| 1. |
- af Sandeberg, Margareta, et al.
(författare)
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Does school attendance during initial cancer treatment in childhood increase the risk of infection?
- 2013
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 60:8, s. 1307-1312
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Tidskriftsartikel (refereegranskat)abstract
- Background The present study aimed to investigate the relationship between school attendance and infection requiring antimicrobial treatment in children undergoing treatment for cancer. Procedure A national cohort of children aged 7-16 years undergoing cancer treatment was assessed during two observation periods of 19 days each, 1 month (n=89) and 2.5 months (n=89) poststart of treatment. Children free from infection at start of each observation period were included. Multivariable logistic regression analyses were performed including factors potentially associated with start of antimicrobial treatment. Results Twenty-seven (30%) children started antimicrobial treatment during the first observation period. Factors associated with an increased risk of starting antimicrobial treatment were diagnosed with sarcoma (OR=24.37, P=0.002) or non-Hodgkin lymphoma (OR=17.57, P=0.025), having neutropenia (OR=5.92, P=0.020) and age less than 13 years (OR=8.54, P=0.014). During the second observation period, when 20 (22%) children started antimicrobial treatment, the probability of starting treatment was increased in children with neutropenia (OR=4.25, P=0.007). There was no statistically significant association between starting treatment for infection and school attendance. Conclusions In this study, children attending school while undergoing cancer treatment did not run a higher risk of starting antimicrobial treatment than children absent from school. However, there is a need for further studies evaluating risk of infections in children with ongoing cancer treatment.
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| 2. |
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| 3. |
- Berntorp, Erik
(författare)
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Von Willebrand disease.
- 2012
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009.
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Tidskriftsartikel (refereegranskat)abstract
- Long-term prophylaxis is not as well known in Von Willebrand disease (VWD) as in hemophilia but attempts to evaluate prophylaxis scientifically in VWD have started. A few cohort studies have been reported. In an international effort the Von Willebrand disease prophylaxis network (VWD PN) has been formed to investigate the role of prophylaxis in clinically severe VWD (e.g., patients with type 3 VWD) that is nonresponsive to other treatments. Findings from the VWD PN studies will hopefully provide more robust evidence for which patients might best benefit from prophylaxis and for appropriate dosing regimens for prophylaxis in patients with VWD. Pediatr Blood Cancer © 2012 Wiley Periodicals, Inc.
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| 4. |
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| 5. |
- Boye, Kjetil, et al.
(författare)
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High-Dose Chemotherapy with Stem Cell Rescue in the Primary Treatment of Metastatic and Pelvic Osteosarcoma: Final Results of the ISG/SSG II Study
- 2014
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009. ; 61:5, s. 840-845
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPatients with metastatic osteosarcoma at diagnosis or axial primary tumors have a poor prognosis. The aim of the study was to evaluate the feasibility and efficacy of intensified treatment with high-dose chemotherapy (HDCT) and stem cell rescue in this group. MethodsFrom May 1996 to August 2004, 71 patients were included in a Scandinavian-Italian single arm phase II study. Preoperative chemotherapy included methotrexate, doxorubicin, cisplatin and ifosfamide, and postoperative treatment consisted of two cycles of doxorubicin, one cycle of cyclophosphamide and etoposide and two courses of high-dose etoposide and carboplatin with stem cell rescue. ResultsTwenty-nine patients (43%) received two courses and 10 patients (15%) received one course of HDCT. HDCT was associated with significant toxicity, but no treatment-related deaths were recorded. Fourteen patients (20%) had disease progression before completion of the study protocol, and only 29/71 patients (41%) received the full planned treatment. Median event-free survival (EFS) was 18 months, and estimated 5-year EFS was 27%. Median overall survival (OS) was 34 months, and estimated 5-year OS was 31%. When patients who did not receive HDCT due to disease progression were excluded, there was no difference in EFS (P=0.72) or OS (P=0.49) between patients who did or did not receive HDCT. ConclusionsThe administration of high-dose chemotherapy with stem cell rescue was feasible, but associated with significant toxicity. Patient outcome seemed comparable to previous studies using conventional chemotherapy. We conclude that HDCT with carboplatin and etoposide should not be further explored as a treatment strategy in high-risk osteosarcoma. Pediatr Blood Cancer 2014;61:840-845. (c) 2013 Wiley Periodicals, Inc.
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| 6. |
- Cario, Holger, et al.
