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Meerim Park,
Soo Hyun Lee,
Young Ho Lee,
Keon Hee Yoo,
Ki Woong Sung,
Hong Hoe Koo,
Hyoung Jin Kang,
Kyung Duk Park,
Hee Young Shin,
Hyo Seop Ahn, [......],
Hoon Kook,
Tai Ju Hwang,
Eun Kyung Lee, Jeong Ok Hah,
Yeon Jung Lim,
Hyun Joo Jung,
Jun Eun Park,
Moon Ju Jang,
So Young Chong,
Doyeun Oh
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ABSTRACT: Pre-engraftment syndrome (PES) is poorly characterized and its clinical significance and the prognostic impact after unrelated cord blood transplantation (CBT) are unclear. To address these issues, we analyzed retrospectively the incidence, risk factors and clinical outcomes of PES in unrelated CBT recipients. Data of 381 patients who received unrelated CBT from 18 medical centers in Korea were reviewed. PES was defined as unexplained fever >38.3°C not associated with infection, and/or unexplained skin rash with or without evidence of fluid retention before neutrophil recovery. PES developed in 102 patients (26.8%) at a median of 7 days after CBT. Of these patients, 74 patients (72.5%) received intravenous corticosteroid at a median dose of 1mg/kg/day, and of these, 95% showed clinical improvement. Risk factors for developing PES included low risk disease, myeloablative conditioning, graft versus host disease (GVHD) prophylaxis without methotrexate or corticosteroid, and >5.43 x 10(7)/kg infused nucleated cells. Absence of PES was one of the risk factors for graft failure in multivariate analysis. The cumulative incidence of grade II-IV acute GVHD by 100 days after CBT was higher in patients with PES than in those without PES (56.0% vs. 34.4%, P<0.01). PES was not associated with chronic GVHD, treatment-related mortality, relapse or overall survival. PES seems to be common after CBT and may be associated with enhanced engraftment without significant morbidity.
Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation 02/2013; · 3.15 Impact Factor
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J Ginseng Res. 10/2012; 36(4):383-390.
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Seok Jeong Kang,
Jae Min Lee, Jeong Ok Hah,
Ye Jee Shim,
Kun Soo Lee,
Hyun Jung Shin,
Heung Sik Kim,
Eun Jin Choi,
So Eun Jeon,
Young Tak Lim,
Ji Kyeong Park,
Eun Sil Park
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ABSTRACT: Natural history and consequences of the novel 2009 influenza A H1N1 (2009 H1N1) infection in immunocompromised pediatric patients are not yet fully understood. In this study, we investigated the clinical features and outcomes of the 2009 H1N1 infection in pediatric patients with hematological and oncological diseases.
We retrospectively reviewed the medical records of 528 patients who had hematological and oncological diseases and who were treated at 7 referral centers located in the Yeungnam region. Among the 528 patients, 27 with definite diagnosis of 2009 H1N1 infection were the subjects of this study. All patients were divided into the following 3 groups: patients who were receiving chemotherapy (group 1), patients who were immunosuppressed due to a non-malignant hematological disease (group 2), and patients who were off chemotherapy and had undergone their last chemotherapy course within 2 years from the influenza A pandemic (group 3).
All 28 episodes of 2009 H1N1 infection were treated with the antiviral agent oseltamivir (Tamiflu®), and 20 episodes were treated after hospitalization. Group 1 patients had higher frequencies of lower respiratory tract infection and longer durations of fever and hospitalization as compared to those in group 2. Ultimately, all episodes resolved completely with no complications.
These results suggest that early antiviral therapy did not influence the morbidity or mortality of pediatric patients with hematological and oncological diseases in the Yeungnam region of Korea after the 2009 H1N1 infection. However, no definite conclusions can be drawn because of the small sample size.
Korean Journal of Pediatrics 03/2011; 54(3):117-22.
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Dae Chul Jeong,
Nack Gyun Chung,
Hyoung Jin Kang,
Hong Hoe Koo,
Hoon Kook,
Soon Ki Kim,
Sun Young Kim,
Heung Sik Kim,
Hwang Min Kim,
Kyung Duk Park, [......],
Soon Yong Lee,
Young Ho Lee,
Young Tak Lim,
Yeon Jung Lim,
Hye Lim Jung,
Bin Cho,
Yong Mook Choi, Jeong Ok Hah,
Tai Ju Hwang,
Hack Ki Kim
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ABSTRACT: Aplastic anemia (AA) is a rare hematologic disease characterized by pancytopenia and hypocellular marrow. The Korean Society of Pediatric Hematology Oncology investigated retrospectively the incidence, survival, and transfusion independency according to treatment strategies in AA.
