Search

The aim of this study was to determine subclinical atherosclerosis and endothelial functional disturbance with measurement of carotid intima-media thickness (IMT), brachial artery reactivity (BAR), and levels of serum adhesion molecules in children with solid tumors who were treated with anthracyclines and are actually in complete remission. Fifty patients who were in remission and 30 healthy children were included in the study. Mean ages of patient and control groups were 13.5 ± 4.7 years (range: 3–23 years) and 12.00 ± 4.3 years (range: 4–21 years), respectively. The patients were divided into 3 groups according to cumulative doxorubicin dose: Group 1, ≤100 mg/m2; Group 2, 101–299 mg/m2; Group 3, ≥300 mg/m2. The BAR and carotid IMT were measured in order to determine the endothelial function. The serum adhesion molecule levels in our patients and controls were also measured. The BAR of the patients with cumulative anthracycline dose ≥300 mg/m2was significantly lower than the patients with cumulative anthracycline dose ≤100 mg/m2and healthy controls (P=.005 andP=.003, respectively). Also, there was a negative correlation between brachial artery reactivity and increasing cumulative anthracycline dose (r= −.287,P=.044). We also found significant difference between the mean carotid IMT of the patients and the healthy children (P=.041). No statistically significant difference was detected between the serum levels of sICAM-1 (soluble intercellular adhesion molecule-1), sVCAM-1 (soluble vascular cell adhesion molecule-1), sE-selectin of the patients and controls. The use of anthracyclines in pediatric patients with cancer could result in increase of the carotid IMT and endothelial dysfunction. [ABSTRACT FROM PUBLISHER]

The purpose of this study was to determine the prevalence of posttraumatic stress disorder (PTSD) in parents of children with cancer. Five questionnaires were administered to 104 parents, including a sociodemographic questionnaire, a traumatic events check list, the Structured Clinical Interview for DSM-IV PTSD and Major Depressive Disorder modules, and the self-rating instrument General Health Questionnaire-12. The prevalence of PTSD was 34.6%. The statistically significant tendency to develop PTSD were found in the female gender, better educational status, death of a loved one, previous history of psychiatric disorder, having a child with poorer prognosis, and the presence of radiotherapy in child's treatment. The vulnerable parents must receive psychosocial support. [ABSTRACT FROM AUTHOR]

Various kinds of second malignant neoplasms after successful treatment for childhood acute leukemia have been reported. The authors describe an unusual case of an olfactory neuroblastoma in a patient previously treated for childhood acute leukemia including autologous bone marrow transplantation. The prophylactic cranial irradiation and the total body irradiation during autologous bone marrow transplantation may have induced the development of their patient's olfactory neuroblastoma. Although a second primary olfactory neuroblastoma is rare, it should be added to the list of second malignant neoplasmsin the sinonasal region. [ABSTRACT FROM AUTHOR]

The aim of this study was to retrospectively evaluate clinical characteristics at diagnosis and outcome of patients with Langerhans cell histiocytosis (LCH). From October 1987 to March 1996, 133 patients with confirmed LCH were admitted to Hospital JP Garrahan in Buenos Aires (123 evaluable). Median age was 5 years (range 15 days to 18 years). Initial organ involvement included bone 114 patients, ear 34, skin 30, liver 18, lung 14, lymph nodes 14, spleen 12, diabetes insipidus 9, and bone marrow 2. Nineteen patients had organ dysfunction, pulmonary 14, hematological 14, and hepatic 12. Two groups were defined: Group A included patients with single system disease (unior multifocal) and group B multisystem (with or without organ dysfunction). In group A (n = 82), 24 patients were treated with chemotherapy (prednisone and vinblastine), 21 with surgery, 15 received radiotherapy, and 22 were only observed. Patients of group B ( n = 41) were treated with chemotherapy consisting of prednisone and vinblastine, DALHX 83, or LCH1-based chemotherapy. At a median follow-up of 3 years (range 1 month-8 5/12 years) 93% of patients of group A and 39% of group B survive free of reactivation. In group B, 22% had a reactivation and 39% died of progressive disease. Sequelae were detected in 35 patients (28%), which included diabetes insipidus in 17, hearing loss in 13, bony sequelae in 11, sclerosing cholangitis in 6, and lung fibrosis with bullae in 6. Two patients had a subsequent malignant disease. A total of 17 (14%) patients died and 16 of them belonged to the group B: 13 died of progressive disease, 2 due to sclerosing cholangitis (with sepsis in one case and encephalitis in the other one), 1 with progressive disease and associated myelofibrosis, and 1 patient of group A with active disease and brain stem tumor. Patients who had organ dysfunction had a reactivation free survival of 32%. All these patients survived with sequelae. Logistic regression analysis showed that organ dysfunction and hematological involvement had significant predictive values in relation to death. Patients of group A had an excellent survival rate, whereas in those of group B a high mortality was found, especially in the subgroup of patients with organ dysfunction. Lahey's criteria should be revised. Sequelae were also more common in this group. [ABSTRACT FROM AUTHOR]

