Your browser doesn't support javascript.
loading
Show: 20 | 50 | 100
Results 1 - 20 de 2.012
Filter
1.
Rev. cuba. hematol. inmunol. hemoter ; 37(3): e1445, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1341399

ABSTRACT

Introducción: Durante el tratamiento de inducción de la leucemia linfoide aguda en niños no siempre se identifican las reacciones adversas a medicamentos. Objetivo: Describir los eventos adversos y las reacciones adversas a medicamentos durante el tratamiento de inducción de la leucemia linfoide aguda, en niños tratados en el Instituto de Hematología e Inmunología de Cuba, durante 2012-2017. Método: Estudio observacional, descriptivo, transversal, de series de casos en farmacovigilancia, se utilizó la farmacovigilancia activa. Variables: sexo, edad, grupo pronóstico, semana de tratamiento, tipo de evento adverso, sistema de órgano afectado, severidad e imputabilidad. La información se obtuvo del registro nacional del protocolo ALLIC-BFM 2009 y las historias clínicas. Resultados: Se incluyeron 69 niños, 55,1 por ciento (38 casos) fueron masculinos, 56,5 por ciento (39 niños) tenía entre uno y seis años. El 52,2 por ciento (36 pacientes) pertenecían al grupo pronóstico intermedio. Se registraron 471 eventos adversos. El 50,5 por ciento (238/471) ocurrió en la primera semana de tratamiento. Los más frecuentes: anemia (17,8 por ciento; 84/471), neutropenia (16,1 por ciento; 76/471) y trombocitopenia (15,9 por ciento; 75/471). Los sistemas de órganos más afectados: hemolinfopoyético (57,54 por ciento; 271/471) y gastrointestinal (15,71 por ciento; 74/471). El 93,2 por ciento (439/471) se clasificó en reacciones adversas posibles. Según gravedad el 72,4 por ciento (330/456) fueron moderadas y el 27,4 por ciento (125/456) graves. Conclusiones: Todos los casos presentaron eventos adversos, predominaron las alteraciones hematológicas y los eventos reportados para fármacos incluidos en la quimioterapia. Se identificaron reacciones adversas clasificadas como posibles, con predominio de las moderadas y graves(AU)


Introduction: During the induction treatment of acute lymphoid leukemia in children, adverse drug reactions are not always identified. Aims: Describe the demographic and clinical characteristics of children with acute lymphoid leukemia who receive induction treatment at the Institute of Hematology and Immunology between 2012-2017. Characterize adverse events that occur during induction treatment. Describe adverse drug reactions during induction. Methods: Observational, descriptive, cross-sectional study of case series in pharmacovigilance, used active pharmacovigilance. Variables: sex, age, prognosis group, week of treatment, type of adverse event, organ system affected, severity and imputability. The information was obtained from the national register of the ALLIC-BFM 2009 protocol and the medical records. Results: 69 children were included, 55.1 percent belonged to the male sex, 56.5 percent were between one and six years old. 52.2 percent (36 children) belonged to the intermediate prognosis group. 471 events were recorded. 50.5 percent occurred in the first week of treatment. The most frequent: anemia (17.8 percent), neutropenia (16.1 percent) and thrombocytopenia (15.9 percent). The most affected organ systems: hemolinfopoietic (57.5 percent) and gastrointestinal (15.7 percent). According to the severity, 72.4 percent were moderate and 27.4 percent severe. Conclusions: The whole presented adverse events, hematological alterations and reported events for drugs included in chemotherapy predominated. Adverse reactions classified as possible were identified, moderate and severe predominated(AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Drug-Related Side Effects and Adverse Reactions , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Remission Induction/methods , Epidemiology, Descriptive , Cross-Sectional Studies
2.
Rev. cuba. hematol. inmunol. hemoter ; 37(3): e1418, 2021. tab, graf
Article in Spanish | LILACS, CUMED | ID: biblio-1341393

ABSTRACT

Introducción: El pronóstico de las enfermedades hematológicas malignas ha experimentado un importante avance en las últimas décadas, sobre todo por las nuevas combinaciones de quimioterapia. Estos hechos han propiciado que muchos de estos pacientes, en algún momento de su enfermedad, sean tratados en unidades de cuidados intensivos, lo que no era frecuente hace dos décadas. Objetivo: Describir el desarrollo de la disfunción múltiple de órganos en pacientes pediátricos con leucemia linfoide aguda en terapia intensiva en el Instituto de Hematología e Inmunología. Métodos: Se realizó un estudio clínico, observacional, transversal en el que se incluyeron los pacientes pediátricos con leucemia linfoblástica aguda y disfunción múltiple de órganos, atendidos en el servicio de terapia intensiva en el periodo 2018 a 2020. Se analizaron las variables: sociodemográficas, estado nutricional, diagnóstico al ingreso, puntaje del score pSOFA, conducta fármaco-terapéutica. Resultados: El grupo de edad más afectado fue el de 1 a 4 años, en su mayoría normopesos, con complicaciones de choque séptico, distrés respiratorio, y con 33 por ciento de mortalidad mayor en aquellos pacientes con score pSOFA con más de 10 puntos. La conducta terapéutica más utilizada fue la administración de oxígeno, fluidoterapia y antibióticos de tercera y cuarta generación en la primera hora de ingreso al servicio. Conclusiones: Si el puntaje del score pSOFA es mayor de 10 puntos existe mayor riesgo de muerte y mortalidad pediátrica (90 por ciento )(AU)


Introduction: The prognosis of hematological malignancies has undergone an important advance in the last decades, mainly due to the new chemotherapy combinations. These facts have led many of these patients to be treated in intensive care units at some point during their illness. Objective: To describe the development of multiple organ dysfunction in pediatric patients with acute lymphoid leukemia in intensive care at the Institute of Hematology and Immunology. Methods: A clinical, observational, cross-sectional study was carried out that included pediatric patients with acute lymphoblastic leukemia and multiple organ dysfunction, treated in the intensive care service in the period from 2018 to 2020. The variables were analyzed: sociodemographic, nutritional status, diagnosis on admission, pSOFA score, drug-therapeutic behavior. Results: The most affected age group was 1 to 4 years old, mostly normal weight, with complications of septic shock, respiratory distress, and 33 percent higher mortality in those patients with a pSOFA score with more than 10 points. The most used therapeutic approach was the administration of oxygen, fluid therapy and third and fourth generation antibiotics in the first hour of admission to the service. Conclusions: If the pSOFA score is greater than 10 points, there is a greater risk of death and pediatric mortality (90 percent)(AU).


