bluuebunny/crossref_metadata_2025 huggingface dataset:
Nephrotoxicity following carboplatin use in children: Is routine monitoring of renal function necessary?
Authors: Brandt Laura J. , Broadbent Valerie
Published: February 2007

Carboplatin is an effective chemotherapeutic agent against many solid tumours. Although it is thought to be less nephrotoxic than its precursor cisplatin, current paediatric treatment protocols require regular monitoring of renal glomerular function during and after carboplatin use. Because accurate assessment of renal function in children requires measurement of isotope‐clearance glomerular filtration rates (GFRs), routine monitoring is costly and time consuming. We studied 26 paediatric patients who were receiving chemotherapy that included 500–600 mg/m2 of carboplatin per course. 51Cr‐EDTA GFRs were measured initially and after one to seven courses (median four). There was no measurable difference between renal function before and after carboplatin (P = 0.8). Our study shows that routine monitoring of renal glomerular function is unnecessary. Carboplatin use in patients who have had unilateral nephrectomy as part of their treatment is also discussed. Paediatric oncology literature concerning nephrotoxicity and carboplatin is reviewed. © 1993 Wiley‐Liss, Inc.
Phase II study of ifosfamide in childhood brain tumors: A report by the French society of pediatric oncology (SFOP)
Authors: Chastagner Pascal , Sommelet‐Olive Danièle , Kalifa Chantal , Brunat‐Mentigny Maud , Zucker Jean‐Michel , Demeocq François , Baranzelli Marie‐Christine , Tron Philippe , Bergeron Christophe , Pein François , De Lumley Lionel
Published: February 2007

Forty‐two evaluable pediatric patients with a variety of recurrent primary brain tumors participated in a phase II ifosfamide trial. Their mean age was 10 years. All patients were treated with ifosfamide, 3 g/m2/day for 2 days every 2 weeks. Response was assessed on clinical and radiological criteria after at least 2 courses of therapy. The overall response rate was 12% (5/42). One complete and 2 partial responses were documented in 21 patients with medulloblastoma. A partial response was demonstrated in 1 patient with primitive neurectodermal tumor (PNET) and in 1 patient with ependymoma. No activity was observed in astrocytic tumors.

Toxicity was primarily neurologic (16 out of 54 patients, 30%). Hematological toxicity, without severe morbidity, was encountered in 9% of courses (16/179). Ifosfamide, administered at this dose regimen has modest efficacy in the treatment of recurrent childhood medulloblastoma and ependymoma and appears inactive for gliomas. Further trials with other dose schedules are necessary to assess the activity of this drug. However, according to the neurotoxicity observed in our trial, we would not recommend building a protocol using ifosfamide for highly progressive brain tumors. © 1993 Wiley‐Liss, Inc.
Alveolar rhabdomyosarcoma with the t(2;13): Cytogenetic findings and clinicopathologic correlations
Authors: Douglass Edwin C. , Shapiro David N. , Valentine Marc , Rowe Susan T. , Carroll Andrew J. , Raney R. Beverly , Ragab Abdel H. , Abella Steven M. , Parham David M.
Published: February 2007

We describe here the clinical and pathologic features associated with a specific translocation, t(2;13), in alveolar rhabdomyo‐sarcoma. Tumor specimens from 14 patients with a t(2;13)‐positive alveolar rhabdomyo‐sarcoma were studied for cytogenetic‐clinicopathologic correlations. Three patients had occult primary tumors; nine patients had primary tumors of the trunk (mediastinal, pelvic, or rectal). The presence of the t(2;13) was ascertained from examination of tumor involved bone marrow in ten patients who had widespread metastatic disease at the time of diagnosis. Marrow involvement was so extensive in three cases that they were initially diagnosed as acute leukemia. Response to therapy was poor, with only five patients achieving a complete response. Twelve patients have died of their disease at a median survival time of 6 months from diagnosis and one is living with recurrent disease; only one patient survives free of disease. © 1993 Wiley‐Liss, Inc.
Effective multi‐agent chemotherapy for advanced abdominal lymphoma and FAB L3 leukemia of childhood
Authors: Toogood Ian R. G. , Tiedemann Karin , Stevens Michael , Smith Peter J.
Published: February 2007

Between June 1981 and May 1988, 51 children with diffuse undifferentiated, advanced (Murphy Stage III and IV) intra‐abdominal non‐Hodgkin′s lymphoma were treated on an intensive multi‐drug chemotherapy protocol without irradiation to the primary tumour. Therapy was completed for Stage III disease at one year, but Stage IV patients continued with a further year of therapy until January 1986, when it was reduced to one year. Central nervous system (CNS) prophylaxis consisted of eight doses of intrathecal MTX for all children, and 24 Gy cranial irradiation for Stage IV patients only.

There were 42 patients with Stage III disease (III A n = 29 and III B n = 13) and nine patients with Stage IV disease, of whom eight had extensive bone marrow and extramedullary disease (FAB L3 ALL). No patient had CNS disease at presentation.

