{"title":"Asymmetric salivary gland 123I-meta-iodobenzylguanidine uptake in a patient with cervical neuroblastoma and Horner syndrome.","authors":"T. Simon, E. Voth, F. Berthold","doi":"10.1002/MPO.1114","DOIUrl":"https://doi.org/10.1002/MPO.1114","url":null,"abstract":"","PeriodicalId":18531,"journal":{"name":"Medical and pediatric oncology","volume":"5 1","pages":"489-90"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75333244","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
G. Pastore, M. Mosso, F. Carnevale, L. C. Montezemolo, M. Forni, E. Madon, U. Ricardi, B. Terracini, C. Magnani
BACKGROUND The Childhood Cancer Registry of Piedmont (CCRP) started its activity in 1967. It is population based and covers the Piedmont Region (population 4,500,000; NW Italy). This article reports on time trends in survival after a childhood cancer diagnosed during 1970-1994. PROCEDURE During 1970-1994, 2,329 incident cases were registered at CCRP on the basis of histological and/or clinical information, excluding 30 cases reported only by death certificate. Histological or hematological diagnosis was available for 2,067 cases. Vital status was assessed through the offices of the town of residence. At the end of follow-up, 1,202 cases were alive, 1,084 dead and 43 were not traceable. Survival was measured for the major diagnostic groups using both univariate and multivariate statistics. RESULTS The 5-yr survival rate for acute lymphoblastic leukemia (ALL) improved regularly from 24.7% in 1970-1974 to 81.1% in 1990-1994, for acute nonlymphoblastic leukemia (ANLL) from 0% to 38.1%, for non-Hodgkin lymphoma (NHL) from 25.2% to 67.7%, for tumors of the central nervous system (CNS) (all types) from 33.4% to 75.9% and for Ewing tumor from 0% to 90%. Focusing on survival by period of diagnosis, the highest 5-year survival rate was observed for children diagnosed during 1985-1989 for medulloblastoma, neuroblastoma (NB), retinoblastoma, Wilms tumor, osteosarcoma, and rhabdomyosarcoma and for children diagnosed in 1990-1994 for the remaining sites. The trend over time was statistically significant for ALL, ANLL, NHL, CNS tumors, NB, and osteosarcoma as well as for all malignancies together. CONCLUSIONS Population-based survival studies are useful complements to clinical studies. Survival results in the present study are similar to those presented for other European countries and the United States. For most types of neoplasm (except CNS) survival probability appears to stabilize 5-10 years after diagnosis.
{"title":"Survival trends of childhood cancer diagnosed during 1970-1994 in Piedmont, Italy: a report from the Childhood Cancer Registry.","authors":"G. Pastore, M. Mosso, F. Carnevale, L. C. Montezemolo, M. Forni, E. Madon, U. Ricardi, B. Terracini, C. Magnani","doi":"10.1002/MPO.1113","DOIUrl":"https://doi.org/10.1002/MPO.1113","url":null,"abstract":"BACKGROUND\u0000The Childhood Cancer Registry of Piedmont (CCRP) started its activity in 1967. It is population based and covers the Piedmont Region (population 4,500,000; NW Italy). This article reports on time trends in survival after a childhood cancer diagnosed during 1970-1994.\u0000\u0000\u0000PROCEDURE\u0000During 1970-1994, 2,329 incident cases were registered at CCRP on the basis of histological and/or clinical information, excluding 30 cases reported only by death certificate. Histological or hematological diagnosis was available for 2,067 cases. Vital status was assessed through the offices of the town of residence. At the end of follow-up, 1,202 cases were alive, 1,084 dead and 43 were not traceable. Survival was measured for the major diagnostic groups using both univariate and multivariate statistics.