Subject(s)
Humans , Infant , Child, Preschool , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Organ Dysfunction Scores , Intensive Care Units , International Cooperation , Anti-Bacterial Agents , Cross-Sectional Studies
3.
Arch. argent. pediatr ; 119(3): e242-e246, Junio 2021. tab, ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1248200

ABSTRACT

La leucemia linfoblástica aguda (LLA) es la patología oncológica más frecuente en pediatría, y corresponde al 23% de las neoplasias en menores de 15 años. Alrededor del 20% de los pacientes con LLA presentan recaídas, en la mayoría de los casos, en la médula ósea. Las recaídas extramedulares son inusuales y las dos localizaciones más frecuentes son el sistema nervioso central (SNC) y los testículos. Cuando las recaídas ocurren en el SNC, suelen manifestarse con un síndrome meníngeo. El síndrome hipotalámico se define como la presencia de hiperfagia, obesidad y/o cambios en el estado de ánimo, y es una forma de presentación clínica inusual de las recaídas en el SNC y debe alertar al pediatra para mantener un alto índice de sospecha.Se describen cuatro casos que se presentaron con síndrome hipotalámico al momento de desarrollar una recaída de LLA en el SNC


Acute lymphoblastic leukemia (ALL) is the most common malignancy in childhood, corresponding to 23% of cancer in children younger than 15 years old. About 20% of ALL cases will relapse, commonly in the bone marrow. Extramedullar relapses are unusual, and the two most frequent locations are CNS and testicles. ALL relapses, when diagnosed in the CNS, frequently present with clinical features of a meningeal syndrome. The hypothalamic syndrome, consisting of hyperphagia, obesity and / or behavior disturbances, corresponds to an unusual presentation of relapses in this location and should alert pediatricians to suspect it.We describe 4 ALL cases of hypothalamic syndrome at the time of CNS relapse


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Lymphoma, B-Cell , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis , Recurrence , Fatal Outcome , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Hypothalamic Diseases/diagnosis
4.
Arch. argent. pediatr ; 119(5): e550-e553, oct. 2021. ilus
Article in Spanish | LILACS, BINACIS | ID: biblio-1292810

ABSTRACT

Las leucemias son las neoplasias malignas más frecuentes en la infancia; la leucemia linfoblástica aguda (LLA) es la más frecuente. Desde principios de los 80, la adición de metotrexato intratecal a los esquemas de quimioterapia ha sido beneficiosa para prevenir la recidiva en el sistema nervioso central y evitar el uso de radioterapia. Su mecanismo de acción es la inhibición de la enzima dihidrofolato reductasa, por lo que posee múltiples efectos adversos (neurotoxicidad aguda, subaguda o crónica) después de la infusión intratecal o de dosis altas por vía intravenosa.Se presenta un paciente de 11 años con diagnóstico de LLA de línea T (LLA-T), que presenta hemiparesia faciobraquial y afasia de expresión de instauración aguda 8 días después de la administración intratecal de metotrexato. Luego de excluir otras patologías más frecuentes de origen vascular y la evolución típica del cuadro, con resolución espontánea ad integrum de los síntomas, se arribó al diagnóstico de encefalopatía subaguda reversible por metotrexato.


Leukemias are the most frequent malignant neoplasms in childhood; acute lymphoblastic leukemia (ALL) is the most frequent. The addition of intrathecal methotrexate to chemotherapy regimens has been beneficial in preventing relapse to the central nervous system and avoiding the use of radiation therapy. Due to its mechanism of action, by inhibiting the enzyme dihydrofolate reductase, when it is used systemically, it has multiple expected adverse effects such as mucositis, myelosuppression and it has also been observed after intrathecal administration or high intravenous doses, acute, subacute neurotoxicity where stroke like syndrome is found. We present an 11-year-old patient diagnosed with T-ALL, who manifested after 8 days of intrathecal administration of methotrexate, faciobrachial hemiparesis and acute onset expression aphasia. The diagnosis of subacute encephalopathy reversible by methotrexate was reached by excluding other more frequent pathologies and the typical evolution, with spontaneously ad integrum resolution of the symptoms


Subject(s)
Humans , Child , Stroke/chemically induced , Neurotoxicity Syndromes , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Methotrexate/adverse effects , Antimetabolites, Antineoplastic/adverse effects
5.
Vive (El Alto) ; 4(10): 16-25, abr. 2021. graf.
Article in Spanish | LILACS | ID: biblio-1292376

