Purpose: We aimed to prospectively interpret the cardiac repolarization changes with 12-lead electrocardiography(ECG) in children with cancer who were treated with anthracycline drugs.Materials and methods: A total of 53 patients with cancer treated with anthracycline were enrolled in the study.During 6-month follow-up, standard 12-lead ECG was performed at basal, 1st, 4th, and 24th hours after thefirst dose of anthracycline treatment, at the time of 120 mg/m2 cumulative anthracycline dose and 240 mg/m2of cumulative anthracycline dose in the same patients, respectively. P dispersion (PWd), QT dispersion (QTd),corrected QT dispersion (QTcd), Tp-e interval, Tp-e/QT, and Tp-e/QTc ratio were obtained from 12-lead ECG.The patients were classified into three groups according to increasing cumulative anthracycline doses: Group 1:first dose (n=53), Group 2: 120 mg/m2 (n=53), Group 3: 240 mg/m2 (n=53).Results: The median age was 48 months (range 9-192 months). While PWd, QTd, QTcd, and Tp-e interval weresignificantly increased during first 24 hours of the first dose (p<0.001, p=0.005, p=0.041, p=0.016, respectively),Tp-e/QT and Tp-e/QTc ratios were significantly altered during first 24 hours of 120 mg/m2 cumulative dose ofanthracycline treatment (p<0.001). Any changes in 12-lead ECG were not significantly at 240 mg/m2 cumulativedose. However, it was detected that all variables were affected according to each increased anthracyclinecumulative dose despite it was not statistically significant.Conclusions: ECG parameters such as PWd, QTd, QTcd, Tp-e interval, Tp-e/QT, and Tp-e/QTc ratios areuseful for detecting subclinical cardiac abnormality and acute anthracycline toxicity during both uses of singledose anthracycline and increased anthracycline doses. These parameters may also predict arrhythmias inpatients with cancer.
|
İlknur ÇAĞLAR ,
İlker DEVRİM ,
Mine DÜZGÖL ,
Ahu AKSAY ,
Özgür CARTI ,
Bengü DEMİRAĞ ,
Salih GÖZMEN ,
Yılmaz AY ,
Tuba Hilkay KARAPINAR ,
Nuri BAYRAM ,
Yeşim OYMAK ,
Canan VERGİN
Objective: There are limited data focusing on incidence and manifestations of cytomegalovirus (CMV) inchildren with acute lymphoblastic leukemia (ALL) apart from bone marrow transplant recipients. In thisstudy, we aimed to review our experience regarding the manifestations, treatment, and outcome of cytomegalovirus infection in pediatric ALL patients.Methods: We retrospectively reviewed the clinical characteristics of patients with ALL that were diagnosed with CMV disease while they were on standard chemotherapy.Results: Fourteen patients were included in the std. Fever was the most common symptom (64%). Eyes,lungs and liver were the most commonly involved organs in CMV disease. Lymphopenia was found in mostof the patients. At the time of diagnosis, 50% of the patients were on maintenance phase of chemotherapy. All patients were treated with intravenous ganciclovir. Two patients died because of concomitantinfections, and two children with retinitis had permanent visual sequelae while others had a completerecovery.Conclusion: In children with ALL, CMV is an important pathogen with serious consequences includingretinitis which may be asymptomatic and result in complete visual loss. Not only during intense chemotherapy but also in maintenance phase CMV disease may occur. Especially when prolonged (>7 days) febrile neutropenia and lymphopenia is present, CMV must be kept in mind in the differential diagnosis.
|
Objective: The aim of this study is to determine the frequency ofdental anomalies (DAs) (microdontia, hypodontia, hyperdontia, enameldefect, root malformation) in pediatric cancer patients at the ages <5years and between 5 and 7 years, and understand their relationshipwith the received therapy.Materials and Methods: Pediatric patients who were diagnosed withcancer and treated before the age of 7 years were investigated in acase- control design. The study included 93 pediatric patients whoseages at diagnosis were between 9 months and 7 years and whosetreatments were completed before 5-8 years. Group A consisted ofpatients in the age range of 9 months to 4 years and Group B consistedof patients in the age range of 5-7 years. Seventy-two siblings withcompatible dental age ranges were included in the control group. Forboth groups, intraoral examinations were performed and panoramicradiographs were taken.Results: Among the 93 pediatric patients, the mean age was9.54±1.25 (range: 8-13 years) and 48 (51.6%) patients were male.The most common diagnosis was hematologic malignancy with a rateof 65.5%. At least one DA was detected in 7 (9.7%) individuals ofthe control group and in 78 (83.9%) of the patient group. While thepatients in the study group had all kinds of DAs, those in the controlgroup had only enamel defects. The rates of microdontia (p=0.077)and hypodontia (p=0.058) were detected to be significantly higherin Group A than in Group B. Root malformation was more commonin patients receiving chemotherapy and radiotherapy than in thosereceiving only chemotherapy (p=0.006).Conclusion: In this study it was found that the pediatric patientswho received cancer treatment before the age of 7 years constituteda high-risk group for DAs. The frequencies of microdontia andhypodontia were increased even more when the patient was treatedfor cancer before 5 years of age.
|
