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Objective To summarize the long-term outcomes and safety of childhood Hodgkin lymphoma (HL) with protocol ABVD. Methods The clinical data of 20 children with HL admitted to the Union Hospital of Fujian Medical University from July 2010 to June 2017 were retrospectively analyzed. Among the 20 children with HL, 15 were male and 5 were female. The median age of initial diagnosis was 6.5 years old (3-12 years old). The pathological types were as follow: 1 case was nodular lymphocyte-predominant HL (NLPHL) and 19 cases were classical HL (cHL), including 9 cases of mixed cell type, 9 cases of nodular sclerosis type and 1 case of lymphocyte rich type. Basing on Ann Arbor staging system, 1 patient was evaluated as stage Ⅰ, 4 patients were stage Ⅱ, 10 patients were stage Ⅲ, and 5 patients were stage Ⅳ. There were 3 patients in the low-risk group, 7 patients in the intermediate-risk group, and 10 patients in the high-risk group. There were 9 patients with B symptoms. All patients were treated with the ABVD regimen. Results All the 20 patients completed all chemotherapy courses. After 2 courses, the effective rate was 100％(20/20), including 12 cases of complete remission (CR) and 8 cases of partial remission (PR). After the treatment, 19 cases achieved CR, and at the end of the 6 courses, the evaluation showed that 1 case had residual lesions. Follow-up to February 2018, clinical symptoms of 18 cases achieved CR, 2 cases relapsed (all high-risk group); the median follow-up time was 42 months (10.1-87.9 months), the overall survival rate was 100 ％ (20/20), the estimated 5-year rate of freedom from treatment failure (FFTF) was (89.1 ±7.3) ％.Conclusions According to the risk stratification, ABVD regimen has good safety and long-term efficacy for children with cHL. Even the patients in low-risk or intermediate-risk group do not achieve CR after 2 courses and do not receive radiotherapy, the prognosis of them is still good.
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Objective To investigate the clinical features,diagnosis,treatment and prognosis of disseminated aspergillosis in children with leukemia after chemotherapy.Methods The clinical features and treatment of 3 leukemia children after chemotherapy complicated with disseminated aspergillosis were retrospectively analyzed.Results The underlying diseases of all recruited cases were leukemia,which occurred many high-risk predisposing factors for invasive fungal diseases.The major clinical features of disseminated aspergillosis in children with leukemia were prolonged and antibiotics uncontrollable fever,subcutaneous solid nodules,nodules or cavities in pulmonary CT,spread low density lesions in hepatosplenic and kidney in abdominal MR(T2 weighted)and positive serum aspergillus galactomannan(GM).The diagnosis of invasive fungal disease was proven by histopathologic examination.Amphotericin B lipid complex was selected in antifungal therapy for 2 patients and the course of treatment was more than 4 weeks.Moreover,chemotherapy was advised for the 2 patients when clinical manifestations of disseminated aspergillosis improved significantly,neutrophil counts recovered and images did not deteriorate.The patients received voriconazole treatment with follow-up from 6 months to 12 months,and then disseminated aspergillosis was cured up to the standard.1 case received complete remission and was still alive until follow-up period,1 case was died of leukemia relapse because of suspension demand from the family members,and the other 1 case was died of no response or serious adverse drug reactions,uncontrolled infection,and leukemia relapse because of long-term chemotherapy suspension.Conclusions Patients with leukemia after chemotherapy may present with the following manifestations,including fever,subcutaneous solid nodules,pulmonary nodules or cavities,spread low density lesions in hepatosplenic and kidney and serum aspergillus GM antigen positive,which may indicate disseminated aspergillosis.The improvement of prognosis depends on effective and adequate antifungal treatment and chemotherapy for leukemia at the right time.
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Objective To investigate the clinical features,diagnosis,treatment and prognosis of disseminated aspergillosis in children with leukemia after chemotherapy.Methods The clinical features and treatment of 3 leukemia children after chemotherapy complicated with disseminated aspergillosis were retrospectively analyzed.Results The underlying diseases of all recruited cases were leukemia,which occurred many high-risk predisposing factors for invasive fungal diseases.The major clinical features of disseminated aspergillosis in children with leukemia were prolonged and antibiotics uncontrollable fever,subcutaneous solid nodules,nodules or cavities in pulmonary CT,spread low density lesions in hepatosplenic and kidney in abdominal MR(T2 weighted)and positive serum aspergillus galactomannan(GM).The diagnosis of invasive fungal disease was proven by histopathologic examination.Amphotericin B lipid complex was selected in antifungal therapy for 2 patients and the course of treatment was more than 4 weeks.Moreover,chemotherapy was advised for the 2 patients when clinical manifestations of disseminated aspergillosis improved significantly,neutrophil counts recovered and images did not deteriorate.The patients received voriconazole treatment with follow-up from 6 months to 12 months,and then disseminated aspergillosis was cured up to the standard.1 case received complete remission and was still alive until follow-up period,1 case was died of leukemia relapse because of suspension demand from the family members,and the other 1 case was died of no response or serious adverse drug reactions,uncontrolled infection,and leukemia relapse because of long-term chemotherapy suspension.Conclusions Patients with leukemia after chemotherapy may present with the following manifestations,including fever,subcutaneous solid nodules,pulmonary nodules or cavities,spread low density lesions in hepatosplenic and kidney and serum aspergillus GM antigen positive,which may indicate disseminated aspergillosis.The improvement of prognosis depends on effective and adequate antifungal treatment and chemotherapy for leukemia at the right time.
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Children with autism spectrum disorders are often accompanied by abnormal eating behavior.The experiment also contains a variety of confounding factors.Due to unclear mechanism and various clinical manifestations.the treatment results of abnormal eating behavior are also different.We review the recent research progress research of abnormal eating behaviorin children with autism spectrum disorders.
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Programmed cell death 5 ( PDCD5 ),formerly designated as TFAR19 ( TF-1 cell apoptosis-related gene 19),is an apoptosis-regulated gene cloned by Peking University Center for Human Disease Genomics.PDCD5 is expressed in many human tissues,with a high degree of homology,plays a regulatory role during cell apoptosis.Disorders of PDCD5 expression is correlated with tumorigenesis.This article reviews the structure,expression and functions of PDCD5,makes a summary of its relationship with kinds of tumors.Further studies about clinical application of PDCD5 are needed.
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Although the incidence of malignant solid tumors in children is not high,it is one of the major death causes in children.MYCN gene amplification is an independent poor prognosis factor of neuroblastoma.MYCN gene involves in neuroblastoma tumorgenesis and is the major evidence of treatment.MYCN gene amplification could be detected in other children's solid tumor.It is associated with unfavorable medulloblastoma pathology,poor outcome of Wilms' tumor and alveolar rhabdomyosarcomas.This review compares different MYCN gene detection methods,makes a summary about the clinical relationship between MYCN gene and children's solid tumor and investigates the possibility of increasing cure rate of malignant solid tumors through molecular specificity treatment.