ABSTRACT

La Organización Mundial de la Salud (OMS), en el año 2018 reporta a la leucemia linfoblástica aguda (LLA) como principal causa de mortalidad en niños y adolescentes en el rango de edad de 0 a 19 años, cada año se diagnostican 300.000 casos nuevos. OBJETIVO: determinar los efectos de los ejercicios de bajo impacto en la prevención de las complicaciones asociadas a la inactividad física en niños y niñas con Leucemia en el Hospital Oncológico SOLCA de la ciudad de Guayaquil. MATERIAL Y MÉTODOS: el alcance de la investigación es descriptivo, observacional con diseño no experimental y de corte transversal. Los datos fueron obtenidos mediante el test de Cpax y la escala de fatiga, aplicada a 57 pacientes. RESULTADOS: la evaluación por el test Cpax presentó que un 81% tenían una buena condición física y un 19% presentó una condición regular; en relación a la saturación de oxígeno post evaluación un 98% presentaron valores superiores a >90 y un 2% valores <90; con respecto a la fatiga inicial se reportó un 49% con fatiga moderada, 42% fatiga extrema, 4% fatiga leve, 4% sin fatiga y 2% con la peor fatiga mientras que en la post evaluación un 51% presentó fatiga moderada, 35% fatiga leve, 11% fatiga extrema, 4% sin fatiga y 0% sin el nivel máximo de fatiga. El resultado de la prueba Chi-Cuadrado sobre la comparación Cpax pre y post evaluación, fue de p <0.05 con un nivel de confianza del 99.9% por lo que se presentó una significancia. CONCLUSIÓN: se evidenció el efecto positivo del plan de ejercicios de bajo impacto aplicado en pacientes con LLA. (AU)


The World Health Organization (WHO), in 2018 reported acute lymphoblastic leukemia (ALL) as the main cause of mortality in children and adolescents in the age range from 0 to 19 years, each year 300,000 are diagnosed new cases. OBJECTIVE: to determine the effects of low-impact exercises in the prevention of complications associated with physical inactivity in boys and girls with Leukemia at the SOLCA Oncological Hospital in the city of Guayaquil. MATERIAL AND METHODS: the scope of the research is descriptive, observational with a non-experimental and cross-sectional design. The data were obtained using the Cpax test and the fatigue scale, applied to 57 patients. RESULTS: the evaluation by the Cpax test showed that 81% had a good physical condition and 19% had a regular condition; in relation to postevaluation oxygen saturation, 98% showed values higher than> 90 and 2% values <90; Regarding the initial fatigue, 49% were reported with moderate fatigue, 42% extreme fatigue, 4% mild fatigue, 4% without fatigue and 2% with the worst fatigue, while in the post-evaluation 51% presented moderate fatigue, 35 % mild fatigue, 11% extreme fatigue, 4% without fatigue and 0% without the maximum level of fatigue. The result of the Chi-Square test on the Cpax comparison before and after the evaluation was p <0.05 with a confidence level of 99.9%, therefore, a significance was presented. CONCLUSION: the positive effect of the low-impact exercise plan applied in patients with ALL was evidenced.(AU)


A Organização Mundial da Saúde (OMS), em 2018 relatou a leucemia linfoblástica aguda (LLA) como principal causa de mortalidade em crianças e adolescentes na faixa etária de 0 a 19 anos, a cada ano 300.000 novos casos são diagnosticados. OBJETIVO: determinar os efeitos dos exercícios de baixo impacto na prevenção de complicações associadas à inatividade física em meninos e meninas com leucemia no Hospital SOLCA Oncológico da cidade de Guayaquil. MATERIAL E MÉTODOS: o escopo da pesquisa é descritivo, observacional com um desenho não experimental e transversal. Os dados foram obtidos por meio do teste Cpax e da escala de fadiga, aplicados em 57 pacientes. RESULTADOS: a avaliação pelo teste Cpax mostrou que 81% apresentavam boa condição física e 19% regularidade; em relação à saturação de oxigênio pós-avaliação, 98% apresentaram valores superiores a> 90 e 2% valores <90; Em relação à fadiga inicial, 49% foram relatados com fadiga moderada, 42% fadiga extrema, 4% fadiga leve, 4% sem fadiga e 2% com a pior fadiga, enquanto na pós-avaliação 51% apresentaram fadiga moderada, 35% leve fadiga, 11% fadiga extrema, 4% sem fadiga e 0% sem o nível máximo de fadiga. O resultado do teste Qui-Quadrado na comparação Cpax antes e após a avaliação foi p <0,05 com nível de confiança de 99,9%, portanto, houve significância. CONCLUSÃO: foi evidenciado o efeito positivo do plano de exercícios de baixo impacto aplicado em pacientes com LLA.(AU)


Subject(s)
Precursor Cell Lymphoblastic Leukemia-Lymphoma , Cross-Sectional Studies , Fatigue , Sedentary Behavior
6.
Rev. cuba. hematol. inmunol. hemoter ; 37(1): e1156, ene.-mar. 2021.
Article in Spanish | LILACS, CUMED | ID: biblio-1251708

ABSTRACT

Introducción: Los síndromes neurocutáneos comprenden un grupo heterogéneo de trastornos hereditarios que comprometen principalmente la piel y el sistema nervioso central. Dentro de estos se incluye la neurofibromatosis, la esclerosis tuberosa y la enfermedad de Von-Hippel Lindau. Se caracterizan por presencia de displasia en distintos tejidos y formación de tumores en diversos órganos. Se ha descrito también un riesgo relativo aumentado para leucemia linfoblástica aguda, leucemia mielomonocítica crónica y linfoma no Hodgkin. Objetivo: Describir caso de paciente con diagnóstico de síndrome neurocutáneo (esclerosis tuberosa) que desarrolló a los 6 años una leucemia linfoide aguda. Caso clínico: Paciente femenina, seis años de edad, con antecedentes de síndrome neurocutáneo tipo esclerosis tuberosa diagnosticado a los dos años de edad- Comenzó con síndrome febril, adenopatías cervicales y hepatoesplenomegalia. El hemograma mostró anemia, trombocitopenia grave y leucocitosis con presencia de blastos. En el medulograma se observó una infiltración de 90 por ciento de blastos linfoides, por lo que se diagnosticó como una leucemia linfoide aguda. Conclusiones: La coexistencia de síndromes neurocutáneos y leucemia linfoide aguda no es frecuente. Se describe una paciente con ambas enfermedades, que fallece a pesar del tratamiento(AU)


