bluuebunny/crossref_metadata_2025_split huggingface dataset:
Paradoxical response of a pineal immature teratoma to combination chemotherapy
Authors: Lee Anselm C. W. , Chan Godfrey C. F. , Fung C. F. , Leung S. Y. , Lau Y. L. 
Published: February 2007

AbstractA case of primary intracranial germ cell tumour is reported in a 5‐year‐old Chinese boy who presented with symptoms and signs of increased intracranial pressure. Computed tomography (CT) scan of the brain revealed a multicystic tumour over the pineal region. Stereotactic biopsy yielded enteric epithelium and isolated cells with hyperchromatic nuclei and high nuclear‐to‐cytoplasmic ratio, suggesting the diagnosis of an immature teratoma. Grossly elevated serum and cerebrospinal fluid (CSF) levels of α‐fetoprotein and mildly elevated levels of β human chorionic gonadotrophin suggested the simultaneous presence of embryonal tissues. Combination chemotherapy with cisplatin, etoposide, and bleomycin resulted in a gradual but complete normalisation of the serum and CSF tumour markers. Paradoxically, the patient's consciousness deteriorated and repeat CT scan after 3 months of treatment showed that the tumour was actually increasing in size. Complete surgical removal was attempted and histologic sections of the specimen revealed only mature teratomatous tissues. The child is now well and remains disease‐free with minimal left hemiparesis 12 months after completion of treatment. This case illustrates the importance of combined neoadjuvant chemotherapy and surgery in the management of intracranial non‐germinomatous germ cell tumour harbouring both germ cell and teratomatous components, while monitoring of both biochemical and radiological parameters are necessary in assessing the clinical behaviour of mixed germ cell tumours. © 1995 Wiley‐Liss, Inc.
Prolonged survival following multiple thoracotomies for metastatic hepatoblastoma
Authors: Passmore S. Jane , Noblett Helen R. , Wisheart James D. , Mott Martin G. 
Published: February 2007

AbstractA 14‐month‐old boy presented with hepatoblastoma, which was completely excised. He had pulmonary metastases, diagnosed 1 year later, treated with chemotherapy followed by resection at age 2 1/2 years. At the age of 3 1/2 years a further metastasis was shown on CT scan and this was resected. Two further metastses were resected at ages 4 1/2 and 5 1/2 years. At age 9 1/2 he had a further isolated pulmonary metastasis resected and is again disease‐free more than 30 months from the last thoracotomy. Prolonged survival following metastatic hepatoblastoma can be achieved with repeated thoracotomies, especially if the first recurrence is more than 6 months from diagnosis and the number of metastases is small. Follow‐up examinations should be both radiological and with serum alpha fetaprotein (SαFP). © 1995 Wiley‐Liss, Inc.
Treatment of osteosarcoma with ifosfamide: Comparison of response in pediatric patients with recurrent disease versus patients previously untreated: A pediatric oncology group study
Authors: Harris Michael B. , Cantor Alan B. , Goorin Allen M. , Shochat Stephen J. , Ayala Alberto G. , Ferguson William S. , Holbrook Tate , Link Michael P. 
Published: February 2007

AbstractThis study was designed to test if the activity of a phase II agent, ifosfamide, would have been underestimated if it was tested exclusively in a population of children and young adults with recurrent osteosarcoma. The response rate to ifosfamide was compared in patients younger than 30 years of age with previously untreated osteosarcoma with metastases at diagnosis and/or unresectable primary tumors (stratum 1) with that of patients with recurrent osteosarcoma following adjuvant chemotherapy who were not previously exposed to ifosfamide (stratum 2). Evaluation of response was conducted 3 weeks after two courses of ifosfamide (2400 mg/m2 × 5 days) were administered 3 weeks apart.Nine of 33 (27%) evaluable patients in stratum 1 responded (1 complete and 8 partial responses) to ifosfamide. Among 30 evaluable patients in stratum 2, only 3 (10%) responded (1 complete and 2 partial responses; P = .04) Both groups of patients received equal doses of ifosfamide and experienced comparable toxicities.Results from this study suggest that the activity of new agents will be underestimated if tested in a population of heavily pretreated patients with recurrent disease. When possible, new chemotherapeutic agents should be tested in patients with a poor prognosis who have not been exposed to chemotherapy. © 1995 Wiley‐Liss, Inc.
Acute urticaria and hepatitis complicating high‐dose methotrexate therapy
Authors: Al‐Lamki Zakiya , Thomas Eileen , El‐Banna Nagwa , Jaffe Norman 
Published: February 2007

