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1. Becton D, Dahl GV, Ravindranath Y, Chang MN, Behm FG, Raimondi SC, Head DR, Stine KC, Lacayo NJ, Sikic BI, Arceci RJ, Weinstein H, Pediatric Oncology Group: Randomized use of cyclosporin A (CsA) to modulate P-glycoprotein in children with AML in remission: Pediatric Oncology Group Study 9421. Blood; 2006 Feb 15;107(4):1315-24
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  • [Title] Randomized use of cyclosporin A (CsA) to modulate P-glycoprotein in children with AML in remission: Pediatric Oncology Group Study 9421.
  • Relapse is a major obstacle in the cure of acute myeloid leukemia (AML).
  • The Pediatric Oncology Group AML Study 9421 tested 2 different strategies to improve event-free survival (EFS) and overall survival (OS).
  • To interfere with P-glycoprotein (P-gp)-dependent drug efflux, the second randomization tested the benefit of cyclosporine (CsA) added to consolidation chemotherapy.
  • Of the 282 children randomly assigned to receive standard DAT induction, 248 (87.9%) achieved remission compared to 253 (91%) of the 278 receiving high-dose DAT (P = ns).
  • Children with HLA-identical sibling donors who achieved a complete remission received an allogeneic bone marrow transplant as consolidation.
  • Of the 418 children who achieved remission and went on to consolidation with and without CsA, the DFS was 40.6% and 33.9%, respectively (P = .24).
  • Overexpression of P-gp was infrequent (14%) in this pediatric population.
  • In this study, intensifying induction with high-dose DAT and the addition of CsA to consolidation chemotherapy did not prolong the durations of remission or improve overall survival for children with AML.

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  • (PMID = 16254147.001).
  • [ISSN] 0006-4971
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R01 CA90916
  • [Publication-type] Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunosuppressive Agents; 0 / P-Glycoprotein; 094ZI81Y45 / Tamoxifen; 80168379AG / Doxorubicin; 83HN0GTJ6D / Cyclosporine; LJ2P1SIK8Y / Mitolactol
  • [Other-IDs] NLM/ PMC1895393
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2. Niewerth D, Creutzig U, Bierings MB, Kaspers GJ: A review on allogeneic stem cell transplantation for newly diagnosed pediatric acute myeloid leukemia. Blood; 2010 Sep 30;116(13):2205-14
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  • [Title] A review on allogeneic stem cell transplantation for newly diagnosed pediatric acute myeloid leukemia.
  • Survival of pediatric acute myeloid leukemia (AML) has improved considerably over the past decades.
  • However, it remains controversial whether allo-SCT is superior to chemotherapy for children with newly diagnosed AML.
  • This review summarizes phase 3 clinical trials that compared allo-SCT with chemotherapy (including autologous SCT) in pediatric AML, excluding studies that did not use the intention-to-treat analysis or correct for time-to-transplantation.
  • Although allo-SCT might prevent more relapses than chemotherapy, the number needed for transplantation (with allo-SCT) to prevent one relapse is in the order of 10 patients.
  • Moreover, overall survival is similar with both methods in most recent studies, apparently because of increased salvagability of a relapse when initial therapy concerned chemotherapy only, and because of a higher treatment-related mortality with allo-SCT.
  • Because allo-SCT also gives more severe side effects and results more often in secondary malignancies than chemotherapy, we do not recommend allo-SCT in first remission for pediatric AML in general.
  • Further research should focus on the possibility that subgroups might benefit from allo-SCT, aiming at further improvements in the prognosis of pediatric AML.
  • [MeSH-major] Leukemia, Myeloid, Acute / therapy. Stem Cell Transplantation
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Clinical Trials, Phase III as Topic. Cost-Benefit Analysis. Disease-Free Survival. Humans. Remission Induction. Survival Analysis. Transplantation, Autologous. Transplantation, Homologous. Treatment Outcome


3. Al-Shehri A, Al-Seraihy A, Owaidah TM, Belgaumi AF: Megakaryocytic blast crisis at presentation in a pediatric patient with chronic myeloid leukemia. Hematol Oncol Stem Cell Ther; 2010;3(1):42-6
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  • [Title] 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.
  • Clinical features were more suggestive of CML in megakaryocytic blast crisis than Philadelphia chromosome positive de novo AML.
  • The patient was treated with AML-directed chemotherapy and imatinib mesylate followed by umbilical cord blood stem cell transplantation.
  • [MeSH-major] Blast Crisis / pathology. Leukemia, Megakaryoblastic, Acute / pathology. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / pathology. Megakaryocytes / pathology
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Benzamides. Child. Cord Blood Stem Cell Transplantation. Diagnosis, Differential. Female. Humans. Imatinib Mesylate. Piperazines / therapeutic use. Pyrimidines / therapeutic use. Remission Induction. Treatment Outcome

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  • (PMID = 20231813.001).
  • [ISSN] 1658-3876
  • [Journal-full-title] Hematology/oncology and stem cell therapy
  • [ISO-abbreviation] Hematol Oncol Stem Cell Ther
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Saudi Arabia
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
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4. Kolb EA, Pan Q, Ladanyi M, Steinherz PG: Imatinib mesylate in Philadelphia chromosome-positive leukemia of childhood. Cancer; 2003 Dec 15;98(12):2643-50
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  • [Title] Imatinib mesylate in Philadelphia chromosome-positive leukemia of childhood.
  • BACKGROUND: Initial treatment for adult patients with Philadelphia chromosome-positive (Ph[+]) chronic myelogenous leukemia (CML) now includes imatinib mesylate.
  • METHODS: In the current series, the authors report 5 consecutive patients ages 20 months to 12 years with Ph+ leukemia who were treated with imatinib and evaluated for a response using cytogenetics, fluorescent in situ hybridization (FISH), and real-time quantitative reverse transcriptase-polymerase chain reaction (RT-PCR) on serial bone marrow aspirations.
  • RESULTS: After the initiation of imatinib therapy, all 4 patients with CML were found to have no detectable Ph chromosome by cytogenetics (median of 198 days of imatinib therapy; range, 138-346 days), FISH (median of 285 days of imatinib therapy; range, 138-366 days), and real-time RT-PCR (median of 287 days of imatinib therapy; range, 224-366 days).
  • One patient with Ph+ acute mixed lineage leukemia achieved a morphologic disease remission with standard chemotherapy, but within 10 months had increasing Ph positivity in consecutive bone marrow aspirations.
  • Imatinib was added to the intensive leukemia therapy, and within 26 days there were no detectable Ph+ cells in the bone marrow.
  • CONCLUSIONS: Imatinib mesylate was found to be effective in inducing undetectable residual disease in a small cohort of pediatric patients with Ph+ leukemia.
  • Further studies of the use of imatinib in childhood Ph+ malignancies are needed.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Leukemia, Myeloid, Chronic-Phase / drug therapy. Philadelphia Chromosome. Piperazines / therapeutic use. Pyrimidines / therapeutic use
  • [MeSH-minor] Benzamides. Child. Child, Preschool. Female. Fusion Proteins, bcr-abl / genetics. Humans. Imatinib Mesylate. In Situ Hybridization, Fluorescence. Infant. Male. Prognosis. Protein-Tyrosine Kinases / antagonists & inhibitors. Risk Factors. Survival Rate. Treatment Outcome

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  • [Copyright] Copyright 2003 American Cancer Society.
  • (PMID = 14669284.001).
  • [ISSN] 0008-543X
  • [Journal-full-title] Cancer
  • [ISO-abbreviation] Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Comparative Study; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate; EC 2.7.10.1 / Protein-Tyrosine Kinases; EC 2.7.10.2 / Fusion Proteins, bcr-abl
  • [Number-of-references] 34
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7. Styczynski J, Wysocki M, Debski R, Juraszewska E, Malinowska I, Stanczak E, Ploszynska A, Stefaniak J, Mazur B, Szczepanski T: Ex vivo drug resistance profile in childhood acute myelogenous leukemia: no drug is more effective in comparison to acute lymphoblastic leukemia. Leuk Lymphoma; 2002 Sep;43(9):1843-8
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  • [Title] Ex vivo drug resistance profile in childhood acute myelogenous leukemia: no drug is more effective in comparison to acute lymphoblastic leukemia.
  • Therapy results in childhood acute myelogenous leukemia (AML) differ from those of acute lymphoblastic leukemia (ALL).
  • Cellular drug resistance might be one of the reasons of therapy failure in AML.
  • The aim of the study was the analysis of ex vivo drug resistance profile in childhood initial and relapsed AML in comparison to initial ALL.
  • Fifty-three AML samples were tested for chemosensitivity and results were compared with those of 106 initial ALL samples.
  • Ex vivo drug resistance was tested by means of the MTT assay.
  • Up to 29 cytotoxic drugs were tested for each patient.
  • When compared to de nova ALL samples, myeloblasts from initial AML samples were significantly more resistant to most tested drugs, except cytarabine, mercaptopurine and thioguanine.
  • Relapsed AML samples, in relation to initial AML samples, showed comparable sensitivity to cytarabine, idarubicin, fludarabine and cladribine.
  • Patients, who have died due to refractory or relapsing disease, were already on first diagnosis 2-fold more resistant to cytarabine, 6.4-fold more resistant to cisplatin and 3-fold more resistant to carboplatin, when compared to those who stay in remission.
  • Resistance to prednisolone was observed in 85% initial and all relapsed AML samples, in comparison to 33% of ALL samples.
  • Resistance to cytarabine occurred in 2.1% of ALL and 12% of AML cases while a patient with Down syndrome presented the most sensitive drug resistance profile.
  • In conclusion this study shows that no drug was found which, on average, was more effective in AML than in ALL samples.
  • [MeSH-major] Drug Resistance, Neoplasm. Leukemia, Myeloid, Acute / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • [MeSH-minor] Carboplatin / therapeutic use. Cell Survival. Child. Cisplatin / therapeutic use. Coloring Agents / pharmacology. Humans. Recurrence. Tetrazolium Salts / pharmacology. Thiazoles / pharmacology. Time Factors. Treatment Outcome. Tumor Cells, Cultured


