Positive direct antiglobulin test in a pediatric patient following high-dose cisplatin.

A positive direct antiglobulin test (DAT) and hemolytic anemia are uncommon side effect of cisplatin (CDDP) therapy. A 9-year-old girl treated for extraosseus Ewing's sarcoma with a multiagent regimen, including 200 mg/m2 CDDP preceded by vincristine (VCR) and cyclophosphamide (CY), developed a positive DAT, followed by hemolytic anemia. When CDDP therapy was discontinued, the DAT became negative and no signs of anemia were observed during the maintenance treatment, which included VCR and actinomycin D.

[Total body irradiation, vincristine in continuous infusion and high-dose melphalan with transplant of autologous bone marrow in the treatment of neuroblastoma].

High dose chemo-radiotherapy followed by autologous bone marrow transplantation (ABMT) is known to be an effective treatment in stage IV neuroblastoma (NB). Since October '84, 19 children with NB (12 relapsed or resistant: Group A; 7 in first CR: Group B) received ablative therapy (AT) consisting of VCR (4 mg/mg), L-PAM (140 mg/mg) and fractionated TBI (1000 Rads). Induction strategy at diagnosis or at relapse included high dose Peptichemio, 2-3 cycles of Vincristine-Cyclophosphamide--high dose Platinum and surgery.