Journal of pediatric hematology/oncology
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J. Pediatr. Hematol. Oncol. · May 2006
Autoimmune hypothyroidism after unrelated haematopoietic stem cell transplantation in children.
We describe two pediatric patients who developed autoimmune hypothyroidism 2 years after unrelated allogeneic hematopoietic stem cell transplantation. The causes of post-transplantation autoimmune hypothyroidism are probably multiple. In these two patients, the presence of chronic graft-versus-host disease may be the most significant contributing factor.
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J. Pediatr. Hematol. Oncol. · Feb 2006
Case ReportsLow oxygen saturation by pulse oximetry may be associated with a low oxygen affinity hemoglobin variant, hemoglobin Titusville.
The authors describe a 10-year-old Caucasian boy who presented with abnormally low oxygen saturation values on pulse oximetry after a routine tonsillectomy. He was asymptomatic and there was no personal or family history of respiratory, cardiac, or hematologic disorders. ⋯ Hemoglobinopathies remain highly prevalent worldwide, with more than 65 low oxygen affinity hemoglobin variants identified to date. Early recognition of abnormal hemoglobin variants in asymptomatic patients may avoid extensive, unnecessary medical investigations.
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J. Pediatr. Hematol. Oncol. · Feb 2006
Comment Comparative StudyCisplatin: continuous versus bolus.
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J. Pediatr. Hematol. Oncol. · Feb 2006
Comparative StudyLow incidence of ototoxicity with continuous infusion of cisplatin in the treatment of pediatric germ cell tumors.
Cisplatin is an important chemotherapeutic agent in the treatment of many pediatric malignancies, but its use is limited in part by ototoxicity. The authors' institution has been administering standard-dose cisplatin by continuous infusion rather than bolus administration in germ cell tumors. The authors retrospectively reviewed 39 patients with germ cell tumors requiring chemotherapy over the past 20 years and recorded data including demographics, cumulative cisplatin dose, degree of ototoxicity (by the Brock grading system), and disease outcome. ⋯ This patient received a total cumulative dose of 500 mg/m of cisplatin. Eighty-two percent of children achieved clinical remission of their disease. The authors conclude that continuous administration of cisplatin is associated with minimal ototoxicity while maintaining good tumoricidal efficacy, and further studies using this regimen are warranted.
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J. Pediatr. Hematol. Oncol. · Jan 2006
Randomized Controlled Trial Comparative StudySubcutaneous bolus injection of deferoxamine is an alternative method to subcutaneous continuous infusion.
The objective of this study was to compare the short- and long-term efficacy of deferoxamine (DFO) given by subcutaneous (SC) continuous infusion over 10 hours via a pump (n = 10) versus a twice-daily subcutaneous bolus injection of the same overall dose (n = 10) in 20 thalassemic children. Urinary iron excretion was measured in 24-hour urine samples after DFO treatment in the 20 patients. The patients were randomized to two groups: 10 patients continued SC continuous infusion with a pump and the remaining 10 received the same overall dose of DFO by twice-daily SC bolus injection for a year. ⋯ Hepatic iron concentration was noted to be slightly increased in two patients in the SC continuous infusion group, which may be due to poor compliance. Based on these results, twice-daily SC bolus injection of DFO is as effective as administration via SC continuous infusion using a pump. Subcutaneous bolus injection, being more convenient for the patient, may be a more preferable method of DFO administration.