\u0000\u0000\u0000RESULTS\u0000The 5-yr survival rate for acute lymphoblastic leukemia (ALL) improved regularly from 24.7% in 1970-1974 to 81.1% in 1990-1994, for acute nonlymphoblastic leukemia (ANLL) from 0% to 38.1%, for non-Hodgkin lymphoma (NHL) from 25.2% to 67.7%, for tumors of the central nervous system (CNS) (all types) from 33.4% to 75.9% and for Ewing tumor from 0% to 90%. Focusing on survival by period of diagnosis, the highest 5-year survival rate was observed for children diagnosed during 1985-1989 for medulloblastoma, neuroblastoma (NB), retinoblastoma, Wilms tumor, osteosarcoma, and rhabdomyosarcoma and for children diagnosed in 1990-1994 for the remaining sites. The trend over time was statistically significant for ALL, ANLL, NHL, CNS tumors, NB, and osteosarcoma as well as for all malignancies together.\u0000\u0000\u0000CONCLUSIONS\u0000Population-based survival studies are useful complements to clinical studies. Survival results in the present study are similar to those presented for other European countries and the United States. For most types of neoplasm (except CNS) survival probability appears to stabilize 5-10 years after diagnosis.","PeriodicalId":18531,"journal":{"name":"Medical and pediatric oncology","volume":"284 1","pages":"481-8"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81306434","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
M. Krawczuk-Rybak, K. Muszyńska-Rosłan, J. Oleński, E. Leszczyńska, B. Zapolska, J. Wargocki
{"title":"Letter to the editor: Priapism as the first sign of a pelvic tumour in a two‐and‐a‐half‐year‐old boy","authors":"M. Krawczuk-Rybak, K. Muszyńska-Rosłan, J. Oleński, E. Leszczyńska, B. Zapolska, J. Wargocki","doi":"10.1002/MPO.1119","DOIUrl":"https://doi.org/10.1002/MPO.1119","url":null,"abstract":"","PeriodicalId":18531,"journal":{"name":"Medical and pediatric oncology","volume":"111 1","pages":"503-504"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75943890","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Successful management of neonatal choriocarcinoma.","authors":"J. Heath, K. Tiedemann","doi":"10.1002/MPO.1117","DOIUrl":"https://doi.org/10.1002/MPO.1117","url":null,"abstract":"","PeriodicalId":18531,"journal":{"name":"Medical and pediatric oncology","volume":"19 1","pages":"497-9"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90766869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Bernstrand, C. Bernstrand, Kerstin Cederlund, Bengt Sandstedt, Lars Åhström, Marie Lundell, G. Dahlquist, J. Henter
BACKGROUND In Langerhans cell histiocytosis (LCH) pulmonary involvement, which is often initially asymptomatic, may contribute to significant morbidity and mortality. To determine the long-term prognosis, a cross-sectional study was undertaken. PROCEDURE Forty-one patients with > or = 5 years follow-up after the diagnosis of LCH were interviewed and underwent physical examination, blood tests, a chest X-ray and a high-resolution CT (HRCT) of the lungs. All patients included had been referred to the Department of Pediatrics at the Karolinska Hospital in Stockholm between July 1962 and February 1990 (median follow-up 16 years). Biopsies from all patients were reviewed and confirmed to be consistent with LCH. Information on previous clinical features including treatment and the results of chest X-rays were also collected for risk factor analysis. RESULTS Radiographic abnormalities of the lungs (cysts and/or emphysema), found in 10/41 (24%) at follow-up, were classified into five groups according to the extent of the cysts. These patients had more often suffered from multisystem than from single-system disease (P = 0.01), were significantly older at diagnosis (P < 0.001), and had been more heavily treated with chemotherapy and/or radiotherapy. They were also more frequently smokers (P < 0.0001) and 7/10 (70%) had suffered lung involvement at diagnosis. At the time of diagnosis of the pulmonary involvement, 4/10 (40%) patients had respiratory symptoms, but only 2/10 (20%) had symptoms at follow-up. CONCLUSIONS Ten (24%) of the 41 patients had abnormal findings on radiological examination of the lungs at long-term follow-up and seven are or had been smokers. It is of great importance that patients with LCH be informed about smoking-related pulmonary morbidity. Prolonged monitoring of the lungs for smokers and patients with known pulmonary involvement is recommended.