The ability to divide subsets of children with astrocytoma into prognostic groups is limited because only a few clinical and pathologic variables are available. This study evaluated DNA ploidy as a potential prognostic factor in 30 children with diagnosed gliomas and examined the correlation of flow cytometric analysis to other parameters such as sex, age at diagnosis, histologic grading, localization of tumor, and completeness of surgical resection. Seventeen children with low-grade glioma and 13 with high-grade glioma were retrospectively reviewed; mean age of the patients was 8.2 years, and mean follow-up of the population was 7.6 years. The tumor was localized to the cerebrum in 19 patients, the cerebellum in 7 patients, the brain stem in 3 patients, and the spine in 1 patient. Fourteen patients underwent complete excision and 16 patients underwent partial excision. DNA diploidy was demonstrated in 21 patients and aneuploidy in 9 patients. Twenty children had no evidence of disease and 10 died of disease. Of the patients with diploid tumors, 81% survived, compared to only 33% survival among patients with aneuploid tumors (p < .011). By Cox regression analysis with age, gender, type of excision, grade, location of tumor, and ploidy as independent variables, ploidy was a statistically significant predictor of survival (p = .043). This investigation provides further evidence that flow cytometry may have prognostic value in children with gliomas. Thus, a larger number of tumors can be studied to extend and validate these observations. [ABSTRACT FROM AUTHOR]

To evaluate the role of serum CA 125 levels for the diagnosis, follow-up, and prognosis in childhood non-Hodgkin's lymphomas (NHL), 44 children (35 newly diagnosed patients and 9 patients with relapsed or progressive disease, median age 6.5 years, M/F ratio 2.1) with NHL were included in this study. CA 125 levels in serum and/or ascites and effusions were measured by radioimmunoassay. The upper limit of normal was 35 IU/mL. The correlation of CA 125 levels with tumoral location and treatment results were investigated. A total of 27 (61.4%) patients had increased and 17 patients had normal serum CA 125 levels. Fifteen patients with increased CA 125 levels had malignant ascites, pleural effusion, or both, although none with normal CA 125 levels had any serous membrane involvement. The mean CA 125 levels were 72.5 IU/mL in patients with no serosal involvement (ascites or effusion) and, 144.0, 273.7, 324.3 IU/mL in patients with pleural effusion, ascites, and ascites + effusion, respectively. The mean CA 125 levels in ascites and pleural effusion were 202.1 and 156.2 IU/mL, respectively, and were similar to the corresponding serum levels. The increased CA 125 levels returned to normal in 18 patients whose diseases were in remission during the follow-up. One-year survival rate for newly diagnosed patients was 80.2 and 87.5% in patients with increased and normal serum CA 125 levels, respectively. In conclusion, CA 125 levels were significantly higher in patients with serous membrane involvement and there was a correlation between treatment response and marker levels. Little is known about the expression of CA 125 in NHLs. This is the first report suggesting that serum CA 125 levels can be a useful marker for the follow-up of childhood NHL. CA 125 seems to be a promising tumor marker in the assessment of prognosis and therapeutic response in non-Hodgkin's lymphomas. [ABSTRACT FROM AUTHOR]

Investigates the diagnostic value of alpha[sub]1-fetoprotein (AFP) and beta-human chorionic gonadotropin (B-hcG) in infancy and childhood. Guidelines for the diagnosis of children with suspected secreting hormones; Application of AFP and B-hcG on pediatric oncology; Representation of AFP and B-hcG as marker of malignant epithelial liver tumors and germ cell tumors.