Forty‐eight of 51 children (94%) achieved a complete remission. Two children died during remission induction therapy and eleven children relapsed, mostly within eight months of diagnosis. All patients have completed therapy. Failure free survival is 76% for Stage III and 67% for Stage IV patients, with a median followup of 90 and 64 months, respectively. Subdividing Stage III patients into Stage III A and III B did not show significantly different survival (P = 0.9), but the number of patients in Stage III B is small. These results compare favourably with the most effective published protocols, and toxicity has been manageable. © 1993 Wiley‐Liss, Inc.
Clinical phenotypes and Wilms tumor
Authors: Clericuzio Carol L.
Published: February 2007

Wilms tumor can occur in association with a number of recognizable patterns of malformation, as first described by Miller et al. in 1964 [1]. This paper represents a synthesis of the current state of knowledge regarding recognizable phenotypes associated with Wilms tumor. Specific disorders discussed include the Beckwith‐Wiedemann syndrome, which has been localized to 11p15.5; isolated hemihypertrophy; sporadic aniridia, which is almost always associated with del(11p13); genital anomalies, particularly male pseudohermaphroditism and the Denys‐Drash syndrome; and more weakly associated or uncommon conditions, such as neurofibromatosis and Perlman syndrome, respectively. Wilms tumor (WT) surveillance for specific high risk phenotypes should include a rational schedule of abdominal ultrasound examinations, taking into account the epidemiology of WT associated with specific disorders. Physical examination, with emphasis on abdominal palpation, and urinalysis should also be performed on a rational schedule. The schedule of examinations needs to be arrived at with input from clinical geneticists, oncologists, epidemiologists and pathologists with WT expertise. Lastly, care‐takers of high risk individuals should be taught abdominal palpation, to be performed daily at home. © 1993 Wiley‐Liss, Inc.
Rare tumors in childhood: Pathological aspects. Experience of the Kiel pediatric tumor registry
Authors: Harms Dieter , Schmidt Dietmar
Published: February 2007

A wide variety of rare tumors can occur in childhood and adolescence. Tumors can be rare in any age group; common tumors of adults can appear in childhood and adolescence, and many rare tumors and tumor‐like lesions show a predilection for younger age groups. Comparatively frequent tumors can present with rare histologic features or can occur in rare atypical locations, and, finally, seemingly common but, in fact, rare tumors have to be distinguished from truly common but rarely recognized tumors. Thus, the spectrum of rare tumors is broad, reflecting the fluent reality of life. © 1993 Wiley‐Liss, Inc.
Langerhans cell histiocytosis in childhood: Results from the Italian cooperative AIEOP‐CNR‐H.X '83 study
Authors: Ceci Adriana , De Terlizzi Marino , Colella Roberto , Loiacono Giuseppe , Balducci Donato , Surico Giammarco , Castello Manuel , Testi Anna Maria , De Bernardi Bruno , Indolfi Paolo , Macchia Pierantonio , Madon Enrico , Mancini Antonia , Rosati Domenico
Published: February 2007

Ninety patients with biopsy‐proven Langerhans cell histiocytosis (LCH) were enrolled from June, 1983, to December, 1988, in the multicenter AIEOP‐CNR‐H.X. '83 study. They were divided into two groups: poor prognosis (PP), comprising 11 children with organ dysfunction (OD), and good prognosis (GP), made up of 79 patients without OD. Eighty‐four patients were evaluable for treatment results. Among GP patients, 16 with a single lesion received only local treatment, while 59 entered a clinical trial of immunotherapy and/or monochemotherapy with vinblastine (VBL). Nonresponders, sequentially received doxorubicin (ADM) and then etoposide (VP16). PP patients were treated with 4 week cycles of vincristine, ADM, cyclophosphamide, and prednisone for nine courses. The overall survival was 92.8% (100% for GP patients and 45.5% for PP patients) at 48 months. The complete response (CR) rates for immunotherapy, VBL, ADM, and VP16 were 10%, 62.9%, 42.8%, and 88.2%, respectively. Two of the 11 PP patients had a CR (18.2%), while six died and three are still alive with recurrent disease. The overall incidence of disease‐related disabilities was 47.7%, while that of diabetes insipidus was 20%. Monochemotherapy is probably adequate in GP patients, while more effective treatments are needed for PP patients. © 1993 Wiley‐Liss, Inc.
The treatment of malignant scala posterior tumors in children: II. Preliminary result of the pre‐ and postoperative adjuvant chemotherapy of scala posterior tumors
Authors: Schuler Dezsõ , Somló Pál , Koós Rozália , Kálmánchey Rozália , Paraicz Ervin
Published: February 2007

Ten children with posterior scala tumor infiltrating the surrounding brain substance and/or the brain stem entered in the present study with preoperative chemotherapy. In 8 of the 10 cases regression and necrosis of the tumor were seen by CT examination after the preoperative therapy. The diameter of the tumor decreased on the average by 35.6% (14.0–74.3%). The main side effect was granulocytopenia. According to our observation, the preoperative therapy enables a more radical surgery in some cases of medulloblastoma and ependymoma. Further observations are necessary to confirm these preliminary results. © 1993 Wiley‐Liss, Inc.
Cerebral non‐Hodgkin's lymphoma discovered when treating Hodgkin's disease
Authors: Bergeron Christophe , Le Moine Philippe , Le Prise‐Fleury Elisabeth Le , Jouan Hélène , Tass Patrick , Darcel Françoise , Chatel Marcel , Edan Christine , Patte Catherine , Faivre Jean , Gall Edouard Le
Published: February 2007

Case report of the appearance of a highly malignant cerebral non‐Hodgkin's lymphoma of a diffuse large cell type, type B, occurring at the immediate onset of chemotherapy for a stage IV (mediastino‐pulmonary) Hodgkin's disease (nodular sclerosis) diagnosed in a 16‐year‐old boy. The treatment of this cerebral lymphoma associated primary chemotherapy with high dose methotrexate, high dose aracytine, etoposide, and ifosfamide. The chemotherapy proved to be highly efficient, producing complete remission. Thoracic and abdominal irradiation for Hodgkin's disease was performed concomitantly with chemotherapy for the non‐Hodgkin's lymphoma. This treatment was followed by 36 Gy of cerebral irradiation. Thirty‐six months after the discovery of the cerebral non‐Hodgkin's lymphoma the patient was still disease‐free and doing well. © 1993 Wiley‐Liss, Inc.
Hodgkin's disease associated with central pontine myelinolysis
Authors: Chintagumpala Murali M. , Mahoney Donald H. , McClain Kenneth , Dreyer Zoann E. , Fishman Marvin A. , Carrol Clark L. , Steuber Charles P.
Published: February 2007

