ABSTRACT
Overcoming childhood cancers is critically dependent on the state of research. Understanding how, with whom and what the research community is doing with childhood cancers is essential for ensuring the evidence-based policies at national and European level to support children, their families and researchers. As part of the European Union funded EUROCANCERCOMS project to study and integrate cancer communications across Europe, we have carried out new research into the state of research in childhood cancers. We are very grateful for all the support we have received from colleagues in the European paediatric oncology community, and in particular from Edel Fitzgerald and Samira Essiaf from the SIOP Europe office. This report and the evidence-based policies that arise from it come at a important junction for Europe and its Member States. They provide a timely reminder that research into childhood cancers is critical and needs sustainable long-term support.
ABSTRACT
Rotavirus infection is common in childhood. We report a 2-year-old boy admitted to hospital with gastro-enteritis who suffered cardio-respiratory arrest and died. Autopsy showed evidence of rotavirus-associated myocarditis and pneumonitis. We are not aware of any previous report of death from this type of consequence of rotavirus infection.
Subject(s)
Myocarditis/virology , Pneumonia, Viral/virology , Rotavirus Infections/diagnosis , Fatal Outcome , Gastroenteritis/virology , Humans , Infant , Male , Myocarditis/diagnosis , Pneumonia, Viral/diagnosisABSTRACT
From 1984 to 1996, 31 consecutive children without sibling donors, aged 5-19 years (median 8) with acute lymphoblastic leukaemia (ALL) in second complete remission (CR), received unpurged autologous bone marrow transplantation (ABMT) after melphalan and single fraction total body irradiation (TBI). ABMT was performed using fresh unmanipulated marrow harvested after standard reinduction and consolidation therapy 2-11 months (median 5) after relapse. With a median survival of 2.9 years the probability of survival for all patients in continuing second CR was 45.1% (95% CI, 24%-62%) after 5 years. Regimen-related and non-leukaemia mortality was 7% (95% CI, 2%-26%). The longest time to second relapse from ABMT was 3.1 years. Pituitary and gonadal dysfunction requiring hormonal replacement therapy occurred in the majority of long-term survivors. Twelve patients developed cataracts. ABMT with melphalan/single fraction TBI has proved an effective anti-leukaemia treatment with low regimen-related mortality but significant long-term morbidity. The current approach of allogeneic BMT from an unrelated donor when no sibling donor is available, following conditioning with cyclophosphamide/ fractionated TBI has resulted in a reduced relapse rate and improved short-term overall survival in the treatment of relapsed childhood ALL. However, long-term results are awaited.
Subject(s)
Bone Marrow Transplantation , Precursor Cell Lymphoblastic Leukemia-Lymphoma/surgery , Adolescent , Cataract/etiology , Child , Child, Preschool , Disease-Free Survival , Female , Fever/microbiology , Follow-Up Studies , Gonadal Disorders/drug therapy , Gonadal Disorders/etiology , Graft Survival , Human Growth Hormone/deficiency , Human Growth Hormone/therapeutic use , Humans , Infant , Male , Melphalan/administration & dosage , Melphalan/toxicity , Mouth Mucosa , Neutrophils , Platelet Count , Pneumocystis Infections , Pneumonia, Pneumocystis/microbiology , Prospective Studies , Sepsis , Stomatitis/microbiology , Survival Rate , Thyroxine/therapeutic use , Time Factors , Transplantation Conditioning , Transplantation, Autologous , Whole-Body IrradiationABSTRACT
Aspergillus species can cause life-threatening infection in immunocompromised children. Pulmonary infections are the most common, and are usually acquired through inhalations of aspergillus spores in unfiltered air. Some patients acquire invasive aspergillus infection from endogenous spread of colonized para-nasal sinuses.
Subject(s)
Aspergillosis/etiology , Fungemia/etiology , Precursor Cell Lymphoblastic Leukemia-Lymphoma/complications , Antifungal Agents/therapeutic use , Aspergillosis/drug therapy , Aspergillus fumigatus , Child , Female , Fungemia/drug therapy , Humans , Itraconazole/therapeutic use , MaleABSTRACT
Eighteen patients with poor risk Ewing's sarcoma (including 11 patients with metastatic disease at presentation) received consolidation therapy of busulphan and melphalan with autologous stem cell rescue. There were nine females. The median age at diagnosis was 14.2 years (range 2.75-30 years). There was one early death due to cytomegalovirus pneumonitis. One patient developed a single generalised convulsion during busulphan therapy. Severe renal toxicity was not encountered. One patient developed veno-occlusive disease of the liver (VOD) which eventually resolved. With a median follow up of 2 years, 13 patients survive including six with initial metastatic disease. We conclude that high-dose busulphan/melphalan is well-tolerated and should be evaluated for efficacy in a larger series of patients with high risk Ewing's sarcoma.