(författare)
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Erythrocytosis in Children and Adolescents : Classification, Characterization, and Consensus Recommendations for the Diagnostic Approach
- 2013
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 60:11, s. 1734-1738
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Tidskriftsartikel (refereegranskat)abstract
- During recent years, the increasing knowledge of genetic and physiological changes in polycythemia vera (PV) and of different types of congenital erythrocytosis has led to fundamental changes in recommendations for the diagnostic approach to patients with erythrocytosis. Although widely accepted for adult patients this approach may not be appropriate with regard to children and adolescents affected by erythrocytosis. The congenital erythrocytosis working group established within the framework of the MPN&MPNr-EuroNet (COST action BM0902) addressed this question in a consensus finding process and developed a specific algorithm for the diagnosis of erythrocytosis in childhood and adolescence which is presented here. Pediatr Blood Cancer 2013;60:1734-1738. (c) 2013 Wiley Periodicals, Inc.
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| 7. |
- Carlsson, G, et al.
(författare)
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Hematopoietic stem cell transplantation in severe congenital neutropenia
- 2011
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 56:3, s. 444-451
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Severe congenital neutropenia (SCN) is an immunodeficiency characterized by disturbed myelopoiesis and an absolute neutrophil count (ANC) <0.5 × 10(9)/L. SCN is also a premalignant condition; a significant proportion of patients develop myelodysplastic syndrome or leukemia (MDS/L). Allogeneic hematopoietic stem cell transplantation (HSCT) is the only curative treatment for SCN.PROCEDURE:Since 2004, eight HSCT have been performed in seven patients at our center. The indications were transformation to MDS/L (n = 2), granulocyte colony-stimulating factor receptor (CSF3R) mutation(s) (n = 2), granulocyte colony-stimulating factor (G-CSF) resistance (n = 2), and at the patient's own request (n = 1).RESULTS:The mean age at transplantation was 13 years (2.8-28 years) (mean follow-up 32 months, range 21-60). Three patients harbored ELANE mutations, three HAX1 mutations, and in one patient no causative mutation was identified. Two of the ELANE mutations were novel mutations. Three patients initially received myeloablative conditioning and four had reduced intensity conditioning (RIC). Three grafts were from HLA-identical siblings, three from matched unrelated donors and two were cord blood units. Engraftment occurred in all patients. Two of seven (29%) patients died; both had MDS/L and both were among the three that underwent myeloablative conditioning. One patient has chronic GVHD 2 years post-transplant.CONCLUSIONS:The role of HSCT should be explored further in patients with SCN. In particular, the influence of the conditioning regime needs to be evaluated in a larger cohort of patients.
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| 8. |
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| 9. |
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| 10. |
- Dantonello, Tobias M, et al.
(författare)
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Embryonal rhabdomyosarcoma with metastases confined to the lungs : Report from the CWS Study Group.
- 2011
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 56:5, s. 725-732
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Embryonal rhabdomyosarcoma [RME] is the most common pediatric soft tissue sarcoma. Whereas the prognosis of localized rhabdomyosarcoma has improved, it remains poor for metastatic disease. METHODS: We analyzed RME-patients with isolated pulmonary metastases [PRME] treated in four consecutive CWS-trials. Treatment included multiagent chemotherapy and local treatment of the primary tumor. Therapy of lung metastases after induction chemotherapy depended on response and individual decisions. RESULTS: Twenty-nine patients <21 years had PRME. Their median age was six years, the median follow-up nine years. Twenty-eight children had their primary tumor located in an unfavorable site and 22 of the primaries were >5 cm. In addition to conventional chemotherapy, seven patients received high-dose treatment and eight patients oral metronomic chemotherapy. The lung metastases were in remission after induction chemotherapy in 22 individuals. 19 patients received no local treatment of metastases; 3 patients had pulmonary metastasectomy and lung radiation was administered to 9 individuals. In total, 24/29 patients achieved a complete remission [CR]. Actuarial 5-year event-free and overall survival for all patients was 37.9 ± 18% and 48.7 ± 18%, respectively; it was 45.8 ± 20% and 58.3 ± 20% for the 24 patients who achieved a CR. Local treatment of metastases had no impact on the failure pattern. Younger age, good response, achievement of CR and maintenance-treatment were favorable prognostic factors in univariate analysis. CONCLUSIONS: Children with PRME have a fair prognosis. Local treatment of metastases did not improve outcome in our sample. Metronomic treatment may be an attractive option for PREM-patients. [correction made here after initial online publication].
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| 11. |
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| 12. |
- Dantonello, Tobias M, et al.
