[Ocular relapse in childhood acute lymphoblastic leukaemia]

In childhood acute lymphoblastic leukaemia [ALL], the eye would represent a pharmacological sanctuary, source of unexpected relapse. Three boys aged of 13 years, 4 and 5 years presented after the complete remission, a lymphoblastic relapse in the anterior segment of the eyes in the first two cases, and in the posterior segment of the left eye in the third case. The treatment was a systemic chemotherapy and orbital radiotherapy of 12 Gray. The patients died after they experienced bone marrow and/or central nervous system relapses within the first year. The outlook for children with ocular relapse remains poor. Only radiotherapy doses superior then 30 Gray can eradicate lymphoblastic cells and improve the prognosis

Infant cancers: epidemiological study of 90 cases

The cancer of infant is a rare event. The differences of infant cancer types lead to a different approach of diagnosis and treatment. This study is a retrospective analysis of all cases of cancer in infants less than 1 year-old in the Paediatric Oncology Unit of Rabat Children Hospital. From January 1992 to December 2002, 90 infants were followed-up for cancer. Neuroblastoma was the most frequent tumour [34%], followed by nephroblastoma [15%], leukaemia [13%], sarcoma [11%] and retinoblastoma [8%]. Germinal cell tumours were found in 6 cases and hepatoblastoma in 3 cases. Treatment consisted in chemotherapy in 73 cases. Surgery alone was done in 7 cases and radiotherapy in 5. The event free survival rate at 130 months was 47.2% +/- 9% and the overall survival 66.8% +/- 7%. In conclusion, the distribution of cancer in the young infant is different of the older child. The diagnostic and therapeutic approach must take these characteristics into account

Primary malignant lymphoma of the rectum: a pediatric case report

Child malignant lymphoma involving the gastrointestinal tract is common, but that of the rectum is rare. Incidence and prognosis are difficult to assess. We present a case of primary malignant lymphoma of the rectum in an 11 year-old boy who had rectal bleeding, altered bowel habits and a bad general status during 3 months before. Proctosigmoidoscopy and histology revealed the presence of B lymphoid cells. Our patient was treated by chemotherapy with GFALB 2001 protocol. We obtained a complete remission after 5 months of treatment with 13 months of backward. We stress the importance of a fast diagnosis in case of a rectal syndrome in a child

Autoimmune haemolytic anemia and Hodgkin disease: a 2 cases report

Hodgkin's disease can be associated to autoimmune disorders including autoimmune hemolytic anemia. This association is rare. We report a Hodgkin's disease revealed by haemolytic anaemia in two children. Case 1: a 13 year-old boy presented acute hemolysis one month before with abdominal lymph nodes. The Coombs test and IgG were positive. In spite of corticosteroid therapy during two months, the hemolysis has persisted. Abdominal lymph nodes biopsy was achieved. This biopsy revealed a Hodgkin's disease. The chemotherapy has permitted a complete remission of the Hodgkin's disease and the cure of hemolysis. The follow-up is 27 months. Case 2: a 11 year-old girl presented an hemolytic anemia two months before. She had an abdominal mass and a splenomegaly. The Coombs test and IgG were positives. The abdominal mass biopsy diagnosed a Hodgkin's disease. The chemotherapy cured the hemolysis. The Hodgkin's disease was in complete remission after a follow-up of 26 months. This patient developed a vitiligo in the beginning of the treatment. Hodgkin's disease is a possible diagnosis when auto-immune hemolytic anemia is associated with lymphoproliferative syndrome, and only chemotherapy can stop the hemolysis