Initiation of Haploidentical Stem Cell Transplantation With Post-Transplant Cyclophosphamide in Children: A Low-Middle-Income Country Institutional Experience.

Background: Haploidentical hematopoietic stem cell transplant (HSCT) is a curative treatment especially for countries where bone marrow registries are nonexistent. We present our experience with haploidentical HSCT in pediatric patients.

Methods: Retrospective data collected and analyzed for patients ≤18 years, from January 2017 to December 2022.

Paediatric oncology in the Eastern Mediterranean region (EMR): the current state and challenges.

The WHO Eastern Mediterranean region (EMR) is characterised by highly economically diverse countries, with healthcare systems in various phases of development. Childhood cancer care provision also ranges from that provided in centres able to deliver sophisticated therapy resulting in outcomes comparable to those seen in highly developed nations, to countries with no provision for care of children with cancer. At 10·1 per 100,000 children at risk, the age standardised incidence-rate for cancer in children below 14 years of age is relatively low but may be consequent to poor registration.

Effectiveness of levofloxacin in the induction of chemotherapy in high-risk acute lymphoblastic leukaemia in children in a developing country.

Background: Infections significantly predominate during induction chemotherapy for acute lymphoblastic leukaemia (ALL) in children. Antibacterial prophylaxis is one strategy that lowers the risk of these infections. This study evaluates the role of levofloxacin prophylaxis on the frequency of infections, febrile neutropenia (FN) and outcomes associated with it along with the development of drug-resistance.

Pediatric oncology infrastructure and workforce training needs: A report from the Pediatric Oncology East and Mediterranean (POEM) Group.

Background: Inadequate numbers of trained health care providers (HCPs) contribute to poor pediatric oncology (PO) outcomes, particularly in low- and lower middle-income countries (L/LMICs). An understanding of the characteristics of the workforce challenges is vital for addressing these problems.

Methods: The Pediatric Oncology East and Mediterranean (POEM) Group surveyed PO centers in countries of North Africa, Middle East, Central Asia, and Indian subcontinent on infrastructure and workforce capacity, service availability, and training opportunities for HCPs.

Evaluation of Baseline Cardiac Function by Echocardiography and its Association With Nutritional Status in Pediatric Cancer Patients at The Indus Hospital in Karachi, Pakistan.

Introduction: Evidence on conducting baseline echocardiogram before starting chemotherapy in pediatric cancer patients is limited from developing countries where malnutrition and infections are common and which may result in cardiac dysfunction.

Materials And Methods: A prospective, observational study was conducted from October 2016 to May 2017 at The Indus Hospital, Karachi, Pakistan, among children 1 to 16 years of age suffering from cancer. Echocardiography was performed before starting chemotherapy.

Incidence, clinical distribution, and patient characteristics of childhood cancer in Saudi Arabia: A population-based analysis.

Purpose: Information regarding the incidence and patterns of childhood malignancies is disproportionately overrepresented by high-income countries, representing mainly the Caucasian population. There is a need to evaluate and disseminate information for other ethnicities, particularly from the Middle East.

Methods: Data from the National Cancer Registry, Saudi Arabia (SA-NCR), for pediatric patients (age 0-14 years) diagnosed between 2005 and 2009 and for similar patients at our institution during the same period were analyzed.

Predictors of treatment abandonment for patients with pediatric cancer at Indus Children Cancer Hospital, Karachi, Pakistan.

Background: Abandonment of treatment is one of the toughest challenges to deal with in pediatric oncology. It leads to unnecessary mortality and morbidity in patients from low- and middle-income countries.

Procedure: The objective of our retrospective study was to determine the prevalence and predictors for abandonment among children with cancer at our hospital in Karachi, Pakistan.

Risk-adapted stratification for optimally intensive treatment assignment of pediatric patients with non-Hodgkin lymphoma is an effective strategy in developing countries.

Background: Pediatric patients with non-Hodgkin lymphoma (NHL) in developing countries (DCs) present with greater tumor load even at lower stages and with comorbidities that impact therapy delivery. This causes toxic mortality with "standard" intensive protocols or recurrences with "gentler" treatment.

Objectives: We developed and evaluated a risk stratification schema that guides intensity of therapy.

The Impact of Socioeconomic Factors on the Outcome of Childhood Acute Lymphoblastic Leukemia (ALL) Treatment in a Low/Middle Income Country (LMIC).

Survival for childhood acute lymphoblastic leukemia (ALL) has improved significantly, but these benefits may not be available to many children from low and middle income countries, where reasons for treatment failure may be unique to their environment. We retrospectively reviewed data on pediatric (1 to 18 y or younger) patients with newly diagnosed ALL treated over 5 years at a children's cancer hospital in Pakistan. Patients were treated with modified Berlin-Frankfurt-Muenster -based therapy without risk stratification.

Chimerism Analysis of Cell-Free DNA in Patients Treated with Hematopoietic Stem Cell Transplantation May Predict Early Relapse in Patients with Hematologic Malignancies.

Background. We studied DNA chimerism in cell-free DNA (cfDNA) in patients treated with HSCT. Methods.

Outcome of pediatric patients with lymphoma following stem cell transplant: a single institution report.

Hematopoietic stem cell transplant (HSCT) is recommended for pediatric patients with relapsed/refractory lymphoma even though the evidence for this is limited. We retrospectively reviewed records of 57 patients (29 Hodgkin lymphoma [HL], 28 non-Hodgkin lymphoma [NHL]) who underwent HSCT between 1995 and 2012. All demonstrated chemoresponsiveness prior to HSCT and 44 patients had a complete response.

Clinical characteristics and treatment outcome of childhood acute lymphoblastic leukemia in Saudi Arabia: a multi-institutional retrospective national collaborative study.