(författare)
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Malignant ectomesenchymoma in children and adolescents : Report from the Cooperative Weichteilsarkom Studiengruppe (CWS)
- 2013
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 60:2, s. 224-229
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Malignant ectomesenchymoma (MEM) is a soft tissue tumor with heterologous rhabdomyoblastic components believed to arise from pluripotent migratory neural crest cells. To date merely 50 cases have been published and the knowledge about the course of disease and optimal treatment is limited.METHODS: Six patients with MEM were registered 1996-2009. The diagnosis was confirmed according to current criteria. Their treatment and outcome was analyzed.RESULTS:The median age of the three females and three males was 0.6 years (range, 0.2-13.5). The mesenchymal component in all tumors was rhabdomyosarcoma (RMS), the neural component ganglioneuroblastoma/neuroblastoma (n = 5) and peripheral primitive neuroectodermal tumor in one case. Five patients presented with localized, one with metastatic disease. All but one patient received multiagent chemotherapy during their initial treatment. The tumors of 4/5 patients with localized MEM were at least grossly resected at best surgery; the patient without gross resection was additionally irradiated. Three of four evaluable tumors responded well to induction chemotherapy. All patients achieved a first complete remission (CR), but three recurrences (two local, one systemic) occurred. The individual with metastatic MEM did not survive, but all five patients with localized MEM are currently alive in CR with a median follow-up of 5 years (range: 2.1-13.7).CONCLUSIONS: Risk-factors and outcome of MEM appear to be comparable with other highly malignant pediatric soft tissue sarcoma when a multimodal treatment strategy including chemotherapy and adequate local treatment is pursued. We propose that treatment of patients with MEM be done according to pediatric protocols similar to other rhabdomyosarcoma-like soft tissue sarcoma.
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| 13. |
- Dantonello, Tobias M., et al.
(författare)
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Survival following disease recurrence of primary localized alveolar rhabdomyosarcoma
- 2013
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 60:8, s. 1267-1273
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Tidskriftsartikel (refereegranskat)abstract
- Background Recurrences in primary localized alveolar rhabdomyosarcoma (RMA) are common. Post-relapse survival is poor. We evaluated prognostic factors including relapse treatment in patients with recurrent RMA. Methods Relapses occurred in 115/235 patients with nonmetastatic RMA treated in four consecutive CWS-trials after achievement of a complete remission. Sufficient information about post-relapse treatment and outcome could be obtained in 99 patients and was retrospectively analyzed. Results Nine of 99 patients received no salvage therapy and died after a median of 2 months. The remaining 90 patients received multimodal relapse treatment including mandatory chemotherapy. Recurrences were grossly resected in 39 patients; 57 patients received radiation. At a median follow-up from relapse of 8 years, 20 patients were alive and disease-free (5-year post-relapse survival [PROS] 21.3 +/- 8). All surviving patients apart from a single individual had an isolated, circumscribed recurrence. Sixteen of 20 survivors were treated with adequate local relapse therapy (ALRT, i.e., either complete resection or gross resection+radiation). Survival in the subgroup of 27 individuals with circumscribed recurrences and ALRT was significantly better (PROS 53.7 +/- 19) compared with disseminated recurrences and/or tumors treated without ALRT. Absence of primary lymph node involvement, circumscribed relapses, ALRT, and achievement of a second CR were identified as independent favorable risk factors. Conclusion Post-relapse survival for primary localized RMA is generally poor. However, certain patient groups differed significantly in their likelihood of survival and 50% of patients with circumscribed relapses treated with ALRT survived. These findings may form the basis for an evidence-based risk-stratification for recurrent disease including relapse treatment.
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| 14. |
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| 15. |
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| 16. |
- Darcy, L., et al.
(författare)
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The life of the preschool aged child with cancer in Sweden
- 2014
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Ingår i: Pediatric Blood & Cancer. - : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 61:S2, s. 190-190
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Objectives: The majority of children who receive a cancer diagnosis are in the 1‐to‐6 year age group. Survival rates are high, roughly 75%, but treatment is aggressive and requires long and frequent hospital admissions and causes adverse side effects. Health care focus is shifting from surviving childhood cancer to living with it on a daily basis. The young child's experiences are crucial to providing evidence based care. The aim of this study was to explore the everyday life of preschool aged children as expressed by the child and their parents during the first year post diagnosisMethods: Interviews were conducted with children and their parents connected to a paediatric oncology unit in Southern Sweden. A qualitative content analysis of interview data from three time points, shortly after diagnosis, six months and one year post diagnosis were made.Results: A dramatic change in the young child's everyday life was described, with experiences of feeling like a stranger, under attack and lonely. Experiences over time of gaining control, making a normality of the illness and treatment and feeling lonely were described. This process may be seen as a striving for an everyday life.Conclusions: Nurses have a major role to play in the process of striving the child goes through by giving and updating information, making them participary in their care and assuring access to both parents and peers. Ongoing contact with preschool is vital. Addressing these issues and updating them regularly can assist the young child in their transition to living with cancer. Longitudinal studies with young children are vital in capturing their variety of experiences through the cancer trajectory and necessary to ensure quality care.