8. Lehrnbecher T, Zimmermann M, Reinhardt D, Dworzak M, Stary J, Creutzig U: Prophylactic human granulocyte colony-stimulating factor after induction therapy in pediatric acute myeloid leukemia. Blood; 2007 Feb 1;109(3):936-43
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  • [Title] Prophylactic human granulocyte colony-stimulating factor after induction therapy in pediatric acute myeloid leukemia.
  • Children with acute myelogenous leukemia (AML) have a high risk of infectious complications that might be reduced by prophylactic granulocyte colony-stimulating factor (G-CSF).
  • However, G-CSF could induce AML blast proliferation.
  • The prospective randomized trial AML-BFM 98 investigated the impact of G-CSF on hematopoetic recovery and infectious complications (primary endpoints) and on outcome (secondary endpoint) in children (aged 0-18 years) with de novo AML.
  • Between 1998 and 2003, 161 children with AML were randomized to receive G-CSF after inductions 1 and 2, whereas 156 patients were assigned to the control group.
  • Time of neutropenia after inductions 1 and 2 was significantly shorter in the G-CSF group (23 vs 18 days and 16 vs 11 days; P=.02 and=.001, respectively).
  • Since G-CSF does not influence the risk of infectious complications or outcome in children undergoing therapy for AML, one cannot advocate the routine use of G-CSF in this patient group.
  • [MeSH-major] Granulocyte Colony-Stimulating Factor / administration & dosage. Leukemia, Myeloid, Acute / drug therapy
  • [MeSH-minor] Adolescent. Cell Proliferation / drug effects. Child. Child, Preschool. Disease-Free Survival. Hematopoiesis / drug effects. Humans. Infant. Infection / drug therapy. Infection / mortality. Infection Control. Neutropenia. Premedication. Remission Induction. Treatment Outcome

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  • (PMID = 17008536.001).
  • [ISSN] 0006-4971
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] eng
  • [Publication-type] Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 143011-72-7 / Granulocyte Colony-Stimulating Factor
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9. Lin CH, Wu KH, Lin WC, Tsai JD, Peng CT, Chen AC: Granulocytic sarcoma of the colon in a child with acute myeloid leukemia presenting as hematochezia. J Pediatr Hematol Oncol; 2008 Dec;30(12):981-3
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  • [Title] Granulocytic sarcoma of the colon in a child with acute myeloid leukemia presenting as hematochezia.
  • Granulocytic sarcoma (GS), an extramedullary myeloid tumor composed of immature cells of the granulocytic series, can occur in patients with acute myeloid leukemia (AML), myelodysplastic syndrome, or chronic myelogenous leukemia.
  • It can occur in any organ or tissue, but the most common involved areas are the skin, bone/spine, and lymph nodes.
  • We report here an extremely rare case of GS in the colon of a 10-year-old boy with AML presenting with hematochezia.
  • His hematochezia responded rapidly to induction chemotherapy and the patient remained in complete remission after 3-month follow-up.
  • In conclusion, hematochezia may be due to colonic involvement of GS, which should be considered in the differentials in addition to thrombocytopenia, as it is usually encountered in AML patients.
  • [MeSH-major] Colonic Neoplasms / complications. Gastrointestinal Hemorrhage / complications. Gastrointestinal Hemorrhage / diagnosis. Leukemia, Myeloid, Acute / complications. Neoplasms, Multiple Primary / pathology. Sarcoma, Myeloid / complications


10. Jaing TH, Hung IJ, Shih LY, Yang CP, Hsueh C, Lo WC: Extramedullary relapse in the left proximal femur with Philadelphia chromosome positive acute lymphoblastic leukemia after allogeneic bone marrow transplantation. J Pediatr Hematol Oncol; 2003 Jan;25(1):65-8
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  • [Title] Extramedullary relapse in the left proximal femur with Philadelphia chromosome positive acute lymphoblastic leukemia after allogeneic bone marrow transplantation.
  • We describe a rare presentation of extra-medullary relapse in an adolescent boy with Philadelphia chromosome-positive acute lymphoblastic leukemia who had undergone allogeneic bone marrow transplantation after first remission.
  • In spite of enduring bone marrow remission, the patient experienced a local relapse in the left proximal femur within 3 years of the transplant.
  • Confirmation of extra-medullary relapse of the proximal femur was delayed until histologic proof of the computed tomography-guided biopsy samples was obtained.
  • Reestablishment of normal donor hematopoiesis was achieved with reinduction chemotherapy.
  • [MeSH-major] Bone Marrow Transplantation. Femur / pathology. Hematopoiesis, Extramedullary. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / etiology. Neoplasm Recurrence, Local / etiology
  • [MeSH-minor] Acute Disease. Adolescent. Bone Marrow / pathology. Humans. Male. Transplantation, Homologous


11. Kimura Y: [Recent progress in the treatment of acute leukemia]. Gan To Kagaku Ryoho; 2003 Jul;30(7):895-901
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  • [Title] [Recent progress in the treatment of acute leukemia].
  • Acute leukemia is classified broadly as either acute myelogenous leukemia (AML) or acute lymphoblastic leukemia (ALL).
  • The main treatments remain remission induction therapy and postremission chemotherapy.
  • The advances in chemotherapy for pediatric patients with ALL have been dramatic, with some 95% achieving complete remission, and long-term survival is 60-80%.
  • Among adults, high long-term survival rates due to improvements in chemotherapy for B-cell type ALL and core binding factor leukemias have been reported.
  • For adult leukemias overall, however, long-term survival rates have stalled at 15-40% despite the high remission rate attained.
  • Among the prognostic factors reported for acute leukemia, chromosome type may be cited as the currently most reliable.
  • Acute leukemia patients are classified based on chromosome type, and the postremission therapeutic strategy is considered in terms of an appropriate combination of chemotherapy and hematopoietic stem cell transplant.
  • This accounts for an important part of the treatment given today.
  • Target-based therapies such as all-trans-retinoic acid (ATRA) for AML have brought dramatic improvements in treatment results.
  • Moreover, promising new treatment strategies that have been developed, including cord blood transplant, mini-transplant, antibody therapy, and immunotherapy, Clinical studies of PCR and other means to reveal small residual lesions and estimate prognosis are also making progress.
  • In the future it will be possible to identify prognostic factors in genetic tests such as DNA microarrays and single nucleotide polymorphisms, so that the optimum treatment can be selected for individual patients.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Leukemia, Myeloid, Acute. Precursor Cell Lymphoblastic Leukemia-Lymphoma
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Chromosome Aberrations. Combined Modality Therapy. Female. Humans. Male. Philadelphia Chromosome. Prognosis. Stem Cell Transplantation / mortality. Survival Rate. Survivors. Tretinoin / therapeutic use

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  • (PMID = 12894700.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 5688UTC01R / Tretinoin
  • [Number-of-references] 12
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12. Godder KT, Hazlett LJ, Abhyankar SH, Chiang KY, Christiansen NP, Bridges KD, Lee CG, Geier SS, Goon-Johnson KS, Gee AP, Pati AR, Parrish RS, Henslee-Downey PJ: Partially mismatched related-donor bone marrow transplantation for pediatric patients with acute leukemia: younger donors and absence of peripheral blasts improve outcome. J Clin Oncol; 2000 May;18(9):1856-66
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  • [Title] Partially mismatched related-donor bone marrow transplantation for pediatric patients with acute leukemia: younger donors and absence of peripheral blasts improve outcome.
  • PURPOSE: To extend access to bone marrow transplantation (BMT), we used partially mismatched related donors (PMRD) for pediatric patients with acute leukemia.
  • PATIENTS AND METHODS: Of 67 such patients, 43 had acute lymphocytic leukemia and 24 had acute myelogenous leukemia.
  • At the time of transplantation, 41 patients were in relapse.
  • Conditioning therapy, including total-body irradiation and chemotherapy followed by graft-versus-host disease (GvHD) prophylaxis with partial T-cell depletion of the graft using T10B9 or OKT3, was combined with posttransplantation immunosuppression.
  • EP of grades 2 to 4 acute GvHD was 0.24 and was not affected by recipient AgMM (P =.796).
  • For patients who were in relapse at the time of transplantation, absence of blasts was associated with a lower relapse rate (0.46 v. 0.84; P =.
  • 083), similar to that of patients in remission.
  • CONCLUSION: PMRD-BMT in pediatric leukemia resulted in high engraftment and low GvHD rates.
  • [MeSH-major] Bone Marrow Transplantation. Leukemia, Myeloid, Acute / therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • [MeSH-minor] Adolescent. Adult. Age Factors. Child. Child, Preschool. Disease-Free Survival. Female. Graft vs Host Disease / epidemiology. Histocompatibility Testing. Humans. Incidence. Infant. Infant, Newborn. Lymphocytes / cytology. Male. Predictive Value of Tests. Prognosis. Retrospective Studies. Tissue Donors / classification. Transplantation, Homologous

