Pediatric blood & cancer
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Pediatric blood & cancer · Feb 2010
Clinical TrialErwinia asparaginase after allergy to E. coli asparaginase in children with acute lymphoblastic leukemia.
Escherichia coli asparaginase is an important component of treatment for childhood acute lymphoblastic leukemia (ALL); however, hypersensitivity develops in up to 30% of patients. We assessed the nadir enzyme activity and tolerability of Erwinia asparaginase, an alternative preparation, in E. coli asparaginase-allergic patients. ⋯ Twice-weekly Erwinia asparaginase was well tolerated and achieved a therapeutically effective NSAA in most E. coli asparaginase-allergic patients. Development of E. coli allergy and subsequent treatment with twice-weekly Erwinia did not adversely impact event-free survival. Erwinia asparaginase should be considered for E. coli asparaginase-allergic patients.
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Pediatric blood & cancer · Feb 2010
Multicenter Study Clinical TrialSafety, efficacy, and pharmacokinetics of intravenous busulfan in children undergoing allogeneic hematopoietic stem cell transplantation.
To determine the safety, efficacy, and PK profile of intravenous busulfan (Bu) in the context of a Bu and cyclophosphamide (IVBuCy) preparative regimen in children undergoing allogeneic hematopoietic stem cell transplantation (HSCT). ⋯ IVBu is a safe and effective and offers the benefit of predictable and consistent systemic exposure.
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Pediatric blood & cancer · Feb 2010
Multicenter StudyThe Quid Pro Quo of pediatric versus adult services for older adolescent cancer patients.
Data from the State of Georgia suggest that pediatric cancers have better survival outcomes when treated at pediatric cancer centers that are members of the nation's Children's Oncology Group (COG). ⋯ These results demonstrate that adolescent patients with pediatric types of cancer fare better when their care is conducted or supervised by oncologists who specialize in the care of their type of cancer. The Georgia data are among the first to indicate that the more adult type of cancers are better treated on an adult treatment regimen and/or under the supervision or in conjunction with adult-treating oncologists.
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The question of where a child should die at home or in the hospital has been a subject of recent debate. We instituted a palliative care program with advanced end-of-life planning and hypothesized that a significant number of families would prefer that their child be at home rather than at a hospital at the end-of-life and that the overall quality of care would thereby improve. ⋯ When palliative care was offered either at hospital or home, palliative care occurred more frequently at home.
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Pediatric blood & cancer · Feb 2010
Hematopoietic stem cell transplantation for familial hemophagocytic lymphohistiocytosis and Epstein-Barr virus-associated hemophagocytic lymphohistiocytosis in Japan.
Post-transplant outcomes of hemophagocytic lymphohistiocytosis (HLH) patients were analyzed in Japan where Epstein-Barr virus (EBV)-associated severe forms are problematic. ⋯ EBV-HLH patients had a better prognosis after SCT than FHL patients. FHL patients showed either an equal or better outcome even after UCBT compared with the recent reports. UCB might therefore be acceptable as an alternate SCT source for HLH patients, although the optimal conditioning remains to be determined.