Klinische Pädiatrie
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Klinische Pädiatrie · Nov 2009
Randomized Controlled Trial Multicenter Study Comparative StudyDose reductions of vincristine in children with medulloblastoma treated in the maintenance arm of the prospective multicenter trial HIT'91.
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Klinische Pädiatrie · Nov 2009
Leukapheresis and exchange transfusion in children with acute leukemia and hyperleukocytosis. A single center experience.
The risk of severe complications or death during the initial period of acute leukemia was markedly decreased due to the progress in pediatric oncology and use of simple measures like hyperhydration, forced diuresis, treatment of hyperuricemia, correction of electrolyte and coagulation disturbances and the careful use of antileukemic drugs. The incidence of leukostasis and tumor lysis syndrome depends on absolute initial white blood cell counts and the underlying type of leukemia. Leukapheresis or exchange transfusion may improve the prognosis of high risk patients. ⋯ Leukapheresis or exchange transfusion together with conservative management and specific oncological therapy may contribute to rapid leukocyte reduction with acceptable risk. The exact impact of leukapheresis or exchange transfusion on short and long term outcome in pediatric patients with acute leukemia and initial hyperleukocytosis has to be evaluated in future multicentre studies or by the formation of clinical registries.