Publications by authors named "Işık Odaman-Al"

15 Publications

  • Page 1 of 1

Evaluation for Metastatic Candida Focus and Mortality at Candida-associated Catheter-related Bloodstream Infections at the Pediatric Hematology-oncology Patients.

J Pediatr Hematol Oncol 2021 Sep 6. Epub 2021 Sep 6.

Departments of Pediatric Infectious Diseases Pediatric Hematology and Oncology Pediatric Cardiology, Dr Behçet Uz Child Disease and Pediatric Surgery Training and Research Hospital, Izmir, Turkey.

Background: Candidemia and Candida-associated catheter-related bloodstream infections (CRBSIs) are the significant cause of mortality and morbidity in patients with malignancy.

Methods: A retrospective analysis including all pediatric hematologic/oncologic malignancies patients with CRBSIs treated in Dr. Behçet Uz Children Diseases and Surgery Training and Research Hospital between the period of 2009 and 2020.

Results: During the study period, 53 children with CRBSIs associated with Candida species were included. The most common malignancy was acute lymphoblastic leukemia (45.3%) and acute myeloid leukemia (15.1%). A total of 56 Candida isolates were present including non-albicans Candida species (80.4%) and Candida albicans (19.6%). The most common isolated Candida species was Candida parapsilosis (42.9%) and followed by C. albicans (19.6%). The ratio of azole prophylaxis was significantly higher in patients with the non-albicans Candida group (P=0.031). Candida-related endocarditis (vegetation) was present in 2 (3.8%) patients, and the overall rate of hepatosplenic candidiasis was 3.8%. Seven days Candida attributable mortality was 7.5% (4 patients) and 30 days Candida attributable mortality was 11.3% (6 patients). The Candida species responsible for the Candida-related deaths were as following: Candida tropicalis (n=3), C. parapsilosis (n=2), and C. lusitanae (n=1).

Conclusion: In pediatric cancer patients with Candida-associated CRBSIs, evaluation of the patient for organ involvement including liver and spleen ultrasonography and cardiac involvement with echocardiography are essential regardless of the patients' clinical picture.
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http://dx.doi.org/10.1097/MPH.0000000000002197DOI Listing
September 2021

Is There a Clinical Significance of Very Low Serum Immunoglobulin E Level?

J Clin Immunol 2021 Sep 3. Epub 2021 Sep 3.

Department of Pediatric Allergy and Clinical Immunology, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Purpose: High serum immunoglobulin (Ig) E levels are associated with allergies, parasitic infections, and some immune deficiencies; however, the potential effects and clinical implications of low IgE levels on the human immune system are not well-known. This study aims to determine the disorders accompanying very low IgE levels in children and adults.

Methods: The patients whose IgE levels were determined between January 2015 and September 2020 were analyzed, and the patients with an IgE level < 2 IU/mL were included in this study. Demographic data, immunoglobulin levels, autoantibody results, and the diagnoses of the patients were noted from the electronic recording system of the hospital.

Result: The IgE levels were measured in 34,809 patients (21,875 children, 12,934 adults), and 130 patients had IgE levels < 2 IU/mL. Fifty-seven patients were children (0.26%); 73 were adults (0.56%). There was a malignant disease in 34 (9 of them children) (26%), autoimmune diseases in 20 (3 of them children) (15.4%), and immunodeficiency in 17 (14 of them children) (13.1%) of the patients. The most common reasons were other diseases, immunodeficiency and malignancy in children, and malignancy, autoimmune disorders, and other diseases in the adults, in rank order. The IgE level did not show any correlation with the levels of other immunoglobulins.

Conclusion: Although rare, a low IgE level has been shown to accompany malignancies, autoimmune disorders, and immune deficiencies. Patients with very low IgE levels should be carefully monitored for systemic disorders.
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http://dx.doi.org/10.1007/s10875-021-01127-yDOI Listing
September 2021

Thrombolysis with Systemic Recombinant Tissue Plasminogen Activator in Children: A Multicenter Retrospective Study.

