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Pediatric Acute Lymphoblastic Leukemia

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https://www.readbyqxmd.com/read/29045268/early-nutrition-intervention-attenuates-weight-gain-for-pediatric-acute-lymphoblastic-leukemia-patients-in-maintenance-therapy
#1
Rachel Hill, Tyler Hamby, Lisa Bashore, Stefanie Rapisand, Kari Galipp, Kenneth Heym, W Paul Bowman
Obesity following treatment of pediatric acute lymphoblastic leukemia (ALL) has become a significant long-term concern. Excessive weight gain often occurs during treatment, particularly during induction and the first 6 months of maintenance therapy, and it may be potentially modifiable. This retrospective study aimed to evaluate the impact of an early, 3-visit nutrition intervention on weight gain during maintenance therapy in ALL patients. Medical records of the intervention group were compared with historical controls who were treated on the same ALL treatment protocols during an earlier time period...
October 17, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29040012/outcome-of-acute-lymphoblastic-leukemia-in-children-with-down-syndrome-polish-pediatric-leukemia-and-lymphoma-study-group-report
#2
Joanna Zawitkowska, Teresa Odój, Katarzyna Drabko, Agnieszka Zaucha-Prażmo, Julia Rudnicka, Michał Romiszewski, Michał Matysiak, Kinga Kwiecińska, Magdalena Ćwiklińska, Walentyna Balwierz, Joanna Owoc-Lempach, Katarzyna Derwich, Jacek Wachowiak, Maciej Niedźwiecki, Elżbieta Adamkiewicz-Drożyńska, Joanna Trelińska, Wojciech Młynarski, Andrzej Kołtan, Mariusz Wysocki, Renata Tomaszewska, Tomasz Szczepański, Marcin Płonowski, Maryna Krawczuk-Rybak, Tomasz Ociepa, Tomasz Urasiński, Agnieszka Mizia-Malarz, Grażyna Sobol-Milejska, Grażyna Karolczyk, Jerzy Kowalczyk
Children with Down syndrome (DS) have a 20-fold increased risk of developing leukemia compared with the general population. The aim of the study was to analyze the outcome of patients diagnosed with Down syndrome and acute lymphoblastic leukemia (ALL) in Poland between the years 2003 and 2010. A total of 1848 children were diagnosed with ALL (810 females and 1038 males). Of those, 41 (2.2%) had DS. The children were classified into three risk groups: a standard-risk group-14 patients, an intermediate-risk group-24, a high-risk group-3...
October 17, 2017: Pediatric Hematology and Oncology
https://www.readbyqxmd.com/read/29032616/a-survey-on-hematology-oncology-pediatric-aieop-centres-the-challenge-of-posterior-reversible-encephalopathy-syndrome
#3
Daniele Zama, Pietro Gasperini, Massimo Berger, Mariagrazia Petris, Maria D De Pasquale, Simone Cesaro, Maria E Guerzoni, Elena Mastrodicasa, Francesca Savina, Ottavio Ziino, Valentina Kiren, Paola Muggeo, Rosa M Mura, Fraia Melchionda, Giulio A Zanazzo
Posterior reversible encephalopathy syndrome (PRES) is one of the most common neurological complications in hematology-oncology pediatric patients. Despite an increasingly recognized occurrence, no clear consensus exists regarding how best to manage the syndrome, because most cases of PRES have reported in single case reports or small series. Aim of this paper is to identify incidence, clinical features, management and outcome of PRES in a large series of hematology-oncology pediatric patients METHODS: The cases of PRES occurred in twelve centres of the Italian Association of Pediatric Haematology and Oncology were reported RESULTS: 124 cases of PRES in 112 pediatric patients were recorded with an incidence of 2...
October 15, 2017: European Journal of Haematology
https://www.readbyqxmd.com/read/29025601/a-neoplasm-with-fip1l1-pdgfra-fusion-presenting-as-pediatric-t-cell-lymphoblastic-leukemia-lymphoma-without-eosinophilia
#4
Matthew J Oberley, Christopher Denton, Jianling Ji, Matthew Hiemenz, Deepa Bhojwani, Dejerianne Ostrow, Samuel Wu, Paul Gaynon, Gordana Raca
The 2016 World Health Organization (2016 WHO) classification of hematopoietic malignancies classifies neoplasms with a fusion between the FIP1L1 and PDGFRA genes in 4q12 into a group called "myeloid and lymphoid neoplasms with eosinophilia and abnormalities of PDGFRA, PDGFRB or FGFR1 or with PCM1-JAK2". Neoplasms characterized by this fusion are pluripotent stem cell disorders that can show both myeloid and lymphoid differentiation. They typically occur in adult patients and most are characterized by eosinophilia...
