Is Mixed Chimerism Post-allogeneic Hematopoietic Stem Cell Transplantation in Pediatric Acute Lymphoid Leukemia a Prognostic Factor for Relapse?

Hematopoietic stem cell transplantation (HSCT) has been considered curative for children with high-risk acute leukemia (ALL), offering better survival. Short tandem repeat has been used as a marker of chimerism status after HSCT. The appearance of recipient cells >1% post-allogeneic stem cell transplant is defined as mixed chimerism (MC).

Physicians' Knowledge, Attitudes, and Perception Toward Pediatric Palliative Care in Saudi Arabia: A National Exploratory Survey.

Background: Pediatric palliative care (PPC) helps maintain the quality of life for both children and their families. It has been identified as an important goal within the global health agenda. In Saudi Arabia, the discipline remains in its infancy, as illustrated by the absence of PPC programs in academic and health care institutions.

Addressing 10 Myths About Pediatric Palliative Care.

With advances in biomedical sciences, a growing number of conditions affecting children have evolved from being considered life-limiting to almost chronic diseases. However, improvements in survival rates often come at a cost of increased medical complexity and lengthy hospitalizations, which can be associated with a poorer quality of life. This is where pediatric palliative care (PPC) can play a significant role.

Outcomes of blood and marrow transplantation in children less than 2-years of age: 23 years of experience at a single center.

Objectives: Allogeneic hematopoietic cell transplantation (Allo-HCT) is a curative option for children with various malignant and non-malignant diseases. Most reports studied all age groups amongst children. Herein we analyzed our data in children transplanted at or less than 2-years of age.

Clofarabine in Pediatric Acute Relapsed or Refractory Leukemia: Where Do We Stand on the Bridge to Hematopoietic Stem Cell Transplantation?

Background: Despite pronounced improvement in overall survival (OS) in pediatric leukemia, a proportion of patients continue to suffer from lack of response or relapse, and the management of such patients is exceedingly difficult. Immunotherapy and engineered chimeric antigen receptor (CAR) T-cell therapy have shown promising results in the course of relapsed or refractory acute lymphoblastic leukemia (ALL). However, conventional chemotherapy continues to be utilized for re-induction purposes whether independently or in combination with immunotherapy.

Can the bone marrow harvest volume be reduced safely in hematopoietic stem cell transplantation with pediatric sibling donors?

Background: Reduced harvest volumes in pediatric donors appear to have the potential to reduce donor-associated risks while maintaining engraftment in recipients; however, the allowable harvest volume reduction remains undefined.

Methods: We retrospectively analyzed the data pairs of 553 bone marrow (BM) harvests from pediatric (age at harvest <18 yr) sibling donors and clinical outcomes of 553 pediatric (age at infusion <14 yr) transplant-naïve recipients to assess the optimal BM harvest volume needed from pediatric donors to obtain the desired CD34+ cell count (≥3.0×10 cells per kg of recipient weight), and to study its impact on the clinical outcomes of transplantation in pediatric recipients.

Orbital relapse in children treated for Pre-B ALL, a retrospective case series.

About 85-90% of children with B-cell leukaemia are cured. If relapse occurs it is usually in the bone marrow (BM), followed by extramedullary sites. Ocular lesions occur secondary to the accumulation of circulating blasts in the uvea, optic disc, intra-ocular tissue as well as fluid.

Pediatric high risk neuroblastoma with autologous stem cell transplant - 20 years of experience.

Background And Objective: Neuroblastoma is the most common extracranial solid tumor found in pediatric patients. High-risk neuroblastoma (HR-NBL) can be characterized by metastasis, age, and other tumor characteristics that result in an adverse outlook for this patient cohort. The standard of care includes induction chemotherapy, surgery, followed by stem cell autologous transplant (ASCT), and later, antidisialoganglioside (anti-GD2) antibodies.

Does Mixed Chimerism After Allogeneic Hematopoietic Cell Transplantation in Pediatric Patients With Fanconi Anemia Impact on Outcome?

Fanconi anemia (FA) cells are characterized by genomic instability, which places FA patients at risk for malignancies such as leukemia and oropharyngeal/urogenital cancers. The risk of development of leukemia is theoretically eliminated after hematopoietic cell transplantation (HCT). Mixed chimerism (MC) in FA patients might have a unique implication because the persistent existence of FA cells might give rise to a malignant clone.

Frequency of Infectious Mortality at the End of Induction Chemotherapy in Acute Lymphoblastic Leukemia and Lymphoma Patients: Findings From a Tertiary Care Cancer Center.

