RESUMO
Paediatric chronic myeloid leukaemia (CML) has biological and clinical differences from adult CML. Management of paediatric CML presents unique challenges in growing children, and there are no specific guidelines for paediatric CML. This review focusses on the clinical characteristics, diagnostic issues and management of paediatric CML. Major studies that provide the basis of managing paediatric CML are summerized here. Studies conducted on adult CML patients were used to guide the management of places where studies were lacking in paediatric CML. Recently, dasatinib and nilotinib have been approved for treatment of paediatric CML, and their role has been discussed in the current management perspective. Allogeneic transplant, fertility and vaccination in paediatric CML, have also been discussed.
RESUMO
BACKGROUND: Large data pertaining to indicators of malnutrition in children with cancer is lacking from India. In view of this, we prospectively analyzed consecutive de novo childhood patients with cancer presenting at a tertiary care center. MATERIALS AND METHODS: Height and weight of each child (n = 690) were compared with World Health Organization child growth standards‑2006 for that particular age and sex to get weight‑for‑age, height‑for‑age, and weight‑for‑height indices and below 2SD of the reference median on these indices were considered as underweight, stunted, and wasted, respectively. Body mass index (BMI) for age was also analyzed for thinness and obesity. RESULTS: Prevalence of malnutrition based on Z‑score for weight‑for‑age, height‑for‑age, weight‑for‑height, and BMI‑for‑age was 30%, 31%, 35%, and 41%, respectively. Weight‑for‑age (underweight) was significantly associated (P = 0.018) with solid tumors. Height‑for‑age, weight‑for‑age, and BMI‑for‑age were significantly associated (P = 0.007, P = 0.016, and P ≤ 0.001, respectively) with rural community. CONCLUSION: Malnutrition was observed in approximately one‑third of children with cancer. Malnutrition is associated with solid tumors and those coming from rural community. Wasting has a higher prevalence in children with cancer in <5 years of age group.