Deniz OĞUZ, İdil YENİCESU, Türkiz GÜRSEL, Burcu BİRAL, Ülker KOÇAK, Zühre KAYA

Akut Lösemili Çocuklarda Antrasiklin Kullanımına Bağlı Kardiyotoksisitenin Değerlendirilmesi

Giriş: Akut lösemiden kurtulan çocukların uzun dönem izlemlerindeki en büyük sorun, kemoterapilere bağlı gelişen organ toksisitesidir. Antrasiklin kullanımına bağlı gelişen toksisite en önemli morbidite ve mortalite nedenlerinden biridir. Biz de kliniğimizde son 10 yılda tanı ve tedavi almış akut lösemili olguların, akut, erken ve geç dönem antrasiklin toksisitesini değerlendirmek için farklı zamanlarda yapılan ekokardiyografik (eko) verilerini inceledik. Yöntem:Çalışmamızda BFM-95 protokolüne göre tedavi edilen 80 ALL'li, MRC-12 protokolüne göre tedavi edilen 21 AML' li olgunun tedavi öncesi (T0) ve tedavi sonrası 3-6. aylar (T1), 6-12. aylar (T2), 12-24. aylar (T3) arası ile 24. ay (T4) sonrası farklı zamanlarda yapılan eko verileri ve risk faktorleri ile 21 sağlıklı kontrolun eko verileri kaydedildi. Bulgular: Tedavi sonrası hiçbir olguda akut dönemde kardiyak toksisite izlenmedi. Tedavi sonrası erken dönemde mitral E/A-velosite (vel), trikuspid E/Avel değerlerinin kontrol grubu değerlerine göre azalmaya başladığı, tedavinin 1. yılından sonra mitral E/A-vel, trikuspid E/A-vel, ejeksiyon fraksiyonu ve fraksiyonel kısalma parametrelerinde tedavi öncesi ve kontrol grubu değerlerine göre istatistiksel azalma saptanmıştır (p

Evaluation of Anthracycline Related Cardiotoxicity in Pediatric Patients with Acute Leukemia

Objective: The major problem in the long term follow up of children who survive acute leukemia is chemotherapy related organ toxicity. Anthracycline related cardiotoxicity is one of the most important cause of morbidity and mortality for those patients. Therefore, we investigate echocardiographic (echo) data for the detection of acute, early and late anthracycline toxicity in patients with acute leukemia, who were diagnosed and treated in our clinic over the last decade. Method: Echocardiographic data and risk factors of 21 acute myeloid leukemia (AML) patients treated with MRC-12 protocol and 80 acute lymphoid leukemia (ALL) patients treated with BFM-95 protocol were recorded before chemotherapy (T0) and within 3-6 months (T1), 6-12 months (T2), 12-24 months (T3) of treatment and after 24 months (T4) of treatment in our study. Results: We did not observe acute cardiac toxicity in any cases. The values of mitral E/A-velocity (vel) and tricuspid E/A vel were significantly lower in patients with leukemia in T2 than in control (p

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