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  • (PMID = 10784626.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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13. Vettenranta K, Hovi L, Saarinen-Pihkala UM: Adoptive immunotherapy as consolidation of remission in pediatric AML relapsing post-transplant. Pediatr Transplant; 2003 Dec;7(6):446-9
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  • [Title] Adoptive immunotherapy as consolidation of remission in pediatric AML relapsing post-transplant.
  • Treatment of acute leukemia relapse following an allogeneic transplantation is a challenge.
  • We reinduced three pediatric patients with acute myeloid leukemia (AML) relapsing after a marrow transplantation from a sibling donor into remission with chemotherapy and used donor lymphocyte infusions (DLIs) as consolidation.
  • Subsequently, all the three developed (acute grade III-IV or chronic extensive) GVHD and remain in remission with a good quality of life 19, 15 and 14 months post-relapse.
  • We consider an active approach in the treatment of pediatric AML relapsing post-transplant justified.
  • [MeSH-major] Bone Marrow Transplantation. Immunotherapy, Adoptive / methods. Leukemia, Myeloid, Acute / therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Female. Humans. Recurrence. Remission Induction. T-Lymphocytes / transplantation. Treatment Outcome

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  • [CommentIn] Pediatr Transplant. 2003 Dec;7(6):419-21 [14870887.001]
  • (PMID = 14870891.001).
  • [ISSN] 1397-3142
  • [Journal-full-title] Pediatric transplantation
  • [ISO-abbreviation] Pediatr Transplant
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Denmark
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14. Haase R, Wiegand P, Hirsch W, Meyer-Bahlburg A, Diwan O, Wawer A, Burdach S: Unusual presentation of central nervous system relapse with oculomotor nerve palsy in a case of CD56-positive acute myeloid leukemia following allogeneic stem cell transplantation. Pediatr Transplant; 2002 Jun;6(3):260-5
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  • [Title] Unusual presentation of central nervous system relapse with oculomotor nerve palsy in a case of CD56-positive acute myeloid leukemia following allogeneic stem cell transplantation.
  • Allogeneic stem cell transplantation (allo-SCT) plays an important role in the treatment of infants and children with acute myelogenous leukemia (AML).
  • Leukemic relapse after allo-SCT is responsible for a high rate of treatment failure.
  • CD56, the neural cell adhesion molecule, may contribute to the higher frequency of CNS relapse in CD56-positive AML.
  • We observed an isolated EMR on the oculomotor nerve of a 17-month-old girl 12 weeks after cord blood transplantation (CBT), who was transplanted because of CD56-positive AML.
  • Therapy consisted of intra-thecal chemotherapy, CNS irradiation, and systemic immunomodulation by cyclosporin A (CsA) and basiliximab withdrawal.
  • Twenty-one months after relapse, the patient shows full remission of symptoms and previously described oculomotor nerve infiltration.
  • [MeSH-major] Hematopoietic Stem Cell Transplantation. Leukemia, Myeloid, Acute / therapy. Ophthalmoplegia / etiology
  • [MeSH-minor] Antigens, CD56 / metabolism. Combined Modality Therapy. Female. Humans. Infant. Recurrence. Transplantation, Homologous

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  • (PMID = 12100514.001).
  • [ISSN] 1397-3142
  • [Journal-full-title] Pediatric transplantation
  • [ISO-abbreviation] Pediatr Transplant
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Denmark
  • [Chemical-registry-number] 0 / Antigens, CD56
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15. Ahn JY, Choi EW, Kang SH, Kim YR: Isolated meningeal chloroma (granulocytic sarcoma) in a child with acute lymphoblastic leukemia mimicking a falx meningioma. Childs Nerv Syst; 2002 Apr;18(3-4):153-6
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  • [Title] Isolated meningeal chloroma (granulocytic sarcoma) in a child with acute lymphoblastic leukemia mimicking a falx meningioma.
  • BACKGROUND: Isolated chloromas (granulocytic sarcomas) are rare tumors.
  • Chloromas are masses composed of immature granulocytic cells.
  • Granulocytic sarcoma occurs primarily in patients with acute myelogenous leukemia, but can also arise in patients with other myeloproliferative disorders, though rarely in patients with acute lymphoblastic leukemia (ALL).
  • When dural-based, granulocytic sarcoma may be indistinguishable from meningioma radiologically.
  • CASE HISTORY: We now describe one patient affected by ALL with isolated granulocytic sarcoma mimicking meningioma as initial CNS relapses.
  • A 12-year-old girl who had been diagnosed with ALL and undergone chemotherapy presented with generalized tonic-clonic seizure while in complete remission.
  • The patient was developed speech disturbance 6 days later.
  • Bone marrow biopsy and cerebrospinal fluid study were negative for leukemia.
  • The pathological diagnosis was acute lymphoblastic leukemia.
  • CONCLUSIONS: These unusual clinical manifestations and radiological findings in acute lymphoblastic leukemia should be regarded as a recurrence of leukemia.
  • Early detection and antileukemic treatment of granulocytic sarcoma are necessary and important for a favorable prognosis.
  • [MeSH-major] Meningeal Neoplasms / diagnosis. Meningioma / diagnosis. Neoplasms, Second Primary / diagnosis. Precursor Cell Lymphoblastic Leukemia-Lymphoma / diagnosis. Sarcoma, Myeloid / diagnosis
  • [MeSH-minor] Child. Diagnosis, Differential. Female. Humans. Magnetic Resonance Imaging. Neoplasm Recurrence, Local. Tomography, X-Ray Computed

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  • (PMID = 11981624.001).
  • [ISSN] 0256-7040
  • [Journal-full-title] Child's nervous system : ChNS : official journal of the International Society for Pediatric Neurosurgery
  • [ISO-abbreviation] Childs Nerv Syst
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Germany
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16. Kobayashi R, Tawa A, Hanada R, Horibe K, Tsuchida M, Tsukimoto I, Japanese childhood AML cooperative study group: Extramedullary infiltration at diagnosis and prognosis in children with acute myelogenous leukemia. Pediatr Blood Cancer; 2007 Apr;48(4):393-8
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  • [Title] Extramedullary infiltration at diagnosis and prognosis in children with acute myelogenous leukemia.
  • BACKGROUND: Extramedullary infiltration (EMI) is an occasional clinical symptom in childhood acute myelogenous leukemia (AML), but there is considerable controversy regarding the prognostic significance of EMI in AML.
  • PROCEDURE: We evaluated the frequency and prognostic significance of EMI at diagnosis of AML in children.
  • RESULTS: Of 240 cases of de novo AML excluding children with Down syndrome and acute promyelocytic leukemia, 56 (23.3%) showed EMI at diagnosis.
  • The complete remission rate following induction chemotherapy was lower in patients with EMI.
  • CONCLUSIONS: CNS leukemia and EMI together with a WBC count of >100 x 10(9)/L at diagnosis of AML are high risk factors for relapse, and alternative treatment approaches for patients with these characteristics should be explored.
  • [MeSH-major] Leukemia, Myeloid / pathology. Leukemic Infiltration / epidemiology. Sarcoma, Myeloid / epidemiology
  • [MeSH-minor] Acute Disease. Adolescent. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone and Bones / pathology. Central Nervous System / pathology. Child. Child, Preschool. Cytarabine / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Follow-Up Studies. Gingiva / pathology. Humans. Hydrocortisone / administration & dosage. Idarubicin / administration & dosage. Infant. Infant, Newborn. Japan / epidemiology. Kaplan-Meier Estimate. Male. Methotrexate / administration & dosage. Orbit / pathology. Prognosis. Remission Induction. Skin / pathology. Testis / pathology

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  • (PMID = 16550530.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 04079A1RDZ / Cytarabine; 6PLQ3CP4P3 / Etoposide; WI4X0X7BPJ / Hydrocortisone; YL5FZ2Y5U1 / Methotrexate; ZRP63D75JW / Idarubicin
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17. Sievers EL, Lange BJ, Sondel PM, Krailo MD, Gan J, Tjoa T, Liu-Mares W, Feig SA: Children's cancer group trials of interleukin-2 therapy to prevent relapse of acute myelogenous leukemia. Cancer J Sci Am; 2000 Feb;6 Suppl 1:S39-44
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  • [Title] Children's cancer group trials of interleukin-2 therapy to prevent relapse of acute myelogenous leukemia.
  • PURPOSE: Up to 80% of children with acute myelogenous leukemia treated with intensive chemotherapy achieve remission; however, a large proportion of patients develops recurrent disease.
  • Because interleukin (IL)-2 can induce remission in patients with overt evidence of acute myelogenous leukemia, we hypothesized that it might prevent relapse when administered to patients in first remission after intensive consolidation chemotherapy.
  • A pilot Children's Cancer Group (CCG) trial (CCG-0941) demonstrated the feasibility of this approach, and we initiated a prospective randomized trial (CCG-2961) to further evaluate the safety and potential efficacy of IL-2 therapy in preventing relapse of acute myelogenous leukemia.
  • PATIENTS AND METHODS: In trial CCG-0941, 21 pediatric patients in complete remission following induction and consolidation chemotherapy on protocol CCG-2941 received IL-2 therapy.
  • In CCG-2961, 79 patients in complete remission were randomized as of February 1999 to receive either IL-2 (n = 39) or no further therapy.
  • Hypotension resolved promptly after treatment with intravenous fluids.
  • No patients have experienced renal toxicity or required cardiac vasopressors or transfer to an intensive care unit; there have been no treatment-related deaths.
  • CONCLUSION: The dose and schedule of IL-2 used in these two trials continue to be reasonably well tolerated by children with acute myelogenous leukemia in first remission.