All the questionnaires were sent to members for medical records. We collected and analyzed 702 available data.
The male and female ratio was 1.2, and the median age at diagnosis was 9.3 years. The annual incidence of Korean children with AA was 5.16 per million per year. Constitutional anemia was diagnosed in 44 children. In acquired AA, causes were identified in 39 children. Severe AA (SAA) at initial diagnosis was more common than nonsevere AA. The overall survival was 47.8% with supportive care, 68.1% with immunosuppressive therapy (IST), and 81.8% with hematopoietic stem cell transplantation. In IST, response rate was 65.7%, and relapse rate after response was 54.4% within a median of 23.0 months. The factors with overall survival were severity of disease in supportive care, severity and response in IST, donor type, graft failure, and posttransplant events in hematopoietic stem cell transplantation.
Long-term outcome in AA was dependent on treatment strategies. These Korean results may help research and prospective international clinical trials for childhood AA.
Journal of Pediatric Hematology/Oncology 02/2011; 33(3):172-8. · 1.16 Impact Factor
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Keon Hee Yoo,
Soo Hyun Lee,
Ki Woong Sung,
Hong Hoe Koo,
Nak Gyun Chung,
Bin Cho,
Hack Ki Kim,
Hyoung Jin Kang,
Hee Young Shin,
Hyo Seop Ahn, [......],
Sang Kyu Park,
Hyun Joo Jung,
Jun Eun Park,
Yeon Jung Lim,
Seong Shik Park,
Young Tak Lim,
Eun Sun Yoo,
Kyung Ha Ryu,
Hyeon Jin Park,
Byung Kiu Park
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ABSTRACT: We report the outcome of 236 pediatric umbilical cord blood transplantations (UCBT) performed in Korea. Given that the sources of the grafts were mostly unrelated donors (n = 226; 95.8%), only the results of unrelated UCBT were included for all statistics. The most frequent primary disease was acute leukemia (n = 167). In total, 91.7% of recipients were seropositive for cytomegalovirus (CMV). The median doses of nucleated cells and CD34+ cells were 4.84 × 10(7)/kg and 2.00 × 10(5)/kg, respectively. The median times to neutrophil (>0.5 × 10(9)/L) and platelet recovery (>20 × 10(9)/L) were 18 and 45 days, respectively. Grade 2-4 acute graft-versus-host-disease (GVHD) and chronic GVHD developed in 41.1 and 36.1% of cases, respectively. Forty-five patients developed CMV disease. The 5-year overall and event-free survival were 47.5 and 36.9%, respectively. Multivariate analysis revealed that adverse factors for survival of the whole cohort were total body irradiation-based conditioning (P = 0.007), salvage transplant (P = 0.001), failure to achieve early complete chimerism (P < 0.0005), and CMV disease (P = 0.001). The outcomes of the single- and double-unit UCBT (n = 64) were similar, while double-unit recipients were heavier (P < 0.0005) and older (P < 0.0005). We conclude that double-unit UCBT is a reasonable option for older or heavier children and that the thorough surveillance of CMV infection and the development of an effective CMV therapeutic strategy may be especially important for Korean children, whose CMV seroprevalence exceeds 90%.
American Journal of Hematology 09/2010; 86(1):12-7. · 4.67 Impact Factor
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Sun Young Kim,
Ki Woong Sung, Jeong Ok Hah,
Keon Hee Yoo,
Hong Hoe Koo,
Hyoung Jin Kang,
Kyung Duk Park,
Hee Young Shin,
Hyo Seop Ahn,
Ho Joon Im,
Jong Jin Seo,
Yeon Jung Lim,
Young Ho Lee,
Hyung Jin Shin,
Do Hoon Lim,
Byung Kyu Cho,
Young Shin Ra,
Joong Uhn Choi
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ABSTRACT: In this study, we investigated the effects of reduced-dose craniospinal radiotherapy (CSRT) followed by tandem high-dose chemotherapy (HDCT) with autologous stem cell rescue (ASCR) in children with a newly diagnosed high-risk medulloblastoma (MB) or supratentorial primitive neuroectodermal tumor (sPNET).
