Journal of pediatric hematology/oncology
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J. Pediatr. Hematol. Oncol. · Dec 2011
Randomized Controlled Trial Multicenter Study Comparative StudyPolyethylene Glycol-conjugated L-asparaginase versus native L-asparaginase in combination with standard agents for children with acute lymphoblastic leukemia in second bone marrow relapse: a Children's Oncology Group Study (POG 8866).
Administration of L-asparaginase is limited by hypersensitivity reactions mediated by anti-asparaginase antibodies. To overcome this problem, native Escherichia coli L-asparaginase was conjugated to polyethylene glycol (PEG) to formulate PEG-L-asparaginase, a preparation with decreased immunogenicity and increased circulating half-life. In early trials, PEG-L-asparaginase was tolerated by patients known to be hypersensitive to the native E. coli product. ⋯ PEG asparaginase is a useful agent in patients with allergic reactions to native asparaginase.
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J. Pediatr. Hematol. Oncol. · Dec 2011
Case ReportsAcute respiratory failure in 3 children with juvenile myelomonocytic leukemia.
Juvenile myelomonocytic leukemia is a rare hematopoietic stem cell disease in children with features of both myelodysplasia and myeloproliferation. Extramedullary involvement has been reported and pulmonary involvement secondary to leukemic infiltration is an initial manifestation, which may result in acute respiratory failure. ⋯ In each case the patients improved rapidly after initiation of antileukemic treatment including 6-mercaptopurine or cytarabine.
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J. Pediatr. Hematol. Oncol. · Oct 2011
ReviewPalliative care and the cancer patient: current state and state of the art.
Comprehensive cancer care requires the integration of palliative care practices and principles across the trajectory of the cancer experience. It complements the treatment of curable disease and may be the sole focus of care for those patients with advanced incurable disease. ⋯ There are numerous barriers to the provision of integrated care, including the ongoing misconception that palliative care is end-of-life care, the "cure-care dichotomy," inadequate training of health professionals and lack of resources. This article reviews the essential elements of comprehensive cancer care and the challenges to providing integrated cancer and palliative care to patients world-wide.
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J. Pediatr. Hematol. Oncol. · Oct 2011
Clinical TrialMeasuring death-related anxiety in advanced cancer: preliminary psychometrics of the Death and Dying Distress Scale.
The alleviation of distress associated with death and dying is a central goal of palliative care, despite the lack of routine measurement of this outcome. In this study, we introduce the Death and Dying Distress Scale (DADDS), a new, brief measure we have developed to assess death-related anxiety in advanced cancer and other palliative populations. We describe its preliminary psychometrics based on a sample of 33 patients with advanced or metastatic cancer. ⋯ Dying and death-related distress was positively associated with depression and negatively associated with spiritual, emotional, physical, and functional well-being, providing early evidence of construct validity. This distress was relatively common, with 45% of the sample scoring in the upper reaches of the scale, suggesting that the DADDS may be a relevant outcome for palliative intervention. We conclude by presenting a revised 15-item version of the scale for further study in advanced cancer and other palliative populations.
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J. Pediatr. Hematol. Oncol. · Oct 2011
Case ReportsInfluenza A (H1N1) in a pediatric patient with newly diagnosed acute promyelocytic leukemia and invasive pulmonary aspergillosis.
Influenza A (H1N1) pandemic reached its peak in Europe in autumn 2009. H1N1 infection can be a serious complication in patients with comorbidity or immunodepression. Here, we report of a boy with newly diagnosed acute promyelocytic leukemia with a very severe respiratory distress caused by influenza A (H1N1) infection in pulmonary aspergillosis, successfully treated with antifungal therapy, oseltamivir, and extracorporeal membrane oxygenation.