Prophylactic Cranial Irradiation May Not Be Needed in Children With ALL Prophylactic Cranial Irradiation May Not Be Needed in Children With ALL



In children with acute lymphoblastic leukemia (ALL) at risk for central nervous system (CNS) relapse, a higher dose of chemotherapy plus two extra doses of intrathecal therapy during early induction can obviate the need for prophylactic cranial irradiation, researchers say.Reuters Health Information

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AbstractPresence of minimal residual disease (MRD) following induction chemotherapy is a well-recognized risk factor to predict relapse in acute lymphoblastic leukemia (ALL). There is paucity of data on MRD and outcome in ALL from India. We share our experience in establishing a flow cytometry-based MRD assay for ALL with emphasis on determination of the number of patients who had MRD on day 35 of induction therapy and its correlation with outcome and other prognostic factors. We prospectively studied MRD in patients with ALL less than 25  years who achieved morphological complete remission with induction therapy. The…

ConclusionIt is feasible to administer intravenous chemotherapy at home in a safe and efficient way. The role of the specialized pediatric oncology nurse practitioner is an essential one.

A 14-year-old boy presented with bilateral knee pain. He had acute lymphoblastic leukemia, B precursor, and had received chemotherapy for 2  years. Following induction and consolidation therapy, maintenance therapy with methotrexate, mercaptopurine, dexamethasone, and vincristine was given. The patient complained of bilateral knee pain in week 103 of maintenance therapy. Physical examination yielded unremarkable findings, and an radiog raphs showed intact bony structures. Magnetic resonance imaging (MRI) showed bone infarction with a “map”-like appearance of bilateral femurs and tibias (Figures 1, 2, …

Source: The Journal of PediatricsCategory: Pediatrics Authors: Tags: Rediscovering the Physical Exam Source Type: research

Nitrous oxide (N2 O) is frequently used for short anaesthesia/analgesia in children undergoing painful or repetitive procedures1 . Children with acute lymphoblastic leukaemia (ALL) require repeated lumbar punctures with direct instillation of intrathecal chemotherapy, usually the anti-folate agent Methotrexate, during their treatment. These procedures are frequently performed under anaesthesia. Concerns have been intermittently raised about a drug-interaction between methotrexate and N2 O that may potentiate the undesirable side effects of methotrexate, including neurotoxicity. However, the clinical evide…

Source: Paediatric AnaesthesiaCategory: Anesthesiology Authors: Tags: Paediatr Anaesth Source Type: research

Conclusion: The cumulative incidence of malnutrition in Finnish pediatric cancer patients is comparable to that reported in other populations. The nutritional status of patients with acute myeloid leukemia, CNS tumors, or solid tumors should be monitored with extra care to facilitate early intervention in the case of impending malnutrition.What is known:•Both malnutrition and obesity are associated with reduced survival and increased drug toxicity in pediatric cancer patients.What is new:•Overall, 28 % of Finnish children receiving chemotherapy for cancer suffer from malnutrition during the first 42 months follow…

Background: Acute lymphoblastic leukemia (ALL) is the most common pediatric malignancy. Vitamin D inadequacy is now an internationally recognized health problem. Some relation has been observed between Vitamin D insufficiency and poor outcome in ALL though evidence is limited. Methods: A prospective observational study was done including children (1-15 years) with newly diagnosed ALL. Vitamin D estimation was performed at baseline and at end of induction chemotherapy. Results: Ninety-three patients were recruited in the study. Majority of them belonged to lower socio-economic status (75.3%), and we…

Source: Nutrition and CancerCategory: Cancer & Oncology Authors: Tags: Nutr Cancer Source Type: research

Publication date: Available online 18 October 2019Source: Best Practice &Research Clinical HaematologyAuthor(s): Luke Maese, Elizabeth A. RaetzAbstractPhiladelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL) is a high-risk subset of B-cell ALL with a spectrum of underlying genetic alterations that activate kinase or cytokine receptor signaling. Ph-like ALL occurs at all ages but is most common in adolescents and young adults and is postulated to be a factor in the inferior outcomes in this age group. Ph-like ALL confers a poor prognosis with conventional chemotherapy and the pediatric and adult oncology …

Allogeneic hematopoietic stem cell transplantation (HSCT) is the standard of care in children with very high-risk acute leukemia.1-3 Through advances in donor selection and supportive care strategies, cure rates in patients with high-risk acute lymphoblastic leukemia (ALL) are approaching 70% in large multi-institutional trials.4 However, this success comes at the cost of complications and sequelae from chemotherapy and HSCT with negative impact on quality of life (QoL).

Source: Biology of Blood and Marrow TransplantationCategory: Hematology Authors: Tags: Review article Source Type: research

CONCLUSION: We report a higher incidence of SIADH (10.8%) in Indian children, compared to that described in the literature, during induction chemotherapy for ALL. Regular monitoring of sodium levels during this period of chemotherapy is hence essential for the timely diagnosis and appropriate management of SIADH, which in turn will avert complications, including neurological symptoms secondary to SIADH.

Source: Indian Journal of CancerCategory: Cancer & Oncology Authors: Source Type: research

Publication date: Available online 9 October 2019Source: Biocatalysis and Agricultural BiotechnologyAuthor(s): Rachna Goswamia, Venkata Dasu Veeranki, Vijay Kumar MishraAbstractl-asparaginase (EC is an important antineoplastic agent, used in the acute lymphoblastic leukemia chemotherapy and well known as food processing aid for reducing the acrylamide formation in starch rich foods. In the present study, we have cloned, expressed and purified recombinant l-asparaginase II of Erwinia carotovora subsp. atroseptica SCRI 1043 in E. coli. To study the best condition for performance of recombinant enzymes, pH and temper…


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