October 2017: Cancer Genetics
https://www.readbyqxmd.com/read/29025600/a-novel-somatic-jak2-kinase-domain-mutation-in-pediatric-acute-lymphoblastic-leukemia-with-rapid-on-treatment-development-of-loh
#5
Teresa Sadras, Susan L Heatley, Chung H Kok, Barbara J McClure, David Yeung, Timothy P Hughes, Rosemary Sutton, David S Ziegler, Deborah L White
We report a novel somatic mutation in the kinase domain of JAK2 (R938Q) in a high-risk pediatric case of B-cell acute lymphoblastic leukemia (ALL). The patient developed on-therapy relapse at 12 months, and interestingly, the JAK2 locus acquired loss of heterozygosity during treatment resulting in 100% mutation load. Furthermore, we show that primary ALL mononuclear cells harboring the JAK2 R938Q mutation display reduced sensitivity to the JAK1/2 ATP-competitive inhibitor ruxolitinib in vitro, compared to ALL cells that carry a more common JAK2 pseudokinase domain mutation...
October 2017: Cancer Genetics
https://www.readbyqxmd.com/read/29025266/the-abcs-of-immunotherapy-for-adult-patients-with-b-cell-acute-lymphoblastic-leukemia
#6
Troy Z Horvat, Amanda N Seddon, Adebayo Ogunniyi, Amber C King, Larry W Buie, Ryan J Daley
OBJECTIVE: To review the pharmacology, efficacy, and safety of Food and Drug Administration approved and promising immunotherapy agents used in the treatment of acute lymphoblastic leukemia (ALL). DATA SOURCES: A literature search was performed of PubMed and MEDLINE databases (1950 to July 2017) and of abstracts from the American Society of Hematology and the American Society of Clinical Oncology. Searches were performed utilizing the following key terms: rituximab, blinatumomab, inotuzumab, ofatumumab, obinutuzumab, Blincyto, Rituxan, Gazyva, Arzerra, CAR T-cell, and chimeric antigen receptor (CAR)...
October 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29024301/emerging-principles-from-the-clinical-application-of-chimeric-antigen-receptor-car-t-cell-therapies-for-b-cell-malignancies
#7
REVIEW
Michael D Jain, Marco L Davila
Gene-engineered T cell therapies are soon to be FDA approved for at least two types of B cell malignancies in pediatric and adult patients, in the form of CD19 targeted chimeric antigen receptor T (CAR T) cell therapy. This represents a triumph of a true bench to bedside clinical translation of a therapy that was conceived of in the early 1990s. Clinical results have demonstrated efficacious responses in patients with the CD19 positive diseases B cell acute lymphoblastic leukemia (B-ALL) and diffuse large B cell lymphoma (DLBCL)...
October 11, 2017: Stem Cells
https://www.readbyqxmd.com/read/29022749/pediatric-precursor-b-cell-acute-lymphoblastic-leukemia-with-myc-8q24-translocation-how-to-treat
#8
Chuer Zhang, Gladstone Austin Amos Burke
Acute lymphoblastic leukemia (ALL) is the most common pediatric cancer. Within ALL, precursor B-cell disease predominates and now has survival >90%. Mature B-cell, or Burkitt leukemia/lymphoma, is distinct from ALL and requires short intensive chemotherapy and with the addition of Rituximab, survival rates of >95% are achieved. Its defining characteristic is MYC translocation at 8q24. Patients who have features of both ALL and Burkitt leukemia/lymphoma represent a rare subpopulation of ALL and present a diagnostic and treatment conundrum...
October 12, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/29020310/levofloxacin-prophylaxis-during-induction-therapy-for-pediatric-acute-lymphoblastic-leukemia
#9
Joshua Wolf, Li Tang, Patricia M Flynn, Ching-Hon Pui, Aditya H Gaur, Yilun Sun, Hiroto Inaba, Tracy Stewart, Randall T Hayden, Hana Hakim, Sima Jeha
Background: Infection is the most important cause of treatment-related morbidity and mortality in pediatric patients treated for acute lymphoblastic leukemia (ALL). Although routine in adults with leukemia, antibacterial prophylaxis is controversial in pediatrics because of insufficient evidence for its efficacy or antibiotic choice and concerns about promoting antibiotic resistance and Clostridium difficile infection. Methods: This was a single-center, observational cohort study of patients with newly diagnosed ALL, comparing prospectively collected infection-related outcomes in patients who received no prophylaxis, levofloxacin prophylaxis, or other prophylaxis during induction therapy on the total XVI study...