{"title":"Pulmonary abnormalities at long-term follow-up of patients with Langerhans cell histiocytosis.","authors":"C. Bernstrand, C. Bernstrand, Kerstin Cederlund, Bengt Sandstedt, Lars Åhström, Marie Lundell, G. Dahlquist, J. Henter","doi":"10.1002/MPO.1110","DOIUrl":"https://doi.org/10.1002/MPO.1110","url":null,"abstract":"BACKGROUND\u0000In Langerhans cell histiocytosis (LCH) pulmonary involvement, which is often initially asymptomatic, may contribute to significant morbidity and mortality. To determine the long-term prognosis, a cross-sectional study was undertaken.\u0000\u0000\u0000PROCEDURE\u0000Forty-one patients with > or = 5 years follow-up after the diagnosis of LCH were interviewed and underwent physical examination, blood tests, a chest X-ray and a high-resolution CT (HRCT) of the lungs. All patients included had been referred to the Department of Pediatrics at the Karolinska Hospital in Stockholm between July 1962 and February 1990 (median follow-up 16 years). Biopsies from all patients were reviewed and confirmed to be consistent with LCH. Information on previous clinical features including treatment and the results of chest X-rays were also collected for risk factor analysis.\u0000\u0000\u0000RESULTS\u0000Radiographic abnormalities of the lungs (cysts and/or emphysema), found in 10/41 (24%) at follow-up, were classified into five groups according to the extent of the cysts. These patients had more often suffered from multisystem than from single-system disease (P = 0.01), were significantly older at diagnosis (P < 0.001), and had been more heavily treated with chemotherapy and/or radiotherapy. They were also more frequently smokers (P < 0.0001) and 7/10 (70%) had suffered lung involvement at diagnosis. At the time of diagnosis of the pulmonary involvement, 4/10 (40%) patients had respiratory symptoms, but only 2/10 (20%) had symptoms at follow-up.\u0000\u0000\u0000CONCLUSIONS\u0000Ten (24%) of the 41 patients had abnormal findings on radiological examination of the lungs at long-term follow-up and seven are or had been smokers. It is of great importance that patients with LCH be informed about smoking-related pulmonary morbidity. Prolonged monitoring of the lungs for smokers and patients with known pulmonary involvement is recommended.","PeriodicalId":18531,"journal":{"name":"Medical and pediatric oncology","volume":"69 1","pages":"459-68"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84442836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Lo Cunsolo, I. Casciano, C. Gambini, B. De Bernardi, G. Tonini, M. Romani
*Neuroblastoma, the most common extracranial solidtumor of childhood, presents heterogeneous molecularand clinical characteristics. To date few molecular studieshave been reported for multifocal neuroblastoma, a modeof presentation of this tumor that occurrs in about 2% ofthe cases and reflects the complex pathogenesis of thisneoplasm [1–3]. Herein, we report a case of bilateraladrenal synchronous neuroblastoma. Our studies revealedthe presence of molecular and cytogenetic heterogeneityand suggest that a clonal evolution might have occurredin one of the primary tumors.A 7› year-old girl was admitted in June 1995 to theGaslini Children’s Hospital (Genova, Italy) for abdom-inal pain. Ultrasonography revealed a round nonhomo-geneous adrenal mass on the right (R) and a smalleradrenal mass on the left (L). Urinary catecholamineexcretion, serum lactate dehydrogenase, and ferritinlevels were abnormally elevated. Both tumors and severallymph nodes were resected. Histopathologic and clinicalevaluation led to a diagnosis of bilateral synchronousneuroblastoma, both stroma-poor [1]. The right-sidedtumor was of the undifferentiated subtype with high MKIaccording to Shimada et al. [4]. This tumor was morpho-logically heterogeneous and presented a differentiating(R1) and an undifferentiated (R2) area. The L tumor wasof the differentiating subtype, with low MKI. Six monthsafter surgery, the tumor recurred retroperitoneally, andthe patient was treated with six cycles of chemotherapyand irradiation. Fourteen months later, multiple relapseswere detected in distant lymph nodes and in the 9th rightrib. A biopsy from a lymph nodal metastasis (M) wasavailable for molecular studies. The patient was treatedwith aggressive chemotherapy, but died of diseaseprogression in 1997.Histopathologic data suggested that the R1, R2, and Ltumor areas had different biologic characteristics. In fact,immunohistochemical analysis showed a high level ofexpression of the proliferation marker Ki-67 in R2. Onthe contrary, in R1 and L an intermediate and a lownumber of cells were positive for Ki-67 (Fig. 1, A–C).The DNA index was 1.00 in all three areas. Comparativegenomic hybridization (CGH) and fluorescent in situhybridization (FISH) showed an additional copy ofchromosome 7 in R1, R2, and M, but not in L (Fig. 1,D–I). MYCN gene amplification, chromosome 1p dele-tion, and additional chromosomal aberrations were notobserved. Microsatellite analysis of 16 chromosome 1pmarkers demonstrated the presence of replication errorsat the adjacent loci D1S496 and D1S197 only in R1 andexcluded the presence of small 1p deletions (data notshown).Neuroblastoma generally presents as a sporadic singlelesion. However, the occurrence of multiple primarytumors in young children has been described and couldunderline a genetic predisposition of this disease [1–3,5].Unlike other cases described in the literature [3], ourpatient developed the tumors at an older age and herdisease progressed rapidly. In Figure 2, we rep
{"title":"Molecular alterations in a case of bilateral adrenal neuroblastoma.","authors":"C. Lo Cunsolo, I. Casciano, C. Gambini, B. De Bernardi, G. Tonini, M. Romani","doi":"10.1002/MPO.1115","DOIUrl":"https://doi.org/10.1002/MPO.1115","url":null,"abstract":"*Neuroblastoma, the most common extracranial solidtumor of childhood, presents heterogeneous molecularand clinical characteristics. To date few molecular studieshave been reported for multifocal neuroblastoma, a modeof presentation of this tumor that occurrs in about 2% ofthe cases and reflects the complex pathogenesis of thisneoplasm [1–3]. Herein, we report a case of bilateraladrenal synchronous neuroblastoma. Our studies revealedthe presence of molecular and cytogenetic heterogeneityand suggest that a clonal evolution might have occurredin one of the primary tumors.A 7› year-old girl was admitted in June 1995 to theGaslini Children’s Hospital (Genova, Italy) for abdom-inal pain. Ultrasonography revealed a round nonhomo-geneous adrenal mass on the right (R) and a smalleradrenal mass on the left (L). Urinary catecholamineexcretion, serum lactate dehydrogenase, and ferritinlevels were abnormally elevated. Both tumors and severallymph nodes were resected. Histopathologic and clinicalevaluation led to a diagnosis of bilateral synchronousneuroblastoma, both stroma-poor [1]. The right-sidedtumor was of the undifferentiated subtype with high MKIaccording to Shimada et al. [4]. This tumor was morpho-logically heterogeneous and presented a differentiating(R1) and an undifferentiated (R2) area. The L tumor wasof the differentiating subtype, with low MKI. Six monthsafter surgery, the tumor recurred retroperitoneally, andthe patient was treated with six cycles of chemotherapyand irradiation. Fourteen months later, multiple relapseswere detected in distant lymph nodes and in the 9th rightrib. A biopsy from a lymph nodal metastasis (M) wasavailable for molecular studies. The patient was treatedwith aggressive chemotherapy, but died of diseaseprogression in 1997.Histopathologic data suggested that the R1, R2, and Ltumor areas had different biologic characteristics. In fact,immunohistochemical analysis showed a high level ofexpression of the proliferation marker Ki-67 in R2. Onthe contrary, in R1 and L an intermediate and a lownumber of cells were positive for Ki-67 (Fig. 1, A–C).The DNA index was 1.00 in all three areas. Comparativegenomic hybridization (CGH) and fluorescent in situhybridization (FISH) showed an additional copy ofchromosome 7 in R1, R2, and M, but not in L (Fig. 1,D–I). MYCN gene amplification, chromosome 1p dele-tion, and additional chromosomal aberrations were notobserved. Microsatellite analysis of 16 chromosome 1pmarkers demonstrated the presence of replication errorsat the adjacent loci D1S496 and D1S197 only in R1 andexcluded the presence of small 1p deletions (data notshown).Neuroblastoma generally presents as a sporadic singlelesion. However, the occurrence of multiple primarytumors in young children has been described and couldunderline a genetic predisposition of this disease [1–3,5].Unlike other cases described in the literature [3], ourpatient developed the tumors at an older age and herdisease progressed rapidly. In Figure 2, we rep","PeriodicalId":18531,"journal":{"name":"Medical and pediatric oncology","volume":"68 1","pages":"491-3"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90952751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Spontaneous nocturnal growth hormone secretion in children after medulloblastoma therapy.","authors":"M. Marx, J. Beck, G. Grabenbauer, H. Dörr","doi":"10.1002/MPO.1116","DOIUrl":"https://doi.org/10.1002/MPO.1116","url":null,"abstract":"","PeriodicalId":18531,"journal":{"name":"Medical and pediatric oncology","volume":"80 1","pages":"494-6"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83516820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
C. Favara‐Scacco, Giuseppina Smirne, Gino Schilirò, Andrea Di Cataldo