AbstractWe report an unusual case of anaphylaxis and hepatitic dysfunction in a child with the administration of the twenty‐third course of high‐dose methotrexate. The latter had been used as an adjuvant to prevent pulmonary metastases and the prior 22 courses had been well tolerated. An attempt to reinstate methotrexate after the twenty‐third course was again followed by a similar reaction. © 1995 Wiley‐Liss, Inc.
Allelic loss of chromosome 1 and additional chromosome 17 material are both unfavourable prognostic markers in neuroblastoma
Authors: Caron Huib 
Published: February 2007

AbstractIn neuroblastoma, N‐myc amplification and loss of heterozygosity for the short arm of chromosome 1 (LOH 1p) are common genetic abnormalities. We have recently shown that the presence of additional material of the long arm of chromosome 17 (add.17q) also occurs relatively frequently. In the present study, we analyzed a series of 55 tumors for LOH 1p, N‐myc amplification and add.17q, using Southern blot analysis with polymorphic DNA probes of pairs of tumor and constitutional DNA. We determined the correlation of these parameters with clinical variables, such as age, stage, serum lactate dehydrogenase (LDH) and ferritin and also with outcome. LOH 1p occurred in 20 out of 55 cases (36%) and was found more often in stage III/IV tumors and in the older age group, although both correlations were not statistically significant. N‐myc amplification was only demonstrated in 12 tumors with concomitant LOH 1p and was not present in the 35 cases without LOH 1p. Add.17q was found in 20/53 (38%) informative cases. LOH 1p was shown to be the most significant predictor of a poor outcome (P < 0.00001), independent of age and stage. LOH 1p is also of prognostic value in those cases without N‐myc amplification, indicating a stronger prognostic value for LOH 1p. Add.17q was also associated with an unfavourable prognosis, although this was less significantly then with LOH 1p (P = 0.00004). © 1995 Wi1ey‐Liss Inc.
Diabetes insipidus in langerhans cell histiocytosi: Results from the DAL‐HX 83 study
Authors: Grois N. , Flucher‐Wolfram B. , Heitger A. , Mostbeck G. H. , Hofmann J. , Gadner H. 
Published: February 2007

AbstractDiabetes insipidus (DI) in Langerhans cell histiocytosis (LCH) is a common complication of unclear etiology. The incidence varies among different publications from 15% to 50%. In the prospective DAL‐HX 83 study, 19 out of 199 patients (9.5%) registered with newly diagnosed LCH were diagnosed to have DI. All patients were stratified according to uniform criteria. One hundred and six patients with disseminated disease were treated with standardized polychemotherapy promptly after diagnosis. At the time of diagnosis of LCH, DI was already established in 8 out of 199 patients (4%). After diagnosis, DI occurred in only one out of the remaining 91 patients with localized disease (1%) and in 10 out of 100 remaining patients with disseminated disease (10%). In 8 patients, the onset of DI was associated with other signs of active LCH. The cumulative risk to develop DI after a median observation time of 5 years 3 months was 11%. Retrospective analysis of clinical features revealed multisystem involvement, skull and orbital lesions, and in particular intracranial extension from osseous lesions to constitute risk factors for DI. Magnetic resonance imaging studies (MRI) were available in 12 patients and showed abnormalities of the pituitary region in 10 children. In none of the patients with established DI was it reversed or ameliorated by any treatment. However, the rapid institution of systemic chemotherapy for disseminated disease seems to prevent the occurrence of DI and may be responsible for the low frequency of DI in the DAL‐HX 83 study. © 1995 Wi1ey‐Liss Inc.
Preoperative chemotherapy for mesoblastic nephroma
Authors: Chan K. L. , Chan K. W. , Lee C. W. , Saing Htut 
Published: February 2007

AbstractA neonate with extensive stage III mesoblastic nephroma was confirmed at operation to have a tumor that was too infiltrative and too advanced for primary excision. The abdomen was closed after multiple biopsies. Vincristine (1.1 mg/m2) was given intravenously once a week for a total of eight doses. Repeat CT scan confirmed shrinkage of the tumor and a nephrectomy could be performed safely and the tumor removed at the second laparotomy. CT scan repeated 1 year later showed no recurrence. This case illustrates the effective use of a single drug pre‐excision chemotherapy which allowed a nephrectomy for extensive stage III mesoblastic nephroma to be carried out safely. © 1995 Wi1ey‐Liss Inc.
The Role of Surgery in the Management of Stage IV Neuroblastoma: A Single Institution Study
Authors: Shorter Nicholas A. , Davidoff Andrew M. , Evans Audrey E. , Ross Arthur J. , Zeigler Moritz M. , O'Neill James A. 
Published: February 2007

