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Pediatric Acute Lymphoblastic Leukemia

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https://www.readbyqxmd.com/read/29244249/flow-cytometric-false-myeloperoxidase-positive-childhood-b-lineage-acute-lymphoblastic-leukemia
#1
Süreyya Savaşan, Steven Buck, Manisha Gadgeel, Ali Gabali
BACKGROUND: Flow cytometric intracellular myeloperoxidase (MPO) staining of leukemic blasts is a useful tool in diagnosis of leukemia subtype. Interpretation of high MPO-positivity can be a diagnostic challenge in B-lineage acute lymphoblastic leukemia (B-ALL). While very few such cases have been reported, high MPO positive B-ALL cases without additional myeloid antigen positivity are suspect and require further investigation. METHODS: Three pediatric cases of B-ALL with strong MPO staining (clone 8E6; Invitrogen) at diagnosis and three others with negative MPO staining were studied by flow cytometry and immunohistochemistry...
December 15, 2017: Cytometry. Part B, Clinical Cytometry
https://www.readbyqxmd.com/read/29234981/sarcopenia-after-induction-therapy-in-childhood-acute-lymphoblastic-leukemia-its-clinical-significance
#2
Daisuke Suzuki, Ryoji Kobayashi, Hirozumi Sano, Daiki Hori, Kunihiko Kobayashi
Muscle weakness is one of the most serious problems during chemotherapy for childhood hematological malignancies. It may be caused by long-term hospitalization, unfavorable physical conditions, and restricted activities. Although the concept of sarcopenia is becoming widely recognized, especially in geriatric medicine, there have been few reports about sarcopenia in pediatric patients with hematological malignancies. A total of 47 consecutive first-onset acute lymphoblastic leukemia (ALL) patients who underwent induction therapy between January 2011 and September 2016 were investigated...
December 12, 2017: International Journal of Hematology
https://www.readbyqxmd.com/read/29222264/incorporation-of-nonchemotherapeutic-agents-in-pediatric-acute-lymphoblastic-leukemia
#3
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
#4
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
https://www.readbyqxmd.com/read/29222234/progress-in-adult-all-incorporation-of-new-agents-to-frontline-treatment
#5
REVIEW
Jessica Leonard, Wendy Stock
Treatment of acute lymphoblastic leukemia (ALL) in adults remains a challenge, as the delivery of intensive chemotherapeutic regimens in this population is less feasible than it is in the pediatric population. This has led to higher rates of treatment-related toxicity as well as lower overall survival in the adult population. Over the past several years, a host of novel therapies (eg, immunotherapy and targeted therapies) with better tolerability than traditional chemotherapy are now being introduced into the relapsed/refractory population with very encouraging results...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29219890/a-cryptic-nup214-abl1-fusion-in-b-cell-precursor-acute-lymphoblastic-leukemia
#6
Shin-Ichi Tsujimoto, Yoshiko Nakano, Tomoo Osumi, Keiko Okada, Meri Ouchi-Uchiyama, Keisuke Kataoka, Yoichi Fujii, Kentaro Ohki, Masafumi Seki, Nobuyoshi Tamagawa, Junko Takita, Seishi Ogawa, Nobutaka Kiyokawa, Junichi Hara, Motohiro Kato
Fluorescent in situ hybridization (FISH) analysis is the standard methods for screening ABL1 fusions, which is recurrently translocated in pediatric acute lymphoblastic leukemia (ALL), and potentially targetable by kinase inhibitors. Here we demonstrated a case of B-cell precursor ALL with NUP214-ABL1 fusion, which break-apart FISH assay for ABL1 failed to detect. The cryptic fusion was generated by small duplication from ABL1 to NUP214, which was detected by copy number analysis using genomic microarray and confirmed by PCR...
