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    Cross-sectional study: long term follow-up care for pediatric cancer survivors in a developing country, Turkey: current status, challenges, and future perspectives
    (Scientific and Technical Research Council of Turkey, 2020) İncesoy Özdemir, Sonay; Taçyıldız, Nurdan; Varan, Ali; Kebudi, Rejin; Zülfikar, Osman Bülent; Celkan, Tülin Tiraje; Şahin, Gürses; Çorapçıoğlu, Funda Vesile; Keskin Yıldırım, Zuhal; Pınarlı, Faruk Güçlü; Olgun, Hatice Nur; Sarı, Neriman; Dağdemir, Ayhan; Özyörük, Derya; Eren, Tuba; Çakır, Fatma Betül; Adaklı Aksoy, Başak; Bozkurt, Ceyhun; Güler, Elif; Özgüven, Ali Aykan; Erbey, Mehmet Fatih; Berber Hamamcı, Melda; Dinçaslan, Handan; Ünal, Emel; Kantar, Mehmet
    Aim: 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.
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    Frequency of obesity and metabolic syndrome in childhood leukemia and lymphoma survivors
    (2022) Kartal, İbrahim; Alaçam, Abdurrahman; Dağdemir, Ayhan; Dinçer, Oğuz Salih; Albayrak, Canan; Elli, Murat
    Objectives: In this study, it was aimed to determine the prevalence and clinical features of obesity and metabolic syndrome, which are long-term effects of survivors after treatment in children with leukemia and lymphoma. Patients and methods: Patients with leukemia and lymphoma, who were diagnosed between 2000 and 2012 (at least 2 two years after remission) were included. Data obtained through reviewing the family history, demographic characteristics, anthropometric measurements, and laboratory parameters (blood glucose, lipid, and insulin levels) were analyzed and compared at the time of diagnosis, after the treatment and at time of the study. Results: Eighty nine patients (45 boys, 44 girls) were included (mean age: 14.7 ± 4.3 years): 77.5% had acute lymphoblastic leukemia, 11.2% had acute myeloid leukemia, and 11.2% had lymphoma. Overall, 46% patients had received radiotherapy, 7% had undergone surgery, and 2.2% had received stem cell transplantation in addition to chemotherapy. The mean duration of treatment was 2.4 years, and the time elapsed after treatment was 4.9 years. While only one had obesity at the diagnosis, a significant increase in obesity (20%), hypertension (15.7%), hyperglycemia (15%), insulin resistance (35%) were observed at the time of study, and family history of hypertension, dyslipidemia, and cardiovascular diseases were significantly higher in this subgroup. Conclusion: The prevalence of metabolic syndorme is higher in children with leukemia and lymphoma after treatment, and begins to increase with the initiation of treatment and continues to increase over time. These children should be followed-up for late-effects including metabolic syndrome through life-long period.