We describe a 12‐year‐old black male who presented with cervical lymphadenopathy, hepatosplenomegaly of 3 months duration, and ataxia and incoordination of recent onset. Hodgkin's disease, stage IVB, was diagnosed. An MRI of the head demonstrated a nonenhancing, well‐defined pontine lesion. The pontine lesion and the associated neurologic symptoms were consistent with central pontine myelinolysis. Treatment of Hodgkin's disease resulted in complete remission and complete disappearance of the pontine abnormality. © 1993 Wiley‐Liss, Inc.
Ovarian function following the treatment of childhood acute lymphoblastic leukaemia
Authors: Wallace W. Hamish B. , Shalet Stephen M. , Tetlow Lesley J. , Morris‐Jones Pat H.
Published: February 2007

Ovarian function was assessed in 40 long term survivors who had received standard United Kingdom Acute Lymphoblastic Leukaemia (UKALL) protocols and were in first clinical and haematological remission.

A menstrual and pregnancy history was taken (median age at assessment: 18.8 (12–34.7) years) and the acquisition of adult secondary sexual characteristics confirmed in each patient. Basal bloods were taken for follicle stimulating hormone (FSH), luteinizing hormone (LH), and serum oestradiol estimations. Serum progesterone concentration was measured in those patients who were in the luteal phase of their menstrual cycle at assessment. In addition, menstrual cycle profiles of salivary progesterone concentrations were derived from daily samples in 12 patients.

All patients achieved adult sexual development; median age at menarche was early at 12.4 (9.0–14.6) years and 37 of them have regular menses. Ten patients have had 14 live births, and evidence of ovulation was seen in a further 11 patients assessed in the luteal phase of the menstrual cycle. Four patients had damaged ovaries, two of whom show evidence of ovulation; three of the four received craniospinal irradiation and one received cyclophosphamide as part of her chemotherapy regimen. None of these patients has yet developed total ovarian failure or required sex steroid replacement therapy.

The medium term outlook for ovarian function is good for the majority of childhood ALL survivors. The spinal component of craniospinal irradiation is a major risk factor for ovarian damage, and cyclophosphamide may be a contributory factor. A premature menopause remains a possibility if significant follicular depletion has occurred at the time of cytotoxic treatment. © 1993 Wiley‐Liss, Inc.
False‐positive MRI detection of recurrent or metastatic pediatric infratentorial tumors
Authors: Nelson Stephen C. , Friedman Henry S. , Hockenberger Beverly , Vandersteenhoven Jacob J. , Gray Linda , Touri Susan L. , Oakes W. Jerry
Published: February 2007

Gadolinium‐DTPA enhanced MRI is the modality of choice when imaging central nervous system infratentorial tumors in the pediatric population. The detection of a new enhancing lesion following initiation of therapy is typically considered pathognomonic for recurrent or metastatic tumor. We report two pediatric patients with infratentorial central nervous system tumors who demonstrated new areas of enhancement with gadolinium‐DTPA enhanced MRI following initiation of multimodality therapy. Both patients had surgical biopsy of the new lesions with histologic review failing to demonstrate viable tumor. These studies suggest caution in considering new enhancing lesions detected by MRI in a child with a brain tumor pathognomonic for new sites of active tumor. © 1993 Wiley‐Liss, Inc.
Fever and granulocytopenia in children with cancer: A study of 299 episodes with two treatment protocols in Brazil
Authors: Petrilli Antonio Sergio , Bianchi Alois , Kusano Eliza , Melaragno Renato , Naspitz Charles , da Silva Mendonça João , Pizzo Philip A.
Published: February 2007

In Brazil, 226 children with cancer presenting 299 episodes of fever and neutropenia (⩽500/mm3) were treated with two consecutive empirical regimens. Regimen I—Cefoxitin Amikacin‐Carbenicillin; and Regimen II Ceftriaxone‐Amikacin. 67.0% of the patients had leukemias or lymphomas, documented infections occurred in 47.2%, superinfections occurred in 18.7% (Reg. 1) and 17.8% (Reg. II) of the episodes. The most common agents identified in Reg. 1 and Reg. II were, respectively, Gram negative rods (55.0%) and Gram positive cocci (52.6%). The overall rate of success with modifications (Amphotericin B, Vancomycin, Clindamycin, Metronidazole) was higher in Reg. II (93.0%) than in Reg. I (84.0%). This study shows that the appropriate formula to maximize the successful treatment of children with cancer, fever and neutropenia in developing nations includes adherence to established principles of supportive care, utilizing the optimal antibiotic agents available in the country. It is important to promote the necessary modifications along the treatment having in mind the high index of resistent agents. © 1993 Wiley‐Liss, Inc.
Resection of a solid and papillary epithelial neoplasm of the pancreas following treatment with Cis‐platinum and 5‐fluorouracil: A case report
Authors: Strauss James F. , Hirsch Victor J. , Rubey Charles N. , Pollock Mark
Published: February 2007

A 15‐year‐old female was found at laparotomy to have an unresecteable 15 cm solid and papillary epithelial neoplasm of the pancreas invading the superior mesenteric vein. The tumor regressed when treated with cis‐platinum and 5‐fluorouracil for 6 months leaving a 3.5 cm mass which was resected at reoperation. Response to chemotherapy has not been previously documented for this tumor histology and may contribute to the management of this locally invasive tumor. © 1993 Wiley‐Liss, Inc.
Treatment of non‐metastatic, non‐seminomatous malignant germ‐cell tumours in childhood: Experience of the “Société Française D'oncologie Pédiatrique” MGCT 1985–1989 study
Authors: Baranzelli Marie Christine , Flamant Françoise , De Lumley Lionel , Le Gall Edouard , Lejars Odile
Published: February 2007