Introduction: Neurocutaneous syndromes comprise a heterogeneous set of hereditary disorders mainly affecting the skin and the central nervous system. Among the conditions included are neurofibromatosis, tuberous sclerosis and von Hippel-Lindau disease, characterized by dysplasia in various tissues and the formation of tumors in various organs. Increased relative risk has also been described for acute lymphoblastic leukemia, chronic myelomonocytic leukemia and non-Hodgkin lymphoma. Objective: Describe the case of a patient diagnosed with neurocutaneous syndrome (tuberous sclerosis) who developed acute lymphoid leukemia at age six. Clinical case: A case is presented of a female six-year-old patient with a history of neurocutaneous syndrome, tuberous sclerosis type, diagnosed at age two. The patient started with febrile syndrome, cervical adenopathies and hepatosplenomegaly. The blood count revealed anemia, severe thrombocytopenia and leukocytosis with the presence of blasts, whereas the medullogram showed 90 percent infiltration by lymphoid blasts, leading to the diagnosis of acute lymphoid leukemia. Conclusions: Coexistence of neurocutaneous syndromes and acute lymphoid leukemia is not frequent. A case is described of a patient with both conditions who died despite the treatment indicated(AU)


Subject(s)
Humans , Female , Child , Tuberous Sclerosis/diagnosis , Neurocutaneous Syndromes/complications , von Hippel-Lindau Disease , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications
7.
Rev. bras. oftalmol ; 80(1): 33-41, jan.-fev. 2021. graf
Article in Portuguese | LILACS | ID: biblio-1251314

ABSTRACT

RESUMO A Leucemia Linfocitica Aguda (LLA) é uma doença caracterizada por uma alta taxa de sobrevida, porém o número absoluto de crianças que morrem por ela representa uma grande parcela dos casos de óbitos infantis por câncer. A morbidade decorrente de seu tratamento pode deixar sequelas em pessoas com grande expectativa de vida, tornando-se extremamente necessário o entendimento da patogênese desta doença, possibilitando o desenvolvimento de novos tratamentos e diminuição de sequelas provocadas pela doença. O diagnóstico precoce é importante para se evitar complicações oculares que possam levar a baixa de acuidade visual em longo prazo e para avaliação de recaídas de tratamento sendo determinante no direcionamento de condutas.


ABSTRACT The Acute Lymphocytic Leukemia (ALL) is a disease characterized by a high survival rate, but the absolute number of children who die from it represents a large proportion of cases of infant deaths from cancer. The morbidity resulting from its treatment can leave sequelae in people with high life expectancy, making it extremely necessary to understand the pathogenesis of this disease, enabling the development of new treatments and reduction of sequelae caused by the disease. This early diagnosis is important to avoid ocular complications that may lead to low long-term visual acuity and to evaluate treatment relapses and determine the conducts.


Subject(s)
Humans , Male , Child , Prognosis , Retina/pathology , Leukemic Infiltration , Precursor Cell Lymphoblastic Leukemia-Lymphoma/diagnosis
8.
Chinese Medical Journal ; (24): 1199-1208, 2021.
Article in English | WPRIM | ID: wpr-878101

ABSTRACT

BACKGROUND@#For patients with B cell acute lymphocytic leukemia (B-ALL) who underwent allogeneic stem cell transplantation (allo-SCT), many variables have been demonstrated to be associated with leukemia relapse. In this study, we attempted to establish a risk score system to predict transplant outcomes more precisely in patients with B-ALL after allo-SCT.@*METHODS@#A total of 477 patients with B-ALL who underwent allo-SCT at Peking University People's Hospital from December 2010 to December 2015 were enrolled in this retrospective study. We aimed to evaluate the factors associated with transplant outcomes after allo-SCT, and establish a risk score to identify patients with different probabilities of relapse. The univariate and multivariate analyses were performed with the Cox proportional hazards model with time-dependent variables.@*RESULTS@#All patients achieved neutrophil engraftment, and 95.4% of patients achieved platelet engraftment. The 5-year cumulative incidence of relapse (CIR), overall survival (OS), leukemia-free survival (LFS), and non-relapse mortality were 20.7%, 70.4%, 65.6%, and 13.9%, respectively. Multivariate analysis showed that patients with positive post-transplantation minimal residual disease (MRD), transplanted beyond the first complete remission (≥CR2), and without chronic graft-versus-host disease (cGVHD) had higher CIR (P  < 0.001, P = 0.004, and P  < 0.001, respectively) and worse LFS (P  < 0.001, P = 0.017, and P  < 0.001, respectively), and OS (P  < 0.001, P = 0.009, and P  < 0.001, respectively) than patients without MRD after transplantation, transplanted in CR1, and with cGVHD. A risk score for predicting relapse was formulated with the three above variables. The 5-year relapse rates were 6.3%, 16.6%, 55.9%, and 81.8% for patients with scores of 0, 1, 2, and 3 (P  < 0.001), respectively, while the 5-year LFS and OS values decreased with increasing risk score.@*CONCLUSION@#This new risk score system might stratify patients with different risks of relapse, which could guide treatment.


