The American journal of pediatric hematology/oncology (J Pediatr Hematol Oncol )

Publisher: American Society of Pediatric Hematology/Oncology

Description

Discontinued. Now published as the Journal of Pediatric Hematology/Oncology.

  • Impact factor
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  • 5-year impact
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  • Other titles
    The American journal of pediatric hematology/oncology
  • ISSN
    0192-8562
  • OCLC
    5089126
  • Material type
    Periodical, Internet resource
  • Document type
    Journal / Magazine / Newspaper, Internet Resource

Publications in this journal

  • The American journal of pediatric hematology/oncology 01/2000; 22(4):392.
  • The American journal of pediatric hematology/oncology 01/1997; 19(4):383.
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    The American journal of pediatric hematology/oncology 01/1997; 19(1).
  • The American journal of pediatric hematology/oncology 12/1994; 16(4):384-6.
  • The American journal of pediatric hematology/oncology 12/1994; 16(4):361-4.
  • [Show abstract] [Hide abstract]
    ABSTRACT: Four children with prolonged emesis during brain tumor therapy were diagnosed with pancreatitis. All were exposed to medications or radiotherapy that potentially contributed to pancreatitis. Because recognition of pancreatitis may necessitate changes in supportive care, pancreatitis should be included in the differential diagnosis of vomiting in this population.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):301-4.
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    ABSTRACT: Despite the excellent prognosis for 90% of patients with Wilms' tumor, survival remains poor among those with recurrent or advanced disease or tumors of unfavorable histology. We sought to identify a chemotherapy regimen for this subset of patients that offers potential efficacy with minimal nephrotoxicity. Through a review of patients' medical records, we compared the efficacy and nephrotoxicity of ifosfamide, cisplatin, cisplatin/etoposide, and ifosfamide/carboplatin/etoposide (ICE) regimens in 32 patients with recurrent (n = 23), refractory (n = 1), or metastatic (n = 8) Wilms' tumor, including six with tumors having unfavorable histologic features. Single-agent ifosfamide was minimally nephrotoxic and induced responses in three of 11 patients, but none have survived. Cisplatin with or without etoposide induced responses in six of 18 patients with recurrent Wilms' tumor (there is one long-term survivor). Seven of eight patients with newly diagnosed extensive metastatic disease responded to cisplatin/etoposide plus vincristine, dactinomycin, adriamycin, and radiotherapy. This regimen produced three long-term survivors, but was associated with significant nephrotoxicity. The ifosfamide, carboplatin, and etoposide regimen induced responses in four of five patients treated, and had minimal nephrotoxicity. Two remain free of disease progression 22 months after recurrence. Although long-term survival remains to be determined, the ICE combination appears to be effective against recurrent Wilms' tumor without endangering the patients' single remaining kidney. Myelotoxicity can be ameliorated by administering growth factors. We suggest that ICE chemotherapy be considered for the primary treatment of high-risk patients with Wilms' tumor.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):296-300.
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    ABSTRACT: G-CSF has been shown to be beneficial in cyclic neutropenia when given as a daily subcutaneous injection. We investigated the usefulness of a new three-day-a-week regimen. A ten year old boy with cyclic neutropenia was initially treated with G-CSF 7 micrograms/kg given on alternate days for seven months. He was then placed on the same dose, given three days a week. The effectiveness of these regimens were assessed by serial CBCs and by the frequency and duration of the symptoms. The mean absolute neutrophil count (ANC) increased from 1282 before therapy to 11,718/microliters on alternate day regimen and 7716/microliters on three-day-a-week regimen. The nadir ANC improved from 30/microliters before therapy to 546/microliters and 198/microliters on treatment. The duration and frequency of mouth sores were significantly less on therapy, and there was an estimated cost savings of $23,826/year on three-day-a-week regimen compared to a daily regimen. The three-day-a-week G-CSF regimen is clinically effective and cost saving in the treatment of cyclic neutropenia and should be studied in a larger cohort of patients.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):338-40.
  • The American journal of pediatric hematology/oncology 12/1994; 16(4):387-8.
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    ABSTRACT: We report three cases of neuroblastoma diagnosed by prenatal ultrasound examination and examine the biologic features of tumors diagnosed prenatally. Neuroblastoma is the most common tumor detected in the newborn period. Thus, some of these tumors develop prenatally and should be detectable by maternal ultrasound. Here we report three cases in which a neuroblastoma was suspected on prenatal ultrasonography. In addition, we review selected features of 17 additional cases reported in the literature. These data indicate that, although the majority of patients have favorable clinical and biological features and do well, some patients do not, and the DNA index may be the most important predictor of outcome.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):356-60.
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    ABSTRACT: CASE REPORT: A 14-month-old infant presented with pancytopenia and Mycobacterium avium intracellularae (MAI) as the initial manifestation of acquired immunodeficiency syndrome (AIDS). CONCLUSION: Human immunodeficiency virus (HIV-1) infections should be considered in the differential diagnosis of infants and children with cytopenias.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):334-7.