Turk J Haematol 2021 Aug 25. Epub 2021 Aug 25.

Turkish Republic Ministry of Health, University of Health Sciences, Ankara City Hospital, Department of Pediatrics, Division of Pediatric Hematology, Ankara.

Objective: Evaluating systemic thrombolysis experience with recombinant tissue plasminogen activator (rtPA).

Materials And Methods: Retrospective data were collected from 13 Turkish pediatric hematology centers. The dose and duration of rtPA treatment, concomitant anticoagulant treatment, complete clot resolution (CCR), partial clot resolution (PCR), and bleeding complications were evaluated. Low dose (LD) rtPA treatment was defined as 0.01-0.06 mg/kg/h and high dose (HD) 0.1-0.5 mg/kg/h.

Results: Between 2005 and 2019, 55 thrombotic episodes of 54 patients, with a median age of 5 years (1 day-17.75 years) were evaluated. There were patients with intracardiac thrombosis (n=16), deep-venous thrombosis (DVT) (n=15), non-stroke arterial thrombosis (n=14), pulmonary thromboembolism (PE) (n=6), and stroke (n=4). The duration from thrombus detection to rtPA initiation was median 12 h (2h -504 h) and it was significantly longer for DVT and PE compared to stroke, non-stroke arterial thrombosis, and intracardiac thrombosis (p=0.024). In 63.6% of the episodes, heparin was initiated before rtPA treatment. LD and HD rtPA were administered in 22 and 33 of the episodes, respectively. Concomitant anticoagulation was used in 90% and 36% of the episodes with LD and HD rtPA, respectively (p=0.0001). Median total duration of LD and HD rtPA infusions was 30 h (2h-120h) and 18 h(2h-120h), respectively (p=0.044). Non-fatal major and minor bleeding rates were 12.5 %, 16.7% for LD and 3.2%, 25.8% for HD rtPA, respectively. At the end of the rtPA infusions, CCR and PCR were achieved in 32.7%, and 49.0% of the episodes, respectively. The most successful site for thrombolysis was intracardiac thrombosis. HD versus LD rtPA administration was not correlated with CCR/PCR or bleeding (p>0.05).

Conclusion: Systemic thrombolytic therapy may save lives and organs effectively if it is used at the right indication and right time in children with high-risk thrombosis by the experienced hematologists under close monitoring of recanalization and bleeding.
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http://dx.doi.org/10.4274/tjh.galenos.2021.2021.0038DOI Listing
August 2021

Safety and efficacy of deferasirox in patients with transfusion-dependent thalassemia: A 4-year single-center experience.

Pediatr Hematol Oncol 2021 Sep 22;38(6):555-563. Epub 2021 Mar 22.

Pediatric Hematology Oncology, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

This study was organized to determine the efficacy and safety of deferasirox (DFX) in reducing the SF of patients with transfusion-dependent thalassemia (TDT). This is a retrospective, descriptive study of 101 transfusion- dependent patients with thalassemia major who were followed for 48 months. Twenty-nine patients who used an alternative chelator either alone or combined, who were not compliant to the treatment, changed the drug due to adverse reactions, and had multiple transfusions and did not complete 4 years of DFX use were excluded. A total 72 out of 101 patients completed the study. SF decreases were noted for the 6-12 and >18-year age groups, from a median of 1532 ng/mL to 1190 ng/mL, and from 1386 ng/mL to 1165 ng/mL, respectively (p > 0.05). The proportion of patients with SF concentrations >2000 ng/mL is decreased (29% at baseline decreased to 15% at the end of the study) during the 48 months. The median SF of those who used <30 mg/kg/day (n = 38) increased from 767 ng/mL to 1006 ng/mL, whereas the >30 mg/kg/day (n = 34) group's SF concentrations decreased from a median of 1575 ng/mL to 1209 ng/mL (p = 0.029). The decrease of median SF values for Syrian patients was statistically significant (p = 0.043). Most common adverse events were gastric irritation symptoms (19.4%). The total DFX discontinuation ratio was calculated as 9.7%. Although dosages between 25-30 mg/kg/day are adequate to stabilize SF concentrations higher dosages are needed to achieve a statistically significant decrease.
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http://dx.doi.org/10.1080/08880018.2021.1901809DOI Listing
September 2021

A novel mutation in the SLC19A2 gene in a Turkish male with thiamine-responsive megaloblastic anemia syndrome.