December 6, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29218844/predictors-of-hepatotoxicity-and-pancreatitis-in-children-and-adolescents-with-acute-lymphoblastic-leukemia-treated-according-to-contemporary-regimens
#7
Christopher C Denton, Yasmin A Rawlins, Matthew J Oberley, Deepa Bhojwani, Etan Orgel
BACKGROUND: Hepatotoxicity and pancreatitis are common treatment-related toxicities (TRTs) during contemporary treatment regimens for acute lymphoblastic leukemia (ALL). Limited detailed data from Children's Oncology Group (COG) regimens has been previously reported to enable identification of patient and treatment risk factors for these toxicities and their impact on outcomes. PROCEDURE: We analyzed a retrospective pediatric ALL cohort treated at a single institution according to COG regimens from 2008 to 2015...
December 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29214875/genetic-polymorphisms-of-arylamine-n-acetyltransferases-1-and-2-and-the-likelihood-of-developing-pediatric-acute-lymphoblastic-leukemia
#8
Oswaldo Hernández-González, Juan José Ortiz-Zamudio, Cristian Jazmín Rodríguez-Pinal, Ildemar Alvarado-Morales, Verónica Del Carmen Martínez-Jiménez, Raúl Alejandro Salazar-González, Lourdes Cecilia Correa-González, Rocío Gómez, Diana Patricia Portales-Pérez, Rosa Del Carmen Milán-Segovia
Acute lymphoblastic leukemia (ALL) is one of the main causes of death in children and is associated with both genetic susceptibility and environmental factors. Genes encoding the arylamine N-acetyltransferases 1 and 2 (NAT1 and NAT2) isoenzymes are highly polymorphic among populations. Single-nucleotide polymorphism analysis was performed by real-time polymerase chain reaction from the genomic DNA of 225 healthy subjects and 57 children with ALL diagnoses. Significant associations were found between the development of ALL and the presence of the haplotypes NAT1*3 (Odds ratio [OR], 2...
December 7, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/29211693/the-t-12-21-p13-q22-in-pediatric-b-acute-lymphoblastic-leukemia-an-update
#9
Maximilian Becker, Kristie Liu, Carlos A Tirado
Erratum: Figure 1 on the last edition The Journal of the Association of Genetic Technologists. 2017;43(3): 113-127 does not contain the derivative 21. We are replacing this figure with the present one. In the section Secondary genetic aberrations we would like to add that: Deletions of 11q23 are observed in 5-6% of cases (Raynaud et al., 1999; Attarbaschi et al., 2004; Alvarez et al., 2005; Forestier et al., 2007).
2017: Journal of the Association of Genetic Technologists
https://www.readbyqxmd.com/read/29210666/a-newly-synthetized-ferrocenyl-derivative-selectively-induces-apoptosis-in-all-lymphocytes-through-mitochondrial-estrogen-receptors
#10
Marjan Aghvami, Jalal Pourahmad, Afshin Zarghi, Peyman Eshghi, Mohammad Hadi Zarei, Shabnam Farzaneh, Fatemeh Sattari
BACKGROUND: Estrogens, as the main female steroid hormones have multiple proven effects on reproductive and non- reproductive systems. Expression of ERα and ERβ, two dominant estrogen receptors, in peripheral blood mononuclear cells in certain B-cell malignancies and the existence of estrogens receptors on mitochondria is open to question that estrogen likely has an impact on the cancerous lymphocytes life span. Acute lymphoblastic leukemia (ALL) is the frequent pediatric malignity which is recurrent and hardly curable in many cases...
December 5, 2017: Anti-cancer Agents in Medicinal Chemistry
https://www.readbyqxmd.com/read/29209600/targeting-flt3-signaling-in-childhood-acute-myeloid-leukemia
#11
REVIEW
Amy N Sexauer, Sarah K Tasian
Acute myeloid leukemia (AML) is the second most common leukemia of childhood and is associated with high rates of chemotherapy resistance and relapse. Clinical outcomes for children with AML treated with maximally intensive multi-agent chemotherapy lag far behind those of children with the more common acute lymphoblastic leukemia, demonstrating continued need for new therapeutic approaches to decrease relapse risk and improve long-term survival. Mutations in the FMS-like tyrosine kinase-3 receptor gene (FLT3) occur in approximately 25% of children and adults with AML and are associated with particularly poor prognoses...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/29200171/reduced-neutrophil-elastase-activity-and-neutrophil-extracellular-traps-in-pediatric-acute-myeloid-leukemia-may-increase-the-rate-of-infections
#12
Sivan Berger-Achituv, Ronit Elhasid
Data on the production of neutrophil extracellular traps (NETs) in leukemia patients are scant. Phagocytosis, hydrogen peroxide, neutrophil elastase and myeloperoxidase enzymatic activity as well as NETs formation were studied in 10 pediatric acute lymphoblastic leukemia and 7 pediatric acute myeloid leukemia (AML) patients after induction chemotherapy. Median neutrophil elastase activity and NETs formation were lower in AML versus acute lymphoblastic leukemia (41% vs. 90%, P=0.005 and 51% vs. 94%, P=0.008, respectively)...