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    ABSTRACT: Infection with human parvovirus B19 is the most common cause of transient aplastic crisis in patients with chronic hemolytic anemia. Multiple reports of children with simultaneous B19 infection and thrombocytopenia as well as the known association between experimental B19 infection and thrombocytopenia prompted us to hypothesize that B19 may be associated with childhood idiopathic, or immune, thrombocytopenic purpura (ITP). Because there is a paucity of evidence regarding a viral etiology for ITP, we performed a comprehensive study to explore its possible relationship to B19 infection. Thirty-five previously healthy children with ITP were studied prospectively. Bone marrow and peripheral blood were analyzed for B19 DNA using the polymerase chain reaction (PCR). Serum was analyzed for anti-B19 immunoglobulin (Ig) M and IgG antibodies using a B19 VP1 antigen-based enzyme-linked immunosorbent assay. Fourteen healthy children served as controls for peripheral blood PCR and serologic analyses. The presenting clinical and laboratory features of the study population were typical of classic ITP. Seventeen of the 35 patients (49%) had evidence of B19 DNA in the peripheral blood, bone marrow, or both. Six of 35 (17%) had anti-B19 IgM antibodies. Eight of 35 (23%) were anti-B19 IgG seropositive. The control group had no positive PCR or anti-B19 IgM specimens. Our results suggest that infection with human parvovirus B19 may be associated with childhood ITP. More investigation is warranted regarding the role of PCR methodology and serologic detection methods in defining B19 pathobiology as it relates to ITP.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):314-9.
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    ABSTRACT: We present a report of a child with subclinical immunodeficiency who became chronically infected with parvovirus resulting in pancytopenia and morphologic abnormalities in the bone marrow mimicking myelodysplastic syndrome (MDS). An 8-year-old boy presented with severe anemia, moderate thrombocytopenia and granulocytopenia. The patient showed hyper-immunoglobulin M (IgM) immunodeficiency but no increased susceptibility to infections. The bone marrow was hypercellular with dysplastic granulocytopoiesis and erythroblastopenia. Treatment with cyclosporine and i.v. Ig resulted in temporary normalization of the hemoglobin level. For several years it was assumed that the patient had MDS. A diagnosis of parvovirus infection was initially rejected due to the lack of specific antibodies and the absence of giant pronormoblasts in the bone marrow. When the polymerase chain reaction technique became available, parvovirus DNA was detected from the entire disease course. This case report expands our conception of the clinical spectrum of parvovirus infection and emphasizes that parvovirus must be considered as a differential diagnosis in MDS. We recommend performing a parvovirus DNA test despite negative serologic findings in patients with MDS, especially when associated with immunologic abnormalities.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):329-33.
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    ABSTRACT: To prospectively evaluate 50 patients with transient erythroblastopenia of childhood (TEC) at a single institution in order to compare those patients presenting with reticulocytopenia (group I) with those presenting in the recovery phase with reticulocytosis (group II); to further describe the clinical course of this common pediatric hematological disorder in a large number of patients, particularly the effect on the neutrophils; and to review the available literature regarding this disorder. Fifty patients presenting to the Children's Hospital from September 1983 to September 1991 were prospectively evaluated. Those patients with a reticulocytosis and in recovery at the time of diagnosis were included and compared with those with reticulocytopenia. All patients were followed through complete recovery. Thirty-six patients were reticulocytopenic (group I) and 14 had a reticulocytosis (group II). There was a high incidence of neutropenia (64%) in both groups and the resolution of this neutropenia was variable in relation to the resolution of the anemia, with 44% having the lowest ANC before, 9% simultaneous with, and 47% after the peak reticulocyte count. Our experience with a large group of patients with TEC suggests that neutropenia is an integral part of this disorder, and its recovery has no relation to the recovery of the anemia. A significant number of patients are described in the recovery phase for the first time, and this clarifies this group of patients in order to aid in their diagnosis, particularly in the differentiation from a hemolytic process. Some previously described associations of TEC are not supported in this study of a large number of patients.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):320-4.
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    ABSTRACT: We report a case of infection-associated hemophagocytic syndrome in the setting of disseminated histoplasmosis. A 6-year-old boy with chronic mucocutaneous candidiasis developed a fulminant hemophagocytic syndrome. Evaluation for an infectious cause included bacterial, mycobacterial, viral, and fungal cultures, serological assessment, and histological examination of bone marrow and bronchoalveolar lavage fluid. Culture of bone marrow aspirate, blood, and bronchoalveolar lavage showed disseminated histoplasmosis as the cause for this patient's hemophagocytic syndrome. The patient was treated with amphotericin B with complete resolution of his hemophagocytic syndrome. Disseminated histoplasmosis is another cause of IAHS in children with an underlying immunodeficiency. Diagnostic difficulties associated with the hemophagocytic syndromes of childhood are discussed.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):368-71.
