Papers by Handan Dinçaslan
Journal of Clinical Research in Pediatric Endocrinology
What is already known about this topic? • Different mutations in the RET are associated with vary... more What is already known about this topic? • Different mutations in the RET are associated with varying age-dependent penetrance and disease manifestations. The American Thyroid Association (ATA) has classified hereditary MTC into three risk categories ("moderate", "high", and "highest") based on the type of RET mutation. • The S891A mutation in the RET is a rare germline mutation associated with a moderate risk of medullary thyroid carcinoma (MTC). • The use of sorafenib and other RET-targeting tyrosine kinase inhibitors (TKIs) in childhood thyroid cancers (DTC and MTC) are quiet rare. What this study adds to the literature? • Despite the well-defined genotype-phenotype correlation of moderate risk RET p.S891A germline mutation, we report an earlyonset, inoperable MTC case. • We also found an additional SDHA somatic mutation, p.S408L, in the same patient, which may have triggered the severity of the presentation. This co-occurrence has not been reported before. • RET p.S891A may cause mixed MTC and papillary thyroid carcinoma. • The patient experienced growth retardation related to the potential side effects of sorafenib.
OBJECTIVES In the etiology of childhood cancers, many genetic and environmental factors play a ro... more OBJECTIVES In the etiology of childhood cancers, many genetic and environmental factors play a role. One of these factors is cigarette smoking and the main source of tobacco smoke exposure of children is parental smoking. However, establishing a causal relationship between parental smoking and childhood cancers has proven challenging due to difficulties in accurately detecting tobacco smoke exposure METHODS To address this issue, we used hair cotinine analysis and a questionnaire to get information about tobacco smoke exposures of pediatric cancer patients and healthy children. 104 pediatric cancer patients and 99 healthy children participated in our study. Parental smoking behaviours (pre-conceptional, during pregnancy and current smoking) and environmental tobacco smoke (ETS) exposures of children are compared. RESULTS We have found no differences between two groups by means of maternal smoking behaviours. However, the rates of paternal pre-conceptional smoking and smoking during ...
Japanese Journal of Infectious Diseases
Invasive aspergillosis (IA) is a major cause of morbidity and mortality. This study aimed to pres... more Invasive aspergillosis (IA) is a major cause of morbidity and mortality. This study aimed to present our 10-year IA experience at a single center. Fifty-nine pediatric patients with IA were included in this study. The male-to-female ratio was 42/17. The median age was 8.75 years. Hematologic malignancy was present in the majority of the patients (40/59, 68%). The mean neutropenia duration was 18.5 days. Cytosine arabinoside was the most common immunosuppressive therapy directed at T cells during IA diagnosis. IA cases were categorized as proven (27%), probable (51%), or possible (22%) according to the 2008 European Organization for Research and Treatment of Cancer/Invasive Fungal Infections Cooperative Group and the National Institute of Allergy and Infectious Diseases Mycoses Study Group (EORTC/MSG) criteria. The lungs (78%) were the most common site of IA, and nodules were the most frequent radiological findings (75.5%). In 38 patients (64.4%) receiving antifungal prophylaxis, prophylactic agents included fluconazole (30.5%), liposomal amphotericin B (23.7%), posaconazole (8.5%), and voriconazole (1.7%). Initial treatment was most commonly administered as monotherapy (69.5%). The median antifungal treatment duration was 67 days. Eleven deaths (18.6%) were due to aspergillosis. With the increased use of corticosteroids, biological agents, and intensive immunosuppressive chemotherapy, IA will most likely continue to occur frequently in pediatric patients.
European Journal of Ophthalmology
Purpose: To evaluate the risk factors leading to recurrence and new tumor (NT) development in pat... more Purpose: To evaluate the risk factors leading to recurrence and new tumor (NT) development in patients with retinoblastoma after intravenous chemotherapy (IVC) and to review the treatment outcomes. Materials and methods: The records of 166 retinoblastoma cases (having 246 affected eyes) who underwent six-cycle IVC (vincristine, etoposide, and carboplatin) as primary treatment between October 1999 and August 2020 were reviewed retrospectively. Results: The mean ages at presentation were 9.0 (median: 8.0) and 9.2 (median: 8.5) months in cases with recurrence and NTs respectively. Recurrence was detected in 40 (16.3%) eyes, NTs in 29 (11.8%), and both recurrence/NTs in 24 (9.8%). The mean time elapsed till recurrence and NT was 10.7 months. Multivariable analysis showed that the factors predictive of recurrence were largest tumor base diameter (LTBD) >12 mm ( p = 0.039) and presence of subretinal seeds at diagnosis ( p = 0.043). Multivariable risk factors for the development of NTs ...