Between March 2005 and April 2007, patients older than 3 years with a newly diagnosed high-risk MB or sPNET were enrolled. The patients received two cycles of pre-RT chemotherapy consisting of cisplatin, etoposide, vincristine, and cyclophosphamide (cycle A), and carboplatin, etoposide, vincristine, and ifosphamide (cycle B), followed by CSRT with 23.4 Gy and local RT with 30.6 Gy. After four cycles of post-RT chemotherapy (cycles A, B, A, and B), tandem double HDCT with ASCR was performed.
A total of 13 patients (MB=11, sPNET=2) were enrolled. Of these, one patient progressed, one patient died of septic shock after the second cycle of B, and one patient relapsed after the third cycle of B. The 3-year event-free survival (EFS) rate of the patients intended for HDCT was 76.9%, whereas the 3-year EFS rate of the patients who received HDCT was 100%. No treatment-related mortality occurred during HDCT.
Although the follow-up period was short and the patient cohort was small in size, the results of this study are encouraging. The limited toxicity and favorable EFS rate observed in children treated with reduced-dose CSRT followed by HDCT and ASCR warrant further exploration in a larger study population.
The Korean journal of hematology 06/2010; 45(2):120-6.
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Jeong Ok Hah
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ABSTRACT: Secondary brain tumors after cranial irradiation occur in survivors of childhood acute lymphoblastic leukemia (ALL). We report a case of anaplastic oligodendroglioma with recurrence occurring in a 15-year-old girl, 8 years after the diagnosis of ALL. She was treated with cisplatin, vincristine, etoposide, and ifosfamide followed by cranial irradiation with good response. However, as new lesions appeared out of the radiation field and then multiple lesions after she stopped the chemotherapy, she was treated with procarbazine, CCNU, and vincristine followed by autologous peripheral blood stem cell transplantation with preconditioning of carboplatin, thiotepa, and etoposide. She showed no evidence of disease for 3 years after last recurrence. High-dose chemotherapy with stem cell rescue seems to be potentially effective for multiple recurrent anaplastic oligodendroglioma occurring after childhood ALL.
Journal of Pediatric Hematology/Oncology 11/2008; 30(10):764-7. · 1.16 Impact Factor
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Jeong Ok Hah
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ABSTRACT: Adrenocortical carcinoma (ACC) is a rare tumor in children. Surgical excision is the most effective therapy for ACC. However, the prognosis of ACC with metastases or unresectability is poor and the therapies for these are not well established. We report successful treatment of a 3-year-old girl with ACC and lung metastases. She had adrenalectomy followed by chemotherapy with cisplatinum, etoposide, and bleomycin. Thoracotomy for lung metastases was done after partial response to chemotherapy. Autologous peripheral blood stem-cell transplantation was performed after preconditioning with carboplatinum, etoposide, and melphalan. She has been well for 2 years since the time of diagnosis. Surgical resection of the primary and metastatic lesions with chemotherapy followed by autologous peripheral blood stem-cell transplantation could be an effective treatment for advanced ACC. However, prospective-controlled studies are necessary for firm conclusion as this is a single case report and the follow-up is not long enough.
Journal of Pediatric Hematology/Oncology 05/2008; 30(4):332-4. · 1.16 Impact Factor
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Korean Journal of Pediatrics 01/2008; 51(1):84-88.
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ABSTRACT: Pancreatoblastoma is an extremely rare pancreatic tumor of childhood. We report our experience in 2 patients with pancreatoblastoma who had long-term survival and review the literature with a focus on chemotherapy in pancreatoblastoma with vascular invasion. The cases were 7-year-old and 4-year-old girls who complained of an abdominal mass without jaundice. Laboratory findings including serum alpha-fetoprotein were within normal limits. Radiologic investigations revealed a mass in the pancreas with vascular invasion. After surgical resection, postoperative chemotherapy included cisplatin, doxorubicin, ifosfamide, and etoposide. They have now been well for 7 years without recurrence.
Journal of Pediatric Hematology/Oncology 01/2008; 29(12):845-7. · 1.16 Impact Factor
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Korean Journal of Pediatrics 01/2008; 51(2):156.
