Comparison of outcomes of children with acute lymphoblastic leukemia treated with BMF protocol across 2 decades.

Acute lymphoblastic leukemia is the most common malignancy of childhood. The aim of this study is to compare the outcome of children with acute lymphoblastic leukemia treated with BFM protocol over two decades at our center. We retrospectively examined the files of 421 patients by dividing them into two groups by decade of treatment, 1995-2005 and 2006-2015. After excluding 117 patients, overall, 304 patients were included in the analysis. From the first to the second decade, the proportion of patients over 12 years of age increased from 7.1% to 16.8% (p < 0.04), the high-risk group increased from 15.5% to 19.5% and patients with central nervous system leukemia increased from 5.2% to 11.4%. The relapse rate remained relatively unchanged during this period (from 12.9% to 12.7%), while the mortality rate decreased from 18.7% to 15.4% (p > 0.05) and the death rate during remission induction treatment decreased from 3.9% to 0.7%. The mortality rate of high-risk and standard-risk patients decreased from 62.5% to 34.5% (p < 0.05) and 11.1% to 3.0% (p > 0.05), respectively. The 5-year overall survival and event-free survival rates for standard-, medium- and high-risk patients were 92.7% ± 6.0%, 87.9% ± 4.7%, and 54.7% ± 13.3% and 92.5% ± 6.3%, 83.2% ± 5.5%, and 48.7% ± 14.7%, respectively. For the cohort, the 5-year overall survival rate was 83.2% ± 4.1% and the event-free survival rate was 79.9% ± 4.7%. These results demonstrate the impact of a standard protocol, experience of staff, achieving better risk stratification on treatment success.

Meanings of the Feelings and Thoughts on Children's Hematology and Oncology Service Nurses' Experience: A Qualitative Study.

AIM: This study aimed to analyze the feelings and thoughts related to working in the pediatric hematology-oncology unit of the nurses who have worked in this unit in the past, related and the meanings they attribute to it. METHOD: In this qualitative study, 15 nurses between the age of 29 and 53 years, who had previously worked in the pediatric hematology-oncology unit and left the unit, were interviewed in depth. The interviews were held using a semi-structured interview form. Each interview lasted for 35 to 45 minutes. RESULTS: In the study, 5 main themes and sub-themes related to these were identified from the perspective of the nurses with working experience in the pediatric hematology-oncology unit in the past with regard to their feelings and thoughts about this experience. These included 1) feelings: (a) fear and anxiety, (b) desperation, mercy, and guilt, (c) exhaustion, and (d) longing; 2) coping; 3) professional attributions; 4) meanings related to life; and 5) unmet requirements and suggestions. CONCLUSION: Working in the pediatric hematology-oncology unit should be considered as a multi-dimensional condition that causes nurses to experience a wide variety of feelings and affects their perspectives on the profession and life. These findings can be used to strengthen the nurses working in hematology-oncology unit.

Relationship Between Coping Strategies, Religious Attitude, and Optimism of Mothers of Children With Cancer.

INTRODUCTION: The purpose of this study was to examine the relationship between coping strategies, religious attitude, and optimism of mothers of children with cancer. METHOD: The sample was 97 mothers of children with cancer. To collect data, the Coping Strategy Questionnaire, Religious Attitude Scale, and Life Orientation were used. RESULTS: There were positive correlations between the total score of Coping Strategy Questionnaire and emotional scores of Religious Attitude Scale ( r = 0.170, p = .04). The correlation relationship between mothers' coping, religious tendencies, and optimism tendencies was not significant ( p > .05). There were also positive correlations between Coping Strategy Questionnaire Social Support Seeking subscale and the total scores of Religious Attitude Scale ( r = 0.189, p = .03) and Life Orientation Test ( r = 0.183, p = .03). DISCUSSION: Mothers with a higher religious attitude had bettter social support and were more optimistic. These results will contribute to understanding the influence of religion in different cultures.