The members of the French Society of Pediatric Oncology treated, between January 1985 and June 1989, 67 cases of non‐metastatic, non‐seminomatous malignant germ cell tumours (nSGCT) in sites other than the brain. They used a clinical pre‐ and post‐surgical TNM‐type classification in order to standardize the treatment regardless of tumour site. The intensity of the treatment was decreased in comparison with the previous regimen (elimination of adriamycin, reduction in the length of treatment). The actuarial 2‐year disease‐free survival rate is 80%; results are excellent for patients with clinical stage I and II tumours and permit cure with moderate chemotherapy, avoiding undesirable late effects. On the other hand it is inadequate for patients with stage III suggesting that the initial chemotherapy should be intensified for these latter patients in future protocols. © 1993 Wiley‐Liss, Inc.
Development of hypertension in neuroblastoma during therapy: A case report
Authors: Wolff Johannes E. A. , Bauch Hans Jochen , Roessner Albert , Boos Joachim , Gressner‐Brocks Veronika , Ritter Jörg , Jürgens Herbert
Published: February 2007

A case of stage 4 neuroblastoma that developed excessive hypertension on day 120 of chemotherapy is presented. The tumor initially had responded well to chemotherapy; however, while the tumor mass decreased, plasma and urine catecholamines and the blood pressure increased. The plasma concentrations of noradrenaline, adrenaline, and dopamine increased to 26.4, 1.8, and 36.2 μg/l, respectively. The profile of catecholamine metabolites changed: on day 150 of therapy, noradrenaline, adrenaline, and dopamine levels were increased, whereas HVA and VMA levels were decreased when compared to day 1 of therapy. The only residual neuroblastoma tissue visible on MIBG scintigraphy on day 150 of treatment was a metastasis in the left tibia which was irradiated with 24 Gy. The adrenaline concentration in the left femoral vein was twice as high compared to the right femoral vein. A treatment, possibly radiation‐associated tumor cell alteration resulting in a different catecholamine production, is discussed. © 1993 Wiley‐Liss, Inc.
When is the optimum time to harvest peripheral blood stem cells in children following standard dose chemotherapy?
Authors: Fernandez Jose Maria , Shepherd Valerie , Millar John , Powles Ray , Pinkerton C. Ross
Published: February 2007

The optimal time for peripheral stem cell harvest may be predicted by recovery of blood count following priming doses of chemotherapy. Bone marrow growth factors have also been used to enhance yield. Both these manoeuvres may necessitate alterations to standard treatment programmes. In order to determine whether adequate peripheral stem cell yields could be obtained without altering chemotherapy regimens, 18 children with either leukaemia or solid tumours were studied. Circulating bone marrow progenitor cells were estimated by CFU‐GM cultures in soft agar. There were 8 males and 10 females, median age 5.6 years (range 2–13 years). Six out of 13 studies in leukaemia patients were done when the bone marrow contained significant leukaemic blasts, and in 2 of 9 studies in patients with solid tumours, there was active infiltration of the bone marrow. In 15 of 23 studies, a rise in CFU‐GM levels to greater than 1,000 × 103/l were observed following postchemotherapy aplasia. Maximum CFU‐GM levels were maintained for only 1–2 days and could be predicted by the achievement of a total white cell count in the region of 2 × 109/l and platelet count around 100 × 109/l. Neutrophil recovery did not predict the rise in CFU‐GM levels. A rapid rise in monocyte levels also preceded maximum CFU‐GM levels. Predictably, the CFU‐GM counts were lower in patients who were heavily pretreated, but in several children, the counts were sufficient to predict an adequate harvest to be used in conjunction with bone marrow autotransplantation.

It is concluded that in children with active bone marrow recovery, chemotherapy priming or the use of bone marrow growth factors may not be necessary to achieve useful stem cell harvests. © 1993 Wiley‐Liss, Inc.
Ectopic neuroblastoma of the thoracic wall: A case report
Authors: Cavallaro Sebastiano , Pineschi Alberto , Bardini Tomaso , Prever Adalberto Brach Del , Forni Marco
Published: February 2007

A case of thoracic neuroblastoma arising at the anterior mammillary line from the inner surface of the second and third right rib in a 17‐month‐old male child is reported. Primary surgery allowed excision of the mass. According to the histologic, histochemical, and molecular features of the tumor, all consistent with the diagnosis of neuroblastoma stage 2, the patient underwent adjuvant chemotherapy and, after 2 years, he is alive and disease free at follow‐up. In view of different clinical and therapeutical approaches, only a strict adherence to histopathologic criteria allows differentiation of neuroblastoma, even in a very unusual anatomical site, from other small‐cell, peripheral neoplasms presumably arising from the embryonic neural crest, such as Askin's tumor, neuroepithelioma, and ectomesenchymoma. The site of origin of these tumors is an important diagnostic clue but can be misleading: only careful microscopic evaluation and molecular analysis lead to incontrovertible diagnosis and yield correct clinical management.
Incidence and etiology of ifosfamide nephrotoxicity: Report of a meeting held in Rhodes, Greece, October 3, 1991, sponsored by Asta Medica, Frankfurt, Germany
Authors: Stevens Michael C. G. , Brandis Matthias
Published: February 2007

