A survey of pediatric malignancy in West Virginia.

The occurrence of malignancy in the pediatric age group is an uncommon but serious event. Since little data are available on the extent, nature or referral patterns of childhood cancer in West Virginia, we conducted a survey of 782 primary care physicians and 17 regional referral centers. The results showed that 249 cases of malignancy in the pediatric age group were reported and that 68% of children with newly diagnosed childhood malignancy were referred to institutions within West Virginia.

Curing children with leukemia in West Virginia.

Leukemia is the most common cancer in childhood with acute lymphoblastic leukemia (ALL) the most common subtype. While once uniformly fatal, today leukemia is a highly curable disease. To determine the outcomes of children with acute lymphoblastic leukemia in West Virginia, we performed a retrospective analysis of the results of treatment of children and adolescents with B-lineage ALL diagnosed between 2/86 and 1/91 and treated by the pediatric oncology teams at Morgantown or Charleston.

Phase II trial of mitoxantrone in acute lymphocytic leukemia of childhood. A Pediatric Oncology Group study.

Thirty children with refractory acute lymphocytic leukemia (ALL) were treated with mitoxantrone, 8 mg/m2/day, for 5 days. Three children received a second course of the drug 3 to 4 weeks later. All but two patients had received prior anthracycline therapy.

Aziridinylbenzoquinone (AZQ) in the treatment of recurrent pediatric brain and other malignant solid tumors. A Pediatric Oncology Group phase II study.

To assess the response rates and toxicity of AZQ in children with recurrent brain and other malignant solid tumors, a phase II study was implemented by the Pediatric Oncology Group. Eligible patients received AZQ 18 mg/M2/week i.v.

Chemotherapy of histiocytosis-X.

This article discusses the efficacy of various chemotherapeutic agents in the treatment of histiocytosis-X. Although these agents alone and in combination have improved the prognoses for children with histiocytosis-X, the need for more effective methods of treatment still exists.

Nongerminomatous malignant germ cell tumors in children. A review of 89 cases from the Pediatric Oncology Group, 1971-1984.

Clinical and morphologic features of 89 cases of childhood yolk sac tumor (YS) and embryonal carcinoma (EC) (29 associated with teratomas) submitted to the Rare Tumor Registry of the Southwest Oncology Group (1971-1979) or the Pediatric Oncology Group (1980-1984) between 1971 and 1984 were reviewed and submitted to statistical analysis. This review showed an improved survival for each 5-year period regardless of tumor site, no statistically significant difference between "pure" tumors and those mixed with other teratomatous components, no statistically significant difference between YS and EC in children, a better than reported prognosis for sacrococcygeal tumors occurring after the neonatal period, a particularly poor prognosis for neonatal "benign" sacrococcygeal teratomas resected without coccygectomy when they recur as YS, excellent survival for all testicular tumors regardless of age or the presence of EC, and the occurrence of mediastinal tumors in females.

Natural history of histiocytosis X: a Pediatric Oncology Group Study.

The best therapy for patients with histiocytosis X with disease involvement other than isolated bone lesions but without organ dysfunction is unclear. This retrospective study was undertaken to define the natural history of this group of patients. In 25 of the 92 studied patients, there was no progression of the disease after diagnosis.

Mitoxantrone in refractory acute leukemia in children: a phase I study.

Nine children with acute non-lymphocytic leukemia (ANLL), ages 16 months to 16 years (median 7 years), and 15 children with acute lymphocytic leukemia (ALL), ages 10 months to 18 years (median 5 years), were treated with 5-day courses of mitoxantrone (Novantrone; dihydroxyanthracenedione) as induction therapy. All the children had leukemia which was resistant to conventional therapy and all but one patient had received anthracycline therapy prior to the initiation of this trial. Three patients (two with ANLL, one with ALL) received the drug at a dose of 6 mg/m2/day i.

Pre-B cell leukemia responds poorly to treatment: a pediatric oncology group study.

