Alan K S Chiang

Alan K S Chiang
The University of Hong Kong | HKU · Department of Paediatrics and Adolescent Medicine

MBChB, PhD

About

191
Publications
25,418
Reads
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4,110
Citations
Introduction
Specialised in Paediatric Haematology and Oncology. Clinical expertise in non-Hodgkin lymphoma. Research in Epstein-Barr virus associated lymphoproliferative diseases and epithelial cancers.
Additional affiliations
August 2000 - present
The University of Hong Kong
Position
  • Professor (Associate)
Description
  • Clinical teaching and lectures; undergraduate and postgraduate science and medical students; mentor MPhil, PhD and postdoctoral fellows; train clinical residents and fellows
May 1998 - present
The University of Hong Kong
Position
  • Professor (Associate)

Publications

Publications (191)
Preprint
Jejunal feeding is increasingly utilized in the pediatric population to reduce gastroesophageal reflux or aspiration pneumonia. We describe a pediatric patient who developed persistent neutropenia and anemia secondary to copper deficiency after more than one year of exclusive jejunal feeding. Bone marrow aspiration and trephine biopsy showed vacuol...
Article
Full-text available
Background Hematopoietic stem cell transplantation, despite being a curative treatment for various pediatric disorders, is associated with significant acute and chronic complications. Methods This retrospective review of 196 hematopoietic stem cell transplantation episodes (144 allogeneic, 52 autologous) performed in a tertiary pediatric unit focu...
Article
Full-text available
Asparaginase is an important drug to treat childhood haematological malignancies. Data on the association between human leukocyte antigens (HLA) and asparaginase hypersensitivity among Chinese are lacking. We conducted a retrospective study to identify HLA alleles associated with asparaginase hypersensitivity among Chinese children with acute lymph...
Article
Full-text available
Non-tuberculous mycobacterial (NTM) infection is uncommon yet clinically significant as it could cause severe morbidity and mortality. This study reviewed all paediatric patients under 20 years of age diagnosed to have NTM infection in Queen Mary Hospital during 1 January 1999 to 30 June 2018. Total 7 patients were identified with median age of dia...
Article
PURPOSE A dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine and prednisone plus rituximab (DA-EPOCH-R) regimen has been shown to deliver excellent survival for adults with primary mediastinal large B-cell lymphoma (PMLBL) without the use of radiotherapy. No international prospective evaluation of this regimen has previousl...
Article
Full-text available
Purpose: Children with mediastinal masses often present with insidious symptoms to nonspecialist centers and require interhospital transport to oncology centers for definitive care. We evaluated clinical characteristics and patient outcomes and proposed a management protocol. Materials and methods: This is a retrospective review of all children...
Conference Paper
p>The reactivation of lytic cycle of Epstein-Barr Virus (EBV) is an important component of the emerging lytic induction therapy to specifically target the virus in EBV-associated malignancies. The potency of the lytic induction is central to the effectiveness of the lytic induction therapy. It is hampered by cancer cells that are refractory to lyti...
Article
Germline adenomatous polyposis coli (APC) gene mutation is a cancer-predisposing condition commonly presenting as familial adenomatous polyposis. We describe a patient first diagnosed at the age of 3 years with metastatic hepatoblastoma. With a positive family history, germline testing confirmed maternally inherited APC mutation (p.Thr899Ansfs*13)....
Article
Full-text available
Despite poor survival, controversies remain in the treatment for refractory or relapsed pediatric non-Hodgkin lymphoma (r/r NHL). The current project aimed to collect international experience on the re-induction treatment of r/r NHL, hematopoietic stem cell transplantation (HSCT), risk factors associated with outcome, and to suggest treatment recom...
Article
Primary central nervous system (CNS) post‐transplant lymphoproliferative disorder (PTLD) in childhood is rare. Twenty‐five patients were retrieved from nine European Intergroup for Childhood Non‐Hodgkin’s Lymphoma and/or international Berlin–Frankfurt–Münster Study Group members. Types of allografts included kidney (n = 11), liver (n = 4), heart (n...
Article
Full-text available
In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monit...
Preprint
Full-text available
In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monit...
