ABSTRACT
Objective: To determine the incidence of hypertension among children during the inductionand re-induction phases of acute lymphoblastic leukemia (ALL) therapy and association withpossible risk factors. Methods: A retrospective analysis of 208 consecutive pediatric (age<18 y) ALL patients, treated per BFM-95 protocol between January 2009 and December2013. Data were analyzed to determine the incidence of hypertension and risk factors for itsdevelopment. Results: Incidence of hypertension requiring antihypertensive medication,was 29% (61/208) during induction and 17% (33/198) during re-induction (P=0.003). Median(range) age of patients developing hypertension was 4 y (4 mo to 8 y). Age <10 y andpresence of constipation were independently predictive of hypertension by multivariateanalysis. Conclusion: The present study reports a high incidence of hypertension amongchildren undergoing ALL induction therapy.
ABSTRACT
Justification: Practitioners and people need information about the therapeutic potential of umbilical cord blood stem cells and pros andcons of storing cord blood in public versus private banks.Process: Indian Academy of Pediatrics conducted a consultative meeting on umbilical cord blood banking on 25th June 2016 in Pune,attended by experts in the field of hematopoietic stem cell transplantation working across India. Review of scientific literature was alsoperformed. All expert committee members reviewed the final manuscript.Objective: To bring out consensus guidelines for umbilical cord banking in India.Recommendations: Umbilical cord blood stem cell transplantation has been used to cure many malignant disorders, hematologicalconditions, immune deficiency disorders and inherited metabolic disorders, even when it’s partially HLA mismatched. Collectionprocedure is safe for mother and baby in an otherwise uncomplicated delivery. Public cord blood banking should be promoted over privatebanking. Private cord blood banking is highly recommended when an existing family member (sibling or biological parent) is sufferingfrom diseases approved to be cured by allogenic stem cell transplantation. Otherwise, private cord blood banking is not a ‘biologicalinsurance’, and should be discouraged. At present, autologous cord stem cells cannot be used for treating diseases of genetic origin,metabolic disorders and hematological cancers. Advertisements for private banking are often misleading. Legislative measures arerequired to regularize the marketing strategies of cord blood banking.