Seventy-eight of 362 children with acute lymphocytic leukemia (ALL) had leukemic cells similar in phenotype to normal pre-B cells. When the clinical and laboratory features of patients with pre-B and "null" cell phenotypes of ALL were compared, no significant differences were noted, except that the pre-B cell ALL phenotype had a higher percentage of black children. In contrast, patients with T cell ALL had a higher median age at diagnosis, frequent thymic involvement, and higher WBC counts.

Malignant histiocytosis in childhood: morphologic considerations.

Eight cases diagnosed over a ten-year period as malignant histiocytosis (MH; histiocytic medullary reticulosis) were reviewed to clarify diagnostic criteria for the childhood disease and to identify sources of diagnostic confusion. Five of the eight cases met the authors' criteria for diagnosis; i.e.

Monoclonal antibody characterization of surface antigens in childhood T-cell lymphoid malignancies.

Although childhood T-cell acute lymphocytic leukemia (T-ALL) and T-cell non-Hodgkin's lymphoma (T-NHL) have certain clinical features in common, T-ALL carries a notably poorer prognosis than does T-NHL. To determine whether the malignant cells from patients with these disorders are distinguishable, we examined bone marrow and/or blood from 51 children with T-ALL and tumor biopsy specimens from 17 with T-NHL, using a panel of monoclonal antibodies directed against T-cell differentiation antigens. We found considerable phenotypic heterogeneity in both T-ALL and T-NHL.

Modified LSA2-L2 treatment in 53 children with E-rosette-positive T-cell leukemia: results and prognostic factors (a Pediatric Oncology Group Study).

In an attempt to improve the poor outlook for children with T-cell leukemia (T-ALL), the Southwest Oncology Group, Pediatric Division, used a modified LSA2-L2 multidrug regimen to treat 53 patients with E-rosette-positive T-ALL. This regimen was chosen because of its demonstrated efficacy in T-cell (mediastinal) non-Hodgkin's lymphoma. Complete remission (CR) rate was 88%.

Doxorubicin and cisplatin therapy in children with neuroblastoma resistant to conventional therapy: a Southwest Oncology Group Study.

Fifteen children with metastatic neuroblastoma resistant to vincristine and cyclophosphamide were treated with two drugs which were known to be effective as single drugs against neuroblastoma. The drugs were given in courses every 3 weeks. Doxorubicin (50 mg/m2 iv) was given on Day 1 and cisplatin (50 mg/m2) was administered on Day 2 as an 8-hour infusion, using a forced diuretic-hydration program.

Adjuvant chemotherapy for medulloblastoma and ependymoma using iv vincristine, intrathecal methotrexate, and intrathecal hydrocortisone: a Southwest Oncology Group Study.

In a prospective, randomized, cooperative group trial, the value of iv vincristine and intrathecal methotrexate and hydrocortisone as adjuvant therapy to radiotherapy in children with medulloblastoma and ependymoma was evaluated. The data showed no improvement in the survival of such children when adjuvant therapy was given.

A staging system for histiocytosis X: a Southwest Oncology Group Study.

Patients with generalized histiocytosis X may be divided into three prognostic groups based on age at the time of diagnosis and presence or absence of organ dysfunction. These variables are independent. Favorable response to initial chemotherapy was shown to be associated with improved survival and overall disease control.

Immunotherapy in acute leukemias. Possible applications in children.

The role of immunotherapy in maintenance of remission in children with acute leukemias is briefly reviewed. With few exceptions, the bulk of clinical trials of immunotherapy in children with acute lymphoblastic leukemia have failed to demonstrate a beneficial effect. Immunotherapy trials for acute myelogenous leukemia mainly have involved adults.

5-fluorouracil and cis-platinum in the treatment of refractory solid tumors: a pediatric oncology group phase I-II study.

Eleven patients with osteogenic sarcoma (9), Hodgkin disease (1), and mesenchymal sarcoma (1), were treated with 5-fluorouracil (5-FU) and cisplatin (DDP). Myelosuppression and vomiting of variable degrees occurred in all. No responses were seen.