The nephrotoxic potential of Ifosfamide is now clearly recognized but the true incidence is unknown and risk factors are uncertain. There are, as yet, few studies which systematically explore these issues although many centers have collected data from patients receiving Ifosfamide. These support the need for collaborative studies to look at the influence of probable risk factors such as age, cumulative dose, schedule, and exposure to other nephrotoxic drugs. The ability to detect acute subclinical changes in renal function may provide the opportunity to predict subsequent clinical toxicity. The consensus of opinion recorded so far provides the basis of recommendations for future studies. © 1993 Wiley‐Liss, Inc.
Anterior pituitary function and computed tomography/magnetic resonance imaging in patients with langerhans cell histiocytosis and diabetes insipidus
Authors: Broadbent Valerie , Dunger David B. , Yeomans Elizabeth , Kendall Brian
Published: February 2007

In order to document anterior pituitary dysfunction in patients with biopsy‐proven Langerhans cell histiocytosis (LCH) and diabetes insipidus and to correlate this with structural changes on imaging, we performed an insulin tolerance test, enhanced computed tomography (CT), and unenhanced magnetic resonance imaging (MRI) in nine patients. Six of the nine patients had growth hormone deficiency, which in two patients was part of panhypopituitarism and in one was associated with poor cortisol response to insulin hypoglycemia. One patient had an exaggerated growth hormone response and one who had had neck irradiation as an infant, had a high resting thyroid stimulating hormone (TSH) suggesting compensated primary hypothyroidism. All enhanced CTs were abnormal, bony defects being the only abnormality in two patients and opaque mastoids in one. The remaining six patients all had structural changes in the hypothalamic/pituitary region.

Unenhanced MRI confirmed the CT findings except in one child who had been treated with radiotherapy in the intervening period, but, in addition, confirmed diabetes insipidus by showing absence of the posterior pituitary bright signal and picked up white matter changes in a child with clinical neurological dysfunction.

Our findings indicate that the development of diabetes insipidus in LCH is commonly associated with anterior pituitary dysfunction and is usually associated with structural changes in the hypothalamic/pituitary axis. © 1993 Wiley‐Liss, Inc.
Favorable response of pediatric AIDS‐related Burkitt's lymphoma treated by aggressive chemotherapy
Authors: Neumann Yoram , Toren Amos , Mandel Matilda , Martinowitz Uri , Varon David , Ramot Bracha , Ben‐Bassat Isaac , Rechavi Gideon
Published: February 2007

We describe 4 male children infected by the human immunodeficiency virus (HIV) who developed Burkitt's lymphoma during their disease. The clinical picture was characterized by an insidious appearance of symptoms. All the children suffered for several months from abdominal discomfort and a gradual elevation of their blood lactic dehydrogenase (LDH) level prior to diagnosis. Bone marrow involvement was found in 2 of the patients and jaw involvement in the other 2. After confirming the diagnosis of Burkitt's lymphoma, they were treated according to conventional protocols, with no need to reduce the dose intensity. They all went into complete remission and did not suffer from major opportunistic infections during chemotherapy. None of them relapsed. Two patients died from opportunistic infections 1 and 3 years after diagnosis. The other 2 are alive, 7 years and 6 months after diagnosis. The various characteristics of this unique pediatric group are described and the comparison of the clinical picture in adults is made, together with a review of the relevant literature. © 1993 Wiley‐Liss, Inc.
Adrenocorticotropic hormone‐secreting ganglioneuroblastoma associated with opsomyoclonic encephalopathy: A case report with immunohistochemical study
Authors: Clerico Anna , Tenore Alfred , Bartolozzi Silvia , Remotti Daniele , Ruco Luigi , Dominici Carlo , Properzi Enrico , Castello Manuel A.
Published: February 2007

This report describes a case of a 3‐year‐old female with Cushing's syndrome associated with ganglioneuroblastoma and opsomyoclonic encephalopathy. Immunohistochemistry showed the tumor to be adrenocorticotropic hormone‐secreting. At autopsy, a cerebellar degenerative lesion was also demonstrated. © 1993 Wiley‐Liss, Inc.
Second malignant tumors following treatment during childhood and adolescence for cancer
Authors: Green Daniel M. , Zevon Michael A. , Reese Peter A. , Lowrie Geoffrey S. , Gaeta John F. , Pearce John I. , Michalek Arthur M. , Stephens Elizabeth A.
Published: February 2007

Many pediatric and adolescent cancer patients are treated with carcinogenic chemotherapeutic agents and radiation therapy to achieve permanent control of their malignancy. These modalities may induce a new cancer in the successfully treated patient. To identify disease and treatment factors which increased the risk of occurrence of a second malignant tumor following modern treatment for cancer during childhood or adolescence, we reviewed the courses of 1,406 previously untreated patients who were less than 20 years of age at diagnosis and were treated at Roswell Park Cancer Institute between January 1, 1960 and December 31, 1989. Eighteen patients developed a second malignant tumor, including two meningiomas, 2.65‐25.65 years after diagnosis of the first cancer. The actuarial risk of a second malignant tumor was 5.6% at 25 years after diagnosis. Using Cox proportional hazards modelling, we identified prior therapy with BCNU (P = 0.0055) and doxorubicin (P = 0.0254) as the only factors that were significantly associated with the risk of a second malignant tumor. Three second malignant tumors of the central nervous system occurred following treatment with a nitrosourea. Successfully treated patients must be carefully followed to identify treatment related malignant tumors at an early Stage. © 1994 Wiley‐Liss, Inc.
Bone and gallium scintigraphy in children with rhabdomyosarcoma: A 10‐year review
Authors: Cogswell Arthur , Howman‐Giles Robert , Bergin Mary
Published: February 2007

