation and apoptosis of leukemic cells in a child with acute megakaryoblastic leukemia.

High-dose methylprednisolone (HDMP) treatment has been shown to induce differentiation of myeloid leukemic cells in children with acute promyelocytic leukemia and other subtypes (FAB AML M1-M2-M4) of acute myeloblastic leukemia. In the present study, a child with acute megakaryoblastic leukemia (AMKL) was given HDMP (30 mg/kg/day) orally in a single dose for the first 4 days of induction therapy. A marked decrease in peripheral blood blast cells and an increase in platelet count associated with a striking change in bone marrow (BM) morphology was observed following a short-course of HDMP treatment alone. BM cells developed distinct morphology characterized by cytoplasmic blebbing and some appeared as platelet producing micromegakaryocytes. Flow cytometric analysis of the BM cells 4 days after HDMP treatment demonstrated a decrease in the percentage of cells co-expressing CD34 and CD117 antigens and a marked increase in CD42a antigen. These changes in BM morphology and immunophenotype may suggest maturation effect of HDMP on megakaryocytic leukemic cells. In addition ultrastructural analysis of BM cells cultured with methylprednisolone (10(-3) and 10(-6) M) for 24 and 48 h showed numerous apoptotic cells. This was coincident with a significant increase in the percentage of annexin positive cells. These results suggest that HDMP treatment may induce differentiation and apoptosis of leukemic cells in a child with AMKL and it could be a promising agent for remission induction of patients with AMKL.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed2002

Changes in hepatitis B virus serology in bone marrow transplanted children.

Suppression of the immune system and reconstitution of the donor's immune system may affect the course of a chronic viral infection in the recipients. The aim of this study is to evaluate changes in hepatitis B virus (HBV) serology after bone marrow transplantation (BMT). HBV serology and hepatic function tests were examined in 45 children before and after BMT. Before BMT, 40 patients were HBsAg negative and 5 positive. There were no HBsAg positive donors. HBsAg disappeared in two patients and anti-HBs became positive in one. Donors of these patients were anti-HBs positive. In a third patient, acute HBV infection developed and lasted without complication. This patient also seroconverted to anti-HBs. Anti-HBs disappeared in 7 of 21 anti-HBs positive patients. Among 18 patients who were HBsAg and anti-HBs negative, 11 seroconverted to anti-HBs positivity. Our findings support the notion that having an anti-HBs positive donor is important for adoptive immunity transfer and for preventing HBV replication.

Adolescent↗
PubMedDate not supplied

Parvovirus B19 infection associated with severe aplastic anemia in an immunocompetent patient.

Human parvovirus B19 (PVB19) infection may cause mild pancytopenia characterized by transient and spontaneous recovery in healthy subjects. Severe aplastic anemia associated with PVB19 infection in patients without an underlying disease has been described in a number of reports. Here, a previous healthy, 10-year-old girl with severe aplastic anemia associated with PVB19 infection is described. The patient underwent bone marrow transplantation from her HLA-identical sibling resulting in complete recovery. PVB19 infection should be considered as one of the causes of aplastic anemia in patients without an underlying disease.

Anemia, Aplastic↗
PubMedDate not supplied

The prognosis and survival of childhood acute lymphoblastic leukemia with central nervous system relapse.

