[Prognostic Significance of Joint Detection of miR-210 and Minimal Residual Disease in Pediatric Acute Lymphoblastic Leukemia].

OBJECTIVE: To detect the expression of microRNA-210(miR-210) in childhood acute lymphoblastic leukemia(ALL), and to evaluate the role of the joint detection of miR-210 and MRD in the prognosis and clinical treatment of pediatric ALL. METHODS: Eighty-eight children diagnosed with ALL were included in the study. miR-210 was quantitatively detected by real-time quantitative polymerase chain reaction(RQ-PCR) in 88 ALL patients. The average Ct value of samples obtained from 5 pediatric ALL patients with long-term complete continuous remission (CCR>5 years) was used as a calibrator. The expression levels of miR-210 in newly diagnosed patients was calculated by the 2-ΔΔCt method and presented as multiple changes compared with that of the 5 CCR patients. RESULTS: The expression of miR-210 in the favorable prognosis group was significantly higher than that in the unfavorable prognosis group (10.64±1.5 vs 3.27±0.68)(P<0.05). Compared with the miR-210 high-expression group, poorer relapse-free survival(RFS), event-free survival(EFS) and overall survival(OS) (P all <0.001) were found in the low-expression group. Based on the expression of miR-210 and MRD, the 88 cases were divided into 3 groups. The relapse rate of miR-210-MRD high-risk group (70%) was significantly higher than that of the miR-210-MRD middle-risk group(6.25%) and miR-210-MRD low-risk group (2.1%). Kaplan-Meier survival analysis demonstrated that the miR-210-MRD high-risk group had poorer RFS, EFS and OS than those in other 2 groups (P all <0.01). CONCLUSION: The expression level of miR-210 is an independent prognostic factor for pediatric ALL, and the miR-210 is a good useful indicator for predicting the relapse and induction failure of childhood ALL. Joint detection of miR-210 and MRD can help predict outcomes more precisely, thus may be used as an effective mean of determining prognosis, monitoring recurrence, and guiding treatment.

Clinical efficacy and prognosis factors for advanced hepatoblastoma in children: a 6-year retrospective study.

OBJECTIVE: This study aimed to investigate the effect of multimodality treatment of advanced paediatric hepatoblastoma (HB) and the factors affecting prognosis. METHODS: A total of 35 children underwent multimodality treatments consisting of chemotherapy, surgery, interventional therapy, and autologous peripheral blood stem cell transplantation. The patients were followed up every month. RESULTS: Serum AFP levels in 33 out of 35 patients in this study were significantly increased (P = 0.0002). According to the statistical scatter plot, the values of serum AFP on the 25th, 50th, and 75th percentages were 1,210, 1,210 and 28,318 ng/dl, respectively. Of the 35 cases, 21 were stage IV. 18 cases were treated with systemic chemotherapy before surgery, and 3 cases with locally interventional chemotherapy before surgery. Statistical analysis showed that the preferred interventional treatment affected prognosis, and that there was a statistically significant difference (P = 0.024). Some 33 patients completed the follow-up, of which 17 were in complete remission (CR), 5 were in partial remission (PR), 1 became disease progressive (DP) , and 10 died. The remission and overall survival rates were 66.7% (22/33) and 69.7% (23/33), respectively. Patients with the mixed HB phenotypes had worse prognoses than the epithelial phenotype (P < 0.001), and patients in stage IV had a lower survival rate than those in stage III (P < 0.001). CONCLUSION: Multimodality treatment can effectively improve remission rate and prolong the survival of children with advanced HB. In addition, alpha-fetoprotein (AFP), a tumor marker of liver malignant tumors, HB pathological classification, and staging are highly useful in predicting prognosis.

[Therapeutic effects of high dose chemotherapy combined with autologous peripheral blood stem cell transplantation for neural ectodermal solid tumor originated from neural crest in children].

OBJECTIVE: To investigate the efficacy of high dose chemotherapy combined with autologous peripheral blood stem cell transplantation (APBSCT) for the treatment of neural ectodermal solid tumor originated from neural crest in children. METHODS: Twenty-three children at a medium age of 5.8 + or - 3.5 years with neural ectodermal solid tumor originated from neural crest were enrolled. Of the 23 children, 20 with stage IV neuroblastoma (9 were in complete remission, 7 were in partial remission and 4 were in progressive disease), 2 with stage IV primitive neuroectodermal tumor (PNET) in complete remission, and 1 with retinoblastoma in partial remission. Before APBSCT the children received 8.0 + or - 4.3 courses of chemotherapy. During chemotherapy the autologous peripheral blood stem cells were harvested and the tumor excision was performed. Then APBSCT was performed. RESULTS: The reconstruction of the hematopoietic system was noted in 19 of 20 children with stage IV neuroblastoma 16.5 + or - 0.9 days after transplantation. A follow-up (median 15.8 months) was done in these children. The follow-up showed that the survival rate in children in complete remission before transplantation was 100%, 57% in those in partial remission, and none of children in progressive disease survived (P<0.05). The total survival rate was 67% in children with neuroblastoma. The child with retinoblastoma had complete remission in a 6-months follow-up. The tumors recurred in children with PNET 5 to 8 months after transplantation and all died within one year after transplantation. CONCLUSIONS: High dose chemotherapy combined with APBSCT can result in a good outcome in children with neural ectodermal solid tumor originated from neural crest in complete remission before transplantation and can improve the outcome in patients in partial remission before transplantation. However, the children with PNET, even in complete remission before transplantation, do not respond to the therapy.