Second Neoplasms in Children Following a Treatment for Acute Leukemia and/or Lymphoma: 29 Years of Experience in a Single Institution in Argentina.

INTRODUCTION: Childhood acute leukemias (AL) and lymphomas achieve good survival rates. However, second neoplasms (SN) are a devastating event. METHODS: From August 1987 to December 2016, 34 of 3321 (1%) patients with diagnosis of AL or lymphoma developed SN. SN were AL (n=16), CNS tumors (n=5), endocrinal tumors (n=3), lymphomas (n=2), schwannoma (n=2) assorted sarcomas (n=4), retinal melanoma (n=1), and Vanek tumor (n=1). Median latency was 51 (range, 10 to 110) months for hematological malignancies and 119 (range, 25 to 236) months for solid tumors (P=0.001). RESULTS: A total of 33 patients with SN were treated taking into account cumulative doses of anthracyclines and radiotherapy. Twenty-three (67.6%) patients achieved complete remission (CR), 5 died early during therapy and 5 were refractory or partial responders. Six patients presented relapses of the SN and 1 died in CR. Seventeen patients remain alive in CR, with a median follow-up of 110 (range, 4 to 276) months. CONCLUSIONS: (1) The latency period was significantly longer for patients developing solid tumors than for those developing AL. (2) AL was the most frequent SN. (3) Our results strongly encourage giving standard therapy to SN, considering cumulative doses of previous treatment, since similar probabilities of surviving as "de novo" counterparts can be achieved.

Tumores cerebrales infratentoriales y supratentoriales: comparación de perfil cognitivo y su impacto en la calidad de vida en niños en edad escolar / Infra- and supratentorial brain tumors: comparison of the cognitive profile and its impact on quality of life in school-age children

INTRODUCCION: Los avances científicos han logrado aumentar la cantidad de pacientes pediátricos que sobreviven a enfermedades oncológicas. En general, para los niños que padecen tumores del sistema nervioso central, esta sobrevida viene acompañada de efectos adversos secundarios, tales como déficits cognitivos.OBJETIVO: Evaluar las funciones cognitivas y la calidad de vida en niños con tumores cerebrales infratentoriales y supratentoriales.METODOS: Se realizó un estudio analítico observacional. La muestra total estuvo conformada por 51 sujetos. Se utilizaron los siguientes instrumentos de medición: Escala de Inteligencia de Wechsler para niños IV, Sistema de Evaluación Cognitiva; Test de Memoria y Aprendizaje; Escala Graffar y Peds Quality of Life 4.0.RESULTADOS: La comparación de los resultados no arrojó diferencias significativas entre localizaciones tumorales infratentoriales y supratentoriales. La totalidad de los pacientes evaluados en un período de post-tratamiento oncológico presentó un descenso similar y significativo en todas las áreas estudiadas, en relación con lo esperado para la población general. Las funciones cognitivas que evidenciaron mayor compromiso fueron la velocidad de procesamiento y la capacidad atencional (principalmente en tareas de planificación). Los resultados observados pusieron de manifiesto estos déficits, así como un alto compromiso de la calidad de vida escolar.CONCLUSIONES: El trabajo se presenta como un estudio preliminar. A partir de él se podría definir la tendencia general del estado neurocognitivo, analizar su impacto en la calidad de vida de la población estudiada y plantear interrogantes dirigidos a futuras investigaciones.

INTRODUCTION: Due to scientific advances, there is a growing number of pediatric patients surviving cancer. In general, for children who suffer from central nervous system tumors, this survival is associated with secondary adverse effects, such as cognitive deficits.OBJECTIVE: To assess cognitive functions and quality of life in children with infratentorial and supratentorial brain tumors.METHODS: An analytical observational study was conducted. The total sample consisted of 51 subjects. Following measurement instruments were used: Wechsler Intelligence Scale for Children, Fourth Edition (WISC IV), Cognitive Assessment System (CAS), Test of Memory and Learning (TOMAL), Graffar Scale and Peds Quality of Life 4.0.RESULTS: The comparisons of the results did not show significant differences between infratentorial and supratentorial tumor location. All patients that were evaluated in the post-cancer treatment period revealed a similar significant impairment in all the areas studied, when compared with the level expected in the general population. The most severely affected cognitive functions were processing speed and attention span, mainly on planning tasks. The findings also showed that quality of life at school is severely affected in these children.CONCLUSIONS: This is a preliminary study whose results may define a general trend of neurocognitive status, analyzing its impact on the quality of life of the study population and posing useful questions for the future research.

Tumores cerebrales infratentoriales y supratentoriales: comparación de perfil cognitivo y su impacto en la calidad de vida en niños en edad escolar / Infra- and supratentorial brain tumors: comparison of the cognitive profile and its impact on quality of life in school-age children

INTRODUCCION: Los avances científicos han logrado aumentar la cantidad de pacientes pediátricos que sobreviven a enfermedades oncológicas. En general, para los niños que padecen tumores del sistema nervioso central, esta sobrevida viene acompañada de efectos adversos secundarios, tales como déficits cognitivos.OBJETIVO: Evaluar las funciones cognitivas y la calidad de vida en niños con tumores cerebrales infratentoriales y supratentoriales.METODOS: Se realizó un estudio analítico observacional. La muestra total estuvo conformada por 51 sujetos. Se utilizaron los siguientes instrumentos de medición: Escala de Inteligencia de Wechsler para niños IV, Sistema de Evaluación Cognitiva; Test de Memoria y Aprendizaje; Escala Graffar y Peds Quality of Life 4.0.RESULTADOS: La comparación de los resultados no arrojó diferencias significativas entre localizaciones tumorales infratentoriales y supratentoriales. La totalidad de los pacientes evaluados en un período de post-tratamiento oncológico presentó un descenso similar y significativo en todas las áreas estudiadas, en relación con lo esperado para la población general. Las funciones cognitivas que evidenciaron mayor compromiso fueron la velocidad de procesamiento y la capacidad atencional (principalmente en tareas de planificación). Los resultados observados pusieron de manifiesto estos déficits, así como un alto compromiso de la calidad de vida escolar.CONCLUSIONES: El trabajo se presenta como un estudio preliminar. A partir de él se podría definir la tendencia general del estado neurocognitivo, analizar su impacto en la calidad de vida de la población estudiada y plantear interrogantes dirigidos a futuras investigaciones.

INTRODUCTION: Due to scientific advances, there is a growing number of pediatric patients surviving cancer. In general, for children who suffer from central nervous system tumors, this survival is associated with secondary adverse effects, such as cognitive deficits.OBJECTIVE: To assess cognitive functions and quality of life in children with infratentorial and supratentorial brain tumors.METHODS: An analytical observational study was conducted. The total sample consisted of 51 subjects. Following measurement instruments were used: Wechsler Intelligence Scale for Children, Fourth Edition (WISC IV), Cognitive Assessment System (CAS), Test of Memory and Learning (TOMAL), Graffar Scale and Peds Quality of Life 4.0.RESULTS: The comparisons of the results did not show significant differences between infratentorial and supratentorial tumor location. All patients that were evaluated in the post-cancer treatment period revealed a similar significant impairment in all the areas studied, when compared with the level expected in the general population. The most severely affected cognitive functions were processing speed and attention span, mainly on planning tasks. The findings also showed that quality of life at school is severely affected in these children.CONCLUSIONS: This is a preliminary study whose results may define a general trend of neurocognitive status, analyzing its impact on the quality of life of the study population and posing useful questions for the future research.