Akut Lösemi Hastalarının Demografik Özellikleri ve Tedavi Sırasında Görülen Komplikasyonları: Tek Merkez Deneyimi

Yıl 2017, Cilt: 11 Sayı: 1, 19 - 26, 01.04.2017

Adem Karbuz Neşe Yaralı Pamir Işık Ali Bay Abdurrahman Kara Bahattin Tunç

Öz

Amaç: Bu retrospektif çalışmada beş yıllık bir süreçte akut lösemi tanısı ile takip ve tedavi edilen hastaların epidemiyolojik, klinik ve laboratuvar özellikleri ile ortaya çıkan komplikasyonların değerlendirilmesi planlanmış ve bu şeklide hastaların tedavi yaklaşımlarına katkıda bulunulması amaçlanmıştır.Gereç ve Yöntemler: Çalışmamızda, Dr. Sami Ulus Eğitim ve Araştırma Hastanesi, Hematoloji Kliniğinde 01.01.2004- 31.12.2008 tarihleri arasında akut lösemi tanısıyla takip edilen 97 hastanın tanı sırasındaki demografik, klinik, laboratuvar, radyolojik ve ekokardiyografik özellikleri incelendi. Ayrıca 94 hastada, kemoterapi aldıkları süre içerisinde gelişen tüm sistemik komplikasyonlar değerlendirildi.Bulgular: Olguların yaş ortalaması 6.0±4.1 yıl (2 ay-17 yaş)’di (en küçük - en büyük). Olguların %64.9’u erkek, %35.1’i kız; %84.5’i ALL, %15.5’i AML’di. Hastalar en sık ateş (%63.9) ve halsizlik (%57.7) yakınması ile başvurmuşlardı. Fizik muayenede en sık %77.3 ile hepatomegali ve %68 ile solukluk tespit edilmişti. Olgularda kemoterapi süresince görülen başlıca komplikasyonlar incelendiğinde %90 olguda en az bir kez febril nötropenik atak, %82.9 olguda karaciğer enzimlerinde en az beş kat artış, %43.6 olguda mukozit, %28.7 olguda L-asparaginaz alerjisi, %9.5 olguda ise hastalığa uyum sorunu görüldü.Sonuç: Çocukluk çağı lösemileri hem hastalığın doğal seyri, hem de kullanılan kemoterapi ilaçlarına bağlı olarak birçok sistemi ilgilendiren komplikasyonlara yol açabilme potansiyeline sahip olan ve multidisipliner yaklaşımla takip ve tedavi edilmesi gereken bir hastalıktır.

Anahtar Kelimeler

Akut lösemi, Çocuk, Kemoterapi, Komplikasyonlar

The Demographic Features and Treatment Complications of Acute Leukemia Patients: A Single Center Experience

Öz

Objective: Our aim was to retrospectively analyze the epidemiological, clinical and laboratory features of patients who were diagnosed as acute leukemia and received chemotherapy in our hospital in a five-year period. All the systemic complications of these patients were also reviewed in order to contribute to the therapeutic approaches to such patients. Material and Methods: A total of 97 patients who were followed by the pediatric hematology department between January 2004 and December 2008 were included in our study. The patients’ demographic, clinical, laboratory, radiological and echocardiographic characteristics at the time of diagnosis were documented. Finally, 94 of these patients were evaluated in terms of their systemic complications.results: The mean age was 6.0±4.1 (2 months -17 years) (min - max). Males made up 64.9% and females 35.1% of all cases. The diagnoses were acute lymphoblastic leukemia in 84.5% and acute myeloid leukemia in 15.5% of the patients. While the most common complaints were fever (63.9%) and fatigue (57.7%), the most common findings on physical examination were hepatomegaly (77.3%) and pallor (68%) at the time of diagnosis. The complications observed during chemotherapy in the patients were at least one episode of febrile neutropenic attack in 90%, five-fold increase in hepatic enzymes in 82.9%, mucositis in 43.6%, allergy to L-asparaginase in 28.7%, and compliance problems in 9.5%.conclusion: Childhood leukemia has a potential to cause complications in many organ systems due to both the disease itself and the chemotherapeutics used for the treatment. Multidisciplinary management and follow-up are required in the follow-up of children with acute leukemia

Anahtar Kelimeler

Acute leukemia, Children, Chemotherapy, Complications

Kaynakça

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