Pediatric blood & cancer
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Pediatric blood & cancer · Mar 2010
Pre-transplant lung function is predictive of survival following pediatric bone marrow transplantation.
Pulmonary toxicity is well described in recipients of bone marrow transplants (BMT), and accounts for a sizeable proportion of post-transplant mortality. The majority of the data on post-transplant pulmonary function is from adults, although several small pediatric case series have been described. In adults, pre-transplant lung function has been predictive of post-transplant respiratory failure and mortality. This use of pulmonary function testing, that is, for pre-transplant risk counseling, is novel but has never been applied to pediatric patients. We hypothesized that in children, as in adults, pre-transplant pulmonary function would also be predictive of outcome post-transplantation morbidity. ⋯ Lung function prior to bone marrow transplant, especially diffusing capacity, is frequently abnormal. Lung function frequently decreases shortly post-transplant and tends to improve over time, but frequently remains abnormal even years after transplant. Post-transplant survival is related to pre-transplant lung function.
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Pediatric blood & cancer · Mar 2010
Pulmonary hypertension in children and young adults with sickle cell disease: evidence for familial clustering.
Pulmonary hypertension (PHTN) is increasingly recognized as a serious complication of sickle cell disease (SCD). Our objective was to determine the prevalence of PHTN and identify factors associated with PHTN among children and young adults with SCD in Lebanon. ⋯ PHTN was common, associated with increased hemolysis but not G6PD deficiency, and clustered in families. Moreover, PHTN developed despite hydroxyurea therapy in five patients.
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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.