Subject(s)
B-Lymphocytes , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Humans , Leukemia, Myeloid, Acute , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Recurrence , Retrospective Studies , Risk Factors , Stem Cell Transplantation
9.
Article in English | WPRIM | ID: wpr-880320

ABSTRACT

OBJECTIVES@#We performed an updated meta-analysis to clarify the relationship between the CEBPE rs2239633 polymorphism and the childhood acute lymphoblastic leukemia (CALL) susceptibility.@*METHODS@#All the case-control studies were updated on October 5, 2020, through Web of Science, PubMed, Cochrane Library, Embase, and China National Knowledge Infrastructure (CNKI) electronic database. The heterogeneity in the study was tested by the Q test and I@*RESULTS@#A total of 20 case-control studies were selected, including 7014 patients and 16,428 controls. There was no association of CEBPE rs2239633 polymorphism with CALL (CC vs CT + TT: OR = 1.08, 95% CI = 0.94-1.26; CC + CT vs TT: OR = 1.10, 95% CI = 0.94-1.30; C vs T: OR = 1.02, 95% CI = 0.92-1.13). In the subgroup analysis by ethnicity, there is no significant association of this polymorphism and CALL risks among Asian and Caucasian populations in the three genetic models (CC vs CT + TT, CC + CT vs TT, and C vs T).@*CONCLUSION@#This meta-analysis found no significant association between the CEBPE rs2239633 polymorphism and susceptibility to CALL.


Subject(s)
Adolescent , CCAAT-Enhancer-Binding Proteins/metabolism , Child , Child, Preschool , Genetic Predisposition to Disease/genetics , Humans , Infant , Polymorphism, Single Nucleotide , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
10.
Article in Chinese | WPRIM | ID: wpr-880138

ABSTRACT

OBJECTIVE@#To retrospective analyze the reason of death in children with acute lymphoblastic leukemia (ALL) treated with CCLG-ALL 2008 protocol, and the experience was summarized in order to reduce the mortality.@*METHODS@#916 children diagnosed as ALL and accepted CCLG-ALL 2008 protocol from April 2008 to April 2015 in our hospital were enrolled, the dead cases in them were analyzed retrospectively.@*RESULTS@#169 children died, including 111 (65.7%) males and 58 (34.3%) females. Recurrence was the main reason of death. 150 (88.7%) children died due to recurrence, among them, 86 (57.3%) cases gave up directly. The second reason of death was infection. The main clinical sites of infection were concentrated in respiratory system and digestive system. Bacterial infection was most common (Gram-negative was common).@*CONCLUSION@#Enough finance and improving family compliance can decrease the mortality in children with ALL. Early rational use of antibiotics can reduce infection-related mortality in children with ALL.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Child , Disease-Free Survival , Female , Humans , Male , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Prognosis , Retrospective Studies
11.
Article in Chinese | WPRIM | ID: wpr-880134

ABSTRACT

OBJECTIVE@#To investigate the relationship between single nucleotide polymorphisms (SNPs) of IKAROS family Zinc finger 3 (IKZF3) gene and the risk of acute lymphoblastic leukemia (ALL) in children.@*METHODS@#The peripheral blood samples from 286 children with ALL and 382 healthy children were collected and divided into ALL group and control group, respectively. The genotypes of IKZF3 gene at rs62066988 C > T and rs12946510 C > T were detected by quantitative PCR with TaqMan detection system, and their correlation with ALL was analyzed.@*RESULTS@#The distribution frequencies of CC, CT and TT genotypes at rs62066988 in ALL group were 58.39%, 37.06% and 4.55%, respectively, while those in control group were 69.19%, 27.68% and 3.13%, respectively. The distribution frequencies of CC, CT and TT genotypes at rs12946510 in ALL group were 58.16%, 34.75% and 7.09%, respectively, while those in control group were 55.76%, 37.43% and 6.81%, respectively. Compared with the control group, the distribution frequency of CT/TT genotype at rs62066988 was significantly increased in the ALL group (OR=1.59, 95%CI: 1.16-2.19, P=0.004). However, there was no significant difference in the distribution of rs12946510 C > T polymorphism between ALL group and control group.@*CONCLUSION@#The CT/TT genotype of IKZF3 at the site of rs62066988 is associated with the increased risk of ALL in children.


Subject(s)
Alleles , Case-Control Studies , Child , Gene Frequency , Genetic Predisposition to Disease , Genotype , Humans , Ikaros Transcription Factor/genetics , Polymorphism, Single Nucleotide , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics
12.
Article in Chinese | WPRIM | ID: wpr-880130

ABSTRACT

OBJECTIVE@#To analyze the efficacy of CCLG-ALL-2008 protocol and the related factors of treatment failure in children with acute lymphoblastic leukemia (ALL).@*METHODS@#The clinical data of 400 children newly-diagnosed ALL in Children's Hospital of Soochow University from March 1, 2008 to December 31, 2012 was retrospectively analyzed. All the children accepted CCLG-ALL-2008 protocol, and were followed-up until October 2019. The dates of relapse, death and causes of death were recorded. Treatment failure was defined as relapse, non-relapse death, and secondary tumor.@*RESULTS@#Following-up for 10 years, there were 152 cases relapse or non-relapse death, the treatment failure rate was 38%, including 122 relapse (80.3%), 30 non-relapse deaths (19.7%) which included 7 cases (4 cases died of infection and 3 cases died of bleeding) died of treatment (23.3% of non-relapse deaths), 8 cases died of minimal residual disease (MRD) continuous positive (26.7% of non-relapse deaths) and 15 cases died of financial burden (50% of non-relapse deaths). According to the relapse stage, 37 cases (30%) in very early stage, 38 cases (31%) in early stage, and 47 cases (39%) in late stage, while according to the relapse site, 107 cases relapsed in bone marrow, 3 cases in testis, 3 cases in central nervous system (CNS), 5 cases in bone marrow plus testis and 4 cases in bone marrow plus CNS. Bone marrow relapse was the main cause of death in 89 cases, followed by nervous system. Initially diagnosed WBC count (≥50×10@*CONCLUSION@#Relapse is the main cause of treatment failure in children with ALL. The initially diagnosed WBC count, immunophenotype and MRD at week 12 were the independent prognostic factors for relapse of the patients. Financial burden accounts for a large proportion of non-relapse death.