Mesothelioma is a rare and aggressive tumor originating from the serosal lining of the pleural, p... more Mesothelioma is a rare and aggressive tumor originating from the serosal lining of the pleural, peritoneal and pericardial cavities. There are very few cases diagnosed with malignant peritoneal mesothelioma reported in childhood. Thanks to the developments in the field of immunotherapy, the prognosis of the disease has improved with the addition of the immune check point inhibitor, an anti-programmed death-1 monoclonal antibody, nivolumab to the treatment of MPM. In the treatment of our case who was diagnosed with diffuse malignant peritoneal mesothelioma at a very early age; cytoreductive surgery, hyperthermic intraperitoneal chemotherapy, platinum and pemetrexed combination chemotherapy and nivolumab were used. Our patient, who has been on nivolumab therapy for 14 months and has been followed up for 20 months since her diagnosis, is still in remission. This case supports the utility of nivolumab in pediatric MPM.
Turkish Archives of Pediatrics
Journal of Clinical Oncology, 2021
e22011 Background: The incidence of childhood cancers increased by 1 % per year over the last thr... more e22011 Background: The incidence of childhood cancers increased by 1 % per year over the last three decades. Life style changes and increased variety of environmental exposures are accused of this trend. One of these environmental factors is cigarette smoking and parental smoking is the main source of tobacco smoke exposure of children. There are strong reasons for considering parental smoking behaviour as a risk factor for childhood cancers. Many tobacco related compounds are detected in fetal tissues, breast milk and tissues of children of smoking parents. However, it is hard to make causal relationship between parental smoking and childhood cancers. One of the reasons is the difficulty to detect tobacco smoke exposure. Questionnaires, commonly used method to detect tobacco smoke exposure, are prone to biases. Cotinine is the main metabolite of nicotine which is the abundant organic compound in tobacco and a good biomarker to detect tobacco smoke exposure. Methods: 104 newly diagn...
TURKISH JOURNAL OF MEDICAL SCIENCES, 2020
The main purpose of this study is to determine the current status of long-term follow-up (LTFU) f... more The main purpose of this study is to determine the current status of long-term follow-up (LTFU) for childhood cancer survivors and the challenges of LTFU for pediatric cancer survivors at pediatric oncology institutions in Turkey. Material and methods: A questionnaire was e-mailed to the directors of 33 pediatric oncology centers (POCs) registered in the Turkish Pediatric Oncology Group (TPOG). Of these 33 active TPOG institutions, 21 participated in the study and returned their completed questionnaires. Results: Only 1 of the 21 participating centers had a separate LTFU clinic. The remaining centers provided LTFU care for childhood cancer survivors at the pediatric oncology outpatient clinic. Of these centers, 17 (80.9%) reported difficulty in transition from the pediatric clinic to the adult clinic, 14 (66.6%) reported insufficient care providers, and 12 (57.1%) reported insufficient time and transportation problems. As neglected late effects, 16 (76.1%) centers reported psychosocial and getty job problems and 11 (52.3%) reported sexual and cognitive problems. None of the centers had their own LTFU guidelines for their daily LTFU practice. Conclusion: This study was the first to gain an overview of the needs of POCs and the gaps in survivorship services in Turkey. The results from this study will help to develop a national health care system and national guidelines for pediatric cancer survivors.