December 1, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29200164/neuropilin-1-cd304-expression-by-flow-cytometry-in-pediatric-precursor-b-acute-lymphoblastic-leukemia-a-minimal-residual-disease-and-potential-prognostic-marker
#13
Hala M Abaza, Mervat A A Alfeky, Deena S Eissa, Mona F Abdel Fattah, Laila M Annaka, Fatma S Ebeid
Flow cytometry (FCM) is used for quantification of minimal residual disease (MRD) in acute lymphoblastic leukemia (ALL) through discriminating leukemic B-lymphoblasts from normal B-cell precursor counterparts "hematogones." Neuropilin-1 (NRP-1)/CD304 is a vascular endothelial growth factor receptor implicated in the progression of hematological malignancies. We evaluated NRP-1/CD304 as MRD and prognostic marker in pediatric precursor B-ALL using FCM. Seventy children with precursor B-ALL and 40 control children were enrolled...
December 1, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29200159/posterior-reversible-encephalopathy-syndrome-risk-factors-and-impact-on-the-outcome-in-children-with-acute-lymphoblastic-leukemia-treated-with-nordic-protocols
#14
Joanna S Banerjee, Mats Heyman, Maarit Palomäki, Päivi Lähteenmäki, Mikko Arola, Pekka V Riikonen, Merja I Möttönen, Tuula Lönnqvist, Mervi H Taskinen, Arja H Harila-Saari
Posterior reversible encephalopathy syndrome (PRES) in children with acute lymphoblastic leukemia has been increasingly recognized as a clinicoradiological entity. Our aim was to describe the incidence of PRES in pediatric patients with ALL, identify its risk factors, and examine its prognostic importance. For this research, we conducted a systematic, retrospective review of the patient records in a population-based series of children with acute lymphoblastic leukemia (n=643) treated in Finland from 1992 to 2008...
December 1, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29199525/molecular-genetic-profile-in-bcr-abl1-negative-pediatric-b-cell-acute-lymphoblastic-leukemia-can-further-refine-outcome-prediction-in-addition-to-that-by-end-induction-minimal-residual-disease-detection
#15
Sanjeev Kumar Gupta, Sameer Bakhshi, Anita Chopra, Vineet Kumar Kamal
The recently proposed molecular genetic criteria promise improved risk-prediction in B-cell acute lymphoblastic leukemia (B-ALL). This study assesses their utility in BCR-ABL1 negative pediatric B-ALL, particularly with respect to end-induction minimal residual disease (MRD). The DNA was analyzed for copy number alterations in CDKN2A/B, PAX5, IKZF1, and other genes. Seventy-six cases with median age 7 years (2 months-18 years) included MRD-positive (24; 32%), and MRD negative-standard (20; 26%), intermediate (20; 26%), & high risk (12;16%) cases...
December 3, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/29193219/therapeutic-leukocytapheresis-in-infants-and-children-with-leukemia-and-hyperleukocytosis-a-single-institution-experience
#16
Namisha Thapa, Robin Pham, Charles Cole, Mitchell Meinershagen, Paul W Bowman, Anish Ray
BACKGROUND: Hyperleukocytosis, defined as white blood cell (WBC) count above 100 × 109 /L, has high early morbidity and mortality from leukostasis-related complications, namely intracranial hemorrhage and pulmonary distress. Initiating chemotherapy without prior leukocytoreduction may lead to tumor lysis syndrome (TLS). Therapeutic leukocytapheresis (TL) is used as one leukocytoreductive intervention; however, its safety and efficacy in pediatric leukemia has not been established. The purpose of this study is to evaluate safety of TL in pediatric patients and assess the efficacy of TL in reducing WBC count in pediatric leukemia...
