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Treatment Complication In Pediatric Leukemia

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https://www.readbyqxmd.com/read/30027379/adjunctive-interferon-%C3%AE-immunotherapy-in-a-pediatric-case-of-aspergillus-terreus-infection
#1
Eemke L Assendorp, Mark S Gresnigt, Evelien G G Sprenkeler, Jacques F Meis, Natasja Dors, Jan W M van der Linden, Stefanie S V Henriet
Aspergillus terreus causes invasive aspergillosis (IA) in immunocompromised patients. Treatment is complicated by intrinsic resistance to amphotericin B and thereby contributing to a high mortality. Therefore, we conducted in vitro studies to investigate the effectivity of adjunctive recombinant interferon-γ immunotherapy. We describe a pediatric patient with A. terreus IA who received adjunctive recombinant interferon-γ (rIFNγ) immunotherapy. In vitro studies were conducted to investigate the capacity of rIFNγ to improve antifungal host defense in terms of fungal killing ability and the release of pro-inflammatory cytokines in cells of the patient as well as healthy controls...
July 19, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/30008805/an-uncommon-t-9-11-p24-q22-with-monoallelic-loss-of-atm-and-kmt2a-genes-in-a-child-with-myelodysplastic-syndrome-acute-myeloid-leukemia-who-evolved-from-fanconi-anemia
#2
Viviane Lamim Lovatel, Daiane Corrêa de Souza, Tatiana Fonseca Alvarenga, Roberto R Capela de Matos, Claudia Diniz, Marcia Trindade Schramm, Juan Clinton Llerena Júnior, Maria Luiza Macedo Silva, Eliana Abdelhay, Teresa de Souza Fernandez
Background: Myelodysplastic syndrome (MDS) is rare in the pediatric age group and it may be associated with inheritable bone marrow failure (BMF) such as Fanconi anemia (FA). FA is a rare multi-system genetic disorder, characterized by congenital malformations and progressive BMF. Patients with FA usually present chromosomal aberrations when evolving to MDS or acute myeloid leukemia (AML). Thus, the cytogenetic studies in the bone marrow (BM) of these patients have an important role in the therapeutic decision, mainly in the indication for hematopoietic stem cell transplantation (HSCT)...
2018: Molecular Cytogenetics
https://www.readbyqxmd.com/read/30005182/factors-associated-with-a-prolonged-hospital-stay-during-induction-chemotherapy-in-newly-diagnosed-high-risk-pediatric-acute-lymphoblastic-leukemia
#3
Kasper Warrick, Sandra K Althouse, April Rahrig, Joy Rupenthal, Sandeep Batra
BACKGROUND: High Risk (HR) or Very High Risk (VHR) acute lymphoblastic leukemia (ALL) treated with 4 drug induction chemotherapy is often associated with adverse events. The aim of this study was to identify risk factors associated with a prolonged inpatient length of stay LOS during induction chemotherapy. PROCEDURE: Data from patients (N = 73) (age<21 years) was collected through a retrospective chart review. Univariable and multivariable logistic regression was used to test for statistical significance...
August 2018: Leukemia Research
https://www.readbyqxmd.com/read/29988797/perforated-jejunitis-in-a-child-with-acute-lymphoblastic-leukemia-treated-with-pegaspargase
#4
Elizabeth R Tang, Teresa Chapman, Laura S Finn, Kasey J Leger
Survival rates of children with acute lymphoblastic leukemia have improved since the incorporation of asparaginase in the treatment protocol, but the medication has potential serious complications, including vascular thrombosis. Here, we describe the case of a 13-year-old boy with pre-T-cell acute lymphoblastic leukemia whose treatment course was complicated by perforated jejunitis requiring resection of a portion of his small bowel. Pathologic assessment showed transmural ischemia, mesenteric venous and arterial thrombi, and scattered cytomegalovirus inclusion bodies...
June 2018: Radiology Case Reports
https://www.readbyqxmd.com/read/29925908/front-line-imatinib-treatment-in-children-and-adolescents-with-chronic-myeloid-leukemia-results-from-a-phase-iii-trial
#5
Meinolf Suttorp, Philipp Schulze, Ingmar Glauche, Gudrun Göhring, Nils von Neuhoff, Markus Metzler, Petr Sedlacek, Eveline S J M de Bont, Adriana Balduzzi, Birgitte Lausen, Olga Aleinikova, Sabina Sufliarska, Günter Henze, Gabriele Strauss, Angelika Eggert, Bernhard Kremens, Andreas H Groll, Frank Berthold, Christoph Klein, Ute Groß-Wieltsch, Karl Walter Sykora, Arndt Borkhardt, Andreas E Kulozik, Martin Schrappe, Christina Nowasz, Manuela Krumbholz, Josephine T Tauer, Alexander Claviez, Jochen Harbott, Hans H Kreipe, Brigitte Schlegelberger, Christian Thiede
A total of 156 patients (age range 1.3-18.0 years, median 13.2 years; 91 (58.3%) male) with newly diagnosed CML (N = 146 chronic phase (CML-CP), N = 3 accelerated phase (CML-AP), N = 7 blastic phase (CML-BP)) received imatinib up-front (300, 400, 500 mg/m2 , respectively) within a prospective phase III trial. Therapy response, progression-free survival, causes of treatment failure, and side effects were analyzed in 148 children and adolescents with complete data. Event-free survival rate by 18 months for patients in CML-CP (median follow-up time 25 months, range: 1-120) was 97% (95% CI, 94...