Supplemental material, sj-pdf-1-ejo-10.1177_11206721211023311 for Recurrence and new tumor develo... more Supplemental material, sj-pdf-1-ejo-10.1177_11206721211023311 for Recurrence and new tumor development after frontline intravenous chemotherapy for retinoblastoma: Risk factors and treatment results by Ahmet Kaan Gündüz, Ibadulla Mirzayev, Handan Dinçaslan and Funda Seher Özalp Ateş in European Journal of Ophthalmology
Asian Pacific Journal of Cancer Prevention, 2020
Background: The immunomodulator mifamurtide plus a chemotherapy regimen has been shown to signifi... more Background: The immunomodulator mifamurtide plus a chemotherapy regimen has been shown to significantly improve the outcome in non-metastatic osteosarcoma patients. We report the results of the addition of mifamurtide to chemotherapy in newly diagnosed patients with osteosarcoma. Methods: A total of 36 children with osteosarcoma without detectable metastasis were treated between November 2010 and April 2018 at the Ankara University Department of Pediatric Oncology. Mifamurtide was added to the chemotherapy regimen in 17 patients while the remaining 19 did not receive mifamurtide. The probabilities of metastasis and overall survival were compared between the groups. Results: The 43-month survival rate was 87.5% and 89.9% in the patients who received and did not receive mifamurtide, respectively (p=0.65). Common side effects of mifamurtide were chills and fever. The addition of mifamurtide in the high-risk group with ≤95% necrosis tended to decrease the probability of distant metastasis (36.4% vs. 58.3%) (p=0.39). The time to metastasis in the group with positive surgical margins (4 months in one patient in the non-mifamurtide group, 7 and 20 months in the mifamurtide group) was also longer in the mifamurtide group. During the 43-month follow up period, median time to metastasis was longer in the mifamurtide group (20 vs. 5 months). In addition, mifamurtide plus chemotherapy decreased the risk of metastasis in the cases with primary site relapse. Conclusions: The addition of mifamurtide to chemotherapy might improve event-free survival by decreasing the probability of distant metastasis in bad histologic responders, and also by increasing the time to distant metastasis in the surgical margin positive group. Additional clinical studies are necessary to determine the long-term effects of mifamurtide on metastatic disease.
Iranian Journal of Pediatrics, 2017
Background: Studies on various adult cancer types showed that there are changes in levels of prot... more Background: Studies on various adult cancer types showed that there are changes in levels of protein types that are related to iron metabolism. In our study, proteins related to iron metabolism are examined for the first time in childhood malignancies and results are presented. Methods: Between January 2013 and December 2014, 58 patients 17 healthy children were included in the study. Blood samples were taken from patients at diagnosis and in remission and serum ferritin heavy chain (FTH-1), ferritin light chain (FTL), LCN-2, soluble transferrin receptor (sTFR), transferrin receptor-2 (TFR-2), hepcidin and ferroportin levels were examined using ELISA method. Results: Levels of FTH-1 were found higher in all patient groups than in control group (P < 0.05). Levels of FTL were found higher in all patient groups than in control group, although this was not statistically significant. It was observed that these levels decreased in remission. Levels of LCN-2 were found significantly high (P = 0.001) in all patient groups. sTfR levels were found lower in acute leukemia patients (P = 0.001). Level of TFR-2 was found to be higher in all patient groups in comparison with the control group and this was statistically significant in lymphoma group (P = 0.05). In remission, levels of TFR-2 decreased. Levels of serum hepcidin were found to be higher in all patient groups in comparison with the control group and this was statistically significant (P = 0.001). Hepcidin levels decreased in remission. Although it was not statistically significant, it was observed that levels of serum ferroportin were low in sarcoma and leukemia groups at diagnosis and increased in remission. As a result, despite the fact that our patients' number was limited, we thought that investigation of the iron metabolism of tumor cells is important and additional studies will be necessary with increasing patients' number.
Introduction: Palpable lymph nodes are very common physical examination findings in childhood, an... more Introduction: Palpable lymph nodes are very common physical examination findings in childhood, and sometimes it can be challenging to say if it is benign or malignant. Objectives: This retrospective study evaluated 157 children admitted to an oncology department because of lymphadenopathy and aimed to determine the clinical, laboratory, and epidemiologic data valuable for differential diagnosis. Materials and Methods: One hundred fifty-two cases were analyzed, which were defined as either malignant or benign by the etiology. The benign cases were also defined to three groups as ‘viral lymphadenopathy’, ‘bacterial lymphadenopathy’, and ‘other reactive lymphadenopathy’. Results: A specific cause for lymphadenopathy was documented in 61 (40,1%) cases. Of 152 cases, benign causes were detected in 133 (87,5%), and malignant causes were detected in 19 (12,5%) cases. The most frequent cause in the benign group was reactive hyperplasia (59,8%) and in the malignant group was lymphoma (7,3%)....