Turk J Pediatr 2019 ;61(2):257-260

Departments of Pediatric Endocrinology, Kanuni Sultan Suleyman Training and Research Hospital, İstanbul, Turkey.

Odaman-Al I, Gezdirici A, Yıldız M, Ersoy G, Aydoğan G, Şalcıoğlu Z, Tahtakesen TN, Önal H, Küçükemre-Aydın B. A novel mutation in the SLC19A2 gene in a Turkish male with thiamine-responsive megaloblastic anemia syndrome. Turk J Pediatr 2019; 61: 257-260. Thiamine-responsive megaloblastic anemia (TRMA) is a very rare syndrome characterized by the triad of early onset megaloblastic anemia, sensorineural deafness and diabetes mellitus. Here we report, a 5-year-old boy who presented with transfusion dependent anemia and diabetes mellitus and was diagnosed with TRMA. Besides reporting a novel mutation of the causative gene SLC19A2, we wanted to emphasize this syndrome in the aspect of coexistence of insulin dependent diabetes, transfusion dependent anemia and thrombocytopenia.
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http://dx.doi.org/10.24953/turkjped.2019.02.015DOI Listing
July 2020

A novel mutation in the SLC19A2 gene in a Turkish male with thiamine-responsive megaloblastic anemia syndrome.

Turk J Pediatr 2019 ;61(2):257-260

Departments of Pediatric Endocrinology, Kanuni Sultan Suleyman Training and Research Hospital, İstanbul, Turkey.

Odaman-Al I, Gezdirici A, Yıldız M, Ersoy G, Aydoğan G, Şalcıoğlu Z, Tahtakesen TN, Önal H, Küçükemre-Aydın B. A novel mutation in the SLC19A2 gene in a Turkish male with thiamine-responsive megaloblastic anemia syndrome. Turk J Pediatr 2019; 61: 257-260. Thiamine-responsive megaloblastic anemia (TRMA) is a very rare syndrome characterized by the triad of early onset megaloblastic anemia, sensorineural deafness and diabetes mellitus. Here we report, a 5-year-old boy who presented with transfusion dependent anemia and diabetes mellitus and was diagnosed with TRMA. Besides reporting a novel mutation of the causative gene SLC19A2, we wanted to emphasize this syndrome in the aspect of coexistence of insulin dependent diabetes, transfusion dependent anemia and thrombocytopenia.
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http://dx.doi.org/10.24953/turkjped.2019.02.015DOI Listing
July 2020

A Pediatric Case of Idiopathic Hypereosinophilia Preceeding Precursor B-cell Lymphoblastic Lymphoma of Nasopharynx.

J Pediatr Hematol Oncol 2020 04;42(3):248-249

Department of Pediatric Hematology and Oncology, Kanuni Sultan Suleyman Traning and Research Hospital.

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http://dx.doi.org/10.1097/MPH.0000000000001561DOI Listing
April 2020

Thiol Disulfide Homeostasis and Ischemia-modified Albumin Level in Children With Beta-Thalassemia.

J Pediatr Hematol Oncol 2019 10;41(7):e463-e466

Department of Clinical Biochemistry, Faculty of Medicine, Yildirim Beyazit University, Ankara, Turkey.

Objective: It is well known that increased oxidative stress leads to tissue damage in beta-thalassemia (β-thal) patients. Thiols are one of the most important antioxidant agents, and thiol/disulfide (SH/SS) homeostasis is a novel oxidative stress marker. This study aimed to investigate the relationship of thiol levels, SH/SS homeostasis, and ischemia-modified albumin (IMA) in patients with β-thal.

Materials And Methods: A hundred transfusion-dependent β-thal patients and 41 healthy controls were included in the study.

