Bone marrow transplantation program pediatric oncology experience at King Hussein medical center

To evaluate the pediatric bone marrow transplantation program at King Hussein Medical Center, between June 1997 to December 2002. Fourteen children were transplanted with a median age of 9.5 years [range; 4-13 years], with the following diseases; Severe aplastic anemia [5], acute lymphoblastic leukemia [2], acute myeloid leukemia [4], chronic granulocytic leukemia [1], hyper-immunoglobulin M syndrome [1] and Fanconi's anemia [1]. All children and their donors were prepared before bone marrow transplantation according to our protocol. The patients engrafted at a median day +15 post transplant [range: 11-25 days]. The mortality rate due to transplant-related toxicity was 14.3% at +100 days and the overall disease-free survival was 78.6% at a median follow-up period of 16.5 months post transplant [range: 1-66 months]. The results of the pediatric bone marrow transplantation program over the last few years were comparable to those reported from other centers in terms of mortality and morbidity. All these make it worthy to move on with the program

Stage IV-s congenital neuroblastoma

To study stage IV-s congenital neuroblastoma in respect to their presentation, investigations, treatment and outcome. The records of 14 neonates with stage IV-s congenital neuroblastoma registered between 1986-1994 in the UK, were reviewed. The diagnosis was made by histological examination in nine neonates and elevated vanillylmandelic acid [VMA] and homovanillic acid [HVA] with ultrasonography [U/S] in the other five. Prenatal U/S diagnosis was done in two cases. Treatment varied from one center to another; chemotherapy in four cases, surgery in three, surgery plus chemotherapy one, radiotherapy one, and no treatment in five. The overall disease-free survival for 14 neonates was 93% at 104 months post diagnosis. One neonate died during the insertion of a central long line catheter. The follow up of 13 neonates showed no evidence of disease with no long-term sequelae of the disease or treatment. Neonates with stage IV-s congenital neuroblastoma have excellent prognosis compared to older children. Therefore, we need to adopt a new treatment strategy for this age group by doing some biological studies so as not to overtreat the good risk group, and to minimise the side effects of the treatment

Congenital Neuroblastoma. A study of 34 cases treated between 1986-1994 in U-K

To collect data congenital neuroblastoma with respect to their presentation, investigations, treatment anol outcome. The records of 34 neonates with neuroblastoma registered in UKCCSG between 1986-1994 were reviewed. The diagnosis was made by histological examination in 27 patients and elevated vanillymandelic acid [VMA], with ultrasonography [U/S] in 7 patients. Prenatal U/S diagnosis was done in 5 cases. Treatment was given according to Evans and International Neuroblastoma Staging System [INSS]; Surgery for stages I and II. Surgery + chemotherapy for stages III and IV and for stage IV-s was varied according to the progression of the disease. The overall disease free survival for 34 neonates is 91% at 104 months post diagnosis. Three neonates died [2 with stage IV and 1 with stage IV-s]. The remaining 6 patients have a residual damage due to the disease itself or due to side effect of the treatment. The prognosis of congenital neuroblastoma is very good compared with that of older children. Therefore we need to define the high risk patients by doing some biological studies so as not to over-treat the good risk group and to minimize the side effect of the treatment