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Intrathecal chemotherapy neurotoxicity: unveiling the challenges of diagnosis, management, and prevention.
IF 1.2 4区 医学 Q4 HEMATOLOGY Pub Date : 2025-04-01 Epub Date: 2025-03-20 DOI: 10.1080/08880018.2025.2471098
Ali H Algiraigri, Wasil Jastaniah

Intrathecal (IT) chemotherapy is a highly effective treatment and prophylaxis for central nervous system (CNS) involvement in leukemia and lymphoma. Despite its therapeutic efficacy, IT chemotherapy has potential neurotoxicity risks, including acute and delayed symptoms that can severely affect patient outcomes. Effective management of acute, IT-related neurotoxicity requires a prompt, case-specific approach that considers symptom severity, the type of chemotherapeutic agent, and individual patient factors. This review examines a case-based approach to managing common scenarios of IT neurotoxicity and provides a structured guide for clinicians in assessing and addressing these complications.

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引用次数: 0
Temporal trends and unbalanced distribution, in pediatric cutaneous melanoma in 204 countries and territories, 1990-2019.
IF 1.2 4区 医学 Q4 HEMATOLOGY Pub Date : 2025-04-01 Epub Date: 2025-02-24 DOI: 10.1080/08880018.2025.2466023
Zhen Yu Wong, Kai Qi Ou, Zhen Ning Wong, Ryan Faderani, Muholan Kanapathy, Afshin Mosahebi

Cutaneous melanoma (CM) is a rare occurrence in the pediatric population and suffers from a dearth of epidemiological data. This study aims to estimate the distribution and temporal trends of pediatric CM. Data specific to the pediatric (<20 years old) CM were extracted from the Global Burden of Disease (GBD) Study 2019, stratified by Socio-demographic Index (SDI) and WHO region. The data encompassed incidence, mortality, and disability-adjusted life-years (DALYs) representing the years of healthy life lost due to a pediatric CM diagnosis. Join point regression analysis and Quality of care index (QCI) were computed. In 2019, the global age-standardized incidence, mortality, and DALYs rates of pediatric CM were estimated at 0.13, 0.02, and 1.46 per 100,000 population, respectively. From 1990 to 2010, an increase in incidence was noted (0.95, 95% UI: 0.89 to 1.02), while mortality (-0.62, 95% UI: -0.71 to -0.53) and DALYs (-0.58, 95% UI: -0.67 to -0.50) exhibited a decline. The global QCI for pediatric melanoma in 2019 was 87, while Somalia was noted to have the lowest QCI (16). The incidence rate was predominantly observed in European regions and high SDI regions, whereas the disease burden was more pronounced in low SDI region and Africa regions. An age-related discrepancy was noted with pediatric CM being higher and more broadly distributed among western countries in children above the age of ten. This study highlights that pediatric CM remains rare but has a disproportionate global distribution, warranting targeted strategies to tackle this issue.

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引用次数: 0
Environmental health disparities in pediatric cancer: a report from the Fourth Symposium on Childhood Cancer Health Disparities.
IF 1.2 4区 医学 Q4 HEMATOLOGY Pub Date : 2025-04-01 Epub Date: 2025-03-20 DOI: 10.1080/08880018.2025.2479479
Thanh T Hoang, Zdenko Herceg, Don W Coulter, Adam de Smith, Manish Arora, William E Funk, David Haynes, Stephen H Linder, Leticia M Nogueira, Amy E Hughes, Lindsay A Williams, Jeremy M Schraw, Michael E Scheurer, Philip J Lupo

The 4th Symposium on Childhood Cancer Health Disparities was held at Texas Children's Hospital in Houston, Texas, on September 26, 2023. The symposium registered 94 attendees from different backgrounds (e.g. clinicians, epidemiologists, exposure assessment scientists, geospatial experts) with an interest in environmental health disparities of pediatric cancer susceptibility and treatment outcomes. The focus of the symposium was to provide an overview of the role of environmental risk factors in studies of pediatric cancer, introduce novel exposure assessment tools that can be applied to the field, and highlight opportunities to study the impact of environmental health disparities in pediatric cancer susceptibility and outcomes. This report summarizes the scientific content of the symposium and highlights priorities to advance the field.