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  • (PMID = 10685657.001).
  • [ISSN] 1081-4442
  • [Journal-full-title] The cancer journal from Scientific American
  • [ISO-abbreviation] Cancer J Sci Am
  • [Language] ENG
  • [Grant] United States / NCI NIH HHS / CA / R25 CA092049; United States / NCI NIH HHS / CA / CA 13539; United States / NCI NIH HHS / CA / CA 14489; United States / NCRR NIH HHS / RR / MO1-RR00240
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Interleukin-2; 0 / Recombinant Proteins
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18. Petersen WC, Schlis KD, Braverman RS, Carlson I, Liang X, Wang M: Pseudohypopyon: Extramedullary relapse of acute myelogenous leukemia with poor prognosis. Pediatr Blood Cancer; 2009 Jul;52(7):885-7
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  • [Title] Pseudohypopyon: Extramedullary relapse of acute myelogenous leukemia with poor prognosis.
  • She was diagnosed with acute myelogenous leukemia.
  • Systemic chemotherapy with intensified intrathecal cytarabine was started, and the patient achieved a clinical remission after the first course of induction.
  • Towards the end of her second course of induction she developed pseudohypopyon in each eye on consecutive days, heralding a central nervous system relapse.
  • [MeSH-major] Anterior Chamber / pathology. Eye Diseases / diagnosis. Leukemia, Myelomonocytic, Acute / diagnosis. Neoplasm Recurrence, Local / diagnosis
  • [MeSH-minor] Antimetabolites, Antineoplastic / therapeutic use. Cytarabine / therapeutic use. Female. Humans. Infant. Injections, Spinal. Prognosis. Suppuration / diagnosis

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  • [Copyright] (c) 2008 Wiley-Liss, Inc.
  • (PMID = 19090546.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 04079A1RDZ / Cytarabine
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19. Frangoul HA, Shaw DW, Hawkins D, Park J: Diabetes insipidus as a presenting symptom of acute myelogenous leukemia. J Pediatr Hematol Oncol; 2000 Sep-Oct;22(5):457-9
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  • [Title] Diabetes insipidus as a presenting symptom of acute myelogenous leukemia.
  • This report describes a case of diabetes insipidus associated with acute myelogenous leukemia.
  • His evaluation revealed a diagnosis of acute myelogenous leukemia FAB-M2, and a water deprivation test confirmed the diagnosis of central diabetes insipidus.
  • He was treated with systemic chemotherapy, intensive intrathecal therapy, and 1,000 cGy to the pituitary.
  • The patient achieved a remission but continued to need desmopressin therapy to control his diabetes insipidus.
  • Diabetes insipidus is a rare complication of acute myelogenous leukemia that can be caused by leukemic infiltration of the pituitary.
  • The diabetes insipidus is irreversible despite intensive systemic and central nervous system chemotherapy and radiation.
  • [MeSH-major] Diabetes Insipidus / etiology. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications


20. Gorman MF, Ji L, Ko RH, Barnette P, Bostrom B, Hutchinson R, Raetz E, Seibel NL, Twist CJ, Eckroth E, Sposto R, Gaynon PS, Loh ML: Outcome for children treated for relapsed or refractory acute myelogenous leukemia (rAML): a Therapeutic Advances in Childhood Leukemia (TACL) Consortium study. Pediatr Blood Cancer; 2010 Sep;55(3):421-9
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  • [Title] Outcome for children treated for relapsed or refractory acute myelogenous leukemia (rAML): a Therapeutic Advances in Childhood Leukemia (TACL) Consortium study.
  • BACKGROUND: Current event-free survival (EFS) rates for children with newly diagnosed acute myeloid leukemia (AML) approach 50-60%.
  • We hypothesize that further improvements in survival are unlikely to be achieved with traditional approaches such as dose intensive chemotherapy or hematopoietic stem cell transplants, since these therapies have been rigorously explored in clinical trials.
  • This report highlights efforts to assess the response rates and survival outcomes after first or greater relapse in children with AML.
  • PROCEDURE: We performed a retrospective cohort review of pediatric patients with relapsed and refractory AML (rAML) previously treated at TACL institutions between the years of 1995 and 2004.
  • Data regarding disease characteristics at diagnosis and relapse, treatment response, and survival was collected on 99 patients and 164 medullary relapses or treatment failures.
  • RESULTS: The complete response (CR) rate following the second therapeutic attempt was 56 +/- 5%.
  • CR rates following a third treatment attempt was 25 +/- 8% while 17 +/- 7% achieved CR following the fourth through sixth treatments.
  • The 5-year disease-free survival in patients achieving CR following a second therapeutic attempt was 43 +/- 7%.
  • The 5-year EFS and overall survival (OS) rates for all patients receiving a second treatment attempt was 24 +/- 5% and 29 +/- 5%, respectively.
  • CONCLUSIONS: This CR rate following a second therapeutic attempt and OS rate in patients with rAML is consistent with the literature.
  • Our data can serve as a historical benchmark to compare outcomes of future therapeutic trials in rAML against traditional chemotherapy regimens.
  • [MeSH-major] Leukemia, Myeloid, Acute / drug therapy
  • [MeSH-minor] Adolescent. Child. Child, Preschool. Disease-Free Survival. Female. Humans. Infant. Male. Prognosis. Recurrence. Remission Induction. Retreatment. Survival Rate. Treatment Outcome. Young Adult

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  • [Copyright] 2010 Wiley-Liss, Inc.
  • (PMID = 20658611.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / K22 CA113557
  • [Publication-type] Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
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21. Bierings M, Nachman JB, Zwaan CM: Stem cell transplantation in pediatric leukemia and myelodysplasia: state of the art and current challenges. Curr Stem Cell Res Ther; 2007 Jan;2(1):53-63
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  • [Title] Stem cell transplantation in pediatric leukemia and myelodysplasia: state of the art and current challenges.
  • The role of stem cell transplantation in the treatment of leukemia and myelodysplasia (MDS) in children has changed over the past decade.
  • In pediatric acute lymphoblastic leukemia (ALL), the overall cure-rate is high with conventional chemotherapy.
  • However, selected patients with a high-risk of relapse are often treated with allogeneic hematopoietic stem cell transplantation (allo-HSCT) in first remission (CR1).
  • Patients with a bone-marrow relapse who attain a second remission frequently receive HSCT.
  • Therefore, MRD positive patients are eligible for more experimental approaches such as intensified or experimental chemotherapy pre-HSCT, as well as immune modulation post-HSCT.
  • In pediatric acute myeloid leukemia (AML) the role of allo-HSCT in CR1 is declining, due to better outcome with modern multi-agent chemotherapy.
  • In relapsed AML patients, allo-HSCT still seems indispensable.
  • Targeted therapy may change the role of HSCT, in particular in chronic myeloid leukemia, where the role of allografting is changing in the imatinib era.
  • [MeSH-major] Leukemia / therapy. Myelodysplastic Syndromes / therapy. Stem Cell Transplantation / trends
  • [MeSH-minor] Child. Humans. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Leukemia, Myeloid, Acute / therapy


22. Sutherland ND, Gonzalez-Peralta R, Douglas-Nikitin V, Hunger SP: Polycythemia vera in a child following treatment for acute lymphoblastic leukemia. J Pediatr Hematol Oncol; 2004 May;26(5):315-9
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  • [Title] Polycythemia vera in a child following treatment for acute lymphoblastic leukemia.
  • Polycythemia vera (PV), a hematologic stem cell disorder characterized by predominant erythroid proliferation, is extremely rare in childhood.
  • Some PV patients develop acute leukemia, especially acute myelogenous leukemia, but cases of PV occurring after treatment of acute leukemia are rare.
  • The authors describe a girl with an atrioventricular canal who was diagnosed with acute lymphoblastic leukemia (ALL) at 23 months of age, was cured with chemotherapy, and developed PV 7 years later.
  • [MeSH-major] Polycythemia Vera / chemically induced. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications
  • [MeSH-minor] Antineoplastic Agents / adverse effects. Antineoplastic Agents / therapeutic use. Bone Marrow Examination. Budd-Chiari Syndrome / etiology. Fatal Outcome. Female. Hematologic Tests. Humans. Infant. Liver Diseases / complications. Remission Induction

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  • (PMID = 15111786.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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23. Winter SS, Holdsworth MT, Devidas M, Raisch DW, Chauvenet A, Ravindranath Y, Ducore JM, Amylon MD: Antimetabolite-based therapy in childhood T-cell acute lymphoblastic leukemia: a report of POG study 9296. Pediatr Blood Cancer; 2006 Feb;46(2):179-86
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  • [Title] Antimetabolite-based therapy in childhood T-cell acute lymphoblastic leukemia: a report of POG study 9296.
  • PURPOSE: A previous Pediatric Oncology Group (POG) study showed high incidence of secondary acute myelogenous leukemia (AML) in children treated for T-cell acute lymphoblastic leukemia (T-ALL) or higher-stage lymphoblastic lymphoma.
  • PATIENTS AND METHODS: Forty-five patients were entered, 29 with T-ALL and 16 with higher-stage NHL.
  • Forty-two of 45 patients achieved complete remission (CR), and 27 completed the therapy in continuous CR.
  • Treatment consisted of 4-week induction then 6 weeks consolidation and ten 9-week maintenance cycles.
  • Therapy primarily comprised antimetabolites, anthracyclines, alkylating agents, and asparaginase.
  • Expected chemotherapy duration was 100 weeks.
  • RESULTS: Forty-two of 45 patients achieved CR, and 27 completed therapy.
  • Five-year EFS was 68.5% (SE 9.1%) for T-ALL and 81.3% (SE 9.8%) for NHL.
  • Five-year EFS was 73.1% (SE 6.8%) for the entire cohort.
  • No patients treated entirely on this study developed secondary neoplasms.
  • One patient taken off study for asparaginase toxicity was treated with multiagent therapy that contained teniposide, and died from secondary myelodysplasia (sMDS)/AML.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • [MeSH-minor] Adolescent. Anthracyclines / administration & dosage. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents, Alkylating / administration & dosage. Asparaginase / administration & dosage. Asparaginase / adverse effects. Child. Child, Preschool. Disease-Free Survival. Drug Hypersensitivity / etiology. Female. Follow-Up Studies. Humans. Lymphoma, Non-Hodgkin / drug therapy. Lymphoma, Non-Hodgkin / mortality. Male. Pilot Projects. Remission Induction. Sepsis / etiology. Sepsis / mortality