Article
Full-text available
Data on the spectrum of second malignant neoplasms (SMNs) after primary childhood non-Hodgkin’s lymphoma (NHL) are scarce. One-hundred-and-eighty-nine NHL patients diagnosed in a 30 years period of 1980–2010 developing an SMN were retrieved from 19 members of the European Intergroup for Childhood NHL and/or the international Berlin-Frankfurt-Münste...
Preprint
Full-text available
the PDF can be download freely on pubmed. https://pubmed.ncbi.nlm.nih.gov/33634751/
Article
Full-text available
In 2008, we published the first set of guidelines for standardizing research in autophagy. Since then, this topic has received increasing attention, and many scientists have entered the field. Our knowledge base and relevant new technologies have also been expanding. Thus, it is important to formulate on a regular basis updated guidelines for monit...
Article
Full-text available
Allogeneic hematopoietic stem cell transplantation is curative for transfusion-dependent thalassemia, but mixed chimerism (MC) may herald graft rejection. We report a child who failed bone marrow transplant (BMT) from matched unrelated donor (MUD) successfully salvaged with haploidentical peripheral blood stem cell transplant (PBSCT), but had MC in...
Article
Epstein-Barr virus (EBV) is strongly associated with lymphoproliferative diseases (LPDs), in particular B cell, in both immunocompetent and immunocompromised hosts. The virus is able to manipulate host cell machineries such as the ubiquitin-proteasome system and regulators of Bcl-2 family to enable the persistence of the virus and the survival of t...
Article
Full-text available
Background: Hepatocellular carcinoma (HCC) is a rare hepatic malignancy in children. HBV infection is a key predisposing factor in endemic regions but its impact on outcome has not been studied. We aim to evaluate the prognostic implication of HBV seropositivity and role of cancer surveillance in children with HCC from East Asian populations with n...
Article
Full-text available
Epstein–Barr virus (EBV) lytic induction therapy is an emerging virus-targeted therapeutic approach that exploits the presence of EBV in tumor cells to confer specific killing effects against EBV-associated malignancies. Efforts have been made in the past years to uncover the mechanisms of EBV latent-lytic switch and discover different classes of c...
Article
Full-text available
HIV and EBV are human pathogens that cause a considerable burden to worldwide health. In combination, these viruses are linked to AIDS-associated lymphomas. We found that EBV, which transforms B cells, renders them susceptible to HIV-1 infection in a CXCR4 and CD4-dependent manner in vitro and that CXCR4-tropic HIV-1 integrates into the genome of t...
Article
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Background Rituximab added to chemotherapy prolongs survival among adults with B-cell cancer. Data on its efficacy and safety in children with high-grade, mature B-cell non-Hodgkin’s lymphoma are limited. Methods We conducted an open-label, international, randomized, phase 3 trial involving patients younger than 18 years of age with high-risk, mat...
Article
Full-text available
Post-transplant lymphoproliferative disorder (PTLD) is a rare but potentially life-threatening complication, frequently associated with Epstein-Barr virus (EBV), which develops after solid organ or stem cell transplantation. Immunosuppression received by transplant recipients has a significant impact on the development of PTLD by suppressing the fu...
Article
Full-text available
Post-transplant lymphoproliferative disorder (PTLD) is a potentially fatal complication after organ transplantation frequently associated with the Epstein-Barr virus (EBV). Immunosuppressive treatment is thought to allow the expansion of EBV-infected B cells, which often express all eight oncogenic EBV latent proteins. Here, we assessed whether HLA...
Article
Full-text available
Key Points Children with PCNSL and no immunodeficiency have a good outcome when treated by a histological subtype–driven and radiation-free protocol. New treatment guidelines are needed for PCNSL in children and adolescents with an underlying immunodeficiency.
Article
Full-text available
Epstein–Barr nuclear antigen 1 (EBNA1) plays a vital role in the maintenance of the viral genome and is the only viral protein expressed in nearly all forms of Epstein–Barr virus (EBV) latency and EBV-associated diseases, including numerous cancer types. To our knowledge, no specific agent against EBV genes or proteins has been established to targe...
