Pediatric blood & cancer
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Pediatric blood & cancer · Jun 2014
Successful use of indwelling tunneled catheters for the management of effusions in children with advanced cancer.
Malignant pleural effusion (MPE) and ascites (MA) negatively impact quality of life of palliative patients. Treatment options are limited. This study's purpose is to examine the experience with indwelling tunneled catheters (ITCs) for management of MPE/MA in children with advanced cancer. ⋯ ITC appears to be a safe, effective treatment for MPE/MA in advanced pediatric cancer, achieving symptomatic relief and discharge home.
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Delirium occurs frequently in critically ill children, and children with neuroblastoma may be at particular risk. Early diagnosis and treatment may improve short- and long-term outcomes. ⋯ In all four patients, the diagnosis of delirium facilitated targeted intervention and improvement. Heightened awareness by pediatric oncologists, surgeons, and intensivists may lead to earlier diagnosis and improvement in clinical outcomes.
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Pediatric blood & cancer · Jun 2014
Outcome of indwelling tunneled PleurX® catheter placement in pediatric and young adult patients with malignant effusions.
Malignant effusions may cause significant morbidity and mortality for cancer patients. Indwelling tunneled PleurX® catheter placement for intermittent drainage of malignant effusions has been shown to be efficacious in adults but has not been studied in children. ⋯ No patients experienced catheter-associated complications. PleurX® catheter placement should be considered for palliation of symptoms due to malignant effusions in pediatric oncology patients.
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Pediatric blood & cancer · May 2014
Phase 1 trial of temsirolimus in combination with irinotecan and temozolomide in children, adolescents and young adults with relapsed or refractory solid tumors: a Children's Oncology Group Study.
mTOR inhibitors have activity in pediatric tumor models. A phase I trial of the mTOR inhibitor temsirolimus (TEM) with irinotecan (IRN) and temozolomide (TMZ) was conducted in children with recurrent/refractory solid tumors, including central nervous system (CNS) tumors. ⋯ The combination of TEM (35 mg/m(2)/dose IV weekly), IRN (90 mg/m(2)/dose days 1-5) and TMZ (125 mg/m(2)/dose days 1-5) administered PO every 21 days is well tolerated in children. Phase 2 trials of this combination are ongoing.