Pediatric blood & cancer
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Pediatric blood & cancer · Aug 2009
Off-label use of rFVIIa in children with excessive bleeding: a consecutive study of 153 off-label uses in 139 children.
Recombinant factor VIIa is a general hemostatic agent. Randomized trials have demonstrated effectiveness in adults; however, data in children are confined to case reports and series subject to publication bias. ⋯ rFVIIa is an effective general hemostatic agent for management of excessive bleeding in children and that with the exception of neonates has excellent safety.
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Pediatric blood & cancer · Aug 2009
ReviewTesticular stem cells for fertility preservation: preclinical studies on male germ cell transplantation and testicular grafting.
Spermatogonial stem cells open novel strategies for preservation of testicular tissue and fertility preservation in boys and men exposed to gonadotoxic therapies. This review provides an update on the physiology of spermatogonial stem cells in rodent and primate testes. Species-specific differences must be considered when new technologies on testicular stem cells are considered. ⋯ Further research is needed before an application in humans can be considered safe and efficient. Despite the current limitations in regard to the generation of sperm from cryopreserved male germline cells and tissues, protocols for cryopreservation of testicular tissue are available and reveal a promising outcome. Since future improvements of germ cell transplantation and grafting approaches can be assumed, bioptic retrieval and cryopreservation of testicular tissue fragments should be performed in oncological patients at high risk of fertility loss since this is their only option to maintain their fertility potential.
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Pediatric blood & cancer · Aug 2009
Case ReportsLactic acidosis and hypoglycemia with ALL relapse following engrafted bone marrow transplant.
Lactic acidosis together with hypoglycemia in the face of hematologic malignancy is a grave development. A 7-year-old male with pre-B-cell ALL following hematopoietic cell transplant was admitted to our hospital in his second relapse. ⋯ Care was withdrawn on hospital day 9. Further understanding of the mechanisms that cause the combined onset of lactic acidosis and hypoglycemia will help clinicians in implementing timely therapies that may reduce mortality.
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Pediatric blood & cancer · Aug 2009
Dissatisfaction with hospital care for children with sickle cell disease not due only to race and chronic disease.
A previous study reported increased dissatisfaction with hospital care for children with sickle cell disease (SCD); however, its small size excluded determining whether race and chronic disease explained the difference. ⋯ Parents of children with SCD report increased dissatisfaction with care. While dissatisfaction was higher in minority families, the high rate of parental concern about race as a reason for families of children with SCD is not seen in African-American families of children with asthma.