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Treatment Complication In Pediatric Leukemia

L Pécheux, P Forget, C Geurten, L Rausin, R Nicolescu, C Hoyoux
Bone pain associated with bone marrow infiltration is often present at diagnosis of pediatric acute lymphoblastic leukemia (ALL). It sometimes signs the presence of pathological fracture, lytic lesions, arthritis, or osteitis associated to ALL that can delay the diagnosis. During treatment, bone complications (pain, osteopenia, fracture, avascular necrosis, ...) are also reported. In order to describe bone involvement (BI) of pediatric LLA, we reviewed the records of 104 patients followed in our unit. The overall incidence of BI was 67 %...
November 2018: Revue Médicale de Liège
Miriam Hinaa Ahmad, Ismat Shafiq
We report a case of a 21-year-old African American female with history of pre-diabetes, and a diagnosis of a rare leukemia, blastic-plasmacytoid dendritic neoplasm (BPDCN), who developed diabetic ketoacidosis (DKA) after the third dose of PEG-asparaginase infusion. She was successfully treated with insulin. Asparaginase is a vital part of treatment protocols for acute lymphoblastic leukemia (ALL) in combination with other chemotherapeutic drugs. Asparaginase therapy has been reported to cause hyperglycemia especially when used in conjunction with glucocorticoids for the treatment of ALL in the pediatric population...
October 31, 2018: Endocrinology, Diabetes & Metabolism Case Reports
Ryoji Kobayashi, Daiki Hori, Hirozumi Sano, Daisuke Suzuki, Kenji Kishimoto, Kunihiko Kobayashi
Infection, especially invasive fungal infection (IFI), is an important complication of chemotherapy and stem cell transplantation. It is also a well-known risk factor in pediatric hematologic malignancy, acute myelogenous leukemia, recurrent disease and allogeneic stem cell transplantation. We previously revealed that a diagnosis of acute myelogenous leukemia, recurrent disease and >10 years of age were risk factors for IFI in patients with pediatric hematologic malignancies. We examined and compared the incidence, risk factors and mortality rate from IFI between 276 patients from 2007 to 2016 and patients in our past report...
December 2018: Pediatric Infectious Disease Journal
Ö E Özmen, N Alici, B Topuz, M Akgül, E Akkuzu, Ö Akdemir, N Buyan, S Göral, Z Kaya
Renal infiltration in children with acute leukemia has been reported previously; however, it has rarely been described in association with atypical hemolytic uremic syndrome (aHUS). We present a case of 9-year-old boy who developed life-threatening aHUS in the 1st week of Burkitt leukemia/lymphoma diagnosis with renal infiltration. Complete resolution of aHUS was achieved after therapeutic plasma exchange. This is an uncommon complication of Burkitt leukemia/lymphoma in a pediatric case.
September 2018: Indian Journal of Nephrology
Darlen Cardoso de Carvalho, Alayde Vieira Wanderley, André Mauricio Ribeiro Dos Santos, Marianne Rodrigues Fernandes, Amanda de Nazaré Cohen Lima de Castro, Luciana Pereira Colares Leitão, João Augusto Nunes de Carvalho, Tatiane Piedade de Souza, André Salim Khayat, Sidney Emanuel Batista Dos Santos, Paulo Pimentel de Assumpção, Ney Pereira Carneiro Dos Santos
The treatment of Acute Lymphoblastic Leukemia (ALL) in children has a high clinical success rate, although toxicological complications are frequent, and often result in the interruption of the treatment. Various studies have shown that toxicities resulting from the treatment are influenced by pharmacogenetic variants. Most of this research has focused on relatively homogeneous populations, and the influence of these variants in highly admixed populations, such as that of Brazil, is still poorly understood. The present study investigated the association between pharmacogenetic variants and severe toxicities in pediatric B-cell ALL patients from an admixed population of the Brazilian Amazon...
September 15, 2018: Leukemia Research
Christopher DeRenzo, Giedre Krenciute, Stephen Gottschalk
Adoptive cell therapy with genetically modified T cells holds the promise to improve outcomes for children with recurrent/refractory solid tumors and has the potential to reduce treatment complications for all patients. Although T cells that express chimeric antigen receptors (CARs) specific for CD19 have had remarkable success for B-cell-derived malignancies, which has led to their approval by the U.S. Food and Drug Administration, CAR T cells have been less effective for solid tumors and brain tumors. Lack of efficacy is most likely multifactorial, but heterogeneous antigen expression; limited migration of T cells to tumor sites; and the immunosuppressive, hostile tumor microenvironment have emerged as major roadblocks that must be addressed...
May 23, 2018: American Society of Clinical Oncology Educational Book
Irappa Madabhavi, Apurva Patel, Malay Sarkar, Pritam Kataria, Nagaveni Kadakol, Asha Anand
Effective and reliable venous access is one of the cornerstones of modern medical therapy in oncology. The focus of this prospective observational research is to study the various indications of a peripherally inserted central catheter (PICC) in different solid and hematological malignancies and the various complications and outcomes in the pediatric and adult cancer patients. This study was conducted in a prospective observational study design and collected data of patients with a diagnosis of any cancer, at a tertiary care oncology hospital in Ahmadabad, Gujarat, India, during a 2-year period...
September 2018: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
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...
October 2018: European Journal of Clinical Microbiology & Infectious Diseases
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
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
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
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...
July 2018: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
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
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
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
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 of 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 II dose of clofarabine replacing fludarabine in the abovementioned combination regimen (3+3 design). Escalating dose levels of clofarabine (20-40 mg/m2 /day × 5 days) and liposomal daunorubicin (40-80 mg/m2 /day) were administered with cytarabine (2 g/m2 /day × 5 days)...
September 2018: Haematologica
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
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
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
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
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