Implementing a risk-adopted therapy in patient with thalassemia in Jordan can result in an excellent thalassemia free and OS, especially in those at highest risk.
Our findings highlight the need for the revision of the teaching curricula in medical schools with regard to the management of hypertension, as well as the initiation of a widespread and intensive continuing medical education for all physicians involved in the management of patients with hypertension. Particular efforts are needed to encourage the use of low-cost thiazides and the use of angiotension converting enzyme inhibitors in heart failure patients and other compelling indications.
Bacterial infection is a serious sequela following AHSCT; however, limited data are available regarding pediatric recipients, especially in developing countries. We retrospectively analyzed the incidence and risk factors of bacterial infections during the first 100 days after AHSCT in children at KHCC in Amman, Jordan between January, 2005 and September, 2013. A total of 65 patients were identified, with median age of four yr (1-17). Forty-seven patients (72.3%) had solid tumors and 18 (27.7%) had lymphoma. Bacterial infections were documented in 33 patients (50%), with a total of 63 episodes. Gram-negative infection (57.1%) was more prevalent than Gram-positive infection (38%). The risk of bacterial infections was higher among patients less than five yr of age (p = 0.028) and those who developed hypogammaglobulinemia requiring IVIG replacement (p = 0.001). Patients with solid tumors developed more bacterial infections compared to patients with lymphoma (p = 0.0057). No deaths were attributed to bacterial infection. Bacterial infection rate is high among recipients of AHSCT in Jordan with Gram-negative bacteria being the most common.
There are limited data on the incidence of CMV reactivation following autologous HSCT (AHSCT) in children. We retrospectively reviewed the incidence and risk factors for CMV reactivation in 72 children who received AHSCT. Twenty-two patients (31%) had positive CMV antigenemia at a median of 23 days (12-31) following transplant. Four patients (6%) required preemptive therapy and all episodes resolved. None of the patients developed CMV disease. Only being CMV seropositivity prior to transplant was significantly associated with CMV reactivation (P < 0.001). The incidence of CMV reactivation following pediatric AHSCT is low, and surveillance beyond 30 days is not needed.
Introduction Patients with Fanconi anemia have an increased susceptibility to malignancies associated with human papillomavirus, and thus prevention and early management of human papillomavirus infections in this patient population are crucial. Case report A nine-year-old girl with Fanconi anemia developed genital warts about three years after undergoing haplo-identical stem cell transplant. The transplant was complicated by chronic graft-versus-host disease, and the patient had therefore received multiple immunosuppressants. The genital warts were treated with several creams, but minimal improvement was reported. Management and outcome Cidofovir was extemporaneously compounded into an unscented 1% moisturizing cream and applied daily at bedtime to the genital warts. By the end of treatment, the warts had been successfully treated, and no adverse events were reported. The patient is still free of any lesions at six months after completing treatment. Discussion Although reports have been published on the use of cidofovir cream, most were in adults with non-genital warts. Cidofovir cream may be considered as a treatment option for refractory genital warts in pediatric patients. However, further studies are needed to better define the optimal preparation and dosing for such patient population.
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