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| 17. |
- Einarsson, Einar-Jon, et al.
(författare)
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Hearing impairment after platinum-based chemotherapy in childhood.
- 2011
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009. ; 56:4, s. 631-637
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Tidskriftsartikel (refereegranskat)abstract
- Chemotherapy is used in the treatment of children and adolescents with malignant diseases. Some of the chemotherapeutic agents are highly toxic and may cause a number of side effects. The primary objective of this study was to evaluate the long-term effects on hearing in cancer survivors who had received platinum-based chemotherapy in childhood or adolescence.
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| 18. |
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| 19. |
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| 20. |
- Fogelstrand, Linda, 1974, et al.
(författare)
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Prognostic Implications of Mutations in NOTCH1 and FBXW7 in Childhood T-ALL Treated According to the NOPHO ALL-1992 and ALL-2000 Protocols
- 2014
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Ingår i: Pediatric Blood & Cancer. - : Wiley-Blackwell. - 1545-5009 .- 1545-5017. ; 61:3, s. 424-430
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Tidskriftsartikel (refereegranskat)abstract
- Background In children, T-cell acute lymphoblastic leukemia (T-ALL) has inferior prognosis compared with B-cell precursor ALL. In order to improve survival, individualized treatment strategies and thus risk stratification algorithms are warranted, ideally already at the time of diagnosis.Procedure We analyzed the frequency and prognostic implication of mutations in NOTCH1 and FBXW7 in 79 cases of Swedish childhood T-ALL treated according to the Nordic Society of Pediatric Hematology and Oncology (NOPHO) ALL-1992 and ALL-2000 protocols. In a subgroup of patients, we also investigated the functional relevance of NOTCH1 mutations measured as expression of the HES1, MYB, and MYC genes.Results Forty-seven of the cases (59%) displayed mutations in NOTCH1 and/or FBXW7. There was no difference in overall (P=0.14) or event-free survival (EFS) (P=0.10) in patients with T-ALL with mutation(s) in NOTCH1/FBXW7 compared with patients with T-ALL without mutations in any of these genes. T-ALL carrying NOTCH1 mutations had increased HES1 and MYB mRNA expression (HES1 9.21.9 (mean +/- SEM), MYB 8.7 +/- 0.8 (mean +/- SEM)) compared to T-ALL with wild-type NOTCH1 (HES1 1.8 +/- 0.7, MYB 5.1 +/- 1.2, P=0.02 and 0.008, respectively). In cases of T-ALL with high HES1 expression, improved overall (P=0.02) and EFS (P=0.028) was seen.Conclusions Increased NOTCH activity, reflected by increased HES1 expression, is associated with improved outcome in pediatric T-ALL, but its role as a diagnostic tool or a therapeutic target in future clinical treatment protocols remains to be elucidated. Pediatr Blood Cancer 2014;61:424-430. (c) 2013 Wiley Periodicals, Inc.
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| 21. |
- Frisk, Per, et al.
(författare)
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A longitudinal study of pulmonary function after stem cell transplantation, from childhood to young adulthood
- 2012
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 58:5, s. 775-779
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Tidskriftsartikel (refereegranskat)abstract
- Background Impairment of pulmonary function after stem cell transplantation (SCT) in childhood has been reported before. However, long-term longitudinal studies are scarce. Procedure. We measured lung volumes and performed dynamic spirometry serially in 18 patients after SCT. At the last investigation, a median of 18.2 years after SCT, the patients were compared with 18 matched controls. The diffusing capacity (DLCO) was only compared cross-sectionally. Results. There was a significant increase in the prevalence of restrictive lung disease (RLD, total lung capacity <80% of that predicted) from 7% (1/14) before SCT to 28% (5/18) 5 years after SCT, and 61% (11/18) a median of 18.2 years after SCT (P = 0.002). In comparison, none of the controls had RLD (61% vs. 0%, P = 0.001). Before SCT, no patient had obstructive lung disease (OLD, forced expiratory volume in 1 sec/vital capacity < 70). OLD was found in one of 18 patients (6%) 5 years after SCT but in none of the patients a median of 18.2 years after SCT. Three of the controls had OLD (P = 0.25). Eleven patients had diffusion impairment (DLCO < 80% of that predicted), as opposed to none of the controls (P = 0.001). The DLCO corrected for alveolar volume was decreased in only two patients. Conclusion. We documented an increase in the prevalence of RLD, but not of OLD, after SCT. At the last investigation, only two patients had diffusion impairment after correction for alveolar volume.