Technetium‐99m bone and Gallium‐67 scintigraphy has been widely used in the management of children with solid tumors. A retrospective review of all patients with rhabdomyosarcoma (RMS) from January 1980 to December 1989 was undertaken in order to determine the sensitivity and specificity of scintigraphy in detection of metastatic disease and to determine optimum frequency of serial scans in follow up. Over the 10‐year period, 40 patients were diagnosed and treated for RMS: 22 were newly diagnosed from 1980‐1984 and of these 16 had a minmum 5‐year disease‐free period whilst 6 died of the disease, giving a cure rate of 73%. A total of 271 bone and 236 Gallium‐67 scans were performed. With respect to detection of metastatic disease in all tissues, Gallium‐67 scans had a sensitivity of 84%, specificity 95% and bone scans had a sensitivity of 70% and specificity 95%. Bone scan sensitivity and specificity for skeletal metastases were 100% and 95%, respectively. Considering only patients with Gallium avid primary tumors, the Gallium‐67 scan sensitivity was 94%. Ten patients developed new metastatic disease or primary recurrence after starting therapy, 8/10 within 12 months of diagnosis. Frequent surveillance scanning in the treatment phase, 2 years post‐diagnosis, is of value in the early detection of metastases and monitoring disease response to therapy. Surveillance scanning after completion of treatment is more difficult to justify.
Wilms' tumor involving the inferior vena cava: Preoperative evaluation and management
Authors: Federici Silvana , Galli Giacomo , Ceccarelli Pier Luca , Rosito Pasquale , Sciutti Rita , Dòmini Remigio
Published: February 2007

Neoplastic invasion of the inferior vena cava due to renal tumors (especially Wilms' tumor) is uncommon in children. The tumor thrombus, according to the aggressiveness of the original neoplasm, can extend in diverse ways, obliterate the vascular lumen completely, and even reach the right atrium. The luminal thrombus might be accompanied by the involvement of the caval wall, which requires wide vascular resection. The purpose of this paper is to present our experience with 7 children, aged 18 months and 6 years, affected by caval invasion due to Wilms' tumor. Furthermore, the diagnostic techniques and the surgical treatment in simple caval thrombosis and in associated invasion of the caval wall are described.
Thymic cyst appearing after treatment of mediastinal non‐Hodgkin lymphoma
Authors: Borgna‐Pignatti Caterina , Andreis Ivo Bergamo , Rugolotto Simone , Balter Rita , Bontempini Lamberto
Published: February 2007

We report the first case of a thymic cyst appearing in the course of treatment for non‐Hodgkin lymphoma of the anterior mediastinum. The patient was a 9‐year‐old child in whom an abnormal contour of the left cardiac border persisted after chemotherapy, suggesting residual disease. The mass was found at thoracotomy to be a benign thymic cyst. The lesion was not present 2 years previously, and most likely represented cystic degeneration of the thymus, secondary to lymphomatous involvement. CT scan was not helpful in distinguishing the cystic lesion from residual lymphoma.
Ifosfamide‐induced renal tubular defect
Authors: Valdivieso María José Torres , Pérez Jesús López , Melero Carmen , Vivanco José Luis , Muley Rafael , Vara Julia
Published: February 2007

We describe 2 cases of proximal tubular defects induced by the administration of ifosfamide at a dosage of 6 g/m2/course over 2 days in children with a diagnosis of malignant mesenchymal tumors. This adverse effect could be minimized dividing dosage of the drug. However at present it is not clear if divided doses are completely safe.
Pubertal growth in response to testosterone replacement therapy for radiation‐induced leydig cell failure
Authors: Didi Mohamed , Morris‐Jones Patricia H. , Gattamaneni Hanumantha R. , Shalet Stephen M.
Published: February 2007

The adolescent growth pattern of eight boys, who had puberty induced with androgen replacement therapy following radiation‐induced Leydig cell failure, was studied from induction of puberty at a mean age of 13.1 years (range 11.6‐14.5) to final height at mean age of 18.8 years (range 17.7‐20.3).

The mean gains during puberty (SD) for standing height, sitting height, and sub‐is‐chial leg length were 18.56 cm (3.98), 10.46 cm (2.39), and 8.1 cm (2.01) respectively, which were significantly reduced compared with normal Tanner standards (P <.001). The peak velocity for each parameter occurred in the 1st year of induced puberty in contrast to the pattern in normal adolescence, although the mean peak velocity for each auxological parameter was not significantly different from the normal Tanner standards.

The mean adult standing height (SD), 167.5 cm (9.88), and mean adult leg length (SD), 80.8 cm (6.19), were not significantly different from the normal Tanner standards, whereas the mean adult sitting height (SD), 86.7 cm (4.78), was shorter (P < .001). Three of the eight patients had a leg length standard deviation score less sitting height standard deviation score in excess of +2.96 suggesting the presence of significant skeletal disproportion. Seven of the eight boys reached target genetic height, though in six, the final height was below mid‐parental height (P < .05).

The modest loss in height potential was mainly due to radiation‐induced skeletal dysplasia attenuating the growth of the spine.

The families of boys with radiation‐induced Leydig cell failure requiring androgen replacement therapy can be reasonably optimistic about height prognosis as seven of the eight boys reached target genetic height. © 1994 Wiley‐Liss, Inc.
B19 parvovirus infection in children with malignant solid tumors receiving chemotherapy
Authors: Rao Sreedhar P. , Miller Scott T. , Cohen Bernard J.
Published: February 2007

Two children with rhabdomyosarcoma developed severe anemia following chemotherapy; anemia was more severe compared to that observed following earlier chemotherapy cycles. While one patient had a brisk reticulocytosis, the other had no demonstrable reticulocytes. Both patients had evidence of acute B19 parvovirus infection and subsequently developed appropriate antibody response. A diagnosis of B19 parvovirus infection should be considered in any patient who develops persistent or severe anemia while on chemotherapy. © 1994 Wiley‐Liss, Inc.
Immuno‐ and cytochemical characterization of congenital leukemia: A case report
Authors: Heikinheimo Markku , Pakkala Seppo , Juvonen Eeva , Saarinen Ulla M.
Published: February 2007

