Home About us Contact
|
Home About us Contact | ||
|
|
||
Excellent Efficacy (excellent + efficacy)
Selected AbstractsAutologous peripheral blood stem cell collections in children weighing less than 10 Kg with solid tumors: Experience of a single centerJOURNAL OF CLINICAL APHERESIS, Issue 2 2005Hyun-Jung Cho Abstract There have only been a few reports and limited performance of peripheral blood stem cell (PBSC) collection in very small children weighing less than 10 kg. In this study, we intended to evaluate the safety and yield of PBSC collection, with the efficacy of PBSC transplantation (PBSCT) in the smallest children with solid tumors. From January 1998 to February 2004, 173 children underwent PBSC collection in Samsung Medical Center, Korea. Of these, 15 (8.7%) children weighed less than 10 kg and their clinical diagnoses were neuroblastoma (10 cases), rhabdoid tumor (2 cases), rhabdomyosarcoma (2 cases), and Wilms tumor (1 case). PBSCs were collected following chemotherapy plus G-CSF mobilization. The median age and weight at the time of apheresis were 15 months and 9 kg, respectively. The median number of PBSC collection procedures per case was 4 (range, 2,7). The median cell yield per apheresis product was 0.95 (range, 0.01,33.32) × 106/kg CD34+ cells and 1.96 (range, 0.12,23.39) × 108/kg mononuclear cells. No complications associated with citrate toxicity and other adverse effect were observed during the procedures. After high-dose chemotherapy, 14 patients were reinfused with PBSCs alone and all showed successful hematopoietic recovery. We concluded that PBSC collection would be a safe and practical procedure, even when done in the smallest children, provided that adequate intravascular fluid volume and circulating red cell mass were maintained. Also, the use of PBSCs to support high