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引用次数: 0
Primary gonadal failure in children with intracranial brain tumors treated with high dose alkylating agents and radiation sparing therapy: an institutional case series.
IF 1.2 4区 医学 Q4 HEMATOLOGY Pub Date : 2025-04-01 Epub Date: 2025-03-20 DOI: 10.1080/08880018.2025.2480741
Sylvia Cheng, Sarah Riedlinger, Rebecca Ronsley, Laura Stewart, Juliette Hukin, Carol K L Lam

Treatment of young children with brain tumors may require the use of high dose chemotherapy with alkylating agents to avoid craniospinal irradiation. The objective of this study is to describe the probability of primary gonadal failure (PGF) in children with a malignant intracranial tumor treated with high-dose alkylating agents in children diagnosed less than age 8 years who were treated with this radiation-sparing approach at our institution. Patient demographics, oncological and endocrine diagnoses, treatment modalities, and laboratory values were collected. Descriptive statistics, Kaplan Meier survival curves, regression analysis, and T-tests were used in data analysis. Eight of 18 (44%) developed PGF. The probability of developing PGF is 11% at 5 years, and 31% at 10 years. Cyclophosphamide equivalent dose (CED) was higher and duration of follow-up was longer in children with PGF. PGF is common in children who received CED without irradiation, but further studies are needed to correlate CED dose and time to onset of PGF.

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引用次数: 0
Child self-regulation and caregiver hope: insights from families navigating Sickle cell disease and pediatric cancer.
IF 1.2 4区 医学 Q4 HEMATOLOGY Pub Date : 2025-04-01 Epub Date: 2025-03-20 DOI: 10.1080/08880018.2025.2480223
James Rujimora, Amanda C DeDiego

This pilot study explored caregiver experiences caring for children with hematologic and oncologic diseases. Survey data were collected from caregivers (n = 85) of children with hematologic and oncologic diseases while participating in therapeutic camp programming. Caregivers of children with Sickle Cell Disease perceived their child's ability to self-regulate higher than caregivers of children with cancer, which impacted aspects of caregiver hope and wellness. Implications for multi-sector collaborations are provided. In assessing caregiver hope, perception of child self-regulation was associated with higher caregiver hope and wellness, which varied by illness. Caregivers of children with SCD had higher hope scores on both the subscales and total scores compared to caregivers of children with cancer.

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引用次数: 0
Response to neoadjuvant selpercatinib in a pediatric patient with advanced papillary thyroid carcinoma: a case report.
IF 1.2 4区 医学 Q4 HEMATOLOGY Pub Date : 2025-03-03 DOI: 10.1080/08880018.2025.2466022
Taylor Luckie, Daniel Chelius, Amy Dimachkieh, Norma Quintanilla, Angshumoy Roy, Andrew C Sher, Priya Mahajan
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引用次数: 0
Vitamin D deficiency in a pediatric population with sickle cell disease. 镰状细胞病儿童人群的维生素D缺乏症
IF 1.2 4区 医学 Q4 HEMATOLOGY Pub Date : 2025-03-01 Epub Date: 2025-01-17 DOI: 10.1080/08880018.2025.2451843
Thiago de Souza Vilela, Mauro Fisberg, Gerson Ferrari, Josefina Aparecida Pellegrini Braga

Pediatric patients with sickle cell disease and vitamin D deficiency have worse clinical and laboratory outcomes. This study aims to quantify the prevalence of vitamin D deficiency in this population and identify possible risk factors for hypovitaminosis D by performing a cross-sectional study with children aged 3-18 years old with sickle cell disease. Sixty patients were evaluated, with a mean age of 10.80 + 4.21 years. The prevalence of vitamin D deficiency was 46.7% (21.02 ± 8.47 ng/mL). Patients were clustered into two groups regarding vitamin D deficiency (25-OH-D < 20 ng/mL). When comparing groups with and without vitamin D deficiency, age (p = 0.002) and season of 25-OH-D collection (p = 0.005) were statistically significant. Age presented OR 1.23 (95% CI: 1.07; 1.41/p = 0.004), as well as the season of the 25-OH-D collection with OR 5.21 (95% CI: 1.58; 17.14/p = 0.007) for autumn/winter assessment. After linear regression, an association was noted for age (β = -0.80/95% CI: -1.29; -0.320/p = 0.002), days of sun exposure (β = 0.83/95% CI: 0.07; 1.58/p = 0.032), and autumn/winter vitamin D assessment (β = -7.94/95% CI: -12.02; -3.85/p = 0.032). In conclusion, hypovitaminosis D is highly prevalent in this population; meanwhile, age, season of 25-OH-D collection, and days of sunlight exposure appeared as risk factors for deficiency.

