Leukapheresis and exchange transfusion in children with acute leukemia and hyperleukocytosis. A single center experience.

Abstract:

BACKGROUND: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. METHODS:Records of all pediatric patients who were newly diagnosed with acute leukemia between 1 / 1998 und 12 / 2008 were retrospectively reviewed for presence of hyperleukocytosis(white blood cell count > 100 GPT / l) at diagnosis and subsequent leukapheresis or exchange transfusion in regards to the clinical outcome. RESULTS:At diagnosis 11 (14 % ) of 77 children with acute leukemia (7 acute lymphoblastic leukemia / ALL; 4 acute myeloblastic leukemia /AML) had hyperleukocytosis. 4 patients (2 ALL, 2 AML) received exchange transfusion and 2 others (1 ALL, 1 AML) underwent leukapheresis. Marked cytoreduction was achieved in all patients within 24 h after therapy initiation. There were no procedure-related adverse events. Symptoms due to hyperleukocytosis markedly improved after cytoreduction. CONCLUSION: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.

journal_name

Klin Padiatr

journal_title

Klinische Padiatrie

authors

Haase R,Merkel N,Diwan O,Elsner K,Kramm CM

doi

10.1055/s-0029-1239533

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

374-8

issue

6

eissn

0300-8630

issn

1439-3824

journal_volume

221

pub_type

杂志文章
  • Reduced expression and defective modulation of TNF receptor/ligand family molecules on proB-ALL blasts.

    abstract:BACKGROUND:There is a subgroup of pediatric patients with an immature immunophenotype of proB-ALL that still poses a therapeutic challenge, even if the overall prognosis in B cell precursor acute lymphoblasic leukemia (BCP-ALL) is very good. Due to impaired treatment response these patients are prone to suffer relapse ...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-0028-1086028

    authors: Troeger A,Glouchkova L,Escherich G,Siepermann M,Hanenberg H,Janka-Schaub G,Göbel U,Ackermann B,Dilloo D

    更新日期:2008-11-01 00:00:00

  • [Assessment and therapeutic possibilities in posthemorrhagic hydrocephalus of the newborn infant].

    abstract::Internal hydrocephalus follows intraventricular hemorrhage in about 10%. Progression is directly related to the degree of hemorrhage. Several studies confirmed that cerebral damage may occur without an increase of intracranial pressure or head circumference. Assessment and therapeutic consequences depend entirely on s...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1033725

    authors: Arnold D,Adis B,Rettwitz W,Lasch P,Kachel W

    更新日期:1988-07-01 00:00:00

  • [Supplementary intravenous nutrition in term and preterm neonates (author's transl)].

    abstract::16 term and preterm neonates received intravenous nutriton for at least three days. The dosage was 1--2 g amino acids, 1 g of fat, and 8--10 g glucose per kg body weight and day. Compatibility was investigated by daily determinations of the amino acid pattern in the serum and measurement of free fatty acids and trigly...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:

    authors: Petrich C,Stephan U,Remy R,von Voss H,Göbel U,Herpertz LM

    更新日期:1979-07-01 00:00:00

  • [Wiedemann-Beckwith syndrome: clinical characteristics, constitutional chromosome abnormalities and tumor incidence].

    abstract::The observation of constitutional chromosome abnormalities in a one and half year old boy with Wiedemann-Beckwith syndrome (WBS) and hepatoblastoma prompted us to review the currently available literature dealing with this subject. In approximately 500 published cases with complete and incomplete forms of WBS, 42 mali...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1026804

    authors: Haas OA,Zoubek A,Grümayer ER,Ferstl G,Gadner H

    更新日期:1987-07-01 00:00:00

  • [Nutritional Therapy for Children and Adolescents with Autism Spectrum Disorders: What is the Evidence?].

    abstract:BACKGROUND:Autism spectrum disorders (ASDs) are a group of developmental disabilities in childhood and adolescence. Beside genetic predisposition also environmental influences may contribute to the ASD pathogenesis. Family members of children and adolescents with ASD often ask for specific diets to alleviate ASD-associ...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章,评审

    doi:10.1055/s-0041-110207

    authors: Sausmikat J,Smollich M

    更新日期:2016-03-01 00:00:00

  • [Interferons--biologic principles and clinical uses].

    abstract::Interferons are components of the nonspecific defense system. Their most prominent biological roles are the antiviral, the antiproliferative, and the immunoregulatory activities. However, their primary functions within the organism remains to be determined. Three types of IFNs have been described so far (IFN alpha, IF...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1033980

    authors: Jacobsen H,Kirchner H

    更新日期:1985-07-01 00:00:00

  • [Esophageal function of infants with sudden infant death--risk].

