Pediatric blood & cancer
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Pediatric blood & cancer · Apr 2010
Case ReportsSecond complete remission of relapsed medulloblastoma induced by metronomic chemotherapy.
Prognosis for children with relapsed medulloblastoma remains poor. Metronomic chemotherapy may offer some benefit to patients treated initially with intensive regimens. However, dosing and duration of such palliative treatment have not been systematically studied. ⋯ The patient was then treated with metronomic chemotherapy and achieved second complete remission after 21 months of treatment. Three months off therapy he relapsed again and died from progressive disease. This case illustrates the potential benefit of metronomic chemotherapy but also shows the uncertainty of when to stop metronomic chemotherapy while balancing toxicity.
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Pediatric blood & cancer · Apr 2010
Multicenter StudyInpatient use of laxatives during opioid administration in children with sickle cell disease.
Constipation is a frequent adverse drug event seen with opioids, the first-line therapy for sickle cell pain crises. Proactive use of laxatives and stool softeners is recommended when opioids are prescribed. Our objective was to generate national estimates of the inpatient use of laxatives during opioid administration in children with sickle cell disease (SCD) and identify associations between individual and hospital-level factors and laxative prescription. ⋯ A substantial number of hospitalized patients with SCD receiving opioids do not receive laxatives and there is unexpected variability in the use of these medications. Increased attention needs to be paid to constipation prophylaxis in patients with SCD, particularly in younger patients and post-surgical patients.
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Pediatric blood & cancer · Apr 2010
Exercise echocardiography in asymptomatic survivors of childhood cancer treated with anthracyclines: a prospective follow-up study.
Exercise echocardiography reveals abnormalities in asymptomatic childhood cancer survivors who previously have been treated with anthracyclines. We determined the added value of monitoring childhood cancer survivors with exercise echocardiography compared to monitoring with resting echocardiography alone to predict anthracycline-induced cardiotoxicity. Secondary aims were to evaluate change in resting cardiac function over 10 years and to determine risk factors for late cardiotoxicity. ⋯ Monitoring with exercise echocardiography has no added value to monitoring with resting echocardiography alone in predicting late anthracycline-induced cardiotoxicity in childhood cancer survivors. RFSz deteriorates over time, even in originally asymptomatic patients. Previous treatment with higher cumulative anthracycline dose is the main risk factor for a lower RFSz at late follow-up.