AbstractThe role of surgery in the management of Stage IV neuroblastoma is still far from clear. Seventy‐nine patients with this diagnosis presented to the Children's Hospital of Philadelphia during the 10‐year period, 1977 to 1986. Four‐year survival was 23%. A major resection of the primary tumor was undertaken in 54 patients. The timing of the procedure (at presentation or delayed) had no effect on survival. The patients were divided into three groups based on the extent of surgical resection: Group 1, no surgery or biopsy only (25); Group 2, complete gross resection (34); Group 3, incomplete resection with residual gross disease (20). Four‐year survival was 16, 15, and 45%, respectively. The patients were then classified as favorable or unfavorable, on the basis of biological prognostic factors at presentation. When this analysis was combined with the extent of surgery it was discovered that Group 3 contained a higher proportion of favorable patients, accounting for the better survival. Within each group survival correlated with the expected prognosis. The outcome for a patient with Stage IV neuroblastoma depends on the biological characteristics of the tumor, and there is currently no evidence that these can be favorably altered by the timing or extent of surgical resection. Defining the appropriate role of surgery in the management of these patients will require a prospective randomized study which takes into account the inherent biological variability of the disease. © 1995 Wi1ey‐Liss, Inc.
Prognostic Value of Proliferating Cell Nuclear Antigen (PCNA) Immunostaining in Neuroblastoma
Authors: Kawasaki Hirohide , Mukai Kiyoshi , Yajima Shuhei , Tanaka Ryuhei , Takayama Jun , Takasaki Yoshinari , Ohira Mutsuro 
Published: February 2007

AbstractImmunostaining for proliferating cell nuclear antigen (PCNA), a marker of cell proliferation, is being increasingly used to study the proliferative activity of tumors, and the PCNA labeling index has been correlated with the prognosis of several malignant neoplasms. Formalin‐fixed, paraffin‐embedded tissue specimens of 24 primary neuroblastomas were immunostained using an anti‐PCNA monoclonal antibody and the PCNA index was calculated. Then the relationship between the PCNA index, prognosis, and various other factors was assessed, retrospectively. The mean PCNA index was 11.0%. Patients having tumors with a high PCNA index (⩾11.0%) showed a significantly lower survival rate than those possessing tumors with a low PCNA index (P < 0.001). Moreover, the tumors showing N‐myc amplification had a high mean PCNA index of 15.6%, while those without N‐myc amplification had a low mean index of 1.7% (P < 0.01). The PCNA index was closely related to the prognosis of neuroblastoma and to N‐myc amplification. It has the potential to be a useful prognostic indicator of the patients with neuroblastoma. © 1995 Wi1ey‐Liss, Inc.
Recovery of Natural Killer Cells After Chemotherapy for Childhood Acute Lymphoblastic Leukemia and Solid Tumors
Authors: Alanko Soile , Salmi Toivo T. , Pelliniemi Tarja‐Terttu 
Published: February 2007

AbstractRecovery of natural killer (NK) cells after cessation of chemotherapy for childhood acute lymphoblastic leukemia (ALL) and solid tumors was investigated in 25 children aged 3 to 18 years. The numbers of CD3‐CD56+, CD16+, and CD8‐CD57+ cells in peripheral blood were analyzed with monoclonal antibodies and flow cytometry at 0, 1, 3, 6, 9, and 12 months after discontinuation of therapy. The CD3‐CD56+ and CD16+ cell counts of ALL patients (n = 14) were below the mean ‐1SD values of controls at cessation but normalized within one month due to a rapid 2.1 and 4.5 fold increase, respectively. The CD8‐CD57+ cell count of ALL patients was normal compared to controls at cessation. In solid tumor patients (n = 11), the counts of all NK cell phenotypes studied were of normal amount compared to controls at cessation and no vigorous increase occurred after the therapy.NK cell function was determined by killing K 562 target cells in five patients. In the two standard risk ALL patients tested, the activity was still low at 5 months after therapy. In contrast, the function was normal at 1 month (Wilms' tumor), 3 months (Mb Hodgkin's) and 6 months (Burkitt lymphoma).In conclusion, NK cell counts were decreased compared to controls during therapy for ALL, but recovered rapidly afterwards. In spite of normal counts, NK cell function may be impaired for several months. The number and function of NK cells is less affected in solid tumor patients. These differences may reflect the milder immunosuppressive effect of interval cytostatic medication in solid tumor patients when compared to the more intensive continuous therapy in ALL patients. © 1995 Wi1ey‐Liss, Inc.
Response of untreated stage IV Wilms' tumor to single dose carboplatin assessed by “up front” window therapy
Authors: Zoubek Andreas , Kajtar Paul , Flucher‐Wolfram Burgi , Holzinger Beatrix , Mostbeck Gerhard , Thun‐Hohenstein Leonhardt , Fink Franz Martin , Urban Christian , Mutz Ingomar , Schuler Deszö , Gadner Helmut 
Published: February 2007

