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Background The aim of this study was to describe the management experience of children with appendix carcinoids ( AC). Method A systematic review of the literature pertaining to AC in the pediatric population was performed. Pub Med, EMBASE and SCOPUS and most significant Congress proceedings were reviewed. In addition, charts and files at Stollery Children's Hospital, University of Alberta, Edmonton, Canada, were retrieved and the data compared with the scientific literature review. Results Between January 2000 and October 2010, seven patients had AC at the authors' institution. Mean age at diagnosis was 15 years while the male : female ratio was 3:4. Five out of seven patients presented with acute appendicitis. Size ranged up to 1.4 cm. In one case only lymph node metastases were observed. No distant metastases were seen in any patient. Carcinoid was low grade in all seven children. One patient suffered from familial adenomatous polyposis. At a mean follow up of 53.4 months, the outcome was excellent with all patients alive without disease. In the systematic review, 206 studies referring to AC in children were identified. Most series on childhood AC were small single-center series with 2-19 patients. Conclusions Older age (>10 years) at diagnosis, female preponderance, and tumor diameter <1.5 cm were the salient observations in the present study. Surgical resection at an early stage allows for excellent prognosis without the need for any additional surgical or adjuvant treatment. Genetic counseling may be appropriate in view of the possible association with colonic adenocarcinoma. [ABSTRACT FROM AUTHOR]

This study was designed to analyze the spectrum of central nervous system (CNS) disease at diagnosis, traumatic lumbar puncture (TLP), role of cranial irradiation, prognostic parameters, and survival outcome in patients with CNS involvement amongst 747 patients with acute lymphoblastic leukemia managed at our center. Twenty-five and six patients had CNS disease and TLP, respectively. Patients with CNS involvement had significantly higher mean presenting leukocyte count ( p = 0.021) and incidence of hyperleukocytosis ( p = 0.01) compared to those without it. The outcome was poor with three patients in continuous complete-remission, nine relapsers, eight deaths, and eight therapy defaulters. Three patients did not opt for therapy. CNS involvement was significantly associated with inferior survival by log-rank ( p = 0.03) analysis but not by Cox-multivariate ( p = 0.145) analysis. CNS involvement is a high-risk indicator. Poor outcome in our cohort indicates the need for the revaluation of our treatment protocols with the inclusion of risk-stratified systemic therapy, categorization of CNS involvement into CNS1/CNS2/CNS3, and appropriate use of intrathecal therapy. [ABSTRACT FROM AUTHOR]

The article explores the association of mediastinal adenopathy (MA) with clinicodemographic factors, as well as its prognostic impact. It notes the relationship between MA, lymphadenopathy, hepatomegaly, splenomegaly, and age at diagnosis. Moreover, it cites the potential of MA to serve as a prognostic marker for childhood acute lymphoblastic leukemia.

The article focuses on a paper which discusses the management of Down Syndrome-related leukemia. It notes the contribution of financial and socioeconomic factors on positive outcomes of the condition's treatment. Moreover, a chart is presented depicting the outcome of T lineage acute lymphoblastic leukemia (ALL) in India.

In this letter the authors describe an acute lymphoblastic leukemia survivor with pontomedulary hemorrhage due to basilar artery malformation. Pathogenesis and management are discussed. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article about acute lymphoblastic leukemia in a 16-year-old patient with cortical venous thrombosis after L-asparaginase therapy.

A letter to the editor is presented in response to the article "Childhood cancer in developing society: A roadmap of healthcare" by P.M. Ramesh, R.K. Marwaha and T.S. Anish in the 2011 issue.

Background: It is questionable whether enrollment on clinical trials offers any survival advantage at the population level over standard-of-care treatment. The objectives of this study were to describe the impact of trial enrollment on event-free survival and overall survival in pediatric acute myeloid leukemia (AML) using the Cancer in Young People in Canada (CYP-C) database.Methods: Children were included if they had had AML newly diagnosed between ages birth and 14 years from 2001 to 2012. CYP-C is a national pediatric cancer population-based database that includes all cases of pediatric cancer diagnosed and treated at 1 of the 17 tertiary pediatric oncology centers in Canada. Univariate and Cox proportional hazards models were used to evaluate the impact of initial trial enrollment on survival.Results: In total, 397 eligible children with AML were included in the analysis, of whom 94 (23.7%) were enrolled on a clinical trial at initial diagnosis. The most common reason for non-enrollment was that no trial was available. The event-free survival rate at 5 years was 57.8% ± 5.2% for those enrolled versus 54.8% ± 2.9% for those not enrolled (P = .75). The overall survival rate at 5 years was 70.1% ± 4.9% for those enrolled versus 66.3% ± 2.8% for those not enrolled (P = .58). Enrollment on a trial was not associated with improved event-free or overall survival in multiple regression analyses.Conclusions: Enrollment on a clinical trial was not associated with improved survival for children with AML in a population-based cohort. Rationale for trial enrollment should not include the likelihood of benefit compared with non-enrollment. [ABSTRACT FROM AUTHOR]