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| 22. |
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| 23. |
- Georgantzi, Kleopatra, et al.
(författare)
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Differentiated expression of somatostatin receptor subtypes in experimental models and clinical neuroblastoma
- 2011
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 56:4, s. 584-589
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND:Neuroblastoma (NB) is a solid tumor of childhood originating from the adrenal medulla or sympathetic nervous system. Somatostatin (SS) is an important regulator of neural and neuroendocrine function, its actions being mediated through five specific membrane receptors. The aim of this study was to investigate the expression of the different somatostatin receptors (SSTRs) in NB tumor cells that may form targets for future therapeutic development.PROCEDURE:Tumor specimens from 11 children with stage II-IV disease were collected before and/or after chemotherapy. Experimental tumors derived from five human NB cell lines were grown subcutaneously in nude mice. Expression of SSRTs, the neuroendocrine marker chromogranin A (CgA) and SS was detected by immunohistochemistry using specific antibodies.RESULTS:SSTR2 was detected in 90%, SSTR5 in 79%, SSTR1 in 74%, SSTR3 in 68% whereas SSTR4 was expressed in 21% of the clinical tumors. The experimental tumors expressed SSTRs in a high but variable frequency. All clinical tumors showed immunoreactivity for CgA but not for SS.CONCLUSION: The frequent expression of SSTRs indicates that treatment with unlabeled or radiolabeled SS analogs should be further explored in NB.
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| 24. |
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| 25. |
- Hansson, Helena, et al.
(författare)
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Hospital-Based Home Care for Children With Cancer
- 2011
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009. ; 57:3, s. 369-377
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Forskningsöversikt (refereegranskat)abstract
- Hospital-based home care (HBHC) is widely applied in Pediatric Oncology. We reviewed the potential effect of HBHC on children's physical health and risk of adverse events, parental and child satisfaction, quality of life of children and their parents, and costs. A search of PubMed, CINAHL, and EMBASE led to identification of five studies that met the inclusion criteria. All sample sizes were small, and both the interventions and the outcome measures were diverse. Although burdened by these limitations, the studies indicate that HBHC is feasible and carries no crucial negative effects for children with cancer. Pediatr Blood Cancer 2011; 57: 369-377. (C) 2011 Wiley-Liss, Inc.
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| 26. |
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| 27. |
- Hansson, Helena, et al.
(författare)
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Hospital-based home care for children with cancer: Feasibility and psychosocial impact on children and their families
- 2013
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009. ; 60:5, s. 865-872
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Tidskriftsartikel (refereegranskat)abstract
- Background To assess the feasibility and psychosocial impact of a hospital-based home care (HBHC) program for children with cancer. Procedure A HBHC program was carried out with 51 children (018 years) with cancer to assess its feasibility in terms of satisfaction, care preferences, safety, and cost. A controlled trial was conducted to assess children's health-related quality of life (HRQOL) using the parent-reported and self-reported PedsQL Generic Core Scale and PedsQL Cancer Module, and the psychosocial impact on the family by PedsQL Family Impact Module comprising a subsample of 28 children and 43 parents in the home care group, and 47 children and 66 parents receiving standard hospital care. Results All parents in the HBHC program were satisfied and preferred home care. There were no serious adverse events associated with HBHC, and costs did not increase. When adjusting for age, gender, diagnosis and time since diagnosis, we found significant higher HRQOL scores in parent-reported physical health (P=0.04; 95% confidence interval (CI): 0.219.5) and worry (P=0.04; 95% CI: 0.420.6) in the home-care group indicating better physical health and less worry for children in the home-care group. No significant difference was found in the Family Impact Module. Conclusion This study indicates that HBHC is a feasible alternative to hospital care for children with cancer, and is greatly preferred by parents. Specific aspects of children's HRQOL may be improved with HBHC and the psychosocial burden on the family does not increase. Pediatr Blood Cancer 2013; 60: 865872. (c) 2013 Wiley Periodicals, Inc.