Central nervous system (CNS) relapse in childhood acute lymphoblastic leukemia (ALL) has been overcome by sensitive therapeutic approachs. This study was planned to present the development of CNS relapse and survival in newly diagnosed 190 ALL patients whose cases were followed in the authors' unit between March 1991 and May 2002. St. Jude Study XI protocol was given to the patients who applied between March 1991 and March 1997 (group A) (n = 122), and St. Jude Study XIII protocol was given to the patients who applied between March 1997 and May 2002 (group B) (n = 68). The patients having isolated CNS relapse in group A received craniospinal irradiation (CSI) median 3.5 months after CNS relapse (range 2-6 months), a short time after reinduction, and 2 cures of consolidation. In group B, patients having isolated CNS relapse received IT once a month and a high-dose methotrexate treatment once every 8 weeks and 3 or 4, cures later therapy CSI median 7 months after CNS relapse (range 6-8 months) was given. When the overall survival rates of the 2 groups are compared, a statistically significant higher survival rate at 5 years was determined in group B than in group A (respectively, 82.3%, 58.4%) (p < .05). When subgroups of the patients (that is, those with no relapse, isolated CNS or BM relapse, or CNS + BM relapse) were compared in both groups, it was found that survival was much higher for the ones with no relapse and with isolated CNS relapse (respectively, 87.9%, 72.7%) compared to isolated BM or CNS + BM relapse groups (respectively, 10%, 13.3%) (p < .05). In a conclusion, for children with acute lymphoblastic leukemia and an isolated CNS relapse, with delayed definitive craniospinal irradiation allowing more intensive systemic and intrathecal chemotherapy results in better overall survival than has been previously reported.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Genital ulcers after treatment with all-trans-retinoic acid in a child with acute promyelocytic leukemia.

All-trans-retinoic acid (ATRA) has been shown to improve the outcome of patients with acute promyelocytic leukemia (APL). However, various adverse effects of ATRA treatment have been noted, such as scrotal and genital ulcers in adult patients. The authors report genital ulcers that developed in a child with APL after ATRA treatment. An 8-year-old girl with APL was treated with ATRA for 21 days and after discontinuation of ATRA treatment she developed genital ulcers. Systemic and local antibiotic pomades were applied and the lesions improved within 15 days. In conclusion, genital ulcers may develop in children with APL as a complication of ATRA treatment and physicians should be alert to this possibility.

Child↗
PubMedDate not supplied

The role of short course of high-dose methylprednisolone in children with acute myeloblastic leukemia (FAB M2) presented with myeloid tumor.

The authors have previously demonstrated a favorable effect of high-dose methylprednisolone (HDMP), which can induce differentiation and apoptosis of leukemic cells in children with acute myeloblastic leukemia (AML). Here, they evaluate the effect of short-course HDMP in 2 children with acute myeloblastic leukemia (AML-M2) presented with myeloid tumor (MT). Methylprednisolone (20 or 30 mg/kg/day) was given orally, in a single dose, without using other antileukemic agents. Rapid cytoreduction in MT, peripheral blood, and bone marrow blasts was observed in both children following short-course (4 or 7 days) HDMP treatment, possibly due to HDMP-induced differentiation and apoptosis of leukemic cells. The effects of HDMP should be explored in patients with other subtypes of AML who present with MT.

Antigens, CD↗
PubMedDate not supplied

Acute lymphoblastic leukemia in infants.

Between January 1978 and August 1999, 29 infants with newly diagnosed acute lymphoblastic leukemia (ALL) were treated on three consecutive protocols. Eighteen patients with infant ALL diagnosed between 1978-1991 were included in Group 1. In this group, treatment comprised a two- or three-drug induction with prednisolone, vincristine and L-asparaginase, and maintenance therapy consisted of weekly oral administration of mercaptopurine and methotrexate for three years. Group 2: Between 1991 and 1999, 11 infants with ALL were treated by St. Jude Total Therapy XI (n=4) and XIII (n=7) protocols with minor modification. Three years' event-free survival (+/-SE) was 14 +/- 9% in group 1. In group 2, this rate was 25 +/- 22% in Total XI and 57 +/- 19% in Total XIII. Outcome for infants on protocols Total Therapy XI and XIII improved compared with that of group 1.

Antineoplastic Combined Chemotherapy Protocols↗
PubMedDate not supplied

Back to the basics: hemorrhage after vaccination: a case report.

A 50-day-old girl with swelling and ecchymosis of right hand dorsum after DTP vaccination on ipsilateral deltoid area was referred to the pediatric infectious disease outpatient unit with a presumed diagnosis of gangrenous cellulites. Physical examination and laboratory evaluation revealed intramuscular bleeding as a result of vitamin K deficiency. We would like to emphasize the importance of both vitamin K prophylaxis in the newborn to prevent hemorrhagic disease of the newborn and of the education of persons administering vaccines about this very basic aspect of pediatrics for early recognition.

Ecchymosis↗