Background and objective In low- and low-to-middle-income countries (LMICs), the incidence of treatment-related mortality (TRM) in patients with acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma (LBL) is up to 52%. This study aimed to determine the mortality rate at the end of the induction phase of the treatment among patients with ALL and lymphoma at a tertiary care cancer center. Methods This retrospective study analyzed outcomes after induction chemotherapy in pediatric patients with acute leukemia and lymphoma at a tertiary care cancer center from January 2015 to December 2016.

Feasibility of Compressed Chemotherapy Pediatric Ewing Sarcoma Regimen In Pakistan.

A retrospective chart review was conducted to determine the feasibility of interval-compressed chemotherapy regimen in pediatric Ewing sarcoma (ES) patients treated at Department of Pediatric Oncology, Shaukat Khanum Memorial Trust Cancer Hospital, Lahore, Pakistan, from June 2017 to December 2018. Data was collected regarding demographics, treatment duration and timing, complications and outcome. Completion of treatment within 8 months as considered on time.

Outcomes of Advanced Retinoblastoma Treated with Local Salvage Treatment; a Retrospective Case Series.

Introduction: Retinoblastoma (RB) is the most common intraocular malignancy arising from the developing retina and occurs in approximately one of every 15,000-20,000 births. With the introduction of the intra-arterial chemotherapy (IAC), the 5-year overall survival of children with RB is 99%, though in low- and middle-income countries, it rarely exceeds 35% due to limited resources and lack of expertise. The aim of this study was to determine the outcome of local salvage in advanced RB.

Outcomes of Refractory and Relapsed Hodgkin Lymphoma With Autologous Stem-Cell Transplantation: A Single Institution Experience.

Purpose: Hodgkin lymphoma is the most common cancer in children, adolescents, and young adults. Overall survival is approximately 80% to 90%. A subset of these patients has refractory disease or experience disease relapse.

Pediatric Cancer Outcomes in an Intensive Care Unit in Pakistan.

Purpose: Although cancer is uncommon, it is a significant cause of pediatric morbidity and mortality in the developing world. The need for intensive care in pediatric oncology has increased with more intense chemotherapeutic interventions. It is important to identify patients who will benefit from management in the intensive care unit (ICU), given the resource limitation in developing countries.

I-131 mIBG Scintigraphy Curie Versus SIOPEN Scoring: Prognostic Value in Stage 4 Neuroblastoma.

Objective: I-131 mIBG scan semi-quantitative analysis with modified Curie and the International Society of Pediatric Oncology Europe Neuroblastoma (SIOPEN) scoring systems is helpful in the evaluation of disease extent and has prognostic impact in stage 4 neuroblastoma.

Methods: Retrospective, cross-sectional analysis of baseline I-131 mIBG scans in 21 patients with stage 4 or 4S neuroblastoma diagnosed between January 2007 and December 2015. All scans were assessed for Curie and SIOPEN scores.

Posterior Reversible Encephalopathy Syndrome in Pediatric Cancer: Clinical and Radiologic Findings.

Purpose: Posterior reversible encephalopathy syndrome (PRES) is associated with a range of medical conditions and medications. In this retrospective analysis, we present 19 pediatric patients with PRES who had undergone chemotherapy.

Methods: We identified four female and 15 male patients diagnosed with PRES on the basis of clinical and radiologic features.

Radiotherapy Outcome for Pediatric Pelvic Ewing Sarcoma.

Objective: To evaluate the outcomes of patients undergoing radiotherapy for primary local control of pelvic ewing sarcoma (ES).

Study Design: Case series.

Place And Duration Of Study: Shaukat Khanum Memorial Cancer Hospital, Lahore, from January 2010 to October 2015.

Bone Marrow Involvement in Metastatic Pediatric Ewing Sarcoma.

Objective: To evaluate the frequency of bone marrow involvement with metastatic lung and bone sites in newly-diagnosed pediatric patients with Ewing sarcoma (ES).

Study Design: An observational study.

Place And Duration Of Study: Shaukat Khanum Memorial Cancer Hospital, Lahore, Pakistan, from January 2010 to October 2015.

Students, stress and coping strategies: a case of Pakistani medical school.

Objective: Assess the perception of stress amongst medical students and their coping strategies. METHODOLOGY/STUDY DESIGN: A cross sectional study using a semi-structured self administered questionnaire was carried out over four weeks, using a small sample of students of all categories and classes of a medical college.

Results: A total of 264 students out of 300 (88%) filled in the questionnaire.