Subject(s)
Antineoplastic Combined Chemotherapy Protocols , Child , Disease-Free Survival , Humans , Male , Neoplasm, Residual , Precursor Cell Lymphoblastic Leukemia-Lymphoma/drug therapy , Prognosis , Recurrence , Retrospective Studies , Treatment Failure , Treatment Outcome
13.
Article in Chinese | WPRIM | ID: wpr-880128

ABSTRACT

B-cell acute lymphoblastic leukemia (B-ALL) is a common malignant tumor in hematopoietic system. Although the remission rate of the patients with adult B-ALL is similar to those with childhood B-ALL, the rate of long-term disease-free survival (DFS) rate is significantly lower, once recurrence, the remission rate of routine chemotherapy is low and the prognosis is so poor. Based on the expression of tumor cell surface antigens(such as CD19, CD20 and CD22), the specific monoclonal antibodies, bispecific antibodies and chimeric antigen receptor T cells (CAR-T), and other targeted immunotherapy can greatly improve the efficacy of B-ALL patients, especially for patients with relapse and refractory. In this review, the progress of immunotherapy against B-ALL cell surface antigen is summarized briefly.


Subject(s)
Adult , Antigens, CD19 , Antigens, Surface , B-Lymphocytes , Burkitt Lymphoma , Child , Humans , Immunotherapy, Adoptive , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Receptors, Antigen, T-Cell
14.
Article in Chinese | WPRIM | ID: wpr-880093

ABSTRACT

OBJECTIVE@#To investigate the significance of low-density lipoprotein receptor-related protein 5 and 6 (LRP5/6) in the Wnt/β-catenin signaling pathway in the pathogenesis and prognosis of childhood acute lymphoblastic leukemia (ALL).@*METHODS@#A total of 43 children who were newly diagnosed and achieved complete remission after remission induction therapy were enrolled. The children before treatment were included in incipient group, and after treatment when achieved complete remission included in remission group. A total of 39 children with immune thrombocytopenia were enrolled in control group. Three milliliter bone marrow samples were collected from above-mentioned each group. QRT-PCR was used to determine the mRNA expression of LRP5 and LRP6 in blood mononuclear cells of bone marrow. Western blot was used to detect the protein expression of LRP5 and LRP6. According to the protein expression levels of LRP5 and LRP6, the children were divided into low-expression group and high-expression group, and the clinical biological characteristics were compared between these two groups. Survival analysis was performed by Kaplan-Meier method.@*RESULTS@#Both mRNA and protein expression levels of LRP5 and 6 were upregulated in the incipient group compared with the control and remission group (P<0.05). The mRNA and protein expressions of LRP5 and LRP6 in the high-risk group were higher than those in the medium-risk group (P<0.05), it is the same as in the medium-risk group than the low-risk group (P<0.05). The mRNA and protein expressions of LRP5 and 6 positively correlated with risk degree in the incipient group (r@*CONCLUSION@#The high expression of LRP5/6 may be one of the pathogenesis of childhood ALL, and the degree of LRP5/6 increase may be related to the risk level.


Subject(s)
Child , Humans , Lipoproteins, LDL , Low Density Lipoprotein Receptor-Related Protein-5 , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Receptors, LDL , Wnt Signaling Pathway , beta Catenin/metabolism
15.
Article in Chinese | WPRIM | ID: wpr-880074

ABSTRACT

OBJECTIVE@#To investigate the clinical features and prognostic factors of acute lymphoblastic leukemia (ALL) children with P2RY8-CRLF2 gene rearrangement.@*METHODS@#A total of 108 children with B-cell ALL (B-ALL) were diagnosed and systematically treated according to Chinese Children's Leukemia Group (CCLG) -ALL 2008 in our hospital from January 2016 to December 2016. The 108 patients were divided into two groups according to the result of mutiplex polymerase chain reaction: group with P2RY8-CRLF2 gene rearrangement and group without P2RY8-CRLF2 gene rearrangement. The ALL children with P2RY8-CRLF2 gene rearrangement were all treated by CCLG-ALL 2008 high-risk group (HR) regimens, and the ALL children in group without P2RY8-CRLF2 gene rearrangement received different intensity chemotherapy according to clinical risk classification.@*RESULTS@#Five (4 male and 1 female) out of 108 patients with B-ALL had P2RY8-CRLF2 gene rearrangement. In the 5 B-ALL patients with P2RY8-CRLF2 gene rearrangement, the median age of the was 4 (2-6) years old and the median WBC count was 26.2 (2.46-525.1)×10@*CONCLUSION@#The early treatment response and prognosis of ALL children with P2RY8-CRLF2 gene rearrangement are worse, and more effective protocol is needed for this subtype patients.


Subject(s)
Child , Child, Preschool , Disease-Free Survival , Female , Gene Rearrangement , Humans , Male , Precursor B-Cell Lymphoblastic Leukemia-Lymphoma/genetics , Precursor Cell Lymphoblastic Leukemia-Lymphoma/genetics , Prognosis , Receptors, Cytokine/genetics , Receptors, Purinergic P2Y/genetics
16.
Article in Chinese | WPRIM | ID: wpr-880028

ABSTRACT

OBJECTIVE@#To analyze the outcomes of the children suffered from philadelphia chromosome positive acute lymphoblastic leukemia (Ph@*METHODS@#21 cases of firstly diagnosed Ph@*RESULTS@#Among 21 patients, 17 were male and 4 were female with a median age of 8 years old (range, 4-12 years), the median follow-up time was 30 moths (range, 10-133 months). All the patients were treated with chemotherapy induced by the high-risk project of CCLG-ALL 2008. Among 14 patients treated with TKI plus chemotherapy, nine patients achieved complete remission. During 3 months after treatment, patients without complete molecular response or with the second complete remission and intensity desire of transplantation were treated with allo-HSCT, among 9 patients with allo-HSCT, six patients achieved long term survival.@*CONCLUSION@#At TKI era, TKI combined with strong chemotherapy can make Ph