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ABSTRACT: Solid pseudopapillary tumor (SPT) is rare primary tumor of the pancreas with low malignant potential affecting adolescent or young women. Radical surgical resection is the definitive treatment for long-term survival even in the patients with metastases. We report a case of 14-year-old girl who presented with unresectable SPT of the pancreas. She received preoperative chemotherapy with cisplatinum, ifosfamide, etoposide, and vincristine followed by intraoperative radiofrequency ablation of metastatic liver lesions with surgical resection of the primary tumor successfully. We demonstrate that all attempts should be made to resect or ablate the primary as well as the metastatic lesions for long-term survival.
Journal of Pediatric Hematology/Oncology 01/2008; 29(12):851-3. · 1.16 Impact Factor
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Korean Journal of Pediatrics 08/2007; 50(8):774-780.
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ABSTRACT: Phorbol 12-myristate 13-acetate (PMA) is a protein kinase C (PKC) activator and tumor promoter that induces terminal differentiation in human myeloid leukemia cells. We undertook to characterize phorbol ester-activated PKC-mediated cell cycle arrest and apoptosis. In the present studies, we determined the effect of high intracellular levels of the anti-apoptosis Bcl-2 protein on caspase 3 activation and cyctochrome c release during phorbol ester 12-myristate 13-acetate (PMA)-induced apoptosis. For this, we used the U937 cells, Bcl-2 overexpressed U937 cells (U937/Bcl-2) and the PMA-resistant derivative cell line R-U937. The G1 arrest of U937 cells and U937/Bcl-2 cells induced by treatment with 20 nM PMA is associated with cyclin A down-regulation and accumulation of p21, cdks inhibitor. However, PMA had no effect on the levels of cyclin A expression and p21 expression under the same conditions of time and concentration of PMA in the R-U937 cells. Treatment with 20 nM PMA for 24 h produced morphological features of apoptosis and DNA fragmentation in U937 and U937/Bcl-2 cells, but not in R-U937 cells. This was associated with the caspase 3 activation and cyctochrome c release. R-U937 cells exhibited less cytochrome c release and sustained phosphorylation level of Akt during PMA-induced apoptosis. These findings indicate that R-U937 cells are resistant to PMA-induced apoptosis by a mechanism of the signaling defect in the activation of the caspase 3 that is involved in the execution of apoptosis.
International Journal of Oncology 06/2003; 22(5):1111-6. · 2.40 Impact Factor
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Kyung Ha Ryu,
Hyo Seop Ahn,
Hong Hoe Koo,
Hoon Kook,
Moon Kyu Kim,
Hack Ki Kim,
Thad Ghim,
Hyung Nam Moon,
Jong Jin Seo,
Ki Woong Sung,
Hee Young Shin,
Eun Sun Yoo,
Chuhl Joo Lyu,
Young Ho Lee,
Hahng Lee,
Bin Cho,
Hyun Sang Cho,
Hyung Soo Choi, Jeong Ok Hah,
Tai Ju Hwang
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ABSTRACT: Autologous stem cell transplantation (ASCT) for the treatment of high-risk neuroblastoma (NBL) is an accepted method for restoring bone marrow depression after high dose chemotherapy. We retrospectively analyzed eighty eight cases of NBL that underwent ASCT following marrow ablative therapy at 12 transplant centers of the Korean Society of Pediatric Hematology-Oncology between January 1996 and September 2000. Seventy nine children were of stage IV NBL and 9 were of stage III with N-myc amplification. Various cytoreductive regimens were used. However, the main regimen was 'CEM' consisting of carboplatin, etoposide and melphalan, and this was used in 66 patients. Total body irradiation was also added in 36 patients for myeloablation. To reduce tumor cell contamination, stem cell infusions after CD34+ cell selection were performed in 16 patients. Post-transplantation therapies included the second transplantation in 18 patients, interleukin2 therapy in 45, 13-cis retinoic acid in 40, 131-meta-iodobenzylguanidine in 4, conventional chemotherapy in 11, and local radiotherapy in 8. Twenty two patients died, sixty six patients are surviving 1 to 46 months after ASCT (median followup duration, 14.5 months). Although the follow-up period was short and the number of patients small, we believe that ASCT might improve the survival rate in high-risk NBL.
Journal of Korean Medical Science 05/2003; 18(2):242-7. · 0.99 Impact Factor