AbstractA total of nine children with previously untreated stage IV Wilms' tumor of favorable histology were treated according to the Austrian/Hungarian Wilms' Tumor Protocol 89 and received a preoperative single dose of carboplatin as an “up front” window therapy. The treatment consisted of carboplatin as a single‐dose of 600 mg/m2 over 30 minutes on day 1. Response evaluation by chest X‐ray, serial CT scans, and sonography was performed on day 22. Investigation of the abdominal tumors revealed seven partial responses (78%), one nonresponse, and one progressive disease with a median tumor volume reduction of 62%. Response of metastases evaluated by CT scans was as follows: four complete remission, four partial response, and one nonresponse.Thrombocytopenia (WHO grade III 1, grade II 2, grade I 2) and leukocytopenia (WHO grade II 1, grade I 5) were the main side effects. No renal or liver toxicity were observed.The overall response rate after a preoperative single‐dose of 600 mg/m2 carboplatin in untreated patients with stage IV Wilms' tumor is encouraging and the toxicity acceptable. This data indicate that carboplatin seems to be an additional effective drug in patients with previously untreated Wilms' tumor of favorable histology. © 1995 Wiley‐Liss, Inc.
Does chemotherapy have a role in low‐grade astrocytoma management? a report of 13 cases
Authors: Castello M. A. , Schiavetti A. , Padula A. , Varrasso G. , Properzi E. , Trasimeni G. , Operamolla P. , Gualdi G. F. , Clerico A. 
Published: February 2007

AbstractSurgery is the treatment of choice for low‐grade astrocytoma while radiotherapy is carried out only when total resection is not possible. This study assessed the effectiveness of chemotherapy in nonresectable cases. Thirteen children with nonresectable astrocytoma were treated with carboplatin and etoposide and after four cycles the response to treatment was evaluated according to radiologic criteria. The results were: one with complete response (CR), three with minor response (MR), six with stable disease (SD), and three with progressive disease (PD). Moreover, in 77% there was an improvement in the neurologic picture. In particular, two cases with hypothalamic astrocytoma showed a regression of the diencephalic syndrome following chemotherapy. In six cases chemotherapy was carried out, at reduced dosage, after the first four cycles either because there was clinical improvement or because it was necessary to postpone radiotherapy in very young patients. After a follow‐up period ranging between 11 and 63 months (average: 30 months), nine of the 13 patients are alive (69%) while four died of disease progression. Further studies would be useful to evaluate the role of chemotherapy in the management of low‐grade astrocytoma. © 1995 Wiley‐Liss, Inc.
Cardiac troponin T and creatine kinase MB mass concentrations in children receiving anthracycline chemotherapy
Authors: Fink Franz‐Martin , Genser Norbert , Fink Christoph , Falk Markus , Mair Johannes , Maurer‐Dengg Kathrin , Hammerer Ignaz , Puschendorf Bernd 
Published: February 2007

AbstractAnthracyclines (doxorubicin, daunorubicin, and derivatives) are among the most effective antineoplastic drugs for pediatric cancer with dose‐limiting acute and longterm cardiotoxicity. The exact mechanism of the development of cardiomyopathy is still not clear. Anthracyclines may induce subclinical acute myocardial injury leading to lysis of a limited number of myocytes. Alternatively, myocytes may experience a transient loss of cytoplasmic membrane integrity. Both conditions may lead to a transient efflux of small amounts of cytoplasmic enzymes and other proteins specific to the heart muscle fibers.To test these hypotheses we assayed plasma creatine kinase (CK) MB mass and cardiac specific troponin T (TnT). CKMB may be released even in case of reversible cell membrane injury, while prolonged elevation of TnT is the most sensitive and specific marker of limited myocardial necrosis.Thirty‐five anthracycline‐containing chemotherapy courses in 22 children with cancer were analyzed. CKMB mass and TnT concentrations were within the normal range in all children before anthracycline therapy. Within 72 hours from anthracycline therapy no increment of one of these two marker proteins was detected (ANOVA for repeated measures, P = 0.94 [TnT] and 0.25 [CKMB]).We conclude that only minimal if any acute necroses of cardiac myocytes occur after anthracycline therapy. Even membrane integrity appears to be maintained within the first 3 days after anthracycline therapy, in the absence of electrocardiographic or echocardiographic signs of acute cardiotoxicity. © 1995 Wiley‐Liss, Inc.
Health insurance access to young adult survivors of childhood cancer in North Carolina
Authors: Vann Julie C. Jacobson , Biddle Andrea K. , Daeschner Charles W. , Chaffee Sara , Gold Stuart H. 
Published: February 2007