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| 28. |
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| 29. |
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| 30. |
- Hjorth, Lars, et al.
(författare)
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Hyperfiltration evaluated by glomerular filtration rate at diagnosis in children with cancer.
- 2011
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009. ; 56:5, s. 762-766
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Renal glomerular filtration rate (GFR) of pediatric cancer patients at diagnosis has previously been investigated in a limited number of studies. PROCEDURE: GFR, measured by iohexol clearance, was prospectively investigated in 55 children over the age of 1 year with malignancies, (group A). Elevated GFR (>175 ml/min/1.73 m(2)) at diagnosis was found. To investigate if this finding was consistent, a second group of 76 children with malignancies was studied, (group B). As a method control for GFR obtained by iohexol clearance, group A and B together were compared to 298 pediatric patients without cancer, group C. RESULTS: GFR was elevated in 40/131 (31%) in Group A + B but only in 17/298 (6%) in Group C. GFR was significantly higher in children aged 1-5 in group A + B (47%) compared to group C (3%). Bone marrow involvement was significantly associated with higher GFR. Children without bone marrow involvement also hyperfiltrated more often than controls, but less often. Urea in urine was used as a marker of renal protein clearance in 14 patients in group A. A significant correlation between u-urea (mmol/L)/u-creatinine (mmol/L) and GFR was noted. CONCLUSIONS: Hyperfiltration is sometimes present in children with cancer at diagnosis. This may be related to increased amino acid turn over in patients with a large tumor burden. An elevated initial GFR in a child with cancer, which normalizes after chemotherapy may indicate chemotherapy-induced decreased renal function, but can be due to normalization of an initially high GFR. Pediatr Blood Cancer © 2011 Wiley-Liss, Inc.
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| 31. |
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| 33. |
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| 34. |
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| 35. |
- Jenholt Nolbris, Margaretha, et al.
(författare)
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A Global Web-based Programme about Cancer in Language Specific for Staff, a Sick Child and Their Family
- 2013
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Ingår i: Pediatric Blood & Cancer. - Hoboken, NJ : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 60:Suppl. 3, s. 185-185
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Tidskriftsartikel (refereegranskat)abstract
- Purpose/Objective: To have expert paediatric oncology nurses to inform and explain childhood cancer diagnoses, treatments, side effects, situations and feelings, by developing a web-based programme.Materials and Methods: The programme will be developed and tested in three steps. Step 1 is to develop a web portal with animated pictures of cancer themes based on the ’See Hear Do’ programme in Sweden and Norway. Step 2 is to add text and audio in several languages for each theme (such as Arabic, English, Spanish). Step 3 is to develop two informational sections on the web portal: one section for staff and for the patient and family. The staff, children and families will evaluate each section as appropriate before the programme is published on the web portal. A participatory design method is going to be used. The programme will also be offered to nurses in the International Society of Paediatric Oncology and nursing working group of the Pediatric Oncology in Developing Countries committee for translation into their native languages.Results: Expected result is that the web portal can easily be downloaded via computer, iPad or mobile and can be used twofold. Staff can use this programme for self-education and for working with the child and family. The child and family can use the web programme in various situations during the child’s cancer treatment, e.g., explaining the diagnosis to family members, schoolmates, families’ networks, during phone calls using an interpreter or for persons with a visual or auditory disability.Conclusions: Goal of the project is to globalize childhood cancer education and information with a web-based programme including pictures, text and audio in various languages. The programme is designed to consider the professional’s information and the child and family’s needs and participation. The active role of all stakeholders to ensure cultural relevance is key to this project.
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| 36. |
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| 37. |
- Johannsdottir, Inga M. R., et al.
(författare)
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Increased prevalence of chronic fatigue among survivors of childhood cancers: A population-based study
- 2012
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009. ; 58:3, s. 415-420
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Tidskriftsartikel (refereegranskat)abstract
- Background Fatigue is prevalent in adult cancer survivors but less studied in childhood cancer survivors. Aims were to assess fatigue levels, prevalence of chronic fatigue (CF) and the association of CF with health-related quality of life (HRQoL) in survivors of acute myeloid leukemia (AML), infratentorial astrocytoma (IA), and Wilms tumor (WT) in childhood.
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| 38. |
- Jönsson, Peter, et al.
(författare)
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High dose methotrexate treatment in children with acute lymphoblastic leukaemia may be optimised by a weight-based dose calculation.