Subject(s)
Aged , Child , Female , Hematopoietic Stem Cell Transplantation , Humans , Infant , Male , Philadelphia Chromosome , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Protein Kinase Inhibitors , Retrospective Studies
17.
Article in Chinese | WPRIM | ID: wpr-879584

ABSTRACT

OBJECTIVE@#To detect fusion gene with pathological significance in a patient with refractory and relapsed acute B cell lymphoblastic leukemia (B-ALL) and to explore its laboratory and clinical characteristics.@*METHODS@#Transcriptome sequencing was used to detect potential fusion transcripts. Other laboratory results and clinical data of the patient were also analyzed.@*RESULTS@#The patient was found to harbor TCF3 exon 17-ZNF384 exon 7 in-frame fusion transcript. The minimal residual disease (MRD) has remained positive after multiple chemotherapy protocols including CD19-, CD22- targeted chimeric antigen receptor T cells immunotherapy. The patient eventually achieved complete remission and sustained MRD negativity after allogeneic hemopoietic stem cell transplantation (allo-HSCT).@*CONCLUSION@#Transcriptome sequencing can effectively detect potential fusion genes with clinical significance in leukemia. TCF3-ZNF384 positive B-ALL has unique laboratory and clinical characteristics, may not well respond to chemotherapy and immunotherapy, and is more likely to relapse. Timely allo-HSCT treatment may help such patients to achieve long-term disease-free survival. TCF3-ZNF384 positive B-ALL is not uncommon in pediatric patients but has not been effectively identified.


Subject(s)
B-Lymphocytes , Basic Helix-Loop-Helix Transcription Factors/genetics , Child , Hematopoietic Stem Cell Transplantation , Humans , Laboratories , Precursor Cell Lymphoblastic Leukemia-Lymphoma/therapy , Trans-Activators/genetics , Transcriptome
18.
Med. infant ; 27(2): 192-199, Diciembre 2020.
Article in Spanish | LILACS, BINACIS, UNISALUD | ID: biblio-1151212

ABSTRACT

Entre los años 2000 y 2016 en Argentina, se reportaron al Registro Oncopediátrico Hospitalario Argentino (ROHA) 22.450 casos de cáncer en niños menores de 15 años de edad. Las Leucemias constituyen la enfermedad oncológica más frecuente, seguida de los Tumores de Sistema Nervioso Central y los Linfomas. Esta distribución es similar a la descripta en los países desarrollados de Europa y Norteamérica. Su tasa de curación a nivel mundial, llega al 80% debido al uso de quimioterapia intensiva, situación que mejora la supervivencia pero que también aumenta la frecuencia de complicaciones. Estas complicaciones pueden ser debidas tanto al propio cáncer como al tratamiento y en ocasiones ser la primera manifestación de la enfermedad oncológica. Los eventos que amenazan la vida en pacientes inmunocomprometidos son mayores que en la población general, y cuando ocurren tienen una mortalidad elevada. El reconocimiento temprano es clave para el resultado en términos de sobrevida y disminución de la mortalidad. Las acciones deberán centrarse al reconocimiento temprano de eventos críticos en pacientes oncológicos. Los pacientes Hemato-Oncológicos constituyen un gran número de ingresos no planificados a las unidades de cuidados intensivos. Uno de cada 4 pacientes requerirá durante su evolución ingreso a Unidades de Cuidados Intensivos. El propósito de este artículo es describir tres de las urgencias oncológicas que requieren con mayor frecuencia admisión en UCI: la presentación y manejo del shock séptico, Shock Cardiogénico y las complicaciones neurológicas en los pacientes con leucemias agudas (AU)


Between 2000 and 2016, 22,450 cases of cancer in children younger than 15 years of age were reported to the Argentine Hospital Registry of Childhood Cancer (ROHA). Leukemia was the most common cancer reported, followed by central nervous system tumors and lymphoma. This distribution is similar to that described in the developed countries of Europe and North America. The worldwide cure rate is up to 80% due to the use of intensive chemotherapy, which improves survival but also increases the complication rate. These complications may be due both to the cancer itself and to the treatment and are sometimes the first manifestation of the disease. Life-threatening events are more common in immunocompromised patients than in the general population, and when they occur, the mortality rate is high. Early recognition is essential for the outcome in terms of survival and decreased mortality. Interventions should focus on early recognition of critical events in cancer patients. Patients with hematology-oncology diseases account for a large number of unplanned admissions to intensive care units (ICU), while one in four of these patients will require admission to the ICU in the course of their disease. The aim of this study was to describe three oncology emergencies that most frequently require ICU admission: septic shock and its management, cardiogenic shock, and neurological complications in patients with acute leukemia (AU)


Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , Shock, Cardiogenic/etiology , Shock, Cardiogenic/therapy , Shock, Septic/etiology , Shock, Septic/therapy , Intensive Care Units, Pediatric , Leukemia, Myeloid, Acute/complications , Central Nervous System Diseases/etiology , Central Nervous System Diseases/therapy , Hematologic Neoplasms/complications , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Survival Rate , Critical Illness/therapy
19.
Univ. salud ; 22(2): 112-119, mayo-ago. 2020. tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1115960