AbstractHistorically, there has been evidence to support the hypothesis that survivors of childhood cancer have been discriminated against in the private health insurance market in some areas of the United States. Results of previous studies have been inconsistent and have generally focused on a limited number of outcome variables. A retrospective cohort study of young adult survivors of childhood cancer and their siblings was performed to determine the risk of health insurance access problems of childhood cancer survivors in North Carolina. Mailed questionnaires were completed by 182 cancer survivors from three institutions who were diagnosed between 1976 and 1988, and by 101 of their siblings for a response of 62.1%. Using logistic regression in SAS, cancer survivors were found to be more likely to be denied health insurance than their siblings, with an adjusted odds ratio of 15.1. Childhood cancer survivors also had health insurance policies that excluded care for pre‐existing medical conditions more often than their siblings (OR = 5.5). In addition, cancer survivors reported problems obtaining health insurance coverage more frequently than their siblings with an adjusted odds ratio of 22.8. In general, survivors of childhood cancer who were diagnosed in North Carolina have had decreased access to health insurance coverage when compared to their siblings of similar age. North Carolina health insurance regulations permit health insurance firms to discriminate against cancer survivors because of their history of illness, often decreasing their access to needed follow‐up care. © 1995 Wiley‐Liss, Inc.
SIOP working committee on psychosocial issues in pediatric oncology: Guidelines for school/education
Authors: Masera Giuseppe , Jankovic Momcilo , Deasy‐Spinetta Pat , Adamoli Luigia , Ben Arush Myriam W. , Challinor Julia , Chesler Mark , Colegrove Robert , van Dongen‐Melman Jeanette , McDowell Heather , Eden Tim , Epelman Claudia , Kingma Annette , Jones Patricia Morris , Nesbit Mark E. , Reynolds Heidi , Schuler Dezso , Stevens Michael , Vasankari‐Vayrynen Leena , Wilbur Jordan R. , Spinetta John J. 
Published: February 2007

AbstractThis is the second official document of the SIOP Working Committee on Psychosocial Issues in Pediatric Oncology constituted in 1991. It develops one of the topics enclosed in the first document approved by the SIOP Board. The topic, “School/Education,” is addressed to the Pediatric Oncology Community as guidelines to follow for considering this issue in a more appropriate way. © 1995 Wiley‐Liss, Inc.
p53 gene mutations in pediatric brain tumors
Authors: Felix Carolyn A. , Slavc Irene , Dunn Michael , Strauss Eric A. , Phillips Peter C. , Rorke Lucy B. , Sutton Leslie , Bunin Greta R. , Biegel Jaclyn A. 
Published: February 2007

AbstractWe investigated the frequency of p53 mutations in 47 pediatric brain tumors of various histologic subtypes that were collected over a period of 5 years. The specimens included 15 primitive neuroectodermal tumors (PNETs), 17 low grade astrocytomas, one anaplastic astrocytoma, three glioblastomas (GBMs), one mixed glial tumor, eight ependymomas, one choroid plexus carcinoma, and one gangliocytoma/ganglioneuroma. Mutations were identified by single strand conformation polymorphism analysis of exons 4–8 and verified by sequencing. Mutations were present in 2 of 3 cases of GBM, but not in 17 low grade astrocytomas (P = 0.02, Fisher's exact test). One GBM demonstrated a germline GGC to AGC transition (gly to ser) at codon 245 with loss of the wild‐type allele. A second GBM contained a CGG to TGG transition (arg to trp) at codon 248, also with loss of the wildtype allele, but normal tissue was not available for comparison. In addition, one of 15 PNETs retained heterozygosity but demonstrated a somatic CGT to TGT transition (arg to cys) at codon 273. p53 mutations were absent in other histologic subtypes and in two cases with multiple primary cancers. These data are consistent with earlier findings that p53 mutations are rare in PNETs, which are primarily pediatric tumors. In contrast to adult gliomas, p53 mutations in pediatric gliomas appear restricted to the GBMs. The lack of p53 mutations in pediatric low grade astrocytomas suggests not only histological differences, but also a different molecular pathogenesis in adult and pediatric patients. © 1995 Wiley‐Liss, Inc.