    abstract::In 24 patients at risk for SIDS (12 infants with a near miss event and 12 infants with apnea and perioral cyanosis during sleep) respiratory and esophageal function were investigated by impedance pneumography (IP) and esophageal manometry combined with simultaneous pH-monitoring (EMPH). Both groups had ad early pathol...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2007-1025483

    authors: Landler U,Höllwarth ME,Uray E,Schober PH,Reiterer F,Schenkeli R

    更新日期:1990-01-01 00:00:00

  • [Wegener's granulomatosis as a rare cause of hemoptysis in childhood].

    abstract::Wegener's granulomatosis is together with Churg-Strauss syndrome and microscopic polyangiitis a very rare cause of hemoptysis in childhood. We report on a 14 years old girl who developed arthralgia, purpura, glomerulonephritis and a diffuse alveolar haemorrhage with hemoptysis after a short time period of unspecific s...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2005-836847

    authors: Heckmann M,Weber K,Reineck P,Schüler D,Geidel C,Steiss JO

    更新日期:2006-01-01 00:00:00

  • [Neurenteric cyst of the mediastinum--case report and review of the literature].

    abstract::A case of an infant with a mediastinal neurenteric cyst is used to review this rare entity. By definition a neurenteric cyst is the combination of an entodermal cyst with a vertebral dysplasia. Neurenteric cysts are located in the posterior mediastinum, preferentially on the right side. In a third of the patients thes...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1026749

    authors: Köster B,Emons D,Kunath U,Födisch HJ

    更新日期:1987-01-01 00:00:00

  • [Influence of nutrition on the cellular defence mechanism (phagocytosis) of preterm and underweight babies during the first six weeks of life (author's transl)].

    abstract::The phagocytic and NBT reduction indices of 94 preterm and underweight babies, divided into 7 groups and two weight classes, were observed over a period of six weeks while they were observed over a period of six weeks while they were given four commercial baby foods (Humana 0, Meb, Multival, Pomil). In all groups the ...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:

    authors: Jeschke R,Ströder J

    更新日期:1978-03-01 00:00:00

  • [Treatment of hepatitis B virus-associated membranous glomerulonephritis with interferon alfa in a 7 year old boy].

    abstract:BACKGROUND:The association between Hepatitis B virus infection and membranous nephropathy has been confirmed by sources in several countries. Most commonly, the illness is seen as a nephrotic syndrome. Optimal treatment remains undefined. Antiviral therapies observed with recombinant human interferon alpha may be the b...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2000-9689

    authors: Steiss JO,Piske-Keyser K,Gröne HJ,Gortner L

    更新日期:2000-09-01 00:00:00

  • [Changes in the granulocyte membrane in mucoviscidosis].

    abstract::Important polymorphonuclear leukocyte (PMN) functions are dependent on an intact cytoskeleton, consistent of the microtubulus and microfilament system. This can be assayed from the mobility of fluorescence labelled Concanavalin A (Con A) receptor complexes on the cell surface. Con A shows an uniform surface distributi...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1034392

    authors: Rister M,Statz A,Brucke G

    更新日期:1983-09-01 00:00:00

  • [Peritonitis and infection in children with idiopathic nephrotic syndrome].

    abstract::We analyzed episodes of peritonitis and/or sepsis associated with the idiopathic nephrotic syndrome (ns) in 23 children treated between 1975 and 1985 at our clinic. 37.5% of the children with infantile ns, 16% of those with steroidsensible ns, and 13.6% of those with steroidresistant ns developed peritonitis. Children...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1033683

    authors: Feldhoff C,Kleine L,Bachmann H

    更新日期:1988-01-01 00:00:00

  • [Preparation of a compatibility chart for intravenous drug therapy in neonatal and pediatric intensive care units].

    abstract:BACKGROUND:Modern neonatal and pediatric intensive care includes a sophisticated pharmacotherapy with numerous drugs, mainly administered intravenously. Often, despite the use of multi-lumen central venous lines, more peripheral venous accesses are required. To reduce the necessity of numerous venous lines on one hand ...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2005-836937

    authors: Höpner JH,Schulte A,Thiessen J,Knuf M,Huth RG

    更新日期:2007-01-01 00:00:00

  • [Echocardiographic diagnosis of congenital diverticuli of the right and left ventricle].