- 2011
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009. ; 57, s. 41-46
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The inter-individual variation in exposure to methotrexate is considerable after intravenous high dose methotrexate (HDMTX) administration and both under- and over exposures may have dire consequences. Thus, optimal dose individualisation is of paramount importance. PROCEDURE: We studied how pharmacokinetic parameters were related to outcome in 340 patients with acute lymphoblastic leukaemia (ALL). A population pharmacokinetic model was developed with data from 1284 HDMTX courses in 304 children evaluating age, height, weight, body surface area (BSA), sex, serum creatinine and serum alanine aminotransferase as potential covariates. RESULT: Body weight improved the population pharmacokinetic model significantly more than any of the other patient characteristics, indicating that body weight may be the better way of dose normalisation. In a logistic regression analysis, higher values of clearance as well as volume of distribution were related to increased relapse risk in the standard (SR) and intermediate risk (IR) groups as well as in the entire cohort. A higher weight was strongly associated with worse outcome in the SR and IR groups, (P = 0.0186 and 0.0121, respectively). CONCLUSIONS: We conclude that dose normalisation of methotrexate according to body weigh may give more predictable pharmacokinetics of methotrexate and may also improve the outcome for children with ALL. Pediatr Blood Cancer © 2011 Wiley-Liss, Inc.
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| 41. |
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| 42. |
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| 43. |
- Levinsen, Mette, et al.
(författare)
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Clinical features and early treatment response of central nervous system involvement in childhood acute lymphoblastic leukemia
- 2014
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 61:8, s. 1416-1421
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Tidskriftsartikel (refereegranskat)abstract
- Background Central nervous system (CNS) involvement in childhood acute lymphoblastic leukemia (ALL) remains a therapeutic challenge. Procedure To explore leukemia characteristics of patients with CNS involvement at ALL diagnosis, we analyzed clinical features and early treatment response of 744 patients on Nordic-Baltic trials. CNS status was classified as CNS1 (no CSF blasts), CNS2 (<5 leukocytes/mu l CSF with blasts), CNS3 (5 leukocytes/mu l with blasts or signs of CNS involvement), TLP+ (traumatic lumbar puncture with blasts), and TLP- (TLP with no blasts). Results Patients with CNS involvement had higher leukocyte count compared with patients with CNS1 (P<0.002). Patients with CNS3 more often had T-ALL (P<0.001) and t(9;22)(q34;q11)[BCR-ABL1] (P<0.004) compared with patients with CNS1. Among patients with CNS involvement headache (17%) and vomiting (14%) were most common symptoms. Symptoms or clinical findings were present among 27 of 54 patients with CNS3 versus only 7 of 39 patients with CNS2 and 15 of 75 patients with TLP+ (P<0.001). The majority of patients with CNS involvement received additional induction therapy. The post induction bone marrow residual disease level did not differ between patients with CNS involvement and patients with CNS1 (0.15). The 12-year event-free survival for patients with leukemic mass on neuroimaging did not differ from patients with negative or no scan (0.50 vs. 0.60; P=0.7) or between patients with symptoms or signs suggestive of CNS leukemia and patients without such characteristics (0.50 vs. 0.61; P=0.2). Conclusion CNS involvement at diagnosis is associated with adverse prognostic features but does not indicate a less chemosensitive leukemia.
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| 44. |
- Levinsen, Mette, et al.
(författare)
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Pharmacogenetically Based Dosing of Thiopurines in Childhood Acute Lymphoblastic Leukemia: Influence on Cure Rates and Risk of Second Cancer
- 2014
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Ingår i: Pediatric Blood & Cancer. - : John Wiley & Sons. - 1545-5009 .- 1545-5017. ; 61:5, s. 797-802
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Tidskriftsartikel (refereegranskat)abstract
- BackgroundPrevious studies have indicated that patients with thiopurine methyltransferase (TPMT) low activity (TPMTLA) have reduced risk of relapse but increased risk of second malignant neoplasm (SMN) compared to patients with TPMT wild-type (TPMTWT) when treated with 6MP maintenance therapy starting doses of 75 mg/m2/day. To reduce SMN risk, 6MP starting doses were reduced to 50 mg/m2/day for patients with TPMT heterozygosity in the Nordic Society of Paediatric Haematology and Oncology (NOPHO) ALL2000 protocol.ProcedureWe explored the pattern of SMN and relapse in the NOPHO ALL2000 protocol (n = 674) and NOPHO ALL92 protocol (n = 601) in relation to TPMT pheno- and/or genotype.ResultsThe overall risk of any event did not differ significantly between the two protocols. However, in event pattern analyses considering only the patients with TPMTLA who experienced relapse or SMN, the risk of SMN versus leukemia relapse was significantly lower in the ALL2000 cohort for patients with a 6MP starting dose <75 mg/m2/day when compared to the patients in ALL92 (relapse (n = 11) and SMN (n = 0) in ALL2000 versus relapse (n = 5) and SMN (n = 4) in ALL92, P = 0.03). Furthermore, the 8-year cumulative incidence of relapse for patients with TPMTLA was significantly higher in the ALL2000 compared to the ALL92 cohort (19.7% (11.6–33.3%) vs. 6.7% (2.9–15.5%), P = 0.03).ConclusionThis study indicates that reducing 6MP starting dose for patients with TPMTLA may reduce SMN risk but lead to a relapse risk similar to that of patients with TPMTWT.