患有镰状细胞病和维生素D缺乏症的儿科患者的临床和实验室结果更差。本研究旨在量化这一人群中维生素D缺乏症的患病率,并通过对3-18岁镰状细胞病儿童进行横断面研究,确定维生素D缺乏症的可能危险因素。60例患者接受评估,平均年龄10.80 + 4.21岁。维生素D缺乏症发生率为46.7%(21.02±8.47 ng/mL)。维生素D缺乏症患者分为两组(25-OH-D p = 0.002),收集25-OH-D的季节(p = 0.005)有统计学意义。年龄呈现OR为1.23 (95% CI: 1.07;1.41/p = 0.004),以及25-OH-D采集的季节,OR为5.21 (95% CI: 1.58;17.14/p = 0.007)进行秋冬评估。线性回归后,发现年龄有相关性(β = -0.80/95% CI: -1.29;-0.320 / p = 0.002),天的日晒(β= 0.83 / 95% CI: 0.07;1.58/p = 0.032),秋季/冬季维生素D评估(β = -7.94/95% CI: -12.02;-3.85/p = 0.032)。总之,维生素D缺乏症在这一人群中非常普遍;年龄、采集25-OH-D的季节和日照天数是维生素d缺乏的危险因素。
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引用次数: 0
Safety and Tolerability of a 3-Day Fosaprepitant Regimen for the Prevention of Chemotherapy-Induced Nausea and Vomiting in Pediatric Patients: Results of an Open-Label, Single-Arm Phase 4 Trial. 一项开放标签、单组4期试验的结果:3天福沙吡坦方案预防儿科患者化疗引起的恶心和呕吐的安全性和耐受性
IF 1.2 4区 医学 Q4 HEMATOLOGY Pub Date : 2025-03-01 Epub Date: 2024-12-10 DOI: 10.1080/08880018.2024.2437047
Juan Luis Garcia Leon, Cara DiCristina, Ruji Yao, Amna Sadaf Afzal

Convenient multiday dosing of antiemetic regimens for the prevention of chemotherapy-induced nausea and vomiting (CINV) are needed in pediatric patients, who are more likely than adults to be treated with emetogenic chemotherapy over multiple consecutive days. Intravenous (IV) fosaprepitant is approved for the prevention of CINV in children aged 6 months and older. This open-label, single-arm study assessed the safety and tolerability of a 3-day fosaprepitant regimen (consecutive daily IV administration on days 1-3) plus a serotonin receptor antagonist with or without dexamethasone in pediatric patients (6 months to 17 years) receiving emetogenic chemotherapy. Study treatment was initiated at the start of a chemotherapy cycle (cycle 1); patients completing cycle 1 could participate in optional cycles 2 and 3. Primary endpoints included adverse events (AEs) and AE-related discontinuation during cycle 1.98/100. Patients completed cycle 1; 69 participated in optional cycles 2 and 3. The AE profile during cycle 1 was typical of cancer patients receiving emetogenic chemotherapy; 80/100 (80.0%) patients experienced ≥1 AE. AE rates were generally similar between patients aged 6 months to <2 years (11/15 patients [73.3%]), 2 to <6 years (22/30 [73.3%]), 6 to <12 years (24/25 [96.0%]), and 12-17 years (23/30 [76.7%]). Rates of drug-related AEs (4/100 [4.0%]) and AE-related discontinuations (2/100 [2.0%]) were low. Similar trends in safety outcomes were observed during cycles 2 and 3. No deaths were reported. The 3-day IV fosaprepitant regimen for the prevention of CINV was generally well tolerated in pediatric patients receiving emetogenic chemotherapy.