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  • (PMID = 16007607.001).
  • [ISSN] 1545-5009
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Grant] United States / NCI NIH HHS / CA / 5 U10 CA5312; United States / NCI NIH HHS / CA / CA29139
  • [Publication-type] Clinical Trial; Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anthracyclines; 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents, Alkylating; EC 3.5.1.1 / Asparaginase
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24. Cheng L, Ramesh KH, Radel E, Ratech H, Wei D, Cannizzaro LA: Characterization of t(11;19)(q23;p13.3) by fluorescence in situ hybridization analysis in a pediatric patient with therapy-related acute myelogenous leukemia. Cancer Genet Cytogenet; 2001 Aug;129(1):17-22
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  • [Title] Characterization of t(11;19)(q23;p13.3) by fluorescence in situ hybridization analysis in a pediatric patient with therapy-related acute myelogenous leukemia.
  • This case presents a Caucasian girl diagnosed with early pre-B cell acute lymphoblastic leukemia at age 2 years.
  • The only chromosomal anomaly detected in her bone marrow cells at this time was an add(12p).
  • By age 4 years, she had a bone marrow and central nervous system (CNS) relapse of ALL and was treated with chemotherapy that included etoposide.
  • She was in complete remission for 2 years following chemotherapy with etoposide, but later developed therapy-related acute myeloid leukemia (t-AML).
  • At this time, a t(11;19)(q23;p13.3) rearrangement was detected in her bone marrow cells.
  • The AML relapsed again 1 year after allogeneic bone marrow transplant (BMT).
  • The presence of a chromosome 11 abnormality involving band 11q23 in this patient suggests that the transformation from ALL to t-AML was a consequence of etoposide included in her chemotherapy.
  • Studies have shown that the 11q23 breakpoint in the t(11;19) rearrangement is consistent, and involves the MLL gene in t-AML patients.
  • However, the breakpoint in 19p is variable in that it could be located either at 19p13.1 or 19p13.3 and thus could involve either of two genes: ELL (11-19 lysine-rich leukemia gene) on 19p13.1 or ENL (11-19 leukemia gene) on 19p13.3.
  • [MeSH-major] Chromosomes, Human, Pair 11. Chromosomes, Human, Pair 19. In Situ Hybridization, Fluorescence. Leukemia, Myeloid, Acute / genetics. Neoplasms, Second Primary / genetics. Proto-Oncogenes. Transcription Factors. Translocation, Genetic
  • [MeSH-minor] Child, Preschool. DNA-Binding Proteins / genetics. Female. Histone-Lysine N-Methyltransferase. Humans. Myeloid-Lymphoid Leukemia Protein

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  • (PMID = 11520560.001).
  • [ISSN] 0165-4608
  • [Journal-full-title] Cancer genetics and cytogenetics
  • [ISO-abbreviation] Cancer Genet. Cytogenet.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / DNA-Binding Proteins; 0 / MLL protein, human; 0 / Transcription Factors; 149025-06-9 / Myeloid-Lymphoid Leukemia Protein; EC 2.1.1.43 / Histone-Lysine N-Methyltransferase
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25. Curran MP, Perry CM: Clofarabine: in pediatric patients with acute lymphoblastic leukemia. Paediatr Drugs; 2005;7(4):259-64; discussion 265-6
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  • [Title] Clofarabine: in pediatric patients with acute lymphoblastic leukemia.
  • In 61 pediatric patients with relapsed or refractory acute lymphoblastic leukemia treated with clofarabine 52 mg/m2 infused intravenously over 2 hours once daily for 5 days every 2-6 weeks, rates of complete remission, complete remission without platelet recovery, and partial remission were 12%, 8%, and 10%, respectively.
  • The most common adverse events associated with clofarabine 52 mg/m2 once daily for 5 days every 2-6 weeks in 96 patients with acute myelogenous or lymphoblastic leukemia (combined analysis of phase I/II trials) were hematologic events (including anemia, leukopenia, thrombocytopenia, neutropenia, and febrile neutro-penia), gastrointestinal events (including vomiting, nausea, and diarrhea), infections, and transient elevations in liver enzymes.
  • [MeSH-major] Arabinonucleosides / therapeutic use. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy
  • [MeSH-minor] Adenine Nucleotides. Adolescent. Child. Clinical Trials, Phase I as Topic. Clinical Trials, Phase II as Topic. Humans. Infant. Treatment Outcome

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  • (PMID = 16117562.001).
  • [ISSN] 1174-5878
  • [Journal-full-title] Paediatric drugs
  • [ISO-abbreviation] Paediatr Drugs
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Adenine Nucleotides; 0 / Arabinonucleosides; 762RDY0Y2H / clofarabine
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26. Monteleone PM, Steele DA, King AK, Konefal S, Kelleher JF: Bilateral breast relapse in acute myelogenous leukemia. J Pediatr Hematol Oncol; 2001 Feb;23(2):126-9
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  • [Title] Bilateral breast relapse in acute myelogenous leukemia.
  • We present the case of an 11.5-year-old girl with M1 acute myelogenous leukemia (AML) who had isolated extramedullary relapse develop in both breasts 12 months after diagnosis and 7 months off chemotherapy.
  • She received further chemotherapy, focal radiation therapy, then underwent a matched, unrelated bone marrow transplant and continues in remission 37 months later.
  • Review of the literature revealed 10 cases in other children younger than 21-years-old with AML and breast involvement.
  • Breast involvement in AML is rare in children.
  • However, regular breast examinations should be performed as part of routine follow-up in all girls with AML.
  • [MeSH-major] Breast / pathology. Leukemia, Myeloid, Acute / pathology. Vidarabine / analogs & derivatives
  • [MeSH-minor] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biopsy. Bone Marrow Transplantation. Child. Combined Modality Therapy. Cytarabine / administration & dosage. Daunorubicin / administration & dosage. Dexamethasone / administration & dosage. Etoposide / administration & dosage. Female. Graft vs Host Disease / etiology. Humans. Idarubicin / administration & dosage. Immunologic Factors / therapeutic use. Interleukin-2 / therapeutic use. Leukemic Infiltration. Radiotherapy, High-Energy. Recurrence. Salvage Therapy. Thioguanine / administration & dosage. Transplantation Conditioning

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  • (PMID = 11216705.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Immunologic Factors; 0 / Interleukin-2; 04079A1RDZ / Cytarabine; 6PLQ3CP4P3 / Etoposide; 7S5I7G3JQL / Dexamethasone; FA2DM6879K / Vidarabine; FTK8U1GZNX / Thioguanine; P2K93U8740 / fludarabine; ZRP63D75JW / Idarubicin; ZS7284E0ZP / Daunorubicin
  • [Number-of-references] 23
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27. Mantadakis E, Samonis G, Kalmanti M: A comprehensive review of acute promyelocytic leukemia in children. Acta Haematol; 2008;119(2):73-82
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  • [Title] A comprehensive review of acute promyelocytic leukemia in children.
  • The outcome of patients with acute promyelocytic leukemia (APL) has substantially improved since the successful introduction of tretinoin, and nowadays combining tretinoin with chemotherapy is potentially curative for at least 70-75% of patients with newly diagnosed APL.
  • In most pediatric series, APL represents < or = 10% of childhood acute myelogenous leukemia.
  • Tretinoin-based therapy is curative for the majority of children with APL.
  • Recent data indicate that > or = 2 negative RT-PCR assays for PML/RARalpha on bone marrow performed at least 1 month apart after completing therapy are strongly associated with long-term remissions, while conversion to PCR positivity for PML/RARalpha during remission is highly predictive of impending relapse.
  • Data from recent studies in adults and limited data from children show that arsenic trioxide is the single most effective agent in APL and deserves immediate study in newly diagnosed children in an effort to further improve prognosis and to limit exposure to conventional cytotoxic chemotherapy.
  • [MeSH-major] Leukemia, Promyelocytic, Acute / diagnosis. Leukemia, Promyelocytic, Acute / therapy
  • [MeSH-minor] Antineoplastic Agents / therapeutic use. Child. Humans. Prognosis. Risk Factors. Treatment Outcome