June 20, 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/29877240/-pediatric-acute-lymphoblastic-leukemia-update-on-pathophysiology-and-management
#6
Motohiro Kato
The prognosis of pediatric acute lymphoblastic leukemia (ALL) has dramatically improved, both basic research and clinical studies are continuously conducted in pursuit of further improvement. Recent advances in genomic analysis technology have enabled us to comprehensively identify genomic alterations in leukemic cells and thus have contributed to the better understanding of the molecular pathogenesis underlying ALL development. These genomic alterations can be applied not only as prognostic factors but also as therapeutic targets...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/29864110/hematologic-malignancies-associated-with-mediastinal-germ-cell-tumors-10-years-experience-at-thailand-s-national-pediatric-tertiary-referral-center
#7
Panjarat Sowithayasakul, Phakatip Sinlapamongkolkul, Jitsupa Treetipsatit, Nassawee Vathana, Nattee Narkbunnam, Kleebsabai Sanpakit, Jassada Buaboonnam
Mediastinal germ cell tumor (MGCT), which accounts for 1% to 3% of extragonadal germ cell tumors, has unique manifestations; it is associated with several types of hematologic malignancy, particularly myeloid neoplasm. The aim of this study was to report the 10-year incidence, clinical characteristics, and outcomes of MGCT at Thailand's national pediatric tertiary referral center. This retrospective study included patients diagnosed with MGCT at the Department of Pediatrics, Siriraj Hospital during 2005 to 2014...
August 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29860341/phase-ii-iii-study-in-children-and-adolescents-with-newly-diagnosed-b-cell-precursor-acute-lymphoblastic-leukemia-protocol-for-a-nationwide-multicenter-trial-in-japan
#8
MULTICENTER STUDY
Katsuyoshi Koh, Motohiro Kato, Akiko M Saito, Akiko Kada, Hirohide Kawasaki, Yasuhiro Okamoto, Toshihiko Imamura, Keizo Horibe, Atsushi Manabe
B-cell precursor acute lymphoblastic leukemia is the most common pediatric malignancy, but its treatment needs to be modified to cause low acute toxicity and few late complications with a high cure rate. In this trial, we will stratify patients with B-cell precursor acute lymphoblastic leukemia into standard, intermediate and high risk groups according to prognostic factors. In addition, we will establish an evaluation system for minimal residual disease that will enable us to stratify patients based on minimal residual disease in subsequent clinical trials...
July 1, 2018: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/29773602/clofarabine-high-dose-cytarabine-and-liposomal-daunorubicin-in-pediatric-relapsed-refractory-acute-myeloid-leukemia-a-phase-ib-study
#9
Natasha K A van Eijkelenburg, Mareike Rasche, Essam Ghazaly, Michael N Dworzak, Thomas Klingebiel, Claudia Rossig, Guy Leverger, Jan Stary, Eveline S J M de Bont, Dana A Chitu, Yves Bertrand, Benoit Brethon, Brigitte Strahm, Inge M van der Sluis, Gertjan J L Kaspers, Dirk Reinhardt, C Michel Zwaan
Survival in children with relapsed/refractory acute myeloid leukemia is unsatisfactory. Treatment consists of one course fludarabine, cytarabine and liposomal daunorubicin, followed by fludarabine and cytarabine and stem-cell transplantation. Study ITCC 020/I-BFM 2009-02 aimed to identify the recommended phase 2 dose of clofarabine replacing fludarabine in the abovementioned combination regimen (3+3 design). Escalating dose-levels of clofarabine (20-40mg/m2/day x5days) and liposomal daunorubicin (40-0mg/m2/day) were administered with cytarabine (2g/m2/day x5days)...
