Abstract:
:Tolerance of full-dose methotrexate/6-mercaptopurine (MTX/6MP) maintenance therapy for childhood acute lymphoblastic leukemia (ALL) without side effects could reflect insufficient systemic drug exposure, and drug withdrawals due to toxicity might reduce the chance of cure. The present study included 122 children with non-B cell acute lymphoblastic leukemia with a median follow-up of 84 months. Leukopenia and hepatotoxicity were calculated as weighted means of all white cell counts and all serum aminotransferase measurements, respectively, registered for each patient. Forty-five patients relapsed (30 in bone marrow). Patients tolerating an average dose of MTX of more than 75% of the recommended protocol doses and having cumulated drug withdrawals of less than 1% of the period of maintenance therapy had an increased risk of hematological relapse (p = 0.008) as well as of any relapse (p = 0.03) when compared to the remaining patients. Patients with a cumulative withdrawal of MTX or of 6MP for greater than 10% of the maintenance therapy period had an increased risk of hematological relapse (MTX: p = 0.009, 6MP: p less than 0.0001) and of any relapse (MTX: p = 0.16, 6MP: p = 0.0002). Liver toxicity was the main reason for cumulative long-term drug withdrawals. However, patients with a mean aminotransferase level above the upper normal limit (40 IU/l) who were kept on therapy (cumulative withdrawals of neither drug for more than 5% of their maintenance therapy period) had a significantly lower risk of hematological relapse (p = 0.02) as well as of any relapse (p = 0.06) than the remaining children. The concept of treating to toxicity seems warranted for maintenance therapy of childhood lymphoblastic leukemia.
journal_name
Pediatr Hematol Oncoljournal_title
Pediatric hematology and oncologyauthors
Schmiegelow Kdoi
10.3109/08880019109028803subject
Has Abstractpub_date
1991-10-01 00:00:00pages
301-12issue
4eissn
0888-0018issn
1521-0669journal_volume
8pub_type
杂志文章abstract::The majority of the anemias during childhood are hypochromic and microcytic. The aim of the present study was to determine the status of α-thalassemia mutations and its association with other etiologies, such as iron deficiency anemia (IDA) and β-thalassemia trait, that are frequently seen hypochromic microcytic anemi...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880018.2012.661831
更新日期:2012-04-01 00:00:00
abstract::In recent years erythropoietic agents have become important tools in the management of anemia in cancer patients, improving hemoglobin (Hb) concentrations, reducing the need for transfusion, and enhancing quality of life. In this prospective and historically controlled study, the effects of epoetin beta on Hb concentr...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.1080/08880010802235132
更新日期:2008-09-01 00:00:00
abstract::The authors report on supernumerary nipples and various hematologic disorders in 7 patients [factor X deficiency (n = 1), factor XI deficiency (n = 2), acute lymphoblastic leukemia (n = 3), and acute myeloblastic leukemia (n = 1)]. They would like to draw attention to the association of supernumerary nipples with hema...
journal_title:Pediatric hematology and oncology
pub_type: 信件
doi:10.1080/08880010490457295
更新日期:2004-07-01 00:00:00
abstract::Infections remain a serious complication in pediatric oncology patients. To determine if daily bathing with Chlorhexidine gluconate can decrease the rate of nosocomial infection in pediatric oncology patients, we reviewed rates of infections in pediatric oncology patients over a 14-month span. Intervention group recei...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880018.2015.1013588
更新日期:2015-01-01 00:00:00
abstract::Primary diffuse leptomeningeal glioneuronal tumors (DLGNT) are rare tumors, recently recognized as a unique entity based on their unique pathologic and clinical characteristics. We report three cases of DLGNT and compare their clinical characteristics and presentation with other reported cases, and with primary leptom...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章,评审
doi:10.1080/08880018.2019.1711270
更新日期:2020-04-01 00:00:00
abstract::This study evaluated the effects of urokinase in the prevention of central venous catheter (CVC)-related complications in children with malignancy. Fifteen patients with 16 CVCs (study group A) received an intraluminal application of urokinase (10,000 IU in each catheter lumen for 4 h) once a week. They were monitored...