BACKGROUND Children with leukemia undergo painful procedures such as lumbar puncture and bone marrow aspiration. To overcome pain, certain units offer total anesthesia; others offer generic support; others offer no preparation at all. Since September, 1997, we have provided leukemic children with art therapy (AT), a nonverbal and creative modality that develops coping skills. Our goal is to prevent anxiety and fear during painful interventions as well as prolonged emotional distress. PROCEDURE We treated 32 children aged 2-14 years. The modes of AT before, during, and after the punctures were as follows: clinical dialogue to calm children and help them cope with painful procedures; visual imagination to activate alternative thought processes and decrease the attention towards overwhelming reality and raise the peripheral sensitivity gate; medical play to clarify illness, eliminate doubts, and offer control over threatening reality; structured drawing to contain anxiety by offering a structured, predictable reality (the drawing) that was controllable by children; free drawing to allow children to externalize confusion and fears; and dramatization to help children accept and reconcile themselves to body changes. RESULTS Children hospitalized before September, 1997, exhibited resistance and anxiety during and after painful procedures. By contrast, children provided with AT from the first hospitalization exhibited collaborative behavior. They or their parents asked for AT when the intervention had to be repeated. Parents declared themselves better able to manage the painful procedures when AT was offered. CONCLUSION AT was shown to be a useful intervention that can prevent permanent trauma and support children and parents during intrusive interventions.
{"title":"Art therapy as support for children with leukemia during painful procedures.","authors":"C. Favara‐Scacco, Giuseppina Smirne, Gino Schilirò, Andrea Di Cataldo","doi":"10.1002/MPO.1112","DOIUrl":"https://doi.org/10.1002/MPO.1112","url":null,"abstract":"BACKGROUND\u0000Children with leukemia undergo painful procedures such as lumbar puncture and bone marrow aspiration. To overcome pain, certain units offer total anesthesia; others offer generic support; others offer no preparation at all. Since September, 1997, we have provided leukemic children with art therapy (AT), a nonverbal and creative modality that develops coping skills. Our goal is to prevent anxiety and fear during painful interventions as well as prolonged emotional distress.\u0000\u0000\u0000PROCEDURE\u0000We treated 32 children aged 2-14 years. The modes of AT before, during, and after the punctures were as follows: clinical dialogue to calm children and help them cope with painful procedures; visual imagination to activate alternative thought processes and decrease the attention towards overwhelming reality and raise the peripheral sensitivity gate; medical play to clarify illness, eliminate doubts, and offer control over threatening reality; structured drawing to contain anxiety by offering a structured, predictable reality (the drawing) that was controllable by children; free drawing to allow children to externalize confusion and fears; and dramatization to help children accept and reconcile themselves to body changes.\u0000\u0000\u0000RESULTS\u0000Children hospitalized before September, 1997, exhibited resistance and anxiety during and after painful procedures. By contrast, children provided with AT from the first hospitalization exhibited collaborative behavior. They or their parents asked for AT when the intervention had to be repeated. Parents declared themselves better able to manage the painful procedures when AT was offered.\u0000\u0000\u0000CONCLUSION\u0000AT was shown to be a useful intervention that can prevent permanent trauma and support children and parents during intrusive interventions.","PeriodicalId":18531,"journal":{"name":"Medical and pediatric oncology","volume":"2 1","pages":"474-80"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85594460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Rapid deterioration of a newborn with congenital spinal cord astrocytoma.","authors":"C. Colby, P. Rozance, T. Goodwin, P. Fisher","doi":"10.1002/MPO.1118","DOIUrl":"https://doi.org/10.1002/MPO.1118","url":null,"abstract":"","PeriodicalId":18531,"journal":{"name":"Medical and pediatric oncology","volume":"59 1","pages":"500-2"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91007522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
H. Meir, I. Balawi, H. Nayel, H. E. El Karaksy, A. El Haddad