Article
Full-text available
Autophagy, a conserved cellular mechanism, is manipulated by a number of viruses for different purposes. We previously demonstrated that an iron-chelator-like small compound, C7, reactivates Epstein-Barr virus (EBV) lytic cycle by activating the ERK1/2-autophagy axis in epithelial cancers. Here, we aim to identify the specific stage of autophagy re...
Article
Full-text available
Blastic plasmacytoid dendritic cell neoplasm is an uncommon aggressive haemato-lymphoid neoplasm derived from type 2 dendritic cells which occur mainly in adults and elderly. It usually manifests as cutaneous lesions on face, scalp, trunk or limbs. In this report, we describe a 6-year old girl with unusual presentation of septic shock and perianal...
Conference Paper
Pharmaceutical reactivation of lytic cycle of Epstein-Barr virus (EBV) represents a potential therapeutic strategy against EBV-associated epithelial malignancies e.g. gastric carcinoma (GC) and nasopharyngeal carcinoma (NPC). A novel lytic inducing compound, C7, which exhibits structural similarity to Dp44mT, a known chelator of intracellular iron,...
Conference Paper
Pharmaceutical reactivation of lytic cycle of Epstein-Barr virus (EBV) represents a potential therapeutic strategy against EBV-associated epithelial malignancies e.g. gastric carcinoma (GC) and nasopharyngeal carcinoma (NPC). A novel lytic inducing compound, C7, which exhibits structural similarity to Dp44mT, a known chelator of intracellular iron,...
Article
Full-text available
We report the first case of microabscesses detected by polymerase chain reaction (PCR) amplification of nucleic acid from ultrasound-guided aspirated fluid in a three-year old boy with acute lymphoblastic leukemia and febrile neutropenia during induction chemotherapy. Fever persisted despite effective antifungal treatment. The addition of corticost...
Article
Full-text available
Epstein-Barr virus (EBV) is strongly associated with a spectrum of EBV-associated lymphoproliferative diseases (EBV-LPDs) ranging from post-transplant lymphoproliferative disorder, B cell lymphomas (e.g., endemic Burkitt lymphoma, Hodgkin lymphoma, and diffuse large B cell lymphoma) to NK or T cell lymphoma (e.g., nasal NK/T-cell lymphoma). The vir...
Chapter
Nasopharyngeal carcinoma (NPC) is an Epstein–Barr-associated malignancy. Both the host and viral factors are known to contribute to the oncogenic development of NPC. NPC has a wide mutational diversity and many signaling pathways are known to be activated in the tumor cells. However, molecularly targeted therapeutic agents licensed for the treatmen...
Article
Full-text available
Pharmaceutical reactivation of lytic cycle of Epstein–Barr virus (EBV) represents a potential therapeutic strategy against EBV-associated epithelial malignancies, e.g., gastric carcinoma (GC) and nasopharyngeal carcinoma (NPC). A novel lytic-inducing compound, C7, which exhibits structural similarity to Di-2-Pyridyl Ketone 4, 4-Dimethyl-3-Thiosemic...
Article
Full-text available
Whether certain variants of Epstein‐Barr virus (EBV) are linked to the pathogenesis of nasopharyngeal carcinoma (NPC), which shows a marked geographic restriction, remains an unresolved issue. We performed a case‐control study comparing genomic sequences of EBV isolated from saliva samples of 142 population carriers with those from primary tumour b...
Poster
Full-text available
4-year old girl with acute myeloid leukaemia (AML) t(8,21) CNS-positive disease developed prolonged neutropenic fever without obvious focus despite broad spectrum anti-bacterials and anti-fungals, later found to have right lower limb pain. She was confirmed to have right calcaneal osteomyelitis due to Mycobacterium abscessus with subcutaneous absce...
Article
The survival rates of childhood cancers have increased significantly in recent years, and the long-term complications of childhood cancers have become an important issue. Although communication and hearing complications have been documented in survivors, they have not been widely investigated across different types of cancer. Therefore, we conducte...
Article
Full-text available
The lack of representative nasopharyngeal carcinoma (NPC) models has seriously hampered research on EBV carcinogenesis and preclinical studies in NPC. Here we report the successful growth of five NPC patient-derived xenografts (PDXs) from fifty-eight attempts of transplantation of NPC specimens into NOD/SCID mice. The take rates for primary and rec...