May 17, 2018: Haematologica
https://www.readbyqxmd.com/read/29743722/management-of-patients-with-acute-promyelocytic-leukemia
#10
REVIEW
Sabine Kayser, Richard F Schlenk, Uwe Platzbecker
With the introduction of all-trans retinoic acid (ATRA) and arsenic trioxide (ATO) acute promyelocytic leukemia (APL) has become from a detrimental to one of the most curable malignant diseases in humans. In particular, the chemotherapy-free regimen with ATO/ATRA has been proven to be highly effective in de novo APL and has become standard first-line therapy in younger adult, non-high-risk patients. Nevertheless, early death is still a major issue in APL, particularly in older patients, emphasizing the need of rapid diagnostics and supportive care together with immediate access to ATRA-based therapy...
June 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/29577762/-oral-mucositis-as-the-most-common-complication-of-childhood-cancer-therapy-review-of-the-literature
#11
REVIEW
Judit Nemes, Ágnes Jenei, Ildikó Márton
Mucositis is the most common oral complication of cancer therapy. Oral mucositis in childhood is more frequent and severe compared to adults, especially in children with leukemia. Lesions develop as the chemotherapeutic agents attack the rapidly dividing cells of the oral mucous membrane. Patients may experience trouble in eating, drinking, swallowing or even speaking due to the significant pain caused by the ulceration of the oral mucosa. Oral mucositis has a direct impact on the quality of life and may affect survival...
April 2018: Orvosi Hetilap
https://www.readbyqxmd.com/read/29499750/grading-of-cytokine-release-syndrome-associated-with-the-car-t-cell-therapy-tisagenlecleucel
#12
REVIEW
David Porter, Noelle Frey, Patricia A Wood, Yanqiu Weng, Stephan A Grupp
BACKGROUND: Anti-CD19 CAR T cell therapy has demonstrated high response rates in patients with relapsed or refractory (r/r) B cell malignancies but is associated with significant toxicity. Cytokine release syndrome (CRS) is the most significant complication associated with CAR T cell therapy, and it is critical to have a reproducible and easy method to grade CRS after CAR T cell infusions. DISCUSSION: The Common Terminology Criteria for Adverse Events scale is inadequate for grading CRS associated with cellular therapy...
March 2, 2018: Journal of Hematology & Oncology
https://www.readbyqxmd.com/read/29399859/hyperleukocytosis-in-infant-acute-leukemia-a-role-for-manual-exchange-transfusion-for-leukoreduction
#13
Daniel V Runco, Cassandra D Josephson, Sunil S Raikar, Kelly C Goldsmith, Glen Lew, Melinda Pauly, Ross M Fasano
BACKGROUND: Hyperleukocytosis is a serious, life-threatening complication of pediatric acute leukemia that can cause neurologic injury, pulmonary leukostasis, metabolic derangements, and coagulopathy. Acute leukemia has the highest risk of mortality and morbidity at presentation when associated with hyperleukocytosis. Infant leukemia presents unique challenges and treatment considerations due to the disease itself and size and overall health of the patient. While medical management of hyperleukocytosis in older patients with acute leukemia has been described, including cytoreductive procedures with automated leukapheresis (AL) or manual whole blood (WB) exchange transfusion, very little data exist for standardized management of hyperleukocytosis in infant leukemia patients...
May 2018: Transfusion
https://www.readbyqxmd.com/read/29360413/low-incidence-of-osteonecrosis-in-childhood-acute-lymphoblastic-leukemia-treated-with-all-97-and-all-02-study-of-japan-association-of-childhood-leukemia-study-group
#14
Kenichi Sakamoto, Toshihiko Imamura, Kentaro Kihira, Koji Suzuki, Hisashi Ishida, Hiromi Morita, Miyako Kanno, Takeshi Mori, Hidefumi Hiramatsu, Kousaku Matsubara, Kiminori Terui, Yoshihiro Takahashi, So-Ichi Suenobu, Daiichiro Hasegawa, Yoshiyuki Kosaka, Koji Kato, Akiko Moriya-Saito, Atsushi Sato, Hirohide Kawasaki, Keiko Yumura-Yagi, Junichi Hara, Hiroki Hori, Keizo Horibe
Purpose Osteonecrosis (ON) is a serious complication of the treatment of childhood acute lymphoblastic leukemia (ALL); however, data relating to ON in Asian pediatric patients with ALL are scarce. Therefore, we performed a retrospective analysis of cohorts of Japanese patients with ALL to clarify the incidence, clinical characteristics, and risk factors of ON. Patients and Methods The incidence and characteristics of ON were determined in patients with ALL (n = 1,662) enrolled in two studies from the Japan Association of Childhood Leukemia Study (JACLS) group (n = 635 and n = 1,027 patients treated with the ALL-97 and ALL-02 protocols, respectively)...