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| 45. |
- Lindvall, Karin, et al.
(författare)
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Increased burden on caregivers of having a child with haemophilia complicated by inhibitors.
- 2013
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009.
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Tidskriftsartikel (refereegranskat)abstract
- Having a child with a chronic disease often increases the burden in the family with more hospital visits, treatment administration, and increased worries for the ill child. A cross-sectional, international, multi-centre study in caregivers of children <18 years with haemophilia and inhibitor was performed at Haemophilia Treatment Centres in Sweden, UK, and Canada to evaluate caregivers' burden and their health-related quality of life (HRQoL) compared to that of caregivers of children on prophylaxis without inhibitors and caregivers of healthy children.
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| 46. |
- Ljung, Rolf
(författare)
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Hemophilia and prophylaxis.
- 2013
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5017 .- 1545-5009. ; 60:Suppl. S1, s. 23-26
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Forskningsöversikt (refereegranskat)abstract
- Clinical experience over decades and numerous retrospective and, recently, also prospective studies clearly demonstrate that prophylactic treatment, albeit much more expensive, is superior to on-demand treatment regardless of whether the outcome is number of joint- or life-threatening bleeds or arthropathy optimal prophylactic treatment should be started early (primary prophylaxis) but various opinions exist on the model. The optimal model should be to individualize prophylaxis taking into account the bleeding phenotype and the individual susceptibility to arthropathy and further develop monitoring by global coagulation assays and pharmacokinetic parameters. This review covers proof of concept of primary prophylaxis in children, comparisons between prophylaxis and on demand treatment, and future trends of prophylactic treatment of hemophilia. Pediatr Blood Cancer © 2012 Wiley Periodicals, Inc.
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| 47. |
- Ljungman, Gustaf, et al.
(författare)
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Effect of morphine on fear, distress and pain in needle procedures in children with cancer
- 2010
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Ingår i: Pediatric Blood & Cancer. - : Wiley. - 1545-5009 .- 1545-5017. ; 55:5, s. 954-955
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Purpose: Children with cancer often mention needle procedures as the most frightening, distressing and sometimes painful aspect of the disease and treatment.The aim was to investigate whether children experience less fear, distress, and/or pain according to parents, nurses, and children>7 years of age when they receive oral morphine vs. placebo before a needle is inserted in a subcutaneously implanted intravenous port and if there is a difference in procedure time. Method: Fifty children 1–18 years of age who were being treated in a pediatric oncology and hematology setting were included consecutively when undergoing routine needle insertion into an intravenous port. All children were subjected to one needle insertion and recieved EMLA in this randomized, triple-blind, placebo controlled study in which orally administered morphine (n¼26) 0.25 mg/kg body weight was compared with placebo (n¼24). Parents, nurses and children>7 years reported the patients’ fear, distress, and pain on 0–100 mm Visual Analogue Scales. In addition behavioral observation with CHEOPS for pain and PBCL for procedure related distress was performed. Results: No differences between the morphine and the placebo group were found with respect to age, weight, height, physical status, sex, weeks from diagnosis, or weeks from latest needle insertion. According to parents, nurses, and children oral morphinein a dose of 0.25 mg/kg body weight did not reduce the primary outcome measure fear; neither did it reduce distress nor pain in the morphine group compared to placebo. No differences in behavioral observations with CHEOPS and PBCL or procedure time for morphine vs. placebo were found. Conclusion: Surprisingly, oral morphine in this dose does not add any value in reducing fear, distress or pain combined with topical anaesthesia in pediatric oncology patients undergoing subcutaneous port needle insertion, and it probably would not add any value for other similar procedures, e.g. venous cannulation.
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