Congenital leukemia (CL) is a rare disorder, which usually presents as a myelocytic leukemia based on morphological features. Very few reports include data on cyto‐ or immunochemical parameters. A case of CL with detailed description of immunochemical, cytochemical features, and colony formation properties of the progenitor cells is reported. This leukemia was classified as an M4 in FAB classification based on the morphological features and special stains. Two different cell populations were identified by flow cytometry. One consisted of small cells expressing early T‐ and early B‐cell associating antigens as well as early myeloid‐associated antigens, but not CD10 (CALLA antigen), which is normally present in cord blood lymphocytes. The other was a population of large cells expressing myeloid‐associated antigens and a pan‐T‐antigen. The growth pattern of hematopoietic progenitors in the patient was compatible with both acute myeloid and acute lymphatic leukemia as well as erythroleukemia. © 1994 Wiley‐Liss, Inc.
Primary lymphoma of the pericardium: Report on a „Cured”︁ case and review of the literature
Authors: Pavlidis Nicholas A. , Elisaf Moses , Bai Mary , Tolis Christos , Papadimitriou Constantine
Published: February 2007

This report describes a 62‐year‐old man with a primary diffuse, immunohistochemically proven B‐cell lymphoma of large non‐cleaved cell (centroblastic) type of the pericardium. The patient responded completely to systemic chemotherapy and remains free of disease 30 months after diagnosis. The use of non‐cardiotoxic drugs in divided doses as initial treatment is emphasized. In addition, the authors reviewed the literature of the last decade regarding the management and outcome of patients with primary cardiac lymphomas. © 1994 Wiley‐Liss, Inc.
Neonatal tumours: A thirty‐year population‐based study
Authors: Parkes S. E. , Muir K. R. , Southern L. , Cameron A. H. , Darbyshire P. J. , Stevens M. C. G.
Published: February 2007

Estimates of the incidence and outcome of tumours in neonates are uncertain and most reports relate to selected experience in single centres. The definition of neonatal tumour is also unclear and histology is not always an accurate predictor of outcome. This report documents the incidence, clinical features, and outcome of neonatal tumours (birth‐3 months) in a population‐based paediatric register over a 30‐year period from 1960‐89. Case note and pathology review identified 170 cases for analysis, of which 21 were leukaemias, 14 CNS tumours, and 135 solid tumours of differing types. Fifty‐eight percent were diagnosed in the first month and mature teratoma was the most common diagnosis (29%). Overall incidence increased over the period of the study. Important family medical history was identified in 16% of cases and 15% of patients had associated congenital abnormalities. Overall survival at 1 year was 55%, with leukaemia having the poorest prognosis. Treatment strategies must be individualised but many patients may have a better prognosis than expected and would benefit from assessment at a designated paediatric oncology centre. © 1994 Wiley‐Liss, Inc.
Multicentric angiofollicular lymph node hyperplasia and associated carcinoma
Authors: Baker William J. , Vukelja Svetislava J. , Weiss Raymond B. , Dich Nguyen
Published: February 2007

There is a well described association between multicentric angiofollicular hyperplasia and non‐Hodgkin's lymphoma and/or Kaposi's sarcoma. Two cases of multifocal angiofollicular hyperplasia and associated carcinomas and non‐Hodgkin's lymphoma are reported. We suggest that underlying immunological defects in patients with multicentric angiofollicular hyperplasia make them susceptible to the development of carcinomas, as well as non‐Hodgkin's lymphoma and Kaposi's sarcoma. © 1994 Wiley‐Liss, Inc.
Pediatric hodgkin's disease in costa rica: Twelve years' experience of primary treatment by chemotherapy alone, without staging laparotomy
Authors: Lobo‐Sanahuja Francisco , García Ivette , Barrantes José C. , Barrantes Max , Gonzalez Mario , Jimenez Rafael
Published: February 2007

This is a prospective and nonrandomized study in which 86 children with previously untreated Hodgkin's disease (HD) were clinically staged (CS) and treated with chemotherapy (CT) alone. Fifty‐two (CS IA‐38, IIA‐7, IIB‐3, IIIA‐4) received six courses of cyclophosphamide, vinblastine, procarbazine, and prednisone (CVPP). Ten (CS IA with peripheral nodes) received only three courses of CVPP with a reinforcement of C on day 8. Twenty‐four (CS IIIB‐18, IVA‐2, IVB‐4) received six courses of CVPP alternating with six courses of epirubicine, bleomycine, and vincristine (EBO). Surgical staging was not performed in any patient. Two patients (CS IIIB) had partial remission and died from progressive disease. Seventy out of 86 children have not relapsed and are in complete remission with a median follow‐up of 65 months (range 13‐156 months); 14 children relapsed seven to 37 months from diagnosis (median 16 months); one of them (IV B) died of disease. Thirteen are in second and third remission (median 55 months). Actuarial five year survival rates and relapse‐free survival rates are 100% and 90% for CS I to IIIA and 81% and 60% for CS 1MB and IV, respectively. As a result of this study, we can conclude that in developing countries most of the children with HD staged by noninvasive diagnostic techniques can be cured with CT alone as primary treatment and thus will not suffer from the late effects of radiotherapy (RT) and the morbidity of laparotomy and splenectomy. RT alone or with other CT combinations should be considered for children who develop relapse of HD. © 1994 Wiley‐Liss, Inc.
Karyotype evolution in a patient with down syndrome and acute leukemia following a congenital leukemoid reaction
Authors: Sawyer J. R. , Roloson G. J. , Head D. R. , Becton D.
Published: February 2007

