Outpatient AML consolidation therapy is safe and feasible in children. It appears to result in less frequent invasive blood studies; shorter duration of febrile neutropenia and consequently less antimicrobial and antifungal usage as compared to inpatient consolidation cycles. To our knowledge, this report is the first of its kind looking specifically at outpatient consolidation chemotherapy in AML.
Presented here is a report of 3 children, out of 66 total pediatric Hodgkin's lymphoma (HL) patients (4.5%) with bone involvement over a 3 and a half year period. Two patients presented with osseous lesions at the time of relapse and one had concurrent evidence of non-osseous disease. The clinical presentation, radiographic findings, histology, treatment and outcome of these patients are discussed. Boys and girls are nearly equally affected, local bone pain is the commonest symptom and B-symptoms are common. Vertebrae and pelvis are most frequently involved, commonly with an osteolytic picture. Nodular sclerosis is the predominant histological subtype. Most children received combined modality treatment and the overall response and survival are good.
Children < or =18 years with malignant proptosis enrolled in ophthalmic tumor clinic at a tertiary cancer center from July 2003 to December 2006 were retrospectively analyzed. The incidence of proptosis among the pediatric cancer patients was 4.9%. Secondary tumors accounted for majority of cases (n=62, 59.6%) with retinoblastoma (51%) being the commonest cause of proptosis. Fourteen (13.5%) patients presented with bilateral proptosis; all but one had metastatic tumor as underlying cause. Metastatic malignancies had significantly lower hemoglobin and platelet count and higher white blood count. Therefore, careful analysis of symptomatology, hemogram, and those with bilateral proptosis warrant a hematologic work-up before imaging studies and invasive orbital biopsy.
Data pertaining to primary and secondary osseous involvement in pediatric non-Hodgkin's lymphoma (NHL) are scarce in English literature. Fifty-nine cases of childhood NHL over a period of 3.5 years were reviewed out of which eight had bone involvement, the incidence of skeletal involvement being 13.6%. There were seven males (87.5%) and mean age was 9.9 years (range: 1-15 years). Two patients (25%) had primary bone lymphoma and six cases (75%) were classified as secondary bone lymphoma. Six patients who opted for treatment received chemotherapy; 4/6 (67%) patients are in complete remission at a median follow-up of 41 months (range 19-44 months). Bone involvement was more common in relapsed cases in comparison to de novo presentations.
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