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From 1972 through 1991, 404 patients with renal tumor (Wilms' tumor and clear cell sarcoma) were seen at the Pediatric Oncology Unit of Hacettepe Children's Hospital. The genital abnormalities and renal diseases in these patients were evaluated retrospectively. Eight patients with renal tumor had genital abnormality and/or renal disease of various types and degrees. One of these patients had a clear cell sarcoma while all the others had Wilms' tumor. Two patients had all components of the Drash syndrome. Two patients with Wilms' tumor had genital abnormality and mild proteinuria. Another two patients had only Wilms' tumor and renal disease. Two patients had only renal tumor and genital abnormality of whom one was the patient with clear cell sarcoma.

We studied the long-term pulmonary function of 25 patients who were at least 5 years post-treatment for Hodgkin's disease. The mean age of the patients was 17 years (range 9.5-25 years) at the time of study. Twenty-one of the patients were male. All patients received six courses of COPP chemotherapy and, in addition, 8 of the 25 patients received radiotherapy to the mediastinum in low or moderate doses (20-30 Gy). One patient had symptoms of bronchiectasia. The chest radiographs of nine patients (36%) showed minimal abnormalities. We divided patients into two groups while evaluating their pulmonary function tests according to whether they received mantle irradiation or not. In patients who received mantle irradiation, pulmonary function tests showed a minimal decrease in FEV 1 . The decrease in FEV 1 indicated an obstructive ventilatory defect. We concluded that our treatment protocols for paediatric Hodgkin's disease were curative, well tolerable and might minimize pulmonary functional changes.

We evaluated the antiemetic efficacy of tropisetron for control of acute emesis during grade 3 or 4 emetogenic chemotherapy in children. Tropisetron was administered as a single intravenous dose of 0.2 mg/kg on the first day and intravenously or orally with the same dose on subsequent days. A total of 125 courses of highly emetogenic chemotherapy was administered to 22 children with a median age of 14 years (range: 3-18 years). All 22 patients received tropisetron for at least two courses. Overall complete response on day 1 was observed in 80 out of 125 courses (64%). The response rates were consistent over multiple courses; a complete and major response rate on the first day of Course I (n: 22 courses) and Course II (n: 22 courses) was observed in 73 and 77 percent of cases, respectively. When the results were analyzed according to the daily schedules, overall complete response for grade 4, grade 3 and grade 1-2 emetogenic treatment days was 59, 85 and 75 percent, respectively. In this study, cost effectiveness for tropisetron was also determined; the cost per successfully controlled course was 162 USD. No side effects of tropisetron other than mild diarrhea and dry-mouth were documented in this study. In conclusion, the results of this study confirmed that tropisetron is a safe, well tolerated and effective antiemetic drug for the prevention of acute emesis in children and adolescents during highly emetogenic chemotherapy.

Of 806 non-Hodgkin's lymphoma cases, only one primary subconjunctival lymphoma case was observed in Hacettepe Children's Hospital over a period of 16 years. The patient was a 12 year-old-boy with a subconjunctival mass on the upper part of his right eye. Biopsy revealed malignant lymphoma. Extensive investigations disclosed no other site of tumor. He was given the modified LSA2-L2 protocol. He has been in remission for 22 months. This may be the first report of a primary subconjunctival lymphoma in the childhood period.

A case of hyperpyrexia induced by procarbazine in a child with Hodgkin's disease, neurofibromatosis, and pectus excavatum deformity is presented. After the diagnosis of stage IIIS Hodgkin's disease, combined COPP chemotherapy was initiated. One week later she presented with high fever. After a diagnosis of infection was made, chemotherapy was stopped and antibiotics were given. Nearly the same picture recurred three times after reinstituting chemotherapy. On the fourth occasion, the patient had to be hospitalized because of hyperpyrexia and arrhythmia. There was no obvious reason for fever, and cytotoxic-induced fever was considered. The drugs were given one at a time. When a test dose (10 mg) of procarbazine was given, she developed a high fever with severe nausea and vomiting. The reaction was controlled by antihistaminics and steroids. To our knowledge this is the second report on hyperpyrexia due to procarbazine administration.