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    ABSTRACT: Surgical resection of cervicofacial cystic hygromas and lymphangiomas rarely effects complete reduction because of severe anatomic restrictions. With prior knowledge of cyclophosphamide activity against lesions of this type, a formal trial of cyclophosphamide was initiated. Overall dose escalation therapy resulted in 50% reduction in mass without recurrence after cessation of therapy and with minimal and readily reversible toxicity. The favorable responses to cyclophosphamide in this study suggest that a prospective randomized trial should be initiated. Certainly, children who have airway and/or esophageal compromise who have failed surgical therapies should be considered for cyclophosphamide treatment.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):325-8.
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    ABSTRACT: Cancer in pregnancy is not uncommon, but cases of maternal malignancy involving the placenta or the fetus are much more rare. We report two additional cases. We report one case of malignant melanoma discovered during pregnancy and found to have metastasized to the placenta. We also describe a case of maternal medulloblastoma involving the placenta at delivery. Although maternal malignancy during pregnancy occurs in as many as one in 1,000 pregnancies, involvement of the products of conception is rare. Subsequent malignancy in the fetus is even more rare. We report two cases, one of melanoma and another of medulloblastoma (the first such case described). Both infants are alive and well.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):380-3.
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    ABSTRACT: Hepatitis C virus (HCV) transmission is a well-documented complication of blood transfusions, although data on transfused children with cancer is sparse. Using a newer assay for anti-HCV antibodies, the prevalence of HCV infection was determined in a population of children with cancer in the United States. Forty-five transfused children with cancer were studied for evidence of HCV infection. Patients had not received chemotherapy for a mean of 2.3 years or transfusions for a mean of 3.1 years before being evaluated. Levels of serum aminotransferases [aspartate aminotransferase and alanine aminotransferase (ALT)], hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (HBsAb), and hepatitis B core antibody (HBcAb) were assessed. A second-generation enzyme immunoassay (EIA) was used to screen for anti-HCV antibodies. Positive EIAs were supplemented by a radioimmunoblot assay (RIBA-2). No patient tested positively for HBsAg, HBsAb, or HBcAb; four of 45 (8.9%) were positive for HCV antibodies by EIA. Three of the four (6.7% of the total) were also positive by RIBA-2 testing. The mean number of donor exposures was not significantly different between HCV-negative versus RIBA-2-positive patients (23.1 vs. 61.7, p = 0.16). ALT levels off therapy and peak ALT levels during therapy were significantly higher in the RIBA-2-positive group versus the HCV-negative group, although 36% of all patients (16 of 45) had at least one elevation in ALT greater than twice the upper limit of normal. All three RIBA-2-positive patients were transfused before institution of universal screening of blood donors for HCV in 1990 and had hepatomegaly noted at least once. We have identified a small group of children who may be at high risk for developing chronic active hepatitis and cirrhosis. Testing for HCV should be a routine part of long-term follow-up in children treated for cancer.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):309-13.
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    ABSTRACT: A 3-year-old girl with acute lymphoblastic leukemia developed typhlitis immediately after diagnosis and before the institution of chemotherapy. Typhlitis is a necrotizing colitis that develops in immunodeficient patients with severe neutropenia. Most patients are leukemic children who are receiving or have received chemotherapy. Typhlitis in the absence of chemotherapy is rare. We report a fatal case of typhlitis in an untreated leukemic patient. This case emphasizes the multifactorial pathogenesis of typhlitis, which may occur in the absence of chemotherapy. Typhlitis should always be considered as a potential cause of acute sepsis and abdominal pain in a leukemic patient.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):348-51.
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    ABSTRACT: After the harvesting of bone marrow for use in transplantation, pain control needs are greatest in the first 12 to 24 hours. This is also the time during which systemic side effects of parenterally administered narcotics are greatest as a result of the recent general anesthetic. We examined the role of regional anesthesia as an adjunct to pain management in pediatric patients undergoing bone marrow harvest. Ten pediatric bone marrow donors were treated with intraoperative caudal blocks using bupivacaine or a combination of bupivacaine and morphine. Donors who received regional anesthesia had a significant decrease in postoperative parenteral narcotic requirement and fewer systemic complications when compared with a control group of 10 age-matched children who did not receive the caudal block. Regional anesthesia with caudal block can decrease the morbidity associated with bone marrow harvest in donors.
    The American journal of pediatric hematology/oncology 12/1994; 16(4):305-8.