儿科患者需要方便的多天给药止吐方案来预防化疗引起的恶心和呕吐(CINV),他们比成人更有可能连续多天接受致吐性化疗。静脉注射(IV) fosaprepitant被批准用于预防6个月及以上儿童的CINV。这项开放标签单组研究评估了接受致吐性化疗的儿科患者(6个月至17岁)3天fosaprepitant方案(连续每日静脉注射,第1-3天)加5 -羟色胺受体拮抗剂加或不加地塞米松的安全性和耐受性。研究治疗开始于化疗周期(周期1);完成第1周期的患者可参加可选的第2和第3周期。主要终点包括1.98/100周期的不良事件(ae)和ae相关停药。患者完成第1周期;69人参加了第2和第3任择周期。第1周期的AE特征是接受致吐性化疗的癌症患者的典型特征;80/100(80.0%)患者发生≥1次AE。AE发生率在6个月至6个月的患者之间大致相似
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引用次数: 0
A case control analysis of pattern and risk factors for pulmonary dysfunction amongst childhood cancer survivors: a single centre study from a low-middle income setting.
IF 1.2 4区 医学 Q4 HEMATOLOGY Pub Date : 2025-03-01 Epub Date: 2025-02-07 DOI: 10.1080/08880018.2025.2456934
Payal Malhotra, Sandeep Jain, Rahul Sharma, Anjali Pahuja, Rajiv Goyal, Anurag Sharma, Gauri Kapoor

Pulmonary toxicity is one of the most common morbidities experienced by childhood cancer survivors (CCS). The aim of this study was to identify prevalence, pattern of dysfunction, and risk factors among CCS and compare with age and sex matched controls. Details of demographic and pulmonary-toxic treatment of CCS at least 2 years off-treatment were collected and a cross-sectional analysis of pulmonary function test (PFT) and risk factors was performed. Spirometry findings were categorized as normal, restrictive, or obstructive and diffusing capacity of carbon monoxide (DLCO) as normal or abnormal. PFT data of 192 CCS and 50 controls was analyzed. One or more abnormalities inspirometry or DLCO were observed among 112 (58.3%) CCS and 8 (16%) controls (p value <0.01). Abnormal PFT was more likely to be associated with older age at evaluation, longer follow-up, and use of chest-directed radiotherapy (p value 0.002, 0.02, 0.03). DLCO was the most common abnormality observed in 85 (44%) patients. Obstructive and restrictive patterns were observed in 66 (34.3%) and 42 (21.8%) survivors respectively. There was no correlation between any risk factor and specific pattern of pulmonary dysfunction. On univariate analysis age at evaluation >20 years, follow-up >10 years, cumulative bleomycin more than 120 mg/m2, chest-directed radiotherapy, surgery, and female gender were found to be predictive for abnormal PFT. On multivariable analysis first four factors retained significance. High subclinical prevalence among CCS especially in older patients with longer follow-up mandates longitudinal follow-up to assess long-term pulmonary outcome and plan intervention strategies for this subset.

{"title":"A case control analysis of pattern and risk factors for pulmonary dysfunction amongst childhood cancer survivors: a single centre study from a low-middle income setting.","authors":"Payal Malhotra, Sandeep Jain, Rahul Sharma, Anjali Pahuja, Rajiv Goyal, Anurag Sharma, Gauri Kapoor","doi":"10.1080/08880018.2025.2456934","DOIUrl":"10.1080/08880018.2025.2456934","url":null,"abstract":"<p><p>Pulmonary toxicity is one of the most common morbidities experienced by childhood cancer survivors (CCS). The aim of this study was to identify prevalence, pattern of dysfunction, and risk factors among CCS and compare with age and sex matched controls. Details of demographic and pulmonary-toxic treatment of CCS at least 2 years off-treatment were collected and a cross-sectional analysis of pulmonary function test (PFT) and risk factors was performed. Spirometry findings were categorized as normal, restrictive, or obstructive and diffusing capacity of carbon monoxide (DLCO) as normal or abnormal. PFT data of 192 CCS and 50 controls was analyzed. One or more abnormalities inspirometry or DLCO were observed among 112 (58.3%) CCS and 8 (16%) controls (<i>p</i> value <0.01). Abnormal PFT was more likely to be associated with older age at evaluation, longer follow-up, and use of chest-directed radiotherapy (<i>p</i> value 0.002, 0.02, 0.03). DLCO was the most common abnormality observed in 85 (44%) patients. Obstructive and restrictive patterns were observed in 66 (34.3%) and 42 (21.8%) survivors respectively. There was no correlation between any risk factor and specific pattern of pulmonary dysfunction. On univariate analysis age at evaluation >20 years, follow-up >10 years, cumulative bleomycin more than 120 mg/m<sup>2</sup>, chest-directed radiotherapy, surgery, and female gender were found to be predictive for abnormal PFT. On multivariable analysis first four factors retained significance. High subclinical prevalence among CCS especially in older patients with longer follow-up mandates longitudinal follow-up to assess long-term pulmonary outcome and plan intervention strategies for this subset.</p>","PeriodicalId":19746,"journal":{"name":"Pediatric Hematology and Oncology","volume":" ","pages":"104-114"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143374541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Comparative analysis of a novel next-generation sequencing-based IGH clonality assay for measurable residual disease detection in pediatric B-cell acute lymphoblastic leukemia patients.
IF 1.2 4区 医学 Q4 HEMATOLOGY Pub Date : 2025-03-01 Epub Date: 2025-02-13 DOI: 10.1080/08880018.2025.2463927
Min-Seung Park, Hee Young Ju, Ji Won Lee, Keon Hee Yoo, Hee-Jin Kim, Duck Cho, Hyun-Young Kim