Journal of Clinical Oncology, 2018
e22500Background: Osteosarcoma (OS) is the most common primary malignant bone tumor.Almost 90% of... more e22500Background: Osteosarcoma (OS) is the most common primary malignant bone tumor.Almost 90% of the patients have micrometastasis during diagnosis. Doxorubicin, cisplatin, high-dose methotrexate ...
Blood, 2014
High-dose chemotherapy (HDC) represents the standard of treatment for high-risk neuroblastoma(NBL... more High-dose chemotherapy (HDC) represents the standard of treatment for high-risk neuroblastoma(NBL), hepatic veno-occlusive disease (VOD) is a common, 10-50% and serious complication of haematological stem cell transplantation (HSCT), with up to 90% mortality rates. We planned study to assess whether the use of prophylactic defibrotide in paediatric patients who were heavily treated with chemo-radiotherapy before transplant, and then underwent autologous HSCT. Seventeen patients who underwent autologous, unpurged peripheral stem cell transplantation PBSC with a high risk of developing VOD, between January 2003-July 2014, were given Defibrotide prophylaxis 25mg/kg/day for 30 days, commencing on -1 of conditioning regimen. All patients were stratified by INSS stage, age, N-MYC status. All were treated with six cycles of induction chemotherapy, myeloablative intensification, surgery for primary site, radiation therapy to the primary tumour site plus metastatic sites i.e bone metastases ...
Journal of Clinical Oncology, 2014
e21028 Background: Cysplatin (CsP) and carboplatin (CP) are chemotherapeutic agents used in the t... more e21028 Background: Cysplatin (CsP) and carboplatin (CP) are chemotherapeutic agents used in the treatment of many childhood cancers but hearing loss (HL) may be limiting side effect. We aimed to as...
Pediatric hematology and oncology, 2017
Fascin plays a role in tumor metastasis under the influence of TGF-β, each potentiating the effec... more Fascin plays a role in tumor metastasis under the influence of TGF-β, each potentiating the effect of the other. We retrospectively investigated whether there was a prognostic relationship between TGF-β and fascin, and disease stage, local recurrence, metastasis tendency, and response to treatment. Twelve neuroblastomas, 17 osteosarcomas, 14 Ewing's sarcomas, 15 rhabdomyosarcoma cases, and 8 rare solid tumors were included. Serum TGF-β levels were high at the time of diagnosis in all groups (p = .015) and decreased significantly during remission (p = .008). Serum TGF-β values in the relapse period rarely reached high levels at the time of diagnosis and even stayed under the control group values (p = .017). When TGF-β receptor expression in tumor tissues was evaluated, the association of TGF-β receptor positivity with metastatic disease and advanced stage was striking. We found that 88% of rhabdomyosarcoma cases with alveolar histopathology expressed the TGF-β receptor, and the a...
Journal of Clinical Oncology, 2008
10039 Background: There is limited information about the histopathologic findings in the enucleat... more 10039 Background: There is limited information about the histopathologic findings in the enucleated eyes with retinoblastoma (Rb) following chemoreduction(ChR) therapy to find out risk factors for ...
Journal of Clinical Oncology, 2010
e20004 Background: Carotenoids and vitamin E are potent antioxidants and potential cancer prevent... more e20004 Background: Carotenoids and vitamin E are potent antioxidants and potential cancer preventive compounds. There are no reports of beta-carotene, vitamin A, lycopene, lutein and vitamin E toge...
Journal of Clinical Oncology, 2010
e20008 Background: Genistein, a soy isoflavone, has been shown to induce apoptosis and sensitize ... more e20008 Background: Genistein, a soy isoflavone, has been shown to induce apoptosis and sensitize cancer cells to chemotherapy and radiotherapy in a variety of cancer cell types. However, there is n...
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Papers by Handan Dinçaslan