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  • [Copyright] 2008 S. Karger AG, Basel
  • (PMID = 18285695.001).
  • [ISSN] 1421-9662
  • [Journal-full-title] Acta haematologica
  • [ISO-abbreviation] Acta Haematol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Switzerland
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 70
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28. Hijiya N, Gaynon P, Barry E, Silverman L, Thomson B, Chu R, Cooper T, Kadota R, Rytting M, Steinherz P, Shen V, Jeha S, Abichandani R, Carroll WL: A multi-center phase I study of clofarabine, etoposide and cyclophosphamide in combination in pediatric patients with refractory or relapsed acute leukemia. Leukemia; 2009 Dec;23(12):2259-64
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  • [Title] A multi-center phase I study of clofarabine, etoposide and cyclophosphamide in combination in pediatric patients with refractory or relapsed acute leukemia.
  • This Phase I study of clofarabine with etoposide and cyclophosphamide for children with relapsed/refractory acute lymphoblastic leukemia (ALL) or acute myelogenous leukemia (AML) was conducted to determine the maximum tolerated dose (MTD), dose-limiting toxicities and the recommended phase 2 doses (RP2Ds).
  • All three drugs were administered for five consecutive days in induction and four consecutive days in consolidation, for a maximum of eight cycles.
  • A total of 25 patients (20 ALL and 5 AML) were enrolled in five cohorts.
  • Complete remission (CR) was achieved in 10 patients (ALL: nine; AML: one), and CR without platelet recovery in six patients (ALL: two; AML: four) for an overall response rate of 64% (ALL: 55%; AML: 100%).
  • In conclusion, the combination of clofarabine, etoposide and cyclophosphamide was well tolerated and effective in pediatric patients with relapsed/refractory leukemia.
  • [MeSH-major] Adenine Nucleotides / administration & dosage. Arabinonucleosides / administration & dosage. Cyclophosphamide / administration & dosage. Etoposide / administration & dosage. Leukemia / drug therapy. Salvage Therapy / methods
  • [MeSH-minor] Acute Disease. Adolescent. Antineoplastic Combined Chemotherapy Protocols / adverse effects. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / toxicity. Child. Child, Preschool. Drug-Induced Liver Injury. Hematopoietic Stem Cell Transplantation. Humans. Infant. Leukemia, Myeloid, Acute / complications. Leukemia, Myeloid, Acute / drug therapy. Maximum Tolerated Dose. Precursor Cell Lymphoblastic Leukemia-Lymphoma / complications. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Remission Induction. Treatment Outcome. Young Adult

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  • (PMID = 19741725.001).
  • [ISSN] 1476-5551
  • [Journal-full-title] Leukemia
  • [ISO-abbreviation] Leukemia
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase I; Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Adenine Nucleotides; 0 / Arabinonucleosides; 6PLQ3CP4P3 / Etoposide; 762RDY0Y2H / clofarabine; 8N3DW7272P / Cyclophosphamide
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29. Koehl U, Sörensen J, Esser R, Zimmermann S, Grüttner HP, Tonn T, Seidl C, Seifried E, Klingebiel T, Schwabe D: IL-2 activated NK cell immunotherapy of three children after haploidentical stem cell transplantation. Blood Cells Mol Dis; 2004 Nov-Dec;33(3):261-6
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  • Therefore, we developed a protocol for clinical-use expansion of highly enriched and IL-2-stimulated NK cells.
  • Purification of unstimulated leukaphereses by a two-step T cell depletion with a final CD56 enrichment procedure leads to a mean purity of 95% CD56(+)CD3- NK cells with a four- to five-log depletion of T cells.
  • So far, three pediatric patients with multiply relapsed acute lymphoblastic leukemia (ALL) or acute myelogenous leukemia (AML) were treated with repeated transfusions post-H-SCT.
  • Although all patients showed blast persistence at the time of transplant, they reached complete remission and complete donor chimerism within 1 month post-H-SCT.
  • NK cell therapy was tolerated well without graft-versus-host disease (GvHD) induction or other adverse events.
  • The AML patient died of early relapse on day +80, while the ALL patients died of thrombotic-thrombocytopenic purpura and atypical viral pneumonia on days +45 and +152, respectively.
  • [MeSH-major] Antineoplastic Agents / pharmacology. Immunotherapy, Adoptive. Interleukin-2 / pharmacology. Killer Cells, Natural / transplantation. Leukemia, Myeloid, Acute / therapy. Lymphocyte Activation / drug effects. Precursor Cell Lymphoblastic Leukemia-Lymphoma / therapy
  • [MeSH-minor] Adolescent. Child. Graft vs Leukemia Effect / drug effects. Haplotypes. Humans. Male

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  • (PMID = 15528141.001).
  • [ISSN] 1079-9796
  • [Journal-full-title] Blood cells, molecules & diseases
  • [ISO-abbreviation] Blood Cells Mol. Dis.
  • [Language] eng
  • [Publication-type] Case Reports; Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Interleukin-2
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30. Creutzig U, Ritter J, Zimmermann M, Reinhardt D, Hermann J, Berthold F, Henze G, Jürgens H, Kabisch H, Havers W, Reiter A, Kluba U, Niggli F, Gadner H: Improved treatment results in high-risk pediatric acute myeloid leukemia patients after intensification with high-dose cytarabine and mitoxantrone: results of Study Acute Myeloid Leukemia-Berlin-Frankfurt-Münster 93. J Clin Oncol; 2001 May 15;19(10):2705-13
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  • [Title] Improved treatment results in high-risk pediatric acute myeloid leukemia patients after intensification with high-dose cytarabine and mitoxantrone: results of Study Acute Myeloid Leukemia-Berlin-Frankfurt-Münster 93.
  • PURPOSE: To improve outcome in high-risk patients, high-dose cytarabine and mitoxantrone (HAM) was introduced into the treatment of children with acute myelogenous leukemia (AML) in study AML-BFM 93.
  • Patients were randomized to HAM as either the second or third therapy block, for the purpose of evaluation of efficacy and toxicity.
  • PATIENTS AND METHODS: A total of 471 children with de novo AML were entered onto the trial; 161 were at standard risk and 310 were at high risk.
  • After the randomized induction (daunorubicin v idarubicin), further therapy, with the exception of HAM, was identical in the two risk groups and also comparable to that in study Acute Myeloid Leukemia-Berlin-Frankfurt-Münster (AML-BFM) 87.
  • RESULTS: Overall, 387 (82%) of 471 patients achieved complete remission, and 5-year survival, event-free survival (EFS), and disease-free survival rates were 60%, 51%, and 62%, respectively.
  • Estimated survival and probability of EFS were superior in study AML-BFM 93 compared with study AML-BFM 87 (P =.01, log-rank test).
  • This improvement, however, was restricted to the 310 high-risk patients (remission rate and probability of 5-year EFS in study AML-BFM 93 v study AML-BFM 87: 78% v 68%, P =.007; and 44% v 31%, P =.01, log-rank test).
  • Probability of 5-year EFS among standard-risk patients in study AML-BFM 93 was similar to that in study AML-BFM 87 (65% v 63%, P = not significant).
  • Whether HAM was placed as the second or third therapy block was of minor importance.
  • However, patients who received the less intensive daunorubicin treatment during induction benefited from early HAM.
  • CONCLUSION: Improved treatment results in children with high-risk AML in study AML-BFM 93 must be attributed mainly to the introduction of HAM.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Daunorubicin / therapeutic use. Idarubicin / therapeutic use. Leukemia, Myeloid, Acute / drug therapy

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  • (PMID = 11352963.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 04079A1RDZ / Cytarabine; BZ114NVM5P / Mitoxantrone; ZRP63D75JW / Idarubicin; ZS7284E0ZP / Daunorubicin
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31. Matsuzaki A, Eguchi H, Ikuno Y, Ayukawa H, Yanai F, Ishii E, Sugimoto T, Inada H, Anami K, Nibu K, Hara T, Miyazaki S, Okamura J: Treatment of childhood acute myelogenous leukemia with allogeneic and autologous stem cell transplantation during the first remission: a report from the Kyushu-Yamaguchi Children's Cancer Study group in Japan. Pediatr Hematol Oncol; 2000 Dec;17(8):623-34
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  • [Title] Treatment of childhood acute myelogenous leukemia with allogeneic and autologous stem cell transplantation during the first remission: a report from the Kyushu-Yamaguchi Children's Cancer Study group in Japan.
  • A total of 64 newly diagnosed acute myelogenous leukemia patients (except FAB M3 and/or Down syndrome) under 18 years of age were consecutively enrolled into the study.
  • Patients having an HLA-identical sibling (allo group) were assigned to undergo allogeneic bone marrow transplantation (allo BMT) in the first complete remission (CR).
  • [MeSH-major] Bone Marrow Transplantation. Hematopoietic Stem Cell Transplantation. Leukemia, Myeloid, Acute / mortality. Leukemia, Myeloid, Acute / therapy
  • [MeSH-minor] Adolescent. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Child. Child, Preschool. Combined Modality Therapy. Cytarabine / administration & dosage. Cytarabine / therapeutic use. Disease-Free Survival. Drug Administration Schedule. Etoposide / administration & dosage. Etoposide / therapeutic use. Female. Humans. Infant. Male. Mitoxantrone / administration & dosage. Mitoxantrone / therapeutic use. Prognosis. Remission Induction. Transplantation, Autologous. Transplantation, Homologous


32. Sandler ES, Hagg R, Coppes MJ, Mustafa MM, Gamis A, Kamani N, Wall D: Hematopoietic stem cell transplantation (HSCT) with a conditioning regimen of busulfan, cyclophosphamide, and etoposide for children with acute myelogenous leukemia (AML): a phase I study of the Pediatric Blood and Marrow Transplant Consortium. Med Pediatr Oncol; 2000 Oct;35(4):403-9
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  • [Title] Hematopoietic stem cell transplantation (HSCT) with a conditioning regimen of busulfan, cyclophosphamide, and etoposide for children with acute myelogenous leukemia (AML): a phase I study of the Pediatric Blood and Marrow Transplant Consortium.
  • BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an important treatment modality for children with AML.
  • PROCEDURE: Twenty patients with a diagnosis of AML in first or second remission, or myelodysplasia scheduled for bone marrow transplantation, were included in this study.
  • Four patients developed bacteremia and one patient died from overwhelming sepsis on day +3.
  • Four patients developed moderate to severe skin toxicity.
  • Eight patients developed clinical veno-occlusive disease, including three patients at dose level 4, two of whom had life-threatening disease.
  • Overall, 9 of 20 patients enrolled in the study survive in remission, 8/14 allogeneic (median follow-up 44 months), and one of six autologous patients (follow-up, 54 months).
  • CONCLUSIONS: We conclude that the combination of busulfan, cyclophosphamide, and etoposide at the doses defined above has activity in the treatment of children with high-risk AML/MDS undergoing allogeneic HSCT.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Hematopoietic Stem Cell Transplantation. Leukemia, Myeloid, Acute / therapy. Transplantation Conditioning
  • [MeSH-minor] Adolescent. Alberta. Busulfan / administration & dosage. Child. Child, Preschool. Cyclophosphamide / administration & dosage. Disease-Free Survival. Drug Administration Schedule. Etoposide / administration & dosage. Female. Humans. Infant. Male. Missouri. Texas. Treatment Outcome