Measurable residual disease (MRD) is critical in guiding therapeutic strategies for B-cell acute lymphoblastic leukemia (B-ALL). This study evaluated the performance of a novel next-generation sequencing-based Celemics IGH assay (CM-IGH; Celemics, Seoul, Korea) compared with the LymphoTrack® IGH FR1 assay (LT-IGH; Invivoscribe Technologies, USA) and multiparameter flow cytometry (MFC). A total of 31 diagnostic and 60 follow-up bone marrow aspirate samples, all from the same 31 pediatric patients with B-ALL, were analyzed using the CM-IGH and LT-IGH assays on the MiSeq platform, as well as MFC according to EuroFlow guidelines. Initial IGH clonality was detected in 83.9% of CM-IGH samples and 90.3% of LT-IGH samples (p = 0.060). MRD positivity rates in follow-up samples were 74.5% for CM-IGH, 61.1% for LT-IGH, and 56.7% for MFC. CM-IGH showed concordance rates of 78.3% with LT-IGH and 68.1% with MFC, while LT-IGH demonstrated an 81.5% concordance rate with MFC. The correlation coefficients (r) of MRD levels were 0.831 between CM-IGH and LT-IGH, 0.702 between CM-IGH and MFC, and 0.776 between LT-IGH and MFC. The CM-IGH assay demonstrates substantial concordance with LT-IGH and MFC in detecting MRD in pediatric patients with B-ALL, highlighting the complementary value of IGH clonality assays and MFC.

{"title":"Comparative analysis of a novel next-generation sequencing-based IGH clonality assay for measurable residual disease detection in pediatric B-cell acute lymphoblastic leukemia patients.","authors":"Min-Seung Park, Hee Young Ju, Ji Won Lee, Keon Hee Yoo, Hee-Jin Kim, Duck Cho, Hyun-Young Kim","doi":"10.1080/08880018.2025.2463927","DOIUrl":"10.1080/08880018.2025.2463927","url":null,"abstract":"<p><p>Measurable residual disease (MRD) is critical in guiding therapeutic strategies for B-cell acute lymphoblastic leukemia (B-ALL). This study evaluated the performance of a novel next-generation sequencing-based Celemics IGH assay (CM-IGH; Celemics, Seoul, Korea) compared with the LymphoTrack<sup>®</sup> IGH FR1 assay (LT-IGH; Invivoscribe Technologies, USA) and multiparameter flow cytometry (MFC). A total of 31 diagnostic and 60 follow-up bone marrow aspirate samples, all from the same 31 pediatric patients with B-ALL, were analyzed using the CM-IGH and LT-IGH assays on the MiSeq platform, as well as MFC according to EuroFlow guidelines. Initial IGH clonality was detected in 83.9% of CM-IGH samples and 90.3% of LT-IGH samples (<i>p</i> = 0.060). MRD positivity rates in follow-up samples were 74.5% for CM-IGH, 61.1% for LT-IGH, and 56.7% for MFC. CM-IGH showed concordance rates of 78.3% with LT-IGH and 68.1% with MFC, while LT-IGH demonstrated an 81.5% concordance rate with MFC. The correlation coefficients (<i>r</i>) of MRD levels were 0.831 between CM-IGH and LT-IGH, 0.702 between CM-IGH and MFC, and 0.776 between LT-IGH and MFC. The CM-IGH assay demonstrates substantial concordance with LT-IGH and MFC in detecting MRD in pediatric patients with B-ALL, highlighting the complementary value of IGH clonality assays and MFC.</p>","PeriodicalId":19746,"journal":{"name":"Pediatric Hematology and Oncology","volume":" ","pages":"115-125"},"PeriodicalIF":1.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143409624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
Pediatric Hematology and Oncology
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