    abstract::A congenital diverticulum of the ventricle is a very rare cardiac lesion which is almost always associated with additional cardiovascular anomalies. In the majority of cases a diverticulum of the heart has been diagnosed during cardiac catheterization for evaluation of additional cardiovascular anomalies. We report no...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2007-1025221

    authors: Wild F,Hofbeck M,Singer H,Hammersen G

    更新日期:1993-05-01 00:00:00

  • [After-care of children and young adults surviving cancer. Initial recommendations by the late sequelae study group].

    abstract::An increasing number of children suffering from cancer has been treated successfully during the last 25 years using therapy protocols of the Gesellschaft für Pädiatrische Onkologie und Hämatologie. The patients had to undergo an interdisciplinary treatment modality and a mostly intensive chemotherapy. Late effects cou...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1046537

    authors: Beck JD,Winkler K,Niethammer D,Brandis M,Hertzberg H,von der Hardt K,Greil J,Uberall MA,Rossi R,Lamprecht-Dinnesen A

    更新日期:1995-07-01 00:00:00

  • [Sonography of the larynx in children. New perspectives due to the use of computerized sonography: 2: Sonographic findings in a case of laryngeal papillomatosis].

    abstract::On our opinion one important indication for sonographic diagnosis in future are masses in the larynx area: in infancy or childhood mainly laryngeal papillomatosis. In one of our boy patients with massive laryngeal papillomatosis laser surgery was first performed at 15 months of age. After a second and third procedure ...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2007-1025304

    authors: Grunert D,Schöning M,Stier B,Klingebiel T

    更新日期:1989-05-01 00:00:00

  • [Right-sided lung hypoplasia in a 13-year-old boy].

    abstract::Initially a right sided pulmonary hypoplasia was diagnosed in our patient at the age of 9 years. The previous years were characterized by recurrent pneumonia, bronchitis and daily coughing fits. Findings of the chest radiograph suggested the diagnosis of right sided hypoplasia. The right hemithorax was small with medi...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2007-1025500

    authors: Riedler J,Rettenbacher L,Weiss P

    更新日期:1990-03-01 00:00:00

  • [Intracranial pressure increase following treatment nalidixic acid in a child aged 3 1/2 years (author's transl)].

    abstract::Neurological symptoms developed in a girl aged three-and-a-half years during treatment with nalidixic acid. The symptoms progressed even after the preparation had been discontinued, and culminated in the development of a transient intracranial pressure increase. ...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:

    authors: Lorenz R

    更新日期:1979-07-01 00:00:00

  • [Clinical and neuroradiological findings in gliomatosis of the brain with special reference to magnetic resonance tomography].

    abstract::We present three cases of GC, one belonging to the brainstem, and two belonging to the hemisphere type. Two cases were investigated by MRI. Tumour infiltration, while yielding only vague CT findings, was well demonstrated in MR studies where extensive hyperintense lesions were found in T2- and proton density images. I...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2007-1025450

    authors: Borgis KJ,Larsen JL,Mørk S,Brückmann H

    更新日期:1991-09-01 00:00:00

  • [The growth rate of healthy children in the first 16 years: Bonn-Dortmund longitudinal developmental study].

    abstract::Standards for supine length/height velocity from birth to 16 years (percentiles, mean and standard deviation) are presented, based on the longitudinal growth studies from Bonn and Dortmund. During the first two years of life growth velocity is twice to three times higher as in the following years. Many things point to...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1033752

    authors: Brandt I,Reinken L

    更新日期:1988-11-01 00:00:00

  • Treatment of multisystem Langerhans cell histiocytosis. Results of the DAL-HX 83 and DAL-HX 90 studies. DAL-HX Study Group.

    abstract:BACKGROUND:The prognosis of children with multisystem Langerhans cell histiocytosis (LCH) has improved with the application of chemotherapy. However, treatment strategies used varied from conservative approach with treatment only during disease exacerbation to intensive chemotherapy starting immediately after diagnosis...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2000-9667

    authors: Minkov M,Grois N,Heitger A,Pötschger U,Westermeier T,Gadner H

    更新日期:2000-07-01 00:00:00

  • [Autoimmune hemolytic anaemia in childhood. Review and report of one case (author's transl)].