journal_title:Pediatric hematology and oncology
pub_type: 临床试验,杂志文章
doi:10.1080/088800102753541323
更新日期:2002-04-01 00:00:00
abstract::In patients undergoing bone marrow transplantation cryptococcosis is rarely encountered. We report a fatal case of Cryptococcus meningitis in a 12-year-old girl with acute lymphoblastic leukemia (ALL) in second remission who had a transplant from a human leukocyte antigen (HLA)-identical unrelated bone marrow donor. T...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880019709028778
更新日期:1997-09-01 00:00:00
abstract::Background: Preclinical studies show that TLR9 agonists can eradicate leukemia by induction of immune responses in vivo against AML and ALL. These studies demonstrated that TLR9 agonists induce an immediate NK response followed by adaptive T and B cells responses resulting in long term anti-leukemia immunity. Methods:...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.1080/08880018.2019.1667461
更新日期:2019-11-01 00:00:00
abstract::Two children are described who presented with fever and generalized seizures, days 50 and 200, respectively, after matched unrelated donor-bone marrow transplantation. Upon antiepileptic treatment the seizures vanished but somnolence and fever remained. Magnetic resonance imaging (MRI) of the brain was performed and r...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.1080/08880010050034337
更新日期:2000-07-01 00:00:00
abstract::Ondansetron (Zofron, Glaxo) and tropisetron (Navoban, Sandoz) are selective serotonin (5HT3) antagonists that have proven very effective in the prevention of vomiting and nausea in adults and children receiving cancer chemotherapy. This study compared the efficacy of the two agents in the prevention of vomiting and na...
journal_title:Pediatric hematology and oncology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1080/088800199277425
更新日期:1999-03-01 00:00:00
abstract::Neutropenic enterocolitis is an acute, life-threatening inflammation of the small and large bowel, often seen in children with malignancies during periods of prolonged or severe neutropenia. During the period 1990-1995, 180 children were treated at the authors' center for acute lymphoblastic leukemia using a standard ...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.1080/088800100276712
更新日期:2000-01-01 00:00:00
abstract::A 9-year-old girl presented at the Pediatric Emergency Department with an acute onset of gastrointestinal symptoms due to hypercalcemia. Despite the absence of circulating blast, bone marrow biopsy was diagnostic of acute lymphoblastic leukemia. The hypercalcemia was initially treated with intravenous hydration and fu...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.1080/08880010490477248
更新日期:2004-09-01 00:00:00
abstract::Modern treatment protocols lead to complete remission in a high proportion of patients with childhood acute lymphoblastic leukemia (ALL). However, a large number of them show a relapse of the disease. Treatment failure in these patients is mainly attributable to de novo or acquired resistance to a wide variety of cyto...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.1080/08880010600719303
更新日期:2006-09-01 00:00:00
abstract:BACKGROUND:We aimed to examine the association between vitamin D deficiency and anemia in a nationally representative sample of Korean children and adolescents. METHODS:Cross-sectional data on 2526 children and adolescents aged 10-20 years from the Korea National Health and Nutrition Examination Survey-V (2010-2012) w...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章,多中心研究
doi:10.3109/08880018.2014.983623
更新日期:2015-03-01 00:00:00
abstract::The clinical usefulness of the measurement of red cell zinc protoporphyrin (ZPP), an indicator of iron-deficient erythropoiesis, was assessed in a group of UK children undergoing investigation for red cell microcytosis. Of 213 children studied, 136 had increased ZPP values. Of these, 86 also had reduced iron stores as...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880019509009475
更新日期:1995-09-01 00:00:00
abstract::A prospective, open-label, randomized, comparative study in pediatric cancer patients was conducted to evaluate the efficacy and safety of cefepime and meropenem in the empiric therapy of febrile neutropenic patients. Febrile episodes were classified as microbiologically documented infection, clinical documented infec...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章,随机对照试验
doi:10.1080/08880010500506867
更新日期:2006-04-01 00:00:00
abstract::In an autopsy series of children with cancer, histopathologic myocardial changes caused by anthracyclines (A) were evaluated. The series comprised three groups: group A, 9 patients given A whose myocardial function had been evaluated before death; group B, 10 patients given A, but no lifetime echocardiographic evaluat...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880019409141669
更新日期:1994-05-01 00:00:00
abstract::The hematologic phenotype was characterized in heterozygotes for three of the most common beta-thalassemia mutations in the Greek population. The study included 17 carriers of beta++ IVS1-n6 (T-->C), 21 carriers of beta+ IVS1-n110 (G-->A), and 17 carriers of beta 0 CD39 (C-->T). The 55 beta-thalassemia heterozygotes w...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880019409141689