September 14, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28991353/asymptomatic-leukemic-optic-nerve-infiltration-as-presentation-of-acute-lymphoblastic-leukemia-relapse
#10
Jane Caty, A Paula Grigorian, Florin Grigorian
The authors report a case of asymptomatic leukemic optic neuropathy as the first sign of acute lymphoblastic leukemia relapse in a 4-year-old boy. Routine ophthalmologic examination showed normal visual acuity and pupillary function in the presence of a tumoral mass covering the left optic disc. The mass resolved with preservation of vision after intrathecal chemotherapy. A routine ophthalmological examination is recommended for all patients with a history of acute lymphoblastic leukemia to exclude optic nerve involvement without systemic symptoms or signs...
October 9, 2017: Journal of Pediatric Ophthalmology and Strabismus
https://www.readbyqxmd.com/read/28991127/safe-use-of-low-molecular-weight-heparin-in-pediatric-acute-lymphoblastic-leukemia-and-lymphoma-around-lumbar-punctures
#11
Jeremie H Estepp, Matthew P Smeltzer, Guolian Kang, Scott C Howard, Ulrike M Reiss
Children with acute lymphoblastic leukemia or lymphoma (ALL) undergo multiple lumbar punctures (LPs) and frequently require low-molecular-weight heparin (LMWH) for thromboembolic complications. We evaluated if withholding LMWH 24 hours before and after LPs prevented bleeding complications. Children (n=133) with ALL from who were: (1) treated at St. Jude Children's Research Hospital, (2) received LMWH (2×/day of ~1 mg/kg) between January 2004 until December 2012, and (3) underwent a LP were analyzed. Spinal hematoma was defined as a clinical suspicion leading to diagnostic imaging...
October 4, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28991126/successful-treatment-of-invasive-conidiobolus-infection-during-therapy-for-acute-lymphoblastic-leukemia
#12
Craig Erker, Anna R Huppler, Thomas J Walsh, Michael E McCormick, Mariko Suchi, Neel S Bhatt, Susan C Kehl, Jessica Southwood, Paul Harker-Murray
Invasive fungal infections are a serious cause of morbidity and mortality in patients with hematologic malignancies. Conidiobolus species are molds within the order Entomophthorales and may disseminate to become rapidly fatal in immunocompromised individuals. This species of fungal infections are often multidrug resistant (MDR) and present unique therapeutic challenges. Reports of Conidiobolus infections are rare in pediatric oncology. We report the successful treatment of an adolescent male with B-cell lymphoblastic leukemia and MDR invasive sinopulmonary Conidiobolus infection with emphasis on early and aggressive neutrophil support with surgical debridement...
October 17, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28990296/association-between-mthfr-microrna-binding-site-polymorphisms-and-methotrexate-concentrations-in-chinese-pediatric-patients-with-acute-lymphoblastic-leukemia
#13
Shu-Mei Wang, Wei-Xin Zeng, Wan-Shui Wu, Lu-Lu Sun, Dan Yan
BACKGROUND: The pharmacokinetics and therapeutic response to methotrexate (MTX) display large variability in the treatment of acute lymphoblastic leukemia (ALL). The aim of the present study was to investigate the association of two microRNA (miRNA) binding site polymorphisms (rs3737966 G > A and rs35134728 DEL/TTC) in the 3'UTR of MTHFR with serum MTX concentrations, in a Chinese pediatric population with ALL. METHODS: Genotyping for MTHFR rs3737966 and rs35134728 in 144 children with ALL was performed using the Sequenom MassArray system...
October 9, 2017: Journal of Gene Medicine
https://www.readbyqxmd.com/read/28979163/a-p53-regulated-apoptotic-gene-signature-predicts-treatment-response-and-outcome-in-pediatric-acute-lymphoblastic-leukemia
#14
Russell O Bainer, Matthew R Trendowski, Cheng Cheng, Deqing Pei, Wenjian Yang, Steven W Paugh, Kathleen H Goss, Andrew D Skol, Paul Pavlidis, Ching-Hon Pui, T Conrad Gilliam, William E Evans, Kenan Onel
Gene signatures have been associated with outcome in pediatric acute lymphoblastic leukemia (ALL) and other malignancies. However, determining the molecular drivers of these expression changes remains challenging. In ALL blasts, the p53 tumor suppressor is the primary regulator of the apoptotic response to genotoxic chemotherapy, which is predictive of outcome. Consequently, we hypothesized that the normal p53-regulated apoptotic response to DNA damage would be altered in ALL and that this alteration would influence drug response and treatment outcome...