    abstract::Autoimmune hemolytic anaemia (AIHA) in childhood is associated with antibodies produced by the patient himself, which coat his red cells causing their hemolysis. Although in some cases no underlying disease could be found, in the majority of children a virus etiology is apparent. There are very few reports regarding t...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:

    authors: Haas RJ,Pöschl U,Christ M,Schaub J,Belohradsky BH

    更新日期:1977-05-01 00:00:00

  • [Hearing screening of newborn infants at risk for perinatal hearing damage].

    abstract::630 neonates with risk factors of perinatal hearing impairment were screened of hearing loss by means of registration of transient otoacoustic emissions before discharge from the newborn nursery. Neonates were screened additionally by means of brainstem evoked response audiometry, if they had bilateral negative emissi...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1043853

    authors: Sitka U,Rehm K,Rasinski C

    更新日期:1998-03-01 00:00:00

  • Painful scoliosis.

    abstract::In case of painful scoliosis, a search for etiologic factors in the vertebral spinal canal and adjacent structures should be made. MRI with Gadolinium is useful to look for various pathology in and around the spine in particular of spinal cord. CT scanning is indispensible for bony details. Thus CT and MRI are complem...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章,评审

    doi:10.1055/s-2008-1043932

    authors: Hoeffel C,Gaucher H,Hoeffel JC,Galloy MA,Arnould V

    更新日期:1997-03-01 00:00:00

  • [The clinical significance of pseudouridine determination of the urine in children and adolescents].

    abstract::A HPLC-method is described to determine the Pseudouridine/creatinine ratio in spontaneous urine samples in infancy and childhood. The urines of 74 healthy children between 1 and 18 years of age and of 231 children with different diseases were examined for this ratio, making 1097 measurements. 157 children suffered fro...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2007-1025295

    authors: Graf N,Bach K,Frisch B,Haas HJ,Sitzmann FC

    更新日期:1989-05-01 00:00:00

  • Chemotherapy as a therapeutic option for congenital neuroblastoma complicated by paraplegia.

    abstract:BACKGROUND:Spinal compression can be a complication of neuroblastoma (NBL). Delayed or insufficient treatment of this condition may lead to permanent neurological sequelae. Therefore, appropriate treatment should be introduced promptly. Therapeutic options include neurosurgery, chemotherapy, and radiation therapy. CAS...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1065340

    authors: Walter KN,Kratz C,Uhl M,Niemeyer C

    更新日期:2008-05-01 00:00:00

  • [NHL-BFM 90 therapy study in treatment of malignant non-Hodgkin's lymphoma in children and adolescents. Part 3: An intermediate term analysis of the B-NHL/B-ALL].

    abstract::The aims of trial NHL-BFM 90 for patients (pts) suffering from B-cell neoplasms are to prove whether: 1. Treatment for pts with complete resection can be reduced from 3 to 2 therapy courses; 2. Results for pts of stage III with large abdominal tumors can be improved by high dose (HD) chemotherapy; 3. Survival for pts ...

    journal_title:Klinische Padiatrie

    pub_type: 临床试验,杂志文章,多中心研究,随机对照试验

    doi:10.1055/s-2008-1046610

    authors: Reiter A,Schrappe M,Yakisan E,Sauter S,Ebell W,Zimmermann M,Hartmann W,Kremens B,Kuhn N,Claviez A

    更新日期:1994-07-01 00:00:00

  • [Increased incidence of developmental hip dysplasia in hypertrophic newborn infants].

    abstract::"Lack of space" in utero is considered to be a major factor in the aetiology of the congenital dislocation of the hip. This study tries to answer the question whether hypertrophy of a newborn has to be regarded as a risk factor on the basis of the principle mentioned above. The results of postnatal clinical and sonogr...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2007-1025256

    authors: Peschgens T,Skopnik H,Casser HR,Rauschning-Sikora K,Heimann G

    更新日期:1993-11-01 00:00:00

  • [Progress in the therapy of children with congenital hemolytic anemias by transfusion of neocyte concentrations. Initial experiences in the separation and transfusion of young erythrocytes, obtained with the cell separator Fenwal CS-3000].

    abstract::Transfusion-induced hemochromatosis remains a major therapeutic complication in the management of patients with chronic hemolytic anemias. Red cell units harvested with blood cell separators have an average estimated mean cell age of 30 days, compared to 60 days for unfractionated blood. Our initial experience with tr...

    journal_title:Klinische Padiatrie

    pub_type: 杂志文章

    doi:10.1055/s-2008-1033936

    authors: Heim MU,Eckstein R,Mittermüller H,Haas RJ,Schmidt P,Graebner E,Pape W,Mempel W

    更新日期:1985-03-01 00:00:00