ABSTRACT

Introducción: En el mundo las leucemias agudas son los tumores más frecuentes en la edad pediátrica, de gran interés por sus implicaciones en el niño y su familia. Objetivo: Identificar la incidencia de leucemia linfoide aguda y su asociación con determinantes demográficos en pacientes con cáncer pediátrico, Antioquia, 2017. Materiales y métodos: Estudio observacional, descriptivo, transversal, retrospectivo con intención analítica, sobre la incidencia de leucemia linfoide aguda (LLA) y su asociación con determinantes demográficos no causales de pacientes con cáncer infantil, en 190 registros del Sistema de Vigilancia en Salud Pública (SIVIGILA). Resultados: Las tasas de incidencia de cáncer infantil y LLA fueron 10 casos y 4 casos por cada 100.000 habitantes ≤18 años respectivamente. Las variables asociadas a LLA son: ser hombre (RPa: 1,02 IC95%: 0,52 - 2,02), residencia rural (RPa: 1,59 IC95%: 0,55 - 4,56), afiliación al régimen subsidiado (RPa: 1,41 IC95%: 0,68 - 2,92), edad ≥ 9 años (RPa: 0,76 IC95%: 0,38 - 1,50) y oportunidad diagnóstica confirmatoria ≥ 16 días (RPa: 0,34 IC95%: 0,10 - 1,15). Conclusiones: Ser hombre, vivir en zona rural y estar afiliado al régimen subsidiado, está relacionado con la incidencia de leucemia linfoide aguda.


Introduction: Acute leukemias are the most frequent pediatric malignancies worldwide that have led to a great interest due to their implications for children and their families. Objective: To identify the incidence of acute lymphocytic leukemia and its association with demographic determinants in pediatric cancer patients from Antioquia (Colombia) in 2017. Materials and methods: An observational, descriptive, cross-sectional, retrospective study was carried out with an analytical approach to identify the incidence of acute lymphocytic leukemia (ALL) and its association with non-causal demographic determinants in patients with pediatric cancer. 190 records from the Public Health Surveillance System (SIVIGILA) were analyzed. Results: The incidence rates of childhood cancer and ALL were 10 and 4 cases per 100,000 inhabitants ≤18 years of age, respectively. The variables associated with ALL are: being male (APR: 1.02 95% CI: 0.52 - 2.02); living in rural areas (APR: 1.59 95% CI: 0.55 - 4.56); being affiliated to the subsidized regime (APR: 1.41 95% CI: 0.68 - 2.92); being ≥ 9 years of age (APR: 0.76 95% CI: 0.38 - 1.50); and having a confirmatory diagnosis after 16 days (APR: 0.34 95% CI: 0.10 - 1.15). Conclusions: The variables related to acute lymphocytic leukemia are: being a man; living in rural areas; and being affiliated to the subsidized regime.


Subject(s)
Leukemia , Child , Precursor Cell Lymphoblastic Leukemia-Lymphoma , Pediatricians , Neoplasms
20.
Arq. bras. med. vet. zootec. (Online) ; 72(3): 787-793, May-June, 2020. tab
Article in English | ID: biblio-1129177

ABSTRACT

The immunophenotype is regarded as an independent prognostic factor in high-grade lymphomas, seeing that lymphomas of T-cell origin are associated with shorter survival time. Although a number of studies have evaluated the immunophenotypical profile of lymphoma in the USA and Europe, Brazilian research on the matter remains scarce. Exact characterization of the histopathological type is crucial to establish proper treatment and prognosis. This study evaluated the database of immunohistochemistry laboratories that perform immunophenotyping of canine lymphoma in Brazil. A total of 203 cases of multicentric lymphoma were classified according to the WHO classification. Immunophenotyping was able to identify 71.4% lymphomas of B-cell line, 27.1% of T-cell line and 1.5% of non-B cells and non-T cell lines. Diffuse large B-cell lymphoma was the most common with 59.1% of the cases. Among T-cell lymphomas, lymphoblastic was the most common (11.33% of the cases). Even though canine lymphomas tend to be high-grade, indolent lymphomas comprised 11.82% of the cases and T-zone lymphoma was the most prevalent (8.86%). The immunophenotype of multicentric lymphoma in Brazil is similar to those in other parts of the world, which suggests similar etiologic factors to the development of this disease.(AU)


O imunofenótipo é considerado um fator prognóstico independente em linfomas de alto grau, visto que os linfomas de origem de células T estão associados a menor tempo de sobrevida. Apesar de vários estudos terem avaliado o perfil imunofenotípico do linfoma nos EUA e na Europa, a pesquisa brasileira sobre o assunto ainda é escassa. A caracterização exata do tipo histopatológico é crucial para estabelecer o tratamento e o prognóstico adequados. Este estudo avaliou a base de dados de laboratórios de imuno-histoquímica que realizam imunofenotipagem do linfoma canino no Brasil. Um total de 203 casos de linfoma multicêntrico foi classificado de acordo com a classificação da OMS. A imunofenotipagem foi capaz de identificar 71,4% dos linfomas da linhagem de células B, 27,1% da linhagem de células T e 1,5% das linhagens de células não B e não T. O linfoma difuso de grandes células B foi o mais comum em 59,1% dos casos. Entre os linfomas de células T, o linfoblástico foi o mais comum (11, 33% dos casos). Embora os linfomas caninos tendam a ser de alto grau, os linfomas indolentes representaram 11,82% dos casos e o linfoma da zona T foi o mais prevalente (8,86%). O imunofenótipo do linfoma multicêntrico no Brasil é semelhante ao de outras partes do mundo, o que sugere fatores etiológicos semelhantes ao desenvolvimento dessa doença.(AU)


Subject(s)
Animals , Dogs , Immunophenotyping/veterinary , Lymphoma, B-Cell/classification , Lymphoma, T-Cell/classification , Lymphoma, Large B-Cell, Diffuse/classification , Precursor Cell Lymphoblastic Leukemia-Lymphoma/classification , Brazil
SELECTION OF CITATIONS
SEARCH DETAIL