ABSTRACT
Background@#Reduced harvest volumes in pediatric donors appear to have the potential to reduce donor-associated risks while maintaining engraftment in recipients; however, the allowable harvest volume reduction remains undefined. @*Methods@#We retrospectively analyzed the data pairs of 553 bone marrow (BM) harvests from pediatric (age at harvest ＜18 yr) sibling donors and clinical outcomes of 553 pediatric (age at infusion ＜14 yr) transplant-naïve recipients to assess the optimal BM harvest volume needed from pediatric donors to obtain the desired CD34+ cell count (≥3.0×10 6 cells per kg of recipient weight), and to study its impact on the clinical outcomes of transplantation in pediatric recipients. @*Results@#The minimum desired CD34+ cell count of ≥3.0×10 6 per kg of recipient weight was achieved for 506 (95.3%) of donor-recipient pairs. The median CD34+ cell yield was 6.4×10 6 per kg of recipient weight (range, 1.2‒33.8×10 6 ) in donors younger than 5 years old at harvest, 4.7×10 6 (range, 0.3‒28.5×10 6 ) in donors aged 5‒10 years and 2.1×10 6 range, 0.3‒11.3×10 6 ) in donors older than 10 years (P ＜0.001). @*Conclusion@#The infused CD34+ cell dose (×10 6 cells/kg of recipient weight) had no impact on GRFS; however, a CD34+ cell dose of ＞7×10 6 cells/kg of recipient weight did not improve hematopoietic recovery
ABSTRACT
Objective: To evaluate the outcomes of patients undergoing radiotherapy for primary local control of pelvic ewing sarcoma [ES]
Study Design: Case series
Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital, Lahore, from January 2010 to October 2015
Methodology: Patients with primary pelvic ES were included in the analysis and all other primary disease sites were excluded. All of them were treated with radiotherapy and followed the EuroEwing-99 chemotherapy protocol. Tumor volume, relapse and metastases were noted
Results: There were 13 patients with pelvic ES. The median age at the time of diagnosis was 15 years with IQR of 7 years [range 2-19 years]. Tumor volume was more than 400ml in more than 50% of the patients. Eight patients [61.5%] had local relapses and 5 patients [38.5%] had combined local and distant disease metastases
Conclusion: These results showed poor local control and overall survival in local pelvic ES cases in children and adolescents. Intensity modulated radiotherapy [IMRT] can be used to deliver higher doses of radiation. Compressed cycles of chemotherapy should be evaluated in local setting
ABSTRACT
Objective: To evaluate the frequency of bone marrow involvement with metastatic lung and bone sites in newly-diagnosed pediatric patients with Ewing sarcoma [ES]
Study Design: An observational study
Place and Duration of Study: Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, from January 2010 to October 2015
Methodology: Newly-diagnosed pediatric-age patients with ES were inducted. Ten patients were excluded because bone marrow aspiration/biopsy [BMAB] was not done. Patients' medical records were reviewed for data collection of age, diagnosis, tumor volume, bone marrow diagnosis, metastatic work-up and outcomes
Results: A total of 139 patients with median age of 12 years were identified. The median volume of tumors was 529 ml. Eleven patients had bone marrow [BM] disease involvement. Five [45.5%] had bone metastatic disease and 1 [9%] had both pulmonary and bone metastases. Four patients [31.1%] with positive BM had primary limb disease
Conclusion: Ewing sarcoma patients with bone metastatic disease have a higher frequency of BM involvement. However, BM can be involved without metastatic disease. BMAB should still be considered at staging for newly diagnosed pediatric patients with localized ES