November 29, 2017: Journal of Clinical Apheresis
https://www.readbyqxmd.com/read/29189615/multi-modal-treatment-of-rhinocerebral-mucormycosis-in-a-pediatric-patient-with-relapsed-pre-b-acute-lymphoblastic-leukemia
#17
Zephyr D Dworsky, John S Bradley, Matthew T Brigger, Alice L Pong, Dennis John Kuo
A 17-year-old female developed invasive rhinocerebral mucormycosis during intensive re-induction chemotherapy for relapsed pre-B acute lymphoblastic leukemia. Due to the high case fatality rate for invasive mucormycosis in profoundly immunosuppressed patients, an aggressive treatment regimen was pursued. In addition to the standard of care treatments with intravenous amphotericin and aggressive surgical debridements, she received intraventricular amphotericin to the brain via an Ommaya reservoir, hyperbaric oxygen treatments, filgrastim, intravenous immunoglobulin and anti-fungal in vitro synergy testing to allow for more targeted antifungal therapy with the addition of micafungin...
November 16, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29189511/invasive-fungal-disease-in-pediatric-acute-leukemia-in-the-nontransplant-setting-8-years-experience-from-a-tertiary-care-center-in-north-india
#18
Anirban Das, Sapna Oberoi, Amita Trehan, Arunaloke Chakrabarti, Deepak Bansal, Akshay K Saxena, Kushaljit S Sodhi, Nandita Kakkar, Radhika Srinivasan
BACKGROUND/AIM: The aim of this article is to study the spectrum, changing prevalence, and predictors for mortality of invasive fungal disease (IFD) in pediatric leukemia in a resource-limited setting. OBSERVATIONS: Prevalence was 7% (proven, 69%; probable, 16.4%; possible, 14.6%) and did not differ between acute lymphoblastic leukemia and acute myeloid leukemia. Lungs were frequently involved (46%). Aspergillus was the commonest fungus (47%). Visceral abscesses were frequent with candidiasis as compared with invasive molds (P=0...
November 17, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29189509/successful-treatment-of-a-very-late-isolated-relapse-in-an-adolescent-with-a-picalm-mllt10-positive-t-lineage-acute-lymphoblastic-leukemia
#19
Emanuela Cannata, Piera Samperi, Carla Cimino, Silvia Marino, Federica Sullo, Elena Mirabile, Andrea Di Cataldo, Giovanna Russo, Luca Lo Nigro
T-lineage ALL is an aggressive disease that needs to be treated with intensive treatment schedules. A late relapse rarely occurs and a clear choice for second-line treatment is on debate. We report on a young adult with a very late isolated extramedullary relapse of PICALM-MLLT10 positive T-ALL, successfully treated with a chemotherapy-based and radiotherapy-based pediatric protocol. We demonstrate that relapse can occur in T-ALL although a SR-MRD behavior treated with a high-risk protocol; specific molecular diagnostic aberrations, as PICALM-MLLT10, are still conserved at very late relapse; a second-line treatment based on pediatric protocol can be effective...
November 17, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29189508/steroid-induced-hypertension-during-induction-chemotherapy-for-acute-lymphoblastic-leukemia-in-us-children-s-hospitals
#20
Ian Bakk, Terah Koch, Joseph Stanek, Sarah H O'Brien, Suzanne Reed
Childhood acute lymphoblastic leukemia achieves excellent cure rates in part due to induction chemotherapy including high dose corticosteroids. Hypertension (HTN) is a known complication of corticosteroids, but incidence and risk factors for steroid-induced HTN are poorly understood. We sought to describe these using a large pediatric health database. Of the 5578 unique patients receiving induction chemotherapy, 14.7% received anti-HTN medications during their initial hospital admission. We found that age below 1 year, obesity, secondary diabetes mellitus, and abnormal glucose were associated with developing steroid-induced HTN...
November 17, 2017: Journal of Pediatric Hematology/oncology
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