BACKGROUND Viral hepatitis is a cause of hepatic dysfunction in children with ALL in remission during maintenance therapy is debated. The aims of the current study were (1) to explore the incidence of hepatic dysfunction in a group of children (Egyptian and Saudi) with ALL under maintenance therapy, (2) to study the prevalence of hepatitis B (HBV) and/or C (HCV) infection and their contributions to chronic liver disease that might be induced by maintenance therapy. PROCEDURE The current study included 105 children with ALL (54 Egyptian and 51 Saudi). All eligible patients had been on maintenance therapy for at least 12 months and all had serial assessments of liver function. These included determination of total bilirubin, AST, ALT, and alkaline phosphatase. Markers for HBV and HCV including HBsAg, anti-HBC, and anti-HCV and for some patients HCV RNA by PCR were studied. Percutaneous liver biopsy was performed for a group of children. RESULTS The prevalence of hepatitis infection (HBV and/or HCV) among Egyptian children was found to be high (43/54-80%). Only five Saudi children had evidence of exposure to HBV (5/51-9.8%), P<0.0001. During the period of study, 22 Egyptian patients vs. four Saudi patients (41 vs. 7.8%, P<0.0001) experienced at least one episode of elevation of liver enzymes, three times the upper limit of normal or more. Twenty-six of the 48 patients (54%) with HBV and/or HCV infection had episodes of elevated liver enzymes, while there was no occurrence among the patients negative for HBV and HCV. In patients with HBV infection, the presence of HBsAg was strongly associated (100%) with elevated liver enzymes. Histopathologic examination of liver biopsies obtained from 35 patients revealed that all five patients negative for HBV and HCV had normal liver biopsies in spite of being under maintenance therapy. CONCLUSION In children undergoing treatment for ALL, elevations in liver enzymes may be primarily due to hepatitis viruses. However, maintenance therapy using known hepatotoxic drugs, may have additive deleterious effects. Liver enzymes are normalized in affected patients when maintenance therapy is temporarily suspended.
{"title":"Hepatic dysfunction in children with acute lymphoblastic leukemia in remission: relation to hepatitis infection.","authors":"H. Meir, I. Balawi, H. Nayel, H. E. El Karaksy, A. El Haddad","doi":"10.1002/MPO.1111","DOIUrl":"https://doi.org/10.1002/MPO.1111","url":null,"abstract":"BACKGROUND\u0000Viral hepatitis is a cause of hepatic dysfunction in children with ALL in remission during maintenance therapy is debated. The aims of the current study were (1) to explore the incidence of hepatic dysfunction in a group of children (Egyptian and Saudi) with ALL under maintenance therapy, (2) to study the prevalence of hepatitis B (HBV) and/or C (HCV) infection and their contributions to chronic liver disease that might be induced by maintenance therapy.\u0000\u0000\u0000PROCEDURE\u0000The current study included 105 children with ALL (54 Egyptian and 51 Saudi). All eligible patients had been on maintenance therapy for at least 12 months and all had serial assessments of liver function. These included determination of total bilirubin, AST, ALT, and alkaline phosphatase. Markers for HBV and HCV including HBsAg, anti-HBC, and anti-HCV and for some patients HCV RNA by PCR were studied. Percutaneous liver biopsy was performed for a group of children.\u0000\u0000\u0000RESULTS\u0000The prevalence of hepatitis infection (HBV and/or HCV) among Egyptian children was found to be high (43/54-80%). Only five Saudi children had evidence of exposure to HBV (5/51-9.8%), P<0.0001. During the period of study, 22 Egyptian patients vs. four Saudi patients (41 vs. 7.8%, P<0.0001) experienced at least one episode of elevation of liver enzymes, three times the upper limit of normal or more. Twenty-six of the 48 patients (54%) with HBV and/or HCV infection had episodes of elevated liver enzymes, while there was no occurrence among the patients negative for HBV and HCV. In patients with HBV infection, the presence of HBsAg was strongly associated (100%) with elevated liver enzymes. Histopathologic examination of liver biopsies obtained from 35 patients revealed that all five patients negative for HBV and HCV had normal liver biopsies in spite of being under maintenance therapy.\u0000\u0000\u0000CONCLUSION\u0000In children undergoing treatment for ALL, elevations in liver enzymes may be primarily due to hepatitis viruses. However, maintenance therapy using known hepatotoxic drugs, may have additive deleterious effects. Liver enzymes are normalized in affected patients when maintenance therapy is temporarily suspended.","PeriodicalId":18531,"journal":{"name":"Medical and pediatric oncology","volume":"259 1","pages":"469-73"},"PeriodicalIF":0.0,"publicationDate":"2001-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"75212616","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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