Results: Native thiol, total thiol, disulfide, catalase, and IMA levels were significantly higher in the β-thal group compared with the control group (P<0.02). There were no correlation between serum ferritin level and SH/SS homeostasis, and weak positive correlations were found between serum ferritin and IMA (r=0.242, P=0.022).

Conclusions: Our study results suggest that antioxidant systems try to compensate for peroxidative damage in the patients' group and serum IMA level was found increased because of increased oxidative status. To the best of our knowledge, there has been no report evaluating plasma dynamic SH/SS homeostasis in β-thal patients.
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http://dx.doi.org/10.1097/MPH.0000000000001535DOI Listing
October 2019

Variant Guillain-Barré syndrome in a patient with Hodgkin lymphoma: AMSAN.

Turk Pediatri Ars 2018 Dec 1;53(4):263-266. Epub 2018 Dec 1.

Pediatric Hematology and Oncology Clinic, Kanuni Sultan Süleyman Training and Research Hospital, İstanbul, Turkey.

Lymphomas are solid tumors characterized by the malignant proliferation of lymphoid cells. Neurologic signs encountered in patients with Hodgkin's lymphoma can be due to the direct spread of tumor to the nervous system, secondary to chemotherapy or radiation, secondary to tumor mass compression, infectious causes and paraneoplastic syndromes. Paraneoplastic neurologic syndromes are rarely encountered in patients with Hodgkin's lymphoma and non-Hodgkin's lymphoma. Except for paraneoplastic cerebellar degeneration in Hodgkin's lymphoma and dermato/polymyositis in both Hodgkin's lymphoma and non-Hodgkin's lymphoma, other paraneoplastic syndromes are uncommon and have only been reported as isolated case reports or short series. Here, we present a patient with Hodgkin's lymphoma with symptoms of bilateral lower extremity weakness and loss of sensation before the start of therapy, who was eventually diagnosed as having motor and sensory axonal neuropathy.
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http://dx.doi.org/10.5152/TurkPediatriArs.2018.4763DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6408190PMC
December 2018

Burkitt Leukemia With Precursor B-Cell Immunophenotype and Dual Translocation of t(14;18) and t(8;14) in a Child: Case Report and Review of the Literature.

J Pediatr Hematol Oncol 2020 01;42(1):e61-e63

Department of Pediatric Hematology and Oncology, Kanuni Sultan Suleyman Education and Research Hospital.

Background: Burkitt leukemia (BL) with the precursor B-cell immunophenotype is a rarely reported condition. The prognosis of such patients is similar to that of classic BL. However, the combination of chromosomal translocations associated with bcl-2 and c-myc rearrangement has a poor prognosis.

Observations: An 11-year-old child presented with fever and weakness. Bone marrow aspiration showed morphologically L1 type blasts and flow cytometry analysis was compatible with precursor B-cell immunophenotype. Cytogenetic analysis revealed a combination of t(8;14) and t(14;l8).

Conclusions: The combination of t(8;14) and t(14;l8) can exhibit different immunophenotypical and morphologic features in leukemias.
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http://dx.doi.org/10.1097/MPH.0000000000001354DOI Listing
January 2020

Hemophagocytic Lymphohistiocytosis Associated With Visceral Leishmaniasis.

J Pediatr Hematol Oncol 2018 07;40(5):395

Pediatric Hematology and Oncology Department, Kanuni Sultan Süleyman Training and Research Hospital, Istanbul, Turkey.

This is the report of a 2-year-old boy who presented with fever, cytopenia, and splenomegaly. The patient was diagnosed with hemophagocytic lymphohistiocytosis (HLH) and treated with HLH-2004 protocol. Repeated bone marrow aspiration showed amastigotes on follow-up. In endemic countries, visceral leishmaniasis should be considered in the differential diagnosis to avoid chemotherapy toxicity.
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http://dx.doi.org/10.1097/MPH.0000000000001178DOI Listing
July 2018

A Rare Cause of Paraplegia: Myeloid Sarcoma

Turk J Haematol 2018 08 2;35(3):206-207. Epub 2018 Feb 2.

