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- Ek, Torben, 1963, et al.
(författare)
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Intensive treatment for childhood acute lymphoblastic leukemia reduces immune responses to diphtheria, tetanus, and Haemophilus influenzae type b
- 2004
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Ingår i: J Pediatr Hematol Oncol. - 1077-4114. ; 26:11, s. 727-34
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVES: Immunity to diphtheria toxoid (D), tetanus toxoid (T), and Haemophilus influenzae type b (Hib) is affected in children with acute lymphoblastic leukemia (ALL). The aims were to examine immunity and to compare the response to immunization at 1 or 6 months after treatment. METHODS: Thirty-one patients were immunized with DT and conjugated Hib vaccine (ActHib) at 1 month or 6 months after treatment of ALL with the NOPHO 92 protocol. Antibody levels were determined before and 3 weeks after vaccination. Specific T and Hib antibody-secreting cells of IgG/IgA/IgM isotypes were analyzed in peripheral blood using an ELISPOT technique. RESULTS: All specific antibody levels decreased during ALL treatment, and protective levels after treatment were noted for 17% against D, 33% against T, and 100% against Hib. No high-risk patient had full D or T protection after treatment. After vaccination all the standard- and intermediate-risk patients achieved full protection against D, T, and Hib. The high-risk group showed insufficient immune response (full protection after vaccination: D 56%, T 22%, Hib 78%). No difference was found between vaccination at 1 month or 6 months after treatment. The poor antibody production in the high-risk group correlated to low numbers of antibody-secreting cells. CONCLUSIONS: Nonprotective antibody levels against D, T, and Hib after childhood ALL are more common than previously thought. Insufficient immune response was restricted to the high-risk group and was related to a low number of memory B cells in this study. Immunizations should be included in follow-up after childhood ALL, and the policy should be adapted to treatment intensity.
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- Ek, Torben, 1963, et al.
(författare)
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Proinflammatory cytokines mediate the systemic inflammatory response associated with high-dose cytarabine treatment in children.
- 2001
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Ingår i: Medical and pediatric oncology. - 0098-1532. ; 37:5, s. 459-64
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Tidskriftsartikel (refereegranskat)abstract
- Treatment with high-dose cytarabine (1-beta-D-arabinofuranosylcytosine) is often associated with an acute febrile reaction sometimes including abdominal pain, myalgia, and rash. The similarity of these symptoms to those caused by hypersecretion of cytokines in the systemic inflammatory response syndrome (SIRS) prompted us to investigate the plasma levels of proinflammatory cytokines during treatment of children with high-dose cytarabine.
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- Ewald, Jonas, 1959-, et al.
(författare)
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A matter of choice - cost sharing and its implication for social development in Pangani District, Tanzania
- 2001
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Ingår i: Göteborg University in Africa. Africa at Göteborg University. - Göteborg : Centre for Africa Studies, Göteborg University. - 9163113481 ; , s. 53-83
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Bokkapitel (refereegranskat)abstract
- This chapter is based on extensive field studies in Pangani district Tanzania on how the introduction of cost-sharing in health and education has affected on the one hand childrens right to health and education, and the quality of health and education provision. The study conclude that cost sharing have had a negative impact on childrens right to health and education and hence on social development in Pangani District. The quality of health and education has not improved with the introduction of cost-sharing.
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- Ewald, Jonas, 1959, et al.
(författare)
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A matter of choice? Cost sharing in health and education from a rights of the child perspective : Preliminary observations and conclusions
- 2004
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Ingår i: Presented at a feed back work shop with national stakeholders Courtyard Hotel, Dar es Salaam the 17th of January 2004.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- The objective with the project "A Matter of Choice? Cost Sharing in Health and Education form a Rights of the Child Perspective" was initially to study the effects of the introduction of user fees in the health and education sectors. The study thus brings user fees for both health and education into the same framework. With the abolition of school fees and other fees in 2001 and 2002, the focus of the study has been slightly changed to study how children's rights to health and education have been affected by the ongoing reforms of the economy, the administration and the reforms in the health and educational sector.
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- Kreuger, A., et al.
(författare)
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[Acute lymphatic leukemia in Swedish children 1968-2001. The marked improvement of the survival can be ascribed to successful treatment]
- 2004
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Ingår i: Lakartidningen. - 0023-7205. ; 101:48
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Tidskriftsartikel (refereegranskat)abstract
- This is a survey of acute lymphoblastic leukemia (ALL) in Swedish children from 1968 to 2001. The survival has increased from a few per cent to more than 80 per cent of children with ALL in these national complete patient materials. Changes in diagnosis and treatment are discussed as well as the importance of supportive care. The favorable results can almost certainly be ascribed to continuous cooperation between the Swedish pediatric departments, the Swedish Child Leukemia Group and international working groups.
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- Kreuger, Anders, et al.
(författare)
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Akut lymfatisk leukemi hos barn i Sverige 19682001. Markant förbättring av överlevnaden tack vare framgångsrik behandling
- 2004
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Ingår i: Läkartidningen. - 0023-7205. ; 101:48, s. 3890-3898
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Tidskriftsartikel (refereegranskat)abstract
- This is a survey of acute lymphoblastic leukemia (ALL) in Swedish children from 1968 to 2001. The survival has increased from a few per cent to more than 80 per cent of children with ALL in these national complete patient materials. Changes in diagnosis and treatment are discussed as well as the importance of supportive care. The favorable results can almost certainly be ascribed to continuous cooperation between the Swedish pediatric departments, the Swedish Child Leukemia Group and international working groups.
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- Lie, Sverre O, et al.
(författare)
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Treatment stratification based on initial in vivo response in acute myeloid leukaemia in children without Down's syndrome: results of NOPHO-AML trials.
- 2003
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Ingår i: British journal of haematology. - : Wiley. - 0007-1048. ; 122:2, s. 217-25
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Tidskriftsartikel (refereegranskat)abstract
- Three consecutive protocols for childhood acute myeloid leukaemia (AML) have been used in the Nordic countries since 1984: the Nordic Society for Paediatric Haematology and Oncology (NOPHO)-AML84 was of moderate intensity, NOPHO-AML88 of high intensity with upfront loading and aggressive consolidation. NOPHO-AML93 utilized the same treatment blocks as NOPHO-AML88, but after the first block those children with a hypoplastic non-leukaemic bone marrow were allowed to recover from aplasia. Poor responders received intensified induction therapy. Between January 1993 and December 2000, 219 children without Down's syndrome were entered on NOPHO-AML93. Compared with NOPHO-AML88, the event-free survival (EFS) at 7 years increased from 41% to 49% (P = 0.06) and 7-year overall survival increased from 47% to 64% (P < 0.01). Toxic death during induction was reduced from 10% to 3%. Survival was similar in patients receiving stem cell transplantation or chemotherapy only in first remission. The major prognostic factors in NOPHO-AML93 were response to therapy and cytogenetics. A total of 67% of patients achieved remission after the first induction course and showed an EFS of 56% compared with 35% in those not in remission (P < 0.01). Cytogenetic results were obtained in 95% of patients. Patients with t(9;11) (p22;q23) (n = 16) experienced a significantly better EFS (86%) than other cytogenetic groups. The overall outcome was improved by employing the previous toxic protocol with different timings, and through individualizing therapy according to the initial response of the patient.
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