We report the serial cytogenetic study of a patient with Down syndrome who experienced a congenital leukemoid reaction, underwent a spontaneous remission within four months, and subsequently developed acute myeloid leukemia at 16 months. A blood chromosome study to rule out Down syndrome performed at age 24 days, during the leukemoid reaction, revealed a 47,XX,+21 karyotype. The diagnosis of acute leukemia was made at 16 months, at which time a chromosome study, on bone marrow, was performed. This analysis revealed a clonal karyotype of 47,XX,+21,‐22,+der (22)t(1;22)(q21;q13) in all but one cell studied. The single apparently nonclonal cell showed a karyotype of 49,XX,+12,‐13,‐19, +der(19)t(19;?)(q11;?)x2,+21,+22. A third chromosome study at 19 months indicated the original leukemic clone with t(1;22) (q21;q13) had been replaced by the clone represented by the single cell with 49 chromosomes seen in the previous chromosome study. This case of an infant with Down syndrome and acute leukemia illustrated rapid evolution and a transitory nature to clonal chromosome aberrations while retaining AML morphology and course. © 1994 Wiley‐Liss, Inc.
Pure dysgerminoma of the ovary in childhood: Treatment results and sequelae
Authors: Teinturier C. , Gelez J. , Flamant F. , Habrand J. L. , Lemerle J.
Published: February 2007

Thirty‐five children with pure dysgerminoma of the ovary were all treated at the Institut Gustave Roussy (IGR) from 1956–1985. The median follow‐up is 8.5 years. The crude 5‐year survival rate is 94.1% (±4.1). The disease‐free 5‐year survival rate is 81.8% (±6.7). Fourteen patients who had stage I disease were treated by unilateral salpingooophorectomy and prophylactic radiotherapy (20 Gy) to ipsilateral iliac, lumbar‐aortic, and subclavicular lymph nodes. All are alive without sequelae. Eighteen patients with stage II and III disease were treated by surgery and radiotherapy (30–40 Gy) to the tumor volume. All are alive but radio‐induced sequelae are severe. Five relapses of stage I, II, and III tumors occurred and were cured by a second line treatment. Two of the three patients with stage IV disease died.

Four patients received a cisplatinum‐containing regimen for disseminated disease or because of a relapse before radiotherapy. Three achieved a complete response of measurable tumor. Given the high efficacy of this kind of chemotherapy and the severe sequelae induced by abdomino‐pelvic irradiation, we propose initial chemotherapy for widespread disease andd radiotherapy in the event of residual tumor. © 1994 Wiley‐Liss, Inc.
Therapy‐related acute myeloid leukemia following treatment with epipodophyllotoxins: Estimating the risks
Authors: Smith Malcolm A. , Rubinstein Lawrence , Ungerleider Richard S.
Published: February 2007

In the past decade, therapy‐related acute myeloid leukemia (t‐AML) following treatment with regimens that include inhibitors of topoisomerase‐II (TOPO‐II) has been reported with increasing frequency. These cases of t‐AML generally have a shorter latency period than t‐AML following alkylator therapy, are associated with chromosomal translocations (especially involving chromosome band 11q23), and usually present as M4 or M5 FAB subtype. Although the epipodophyllotoxins (etoposide and teniposide) have been most often implicated, similar cases of t‐AML occur following therapy with other classes of Topo‐II inhibitors (e.g., anthracyclines).

There is wide variation in published studies in the estimates of risk of t‐AML following epipodophyllotoxin therapy. These varying estimates may reflect a number of factors, including: small sample size leading to large confidence intervals around risk estimates; varying susceptibility of different patient populations; varying schedules of epipodophyllotoxin administration; different cumulative doses of epipodophyllotoxins; and administration of epopodophyllotoxins with additional agents that may alter the leukemogenic effect of the epipodophyllotoxins.

Available data suggest that children with acute lymphocytic leukemia (ALL) treated with high cumulative doses of epipodophyllotoxins using either weekly or twice‐weekly schedules of administration have a relatively high risk of developing t‐AML (5–12% cumulative risk). On the other hand, germ cell patients treated with relatively low cumulative doses of etoposide (usually 1,500–2,500 mg/m2) appear to have a low risk for developing t‐AML. There is inadequate experience at this time with higher cumulative doses of etoposide (e.g., 4,000–5,000 mg/m2 as used for pediatric solid tumors) given on a daily x 5 schedule to allow estimates of risk to be developed for this schedule and cumulative dose.

The Cancer Therapy Evaluation Program (CTEP) of the National Cancer Institute (NCI) has developed a monitoring plan designed to obtain reliable estimates of the risk of t‐AML following epipodophyllotoxin treatment. Twelve Cooperative Group clinical trials that use epipodophyllotoxins at either low (<1,500 mg/m2), moderate (1,500–3,999 mg/m2), or higher cumulative doses (>4,000 mg/m2) are being prospectively monitored for cases of t‐AML occurring among patients entered onto the trials. © 1994 Wiley‐Liss, Inc.

This article is a US Government work and, as such, is in the public domain in the United States of America.
LCH‐I: A randomized trial of etoposide vs. vinblastine in disseminated langerhans cell histiocytosis
Authors: Ladisch Stephan , Gadner Helmut , Arico Maurizio , Broadbent Valerie , Grois Nicole , Jacobson Ake , Komp Diane , Nicholson H. Stacy
Published: February 2007

An international randomized trial in Langerhans cell histiocytosis (LCH) has been initiated by the Histiocyte Society. This report reviews the rationale, design, and progress of LCH‐I, which compares etoposide (VP‐16) and vinblastine in the treatment of disseminated LCH. Data on the risk of etoposide‐associated (therapy‐induced) malignancy, in the setting of histiocytosis, are reviewed. The available evidence leads to the recommendation that the study of etoposide in LCH should be continued. © 1994 Wiley‐Liss, Inc.