University of Health Sciences, Kanuni Sultan Süleyman Traning and Research Hospital, Clinic of Pediatric Hematology and Oncology, İstanbul, Turkey

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http://dx.doi.org/10.4274/tjh.2017.0423DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6110446PMC
August 2018

Assessment of red blood cell distribution width and mean platelet volume in children with epistaxis.

Int J Pediatr Otorhinolaryngol 2017 Apr 29;95:20-23. Epub 2017 Jan 29.

İstanbul Kanuni Sultan Süleyman Training and Research Hospital, Pediatric Hematology and Oncology Department, İstanbul, Turkey.

Objective: This study aimed to investigate whether there is a relationship between red blood cell distribution width, mean platelet volume and epistaxis in children.

Methods: Between January 2015 and July 2016, 105 children who were referred to our clinic with epistaxis and 100 sex- and age-matched controls were retrospectively analyzed. Red blood cell distribution width (RDW) and mean platelet volume (MPV) values were determined in both groups.

Results: RDW values were found significantly (P < 0.05) lower in the group with epistaxis than in the control group (11.95 ± 1.31 vs. 12.74 ± 1.21). MPV was 7.49 ± 1.33 in the group with epistaxis and 7.23 ± 1.06 in the control group, and there was no significant difference between the groups (p > 0.05).

Conclusion: We found no difference between MPV values of both groups and significantly lower RDW values in children with epistaxis. Decreased RDW values were considered as an accompanying marker rather than a result of epistaxis. In addition, it may be thought that low RDW values may increase the bleeding tendency by disrupting the thrombotic activities. Further studies are needed to validate the relation of these parameters with epistaxis and its mechanisms.
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http://dx.doi.org/10.1016/j.ijporl.2017.01.030DOI Listing
April 2017

A Rare Late Complication of Port Catheter Implantation: Embolization of the Catheter.

Turk J Haematol 2018 May 26;35(2):142-143. Epub 2017 Apr 26.

University of Health Sciences, İstanbul Kanuni Sultan Süleyman Training and Research Hospital, Clinic of Pediatric Hematology and Oncology, İstanbul, Turkey.

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http://dx.doi.org/10.4274/tjh.2017.0134DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5972342PMC
May 2018

Subarachnoid-pleural fistula in a child: the cause and treatment.

Pediatr Int 2012 Dec;54(6):929-31

Pediatric Intensive Care Unit, Kanuni Sultan Suleyman Training and Research Hospital, Istanbul, Turkey.

Hydrothorax of the cerebrospinal fluid after a subarachnoid-pleural fistula is a rare condition. Subarachnoid-pleural fistula may appear after a trauma at the thoracolumbar vertebral column or iatrogenically after thoracotomy. A two years and four months old boy who was operated because of ganglioneuroblastoma was admitted to hospital due to respiratory distress. The chest roentgenogram obtained two months after thoracotomy, showed a pleural effusion at the left side and a chest tube was inserted. The craniospinal magnetic resonance imagining revealed subarachnoid-pleural fistula and lumbar external cerebrospinal fluid drainage was performed. The chest tube was removed by application of tetracycline between pleural layers. After the patient was discharged, respiratory distress reoccurred after 3 weeks and a chest tube was reinserted due to fluid at the left hemithorax. An external lumbar drainage was reapplied. The location of the fistula was determined by craniospinal magnetic resonance imagining and myelography. The fistula was surgically restored by a posterior approach and laminectomy. The cerebrospinal fluid drainage and chest tube was removed three days and seven days after the operation respectively. The patient was discharged at the 13 days after the operation. During periodical outpatient follow up the patient has no symptoms and is neurologically intact. Subarachnoid-pleural fistulas, usually do not regress spontaneously or respond to conservative methods. Invasive approaches including surgery may be needed to treat patients with subarachnoid-pleural fistulae.
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http://dx.doi.org/10.1111/j.1442-200X.2012.03600.xDOI Listing
December 2012
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