March 20, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29325825/-thromboembolic-disease-in-pediatric-oncology
#15
A Theron, C Biron-Andreani, S Haouy, L Saumet, M Saguintah, E Jeziorski, N Sirvent
The survival rate of children with cancer is now close to 80 %, as a result of continuous improvement in diagnostic and treatment procedures. Prevention and treatment of treatment-associated complications is now a major challenge. Thromboembolic venous disease, due to multifactorial pathogenesis, is a frequent complication (up to 40 % asymptomatic thrombosis in children with cancer), responsible for significant morbidity. Predominantly in children with acute lymphoblastic leukemia, lymphoma, or sarcoma, thromboembolic disease justifies primary prophylaxis in certain populations at risk, whether genetic or environmental...
February 2018: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/29285951/seifem-2017-from-real-life-to-an-agreement-on-the-use-of-granulocyte-transfusions-and-colony-stimulating-factors-for-prophylaxis-and-treatment-of-infectious-complications-in-patients-with-hematologic-malignant-disorders
#16
Alessandro Busca, Simone Cesaro, Luciana Teofili, Mario Delia, Chiara Cattaneo, Marianna Criscuolo, Francesco Marchesi, Nicola Stefano Fracchiolla, Caterina Giovanna Valentini, Francesca Farina, Roberta Di Blasi, Lucia Prezioso, Angelica Spolzino, Anna Candoni, Maria Ilaria Del Principe, Luisa Verga, Annamaria Nosari, Franco Aversa, Livio Pagano
The rapid spread of severe infections mainly due to resistant pathogens, justifies the search for therapies aiming to restore immune functions severely compromised in patients with hematologic malignancies. Areas covered: The present review summarizes the current knowledge on the role of granulocyte transfusions and colony-stimulating factors as treatment strategy for hematologic patients with serious infectious complications. In addition, a survey among 21 hematologic centers, to evaluate the clinical practice for the use of G-CSF originator and biosimilars was performed...
February 2018: Expert Review of Hematology
https://www.readbyqxmd.com/read/29273940/investigation-of-clostridium-difficile-ribotypes-in-symptomatic-patients-of-a-german-pediatric-oncology-center
#17
Arne Simon, Markus Mock, Norbert Graf, Lutz von Müller
In a German pediatric oncology unit, the attending physicians diagnosed 27 cases of Clostridium difficile-associated disease (CDI) from January 01, 2010 to October 31, 2013. This refers to a CDI incidence density of 2.0/1000 inpatient days. According to the hospital hygiene standard, symptomatic patients with CDI were kept in contact isolation. Most patients (median age 8.2 years) suffered from acute lymphoblastic leukemia; 88.9% were treated with broad-spectrum antibiotics during the preceding 4 weeks. 29...
March 2018: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29260426/the-use-of-prophylactic-anticoagulation-during-induction-and-consolidation-chemotherapy-in-adults-with-acute-lymphoblastic-leukemia
#18
Rachael F Grace, Daniel J DeAngelo, Kristen E Stevenson, Donna Neuberg, Stephen E Sallan, Yasser R Abou Mourad, Julie Bergeron, Matthew D Seftel, Caroline Kokulis, Jean M Connors
Treatment for acute lymphoblastic leukemia (ALL) in adults confers a high risk of venous thromboembolic (VTE) complications. We describe the implementation and results of prophylactic anticoagulation guidelines in adults (18-50 years) treated on a Dana-Farber Cancer Institute ALL pediatric inspired consortium protocol from 2007 to 2013. A high rate of asparaginase related toxicity events, including thrombosis, resulted in a protocol amendment adding guidelines for prophylactic anticoagulation and a modified asparaginase dose and schedule...
February 2018: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29222264/incorporation-of-nonchemotherapeutic-agents-in-pediatric-acute-lymphoblastic-leukemia
#19
REVIEW
Lewis B Silverman
With current available therapies, the prognosis for most children and adolescents with acute lymphoblastic leukemia (ALL) is favorable. However, the multiagent chemotherapy regimens used to treat newly diagnosed patients are associated with many acute and long-term complications, and therapy for relapsed disease is intensive and suboptimally effective. Over the last decade, several nonchemotherapeutic approaches have been evaluated, with the goal of identifying more effective, less toxic therapies that can be used in conjunction with, or even replace, current regimens...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29222263/crisis-management-in-the-treatment-of-childhood-acute-lymphoblastic-leukemia-putting-right-what-can-go-wrong-emergency-complications-of-disease-and-treatment
#20
REVIEW
Rachael Hough, Ajay Vora
The improvement in overall survival in children with acute lymphoblastic leukemia (ALL) over the last 5 decades has been considerable, with around 90% now surviving long term. The risk of relapse has been reduced to such an extent that the risk of treatment-related mortality is now approaching that of mortality caused by relapse. Toxicities may also lead to the suboptimal delivery of chemotherapy (treatment delays, dose reductions, dose omissions), potentially increasing relapse risk, and short- and long-term morbidity, adding to the "burden of therapy" in an increasing number of survivors...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
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