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  • [Copyright] Copyright 2000 Wiley-Liss, Inc.
  • (PMID = 11025470.001).
  • [ISSN] 0098-1532
  • [Journal-full-title] Medical and pediatric oncology
  • [ISO-abbreviation] Med. Pediatr. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase I; Journal Article; Multicenter Study
  • [Publication-country] UNITED STATES
  • [Chemical-registry-number] 6PLQ3CP4P3 / Etoposide; 8N3DW7272P / Cyclophosphamide; G1LN9045DK / Busulfan
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33. Alonzo TA, Kobrinsky NL, Aledo A, Lange BJ, Buxton AB, Woods WG: Impact of granulocyte colony-stimulating factor use during induction for acute myelogenous leukemia in children: a report from the Children's Cancer Group. J Pediatr Hematol Oncol; 2002 Nov;24(8):627-35
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  • [Title] Impact of granulocyte colony-stimulating factor use during induction for acute myelogenous leukemia in children: a report from the Children's Cancer Group.
  • PURPOSE: To determine whether granulocyte colony-stimulating factor (G-CSF) administered during acute myelogenous leukemia (AML) induction affects hematopoietic and nonhematopoietic toxicity, length and outcome of induction therapy, event-free survival, overall survival, and prognostic significance of the day 7 bone marrow.
  • RESULTS: Time to neutropenic recovery after induction courses 1 and 2 was significantly shorter for patients who received G-CSF.
  • Times to platelet recovery were similar regardless of G-CSF use.
  • Induction remission rates, overall survival, and event-free survival were similar with and without G-CSF.
  • Patients with hypercellular day 7 marrow who received G-CSF had a higher remission rate and event-free survival than patients who did not receive G-CSF.
  • CONCLUSIONS: The incidence of severe toxic event and infection, induction remission rate, overall survival, and event-free survival were comparable regardless of G-CSF use.
  • Patients with hypercellular day 7 bone marrow who received G-CSF had an induction remission rate and event-free survival superior to those of patients who did not receive G-CSF.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Granulocyte Colony-Stimulating Factor / pharmacology. Leukemia, Myeloid / drug therapy
  • [MeSH-minor] Acute Disease. Bone Marrow / pathology. Child. Cytarabine / administration & dosage. Daunorubicin / administration & dosage. Dexamethasone / administration & dosage. Disease-Free Survival. Etoposide / administration & dosage. Female. Filgrastim. Follow-Up Studies. Humans. Hyperbilirubinemia / chemically induced. Infection Control. Length of Stay. Male. Neutropenia / chemically induced. Neutropenia / prevention & control. Prospective Studies. Recombinant Proteins. Remission Induction. Survival Analysis. Thioguanine / administration & dosage. Thrombocytosis / chemically induced. Thrombocytosis / prevention & control. Treatment Outcome

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  • (PMID = 12439034.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Recombinant Proteins; 04079A1RDZ / Cytarabine; 143011-72-7 / Granulocyte Colony-Stimulating Factor; 6PLQ3CP4P3 / Etoposide; 7S5I7G3JQL / Dexamethasone; FTK8U1GZNX / Thioguanine; PVI5M0M1GW / Filgrastim; ZS7284E0ZP / Daunorubicin; DCTER protocol
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34. Levine JE, Barrett AJ, Zhang MJ, Arora M, Pulsipher MA, Bunin N, Fort J, Loberiza F, Porter D, Giralt S, Drobyski W, Wang D, Pavletic S, Ringden O, Horowitz MM, Collins R Jr: Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population. Bone Marrow Transplant; 2008 Aug;42(3):201-5

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Donor leukocyte infusions to treat hematologic malignancy relapse following allo-SCT in a pediatric population.
  • DLI rarely induced remission when given as sole therapy for marrow relapse.
  • One-year disease-free survival was 30% (6/20) in patients who received DLI as consolidation following chemotherapy.
  • The development of GVHD grades 1-2 was associated with superior 3-year survival than patients who developed GVHD grades 3-4 (P<0.002).
  • There was no difference in survival (P=0.30) once adjustments were made to account for the time from relapse to DLI.
  • Although a few children achieved durable remissions when DLI was used as part of a post-relapse treatment strategy, DLI was unsuccessful in the majority of cases.
  • [MeSH-major] Hematologic Neoplasms / surgery. Hematologic Neoplasms / therapy. Leukocyte Transfusion. Stem Cell Transplantation / methods
  • [MeSH-minor] Acute Disease. Child. Combined Modality Therapy. Disease-Free Survival. Female. Graft vs Host Disease / epidemiology. Graft vs Tumor Effect. Humans. Leukemia / surgery. Leukemia / therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / surgery. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / therapy. Male. Recurrence. Tissue Donors. Transplantation, Homologous

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  • (PMID = 18490913.001).
  • [ISSN] 0268-3369
  • [Journal-full-title] Bone marrow transplantation
  • [ISO-abbreviation] Bone Marrow Transplant.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] England
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35. Tirado CA, Valdez F, Klesse L, Karandikar NJ, Uddin N, Arbini A, Fustino N, Collins R, Patel S, Smart RL, Garcia R, Doolittle J, Chen W: Acute myeloid leukemia with inv(16) with CBFB-MYH11, 3'CBFB deletion, variant t(9;22) with BCR-ABL1, and del(7)(q22q32) in a pediatric patient: case report and literature review. Cancer Genet Cytogenet; 2010 Jul 1;200(1):54-9
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  • [Title] Acute myeloid leukemia with inv(16) with CBFB-MYH11, 3'CBFB deletion, variant t(9;22) with BCR-ABL1, and del(7)(q22q32) in a pediatric patient: case report and literature review.
  • Coexistence of inv(16) and t(9;22) is a rare chromosomal aberration, one that has been described in chronic myelogenous leukemia (CML), mainly in myeloid blast crisis, and de novo acute myeloid leukemia (AML).
  • Approximately 14 cases have been reported, including only 1 pediatric case.
  • Here we present the case of a 13-year-old boy with a new diagnosis of AML with some features of monocytic differentiation.
  • The patient was treated with standard AML chemotherapy plus gemtuzumab as part of a clinical trial.
  • At 10-months follow-up, he was in remission.
  • To the best of our knowledge, this is the first description of a pediatric case of de novo AML with a stemline showing inv(16) along with 3'CBFB deletion, an abnormal clone revealing in addition a del(7)(q22q32), and another clone with a t(9;22;19)(q34;q11.2;p13.1) as an additional abnormality.
  • [MeSH-major] Chromosome Deletion. Chromosome Inversion. Chromosomes, Human, Pair 16. Chromosomes, Human, Pair 22. Chromosomes, Human, Pair 7. Chromosomes, Human, Pair 9. Fusion Proteins, bcr-abl / genetics. Leukemia, Myeloid, Acute / genetics. Oncogene Proteins, Fusion / genetics. Translocation, Genetic

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  • [Copyright] 2010 Elsevier Inc. All rights reserved.
  • (PMID = 20513535.001).
  • [ISSN] 1873-4456
  • [Journal-full-title] Cancer genetics and cytogenetics
  • [ISO-abbreviation] Cancer Genet. Cytogenet.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / CBFbeta-MYH11 fusion protein; 0 / Oncogene Proteins, Fusion; EC 2.7.10.2 / Fusion Proteins, bcr-abl
  • [Number-of-references] 16
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36. Hartwig M, Weigel S, Bernig T, Bader P, Dölken R, Beck J: Maintenance immunotherapy by repetitive low-dose donor lymphocytes infusions in a child with relapse state aml after allogeneic stem cell transplantation. Pediatr Hematol Oncol; 2007 Mar;24(2):137-40
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  • [Title] Maintenance immunotherapy by repetitive low-dose donor lymphocytes infusions in a child with relapse state aml after allogeneic stem cell transplantation.
  • The treatment of a child with a relapsed state acute leukemia after allogeneic stem cell transplantation (allo-SCT) is a challenge.
  • The authors report about a child with an acute myelogenous leukemia (AML), which relapsed after allo-SCT despite immunological intervention.
  • It was further treated with a second line chemotherapy followed by an infusion of stem cells and donor lymphocytes.
  • Because of an immense risk for a further relapse, an immunological maintenance therapy was also performed, consisting of repetitive infusions of low doses of donor lymphocytes combined with low-dose chemotherapy.
  • Presently, the child is in continuous complete remission and has a good quality of life.
  • [MeSH-major] Graft vs Host Disease / therapy. Leukemia, Myeloid, Acute / therapy. Lymphocyte Transfusion. Stem Cell Transplantation
  • [MeSH-minor] Blood Donors. Dose-Response Relationship, Immunologic. Female. Humans. Immunotherapy. Infant. Neoplasm Recurrence, Local / therapy. Transplantation, Homologous. Treatment Outcome