2017: Cancer Management and Research
https://www.readbyqxmd.com/read/28978861/acute-leukemia-in-adolescents-and-young-adults
#15
Daisuke Tomizawa
Both acute lymphoblastic leukemia (ALL) and acute myeloid leukemia (AML) are common malignant diseases in adolescents and young adults (AYAs). Recent advances in genomic studies have helped us understand the biological nature of acute leukemia in AYAs; higher frequency of Ph-like ALL and rearrangements in DUX4, ERG, MEF2D, and ZNF384 genes in AYAs with ALL and higher frequency of FLT3-ITD, NPM1, IDH1/2, DNMT3A, ASXL1, TET2, and CEBPA mutations in AYAs with AML than that in children. The pediatric-inspired regimen has become a standard treatment approach for AYAs with ALL, but optimal treatment strategy for AYAs with AML is not yet established to date...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28978840/current-treatment-of-adult-acute-lymphoblastic-leukemia
#16
Shin Fujisawa
The survival outcomes for children with acute lymphoblastic leukemia (ALL) have dramatically improved over recent years, and improved outcomes in adolescents and young adults patients have been achieved by applying regimens based on pediatric protocols. The treatment strategies for adult ALL are similar to those for pediatric ALL. T-cell ALL is less common than B-cell ALL. Therefore, there are only few reports of investigations in a large group of adult T-ALL patients. In Japan, nelarabine-combined chemotherapy has been tested in a phase II study in patients with newly diagnosed T-ALL...
2017: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
https://www.readbyqxmd.com/read/28973362/cd20-positivity-and-white-blood-cell-count-predict-treatment-outcomes-in-philadelphia-chromosome-negative-acute-lymphoblastic-leukemia-patients-ineligible-for-pediatric-inspired-chemotherapy
#17
Yusuke Isshiki, Chikako Ohwada, Emiko Sakaida, Masahiro Onoda, Nobuyuki Aotsuka, Hiroaki Tanaka, Motoharu Fukazawa, Ryuko Cho, Takeaki Sugawara, Takeharu Kawaguchi, Satoru Hara, Akira Yokota
Background: The efficacy of conventional chemotherapy and allogeneic hematopoietic stem cell transplantation (allo-HSCT) has been controversial as post-remission therapies for adult Philadelphia chromosome-negative acute lymphoblastic leukemia patients. Methods: We retrospectively analyzed 96 adolescent and adult cases of Philadelphia chromosome-negative acute lymphoblastic leukemia to evaluate whether allo-HSCT should be performed after first complete remission (1CR)...
September 8, 2017: Japanese Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28972594/ras-pathway-mutations-as-predictive-biomarker-for-treatment-adaptation-in-pediatric-b-cell-precursor-acute-lymphoblastic-leukemia
#18
I S Jerchel, A Q Hoogkamer, I M Ariës, E M P Steeghs, J M Boer, N J M Besselink, A Boeree, C van de Ven, H A de Groot-Kruseman, V de Haas, M A Horstmann, G Escherich, C M Zwaan, E Cuppen, M J Koudijs, R Pieters, M L den Boer
RAS pathway mutations have been linked to relapse and chemotherapy resistance in pediatric B-cell precursor acute lymphoblastic leukemia (BCP-ALL). However, comprehensive data on the frequency and prognostic value of subclonal mutations in well-defined subgroups using highly sensitive and quantitative methods is lacking. Targeted deep sequencing of 13 RAS-pathway genes was performed in 461 pediatric BCP-ALL cases at initial diagnosis and in 19 diagnosis-relapse pairs. Mutations were present in 44.2% of patients, with 24...
October 3, 2017: Leukemia: Official Journal of the Leukemia Society of America, Leukemia Research Fund, U.K
https://www.readbyqxmd.com/read/28969872/closing-the-gap-novel-therapies-in-treating-acute-lymphoblastic-leukemia-in-adolescents-and-young-adults
#19
REVIEW
Brian D Friend, Gary J Schiller
Acute lymphoblastic leukemia (ALL) is one of the most common cancer diagnoses identified in adolescents and young adults (AYAs). Although most children with ALL are cured of their disease, AYAs have experienced much worse outcomes over time, with event-free survival ranging from 30 to 45%. This survival disparity is likely due to differences in tumor biology, treatment-related toxicities, and nonmedical issues. This review summarizes these differences as well as focusing on the various trials that have demonstrated superior outcomes with pediatric protocols in AYAs with ALL...
September 21, 2017: Blood Reviews
https://www.readbyqxmd.com/read/28968716/dependent-generalized-dirichlet-process-priors-for-the-analysis-of-acute-lymphoblastic-leukemia
#20
William Barcella, Maria De Iorio, Stefano Favaro, Gary L Rosner
We propose a novel Bayesian nonparametric process prior for modeling a collection of random discrete distributions. This process is defined by including a suitable Beta regression framework within a generalized Dirichlet process to induce dependence among the discrete random distributions. This strategy allows for covariate dependent clustering of the observations. Some advantages of the proposed approach include wide applicability, ease of interpretation, and availability of efficient MCMC algorithms. The motivation for this work is the study of the impact of asparginage metabolism on lipid levels in a group of pediatric patients treated for acute lymphoblastic leukemia...
September 6, 2017: Biostatistics
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