Article
1 Background and aim We reviewed the results and pattern of failure of the consensus HB/HCC 1996 treatment protocol for pediatric hepatoblastoma (HB) in Hong Kong. The role of SIOPEL and Children's Hepatic tumors International Collaboration (CHIC) risk stratification was evaluated. 2 Methods Patients enrolled on the protocol from 1996 to 2014 were...
Conference Paper
Full-text available
BACKGROUND An 8-year old girl initially presented with petechiae for 6 months and hepatomegaly of 2 centimeters. Investigations showed platelet count of 25x109/L, haemoglobin level of 11g/dL and serial absolute neutrophil counts (ANC) around 0.7 to 1.2 x109/L. Bone marrow aspiration (BMA) and trephine showed active trilineage haematopoiesis. Intrav...
Article
1 Objective The aim of this study was to review clinical outcomes and prognosis of paediatric patients with acute lymphoblastic leukaemia (ALL) with TCF3‐PBX1 rearrangement. 2 Patients All children in Hong Kong diagnosed with ALL with TCF3‐PBX1 rearrangement over the past two decades were included. 3 Methods Six hundred and twenty‐four newly diag...
Article
Relapsed/refractory NB carries a bleak outcome, warranting novel treatment options. HaploHSCT induces a graft‐versus‐NB effect via natural killer cell alloreactivity. Review of patients with relapsed/refractory NB who underwent haploHSCT with ex vivo T‐cell depletion in our unit from 2013 through 2018. Ten patients were identified (male=5; median a...
Article
Full-text available
Combination of suberoylanilide hydroxamic acid (SAHA) and bortezomib (SAHA/ bortezomib) was shown to synergistically induce killing of lymphoblastoid cell lines (LCL) and Burkitt lymphoma (BL) of type III or Wp-restricted latency, both of which express EBNA3A, -3B and -3C proteins. We hypothesize that SAHA/bortezomib can counteract the survival fun...
Article
Full-text available
Long term carriers were shown to generate robust polyfunctional T cell (PFC) responses against lytic and latent antigens of Epstein-Barr virus (EBV). However, the time of emergence of PFC responses against EBV antigens, pattern of immunodominance and difference between CD4+ and CD8+ T cell responses during various stages of EBV infection are not cl...
Article
Full-text available
Epstein-Barr virus (EBV) is closely associated with several lymphomas (endemic Burkitt lymphoma, Hodgkin lymphoma and nasal NK/T-cell lymphoma) and epithelial cancers (nasopharyngeal carcinoma and gastric carcinoma). To maintain its persistence in the host cells, the virus manipulates the ubiquitin-proteasome system to regulate viral lytic reactiva...
Article
Currently, out of the 82 US FDA-approved targeted therapies for adult cancer treatments, only three are approved for use in children irrespective of their genomic status. Apart from leukemia, only a handful of genomic-based trials involving children with solid tumors are ongoing. Emerging genomic data for pediatric solid tumors may facilitate the d...
Article
A total of 16 cases of congenital fibrosarcoma have been reported from 1975 to March 2015. Five of the 16 had abnormal fusion between erythroblast transformation specific translocation variant 6 and neurotrophin recptor gene neurotrophic tyrosine kinase, receptor, type 3 (ETV6-NTRK3); in another five out of 16 this was absent, and six were not test...
Article
Full-text available
Background: Tumour lysis syndrome (TLS) is a serious complication of malignancies and can result in renal failure or death. Previous reviews did not find clear evidence of benefit of urate oxidase in children with cancer. This review is the second update of a previously published Cochrane review. Objectives: To assess the effects and safety of u...
Article
Full-text available
Epstein-Barr Virus (EBV) latent infection is a causative co-factor for endemic Nasopharyngeal Carcinoma (NPC). NPC-associated variants have been identified in EBV-encoded nuclear antigen EBNA1. Here, we solve the X-ray crystal structure of an NPC-derived EBNA1 DNA binding domain (DBD) and show that variant amino acids are found on the surface away...
Chapter
This is a protocol for a Cochrane Review (Intervention). The objectives are as follows: We aimed to determine the effects of various treatments for hepatic VOD on overall survival, mortality, quality of life and safety in patients undergoing HSCT. © 2016 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.