更新日期:1994-09-01 00:00:00
abstract::We investigated bone marrow (BM) recovery of hematopoietic stem cells (HSC) and hematopoietic microenvironment after chemotherapy in childhood acute lymphoblastic leukemia (ALL). Twenty-nine de novo childhood ALL patients were enrolled and BM biopsy sections at diagnosis (BM0), after induction (BM1), consolidation (BM...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.1080/08880018.2019.1623354
更新日期:2019-05-01 00:00:00
abstract::To determine the effect of recombinant human granulocyte-colony stimulation factor (rhG-CSF) on the immune system, serum immunoglobulins, lymphocyte subsets, and serum cytokines were analyzed in eight pediatric patients with aplastic anemia (AA) during 8-week rhG-CSF therapy. The rhG-CSF was administered either subcut...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880019409141675
更新日期:1994-05-01 00:00:00
abstract::Endothelial protein C receptor (EPCR) is primarily localized on the endothelial cells of large blood vessels and is very low or absent in the microvascular endothelium of most tissues. EPCR augments the thrombin/thrombomodulin-dependent activation of protein C by 5- to 20-fold. EPCR appears to be physiologically signi...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.1080/08880010701198811
更新日期:2007-04-01 00:00:00
abstract::Since the mid-1960s intrathecal chemotherapy (methotrexate [MTX], cytarabine [Ara-C], or both, plus hydrocortisone) has constituted the standard approach to prophylaxis and treatment of central nervous system (CNS) leukemia and lymphoma. Intrathecal chemotherapy-related neurotoxicity has been described in a variable p...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880019509029588
更新日期:1995-07-01 00:00:00
abstract::Homozygous beta-thalassemia is usually characterized by severe anemia requiring regular blood transfusion for survival. For homozygous patients with milder clinical manifestations and no dependence on transfusion therapy, the term thalassemia intermedia is usually applied. Genetic mechanisms that may ameliorate the cl...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880019509029526
更新日期:1995-01-01 00:00:00
abstract::Maternal education might be an important factor for the neuroblastoma risk in children, but it was conflicting. This meta-analysis was performed to evaluate the relationship between maternal education and neuroblastoma susceptibility and to explore whether maternal education was an important indicator to be associated...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章,meta分析
doi:10.3109/08880018.2012.742605
更新日期:2013-02-01 00:00:00
abstract::Adrenocortical carcinoma (ACC) is a rare, aggressive endocrine neoplasm. Complete surgical resection is the single most important treatment. Most available information has been learned from experience with its more frequent adult counterpart. In this study, we assessed the features and survival outcome of patients wit...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.1080/08880018.2019.1710309
更新日期:2020-04-01 00:00:00
abstract::The purpose of this study was to retrospectively analyze the clinical presentation, treatment, and outcomes of children with Wilms tumor (WT) and intravascular extension who were treated at a single institution. A retrospective review was conducted of medical records of all children with Wilms tumor and intravascular ...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880018.2011.642941
更新日期:2012-02-01 00:00:00
abstract::The authors aimed to investigate the efficacy of epoetin-alpha on hemoglobin levels and red cell transfusion requirement in children with both hematologic malignancy (HM, n = 27) and solid tumors (ST, n = 14). Epoetin-alpha was given (150 U/kg or 250 U/kg, thrice weekly) for 12 weeks. Epoetin alpha significantly incre...
journal_title:Pediatric hematology and oncology
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:2004-01-01 00:00:00
abstract::Infantile hemangioendothelioma is the most common hepatic vascular tumor in infants less than 6 months of age, with a prevalence of 1%. Serum alpha-fetoprotein levels have been used as an important tumor marker for hepatoblastoma, hepatocellular carcinoma, and germ cell tumors. It is rarely elevated in hepatic hemangi...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章,评审
doi:10.1080/08880010600954397
更新日期:2006-12-01 00:00:00
abstract::Olfactory neuroblastoma, a rare malignancy of the olfactory epithelium, is an uncommon tumor in children. It occurs mostly in older individuals and the treatment strategies are based on the experience with adults. In this report, clinical characteristics and treatment results of 2 patients with olfactory neuroblastoma...
journal_title:Pediatric hematology and oncology
pub_type: 杂志文章
doi:10.3109/08880018.2010.514656
更新日期:2011-02-01 00:00:00
abstract:BACKGROUND:Alterations in the tumor suppressor gene TP53 have been associated with poor outcome in adult hematological malignancies. We have earlier reported an increased expression of the TP53 encoded protein p53, in bone marrow samples from pediatric patients with aggressive leukemia. Our aim was now to evaluate p53 ...
journal_title:Pediatric hematology and oncology
pub_type: 临床试验,杂志文章
doi:10.3109/08880018.2014.898723
更新日期:2014-05-01 00:00:00