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  • (PMID = 17454780.001).
  • [ISSN] 1521-0669
  • [Journal-full-title] Pediatric hematology and oncology
  • [ISO-abbreviation] Pediatr Hematol Oncol
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
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37. Burke MJ, Willert J, Desai S, Kadota R: The treatment of pediatric Philadelphia positive (Ph+) leukemias in the imatinib era. Pediatr Blood Cancer; 2009 Dec;53(6):992-5
Hazardous Substances Data Bank. IMATINIB MESYLATE .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The treatment of pediatric Philadelphia positive (Ph+) leukemias in the imatinib era.
  • BACKGROUND: As the treatment of Philadelphia positive (Ph+) leukemias in the era of imatinib continues to evolve, the role of allogeneic hematopoietic cell transplantation (allogeneic-HCT) in first remission is becoming more unclear.
  • PROCEDURE: Thirty-two pediatric centers across the United States and Canada were surveyed regarding current treatment practices for Ph+ acute lymphoblastic leukemia (ALL) and chronic myelogenous leukemia (CML).
  • The survey addressed treatment approaches for Ph+ ALL and CML in terms of imatinib therapy and use of allogeneic-HCT.
  • Of the 27 physicians responding to the survey, 22 (81%) recommended a matched sibling donor (MSD) allogeneic-HCT, when available, in first remission for Ph+ ALL compared to 17/27 (63%) for patients with first chronic phase CML.
  • There was universal agreement among survey responders regarding the use of imatinib upfront in Ph+ ALL and CML patients while 13 of 27 (48%) physicians reported using imatinib as maintenance therapy post-HCT for Ph+ ALL compared to 9 of 27 (33%) for CML.
  • CONCLUSIONS: Although a treatment consensus did not exist based on the results of this small survey, current treatment practices for pediatric Ph+ ALL and CML appear to favor allogeneic-HCT when a MSD is available.
  • The use of post-HCT imatinib as maintenance therapy to avoid relapse for either Ph+ ALL or CML remains uncertain and awaits future prospective studies.
  • [MeSH-major] Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Piperazines / therapeutic use. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Pyrimidines / therapeutic use
  • [MeSH-minor] Benzamides. Canada. Data Collection / statistics & numerical data. Hematopoietic Stem Cell Transplantation / methods. Humans. Imatinib Mesylate. Physicians / statistics & numerical data. Practice Patterns, Physicians'. Siblings. Tissue Donors. Transplantation, Homologous. United States

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  • (PMID = 19621426.001).
  • [ISSN] 1545-5017
  • [Journal-full-title] Pediatric blood & cancer
  • [ISO-abbreviation] Pediatr Blood Cancer
  • [Language] eng
  • [Publication-type] Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Benzamides; 0 / Piperazines; 0 / Pyrimidines; 8A1O1M485B / Imatinib Mesylate
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38. Sato T, Kaneda M, Ichikawa M, Suzuki D, Nakagawa A, Kobayashi R: Current approaches to management of cerebral fungal infection in pediatric patients with hematologic disorders. J Pediatr Hematol Oncol; 2008 Mar;30(3):249-53
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Current approaches to management of cerebral fungal infection in pediatric patients with hematologic disorders.
  • We report 2 pediatric cases of cerebral fungal infection.
  • A patient with severe aplastic anemia developed an Aspergillus species brain abscess and pulmonary aspergillosis after peripheral blood stem cell transplantation.
  • Another patient with acute myelogenous leukemia developed a huge brain abscess with histopathologic findings suspicious of mucormycosis.
  • This patient was cured with combination therapy of antifungal agents and intensive surgery, without sequelae.
  • It is important to perform aggressive multimodality treatment, when indicated, including surgical intervention, even if in myelosuppression.
  • [MeSH-major] Aspergillosis / diagnosis. Central Nervous System Fungal Infections / diagnosis. Hematologic Diseases / complications. Leukemia, Myeloid, Acute / complications. Mucormycosis / diagnosis
  • [MeSH-minor] Adolescent. Amphotericin B / administration & dosage. Anti-Bacterial Agents / administration & dosage. Antifungal Agents / administration & dosage. Child. Drug Combinations. Echinocandins / administration & dosage. Fatal Outcome. Female. Flucytosine / administration & dosage. Follow-Up Studies. Graft Rejection. Humans. Lipopeptides. Lipoproteins / administration & dosage. Magnetic Resonance Imaging. Male. Peripheral Blood Stem Cell Transplantation / adverse effects. Remission Induction. Treatment Outcome

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  • (PMID = 18376292.001).
  • [ISSN] 1077-4114
  • [Journal-full-title] Journal of pediatric hematology/oncology
  • [ISO-abbreviation] J. Pediatr. Hematol. Oncol.
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Anti-Bacterial Agents; 0 / Antifungal Agents; 0 / Drug Combinations; 0 / Echinocandins; 0 / Lipopeptides; 0 / Lipoproteins; 7XU7A7DROE / Amphotericin B; D83282DT06 / Flucytosine; R10H71BSWG / micafungin
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39. Porkka K, Koskenvesa P, Lundán T, Rimpiläinen J, Mustjoki S, Smykla R, Wild R, Luo R, Arnan M, Brethon B, Eccersley L, Hjorth-Hansen H, Höglund M, Klamova H, Knutsen H, Parikh S, Raffoux E, Gruber F, Brito-Babapulle F, Dombret H, Duarte RF, Elonen E, Paquette R, Zwaan CM, Lee FY: Dasatinib crosses the blood-brain barrier and is an efficient therapy for central nervous system Philadelphia chromosome-positive leukemia. Blood; 2008 Aug 15;112(4):1005-12
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Dasatinib crosses the blood-brain barrier and is an efficient therapy for central nervous system Philadelphia chromosome-positive leukemia.
  • Although imatinib, a BCR-ABL tyrosine kinase inhibitor, is used to treat acute Philadelphia chromosome-positive (Ph(+)) leukemia, it does not prevent central nervous system (CNS) relapses resulting from poor drug penetration through the blood-brain barrier.
  • Imatinib and dasa-tinib (a dual-specific SRC/BCR-ABL kinase inhibitor) were compared in a preclinical mouse model of intracranial Ph(+) leukemia.
  • Clinical dasatinib treatment in patients with CNS Ph(+) leukemia was assessed.
  • The drug also demonstrated substantial activity in 11 adult and pediatric patients with CNS Ph(+) leukemia.
  • In 3 additional patients, isolated CNS relapse occurred during dasatinib therapy; and in 2 of them, it was caused by expansion of a BCR-ABL-mutated dasatinib-resistant clone, implying selection pressure exerted by the compound in the CNS.
  • Dasatinib has promising therapeutic potential in managing intracranial leukemic disease and substantial clinical activity in patients who experience CNS relapse while on imatinib therapy.
  • [MeSH-major] Blood-Brain Barrier / metabolism. Central Nervous System Neoplasms / drug therapy. Leukemia, Myelogenous, Chronic, BCR-ABL Positive / drug therapy. Pyrimidines / administration & dosage. Pyrimidines / pharmacokinetics. Thiazoles / administration & dosage. Thiazoles / pharmacokinetics
  • [MeSH-minor] Adolescent. Adult. Aged. Animals. Child. Cytogenetic Analysis. Dasatinib. Disease Models, Animal. Drug Evaluation, Preclinical. Drug Monitoring. Female. Humans. Male. Mice. Middle Aged. Precursor Cell Lymphoblastic Leukemia-Lymphoma. Remission Induction. Spinal Puncture. Survival Rate. Treatment Outcome. Tumor Burden / drug effects

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  • (PMID = 18477770.001).
  • [ISSN] 1528-0020
  • [Journal-full-title] Blood
  • [ISO-abbreviation] Blood
  • [Language] eng
  • [Databank-accession-numbers] ClinicalTrials.gov/ NCT00108719/ NCT00110097
  • [Publication-type] Clinical Trial; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Pyrimidines; 0 / Thiazoles; RBZ1571X5H / Dasatinib
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40. Colby-Graham MF, Chordas C: The childhood leukemias. J Pediatr Nurs; 2003 Apr;18(2):87-95
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] The childhood leukemias.
  • Advances in treatment and prognosis of childhood leukemia are considered a remarkable success of modern medicine.
  • Childhood leukemia, once considered a universally fatal disease, now boasts overall cure rates ranging from 75% to 85% for acute lymphocytic leukemia (ALL) and cure rates approaching 40% to 50% for acute myelogenous leukemia (AML).
  • Inherent to this success is the expertise nurses provide when caring for children with leukemia.
  • Understanding the classifications of leukemia and the specific therapies help direct the specialized care children with leukemia need.
  • This article provides an overview of childhood leukemias, diagnostic and classification methods used to differentiate and evaluate childhood leukemias, and treatment strategies applied toward various forms of childhood leukemias.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Leukemia, Myeloid, Acute / drug therapy. Leukemia, Myeloid, Acute / nursing. Precursor Cell Lymphoblastic Leukemia-Lymphoma / drug therapy. Precursor Cell Lymphoblastic Leukemia-Lymphoma / nursing
  • [MeSH-minor] Child. Child, Preschool. Diagnosis, Differential. Female. Follow-Up Studies. Humans. Infant. Male. Neoplasm Staging. Nursing Assessment. Nursing Diagnosis. Remission Induction. Risk Assessment. Survival Rate. Treatment Outcome

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  • [Copyright] Copyright 2003, Elsevier Inc. All rights reserved.
  • (PMID = 12720205.001).
  • [ISSN] 0882-5963
  • [Journal-full-title] Journal of pediatric nursing
  • [ISO-abbreviation] J Pediatr Nurs
  • [Language] eng
  • [Publication-type] Comparative Study; Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 24
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