Background: Treatment of childhood acute lymphoblastic leukemia (ALL) has been available in Saudi Arabia (SA) for over 30 years; however, only limited data have been published from there. This study was conducted to establish processes for collaborative data collection and provide clinical characteristics and outcome of children with ALL in SA.

Procedure: Clinical data for patients diagnosed from 2004 to 2008 were retrospectively collected at eight institutions and entered remotely into a custom-built database.

Pediatric Hodgkin's lymphoma: changing concepts and moving points in radiation therapy.

The classic treatment of Hodgkin's lymphoma (HL) in children resulted in significant late toxicity in long-term survivors. Late treatment effects included skeletal, cardio- pulmonary, gonadal toxicities, and second malignant tumor (SMN). This has driven pediatric HL groups to adopt treatment strategies using less intense chemotherapy, less alkylating agents, reduced radiation dose and volume, and omission of radiation therapy in selected group of patients.

Outcome of risk adapted therapy for relapsed/refractory acute lymphoblastic leukemia in children.

Results of second-line therapy for childhood acute lymphoblastic leukemia (ALL) remain suboptimal, particularly for high-risk groups identified using timing and site of relapse. We report results of prospectively collected data for pediatric patients with ALL who received risk adjusted second-line therapy. The 59 patients who failed first-line ALL therapy included 36 (61%) with bone marrow (BM), 13 (22.

Clinical characteristics and treatment outcome of pediatric patients with chronic myeloid leukemia.

As chronic myeloid leukemia is rare in children, most data on imatinib mesylate therapy is derived from adult studies. We retrospectively evaluated pediatric (<14 years) patients with Ph+ chronic myeloid leukemia treated with imatinib mesylate, from January 2003 through June 2008. Of the 12 chronic myeloid leukemia patients (2% of all leukemias) 11 were in chronic phase while one had myeloid blast crisis.

Megakaryocytic blast crisis at presentation in a pediatric patient with chronic myeloid leukemia.

Patients with chronic myeloid leukemia (CML) infrequently present in blast crisis (BC). While most BC are of myeloid origin, megakaryocytic BC is rare, especially at the time of CML diagnosis. We describe the first pediatric patient presenting with megakaryocytic leukemia and having BCR-ABL1 translocation as the single chromosomal abnormality.

Hodgkin's lymphoma in the young child.

Primarily a disease of adults, Hodgkin's lymphoma (HL) contributes significantly to pediatric malignant diseases, particularly in developing countries where the incidence is higher. The treatment has evolved and now most patients are treated with chemotherapy; the optimal use additional radiation therapy (XRT) is being questioned, and it is likely that XRT will be reserved for a subset of higher risk patients. Patients with advanced disease have lower outcomes, which have improved with chemotherapy intensification.

Clinical characteristics and outcome of children with biphenotypic acute leukemia.

Background: Knowledge concerning the clinical and biological presentation, as well as the outcome of treatment, of biphenotypic acute leukemia in children is limited.

Design And Methods: This retrospective review analyzes the clinical features and outcome of children with biphenotypic acute leukemia diagnosed and treated over an 8-year period. According to the EGIL scoring system 24 (3.

Precursor B-cell lymphoblastic lymphoma (PBLL) in children: pattern of presentation and outcome.

Purpose And Background: Precursor B-cell lymphoblastic lymphoma (PBLL) is a rare subtype of NHL seen primarily in children or young adults. There are approximately 100 immunophenotyped cases of PBLL; reported in the literature; most as single case reports or very small series. In this report, we describe patterns of presentation, and results of a retrospective study looking at patients with PBLL treated at KFSH and RC between 1993 and 2000.

Treatment of a clinically determined lower-risk stage III non-lymphoblastic Non-Hodgkin lymphoma with less intensive therapy does not impact negatively on outcome.

Stage III NHL was divided into lower-risk (LR) or high-risk (HR) groups. Results of treatment were retrospectively reviewed for patients between 1993 through 2000. An intensive multiagent protocol was used for IIIHR, and a CHOP-based, milder treatment for IIILR.

Cancer in Sotos syndrome: report of a patient with acute myelocytic leukemia and review of the literature.

Sotos syndrome is a rare congenital disorder that is associated with various malignancies, including acute lymphoblastic leukemia and lymphomas. The NSD1 gene haploinsufficiency is associated with this syndrome. The authors report a case of acute myeloid leukemia developing in a child with Sotos syndrome.

Favorable response to treatment of a child with T-cell-rich large B-cell lymphoma presenting with liver failure.

The authors describe the successful management of a child with T-cell-rich large B-cell lymphoma (TCRBCL) involving the lymph nodes and liver, causing severe hepatic dysfunction. After immunohistochemical confirmation of the diagnosis, the patient was treated initially with low-dose, non-hepatotoxic chemotherapy and irradiation to the porta hepatis. Chemotherapy was gradually escalated to intensified B cell-lymphoma treatment regimens (CHOP, CYVE, COPAdM) as liver function improved.

Dexamethasone-associated toxicity during induction chemotherapy for childhood acute lymphoblastic leukemia is augmented by concurrent use of daunomycin.

Background: The goals of the current study were to examine the incidence and severity of toxicity resulting from dexamethasone and prednisone during induction therapy for children with precursor B-cell acute lymphoblastic leukemia (ALL) and to determine whether the addition of daunomycin affected toxicity.

Methods: Medical records of patients with precursor B-cell ALL from January 1996 through June 2000 were reviewed retrospectively for toxicity during the 4-week induction phase and the 2 weeks after the induction phase.

Results: One hundred seventy-six patients age < 14 years were diagnosed with precursor B-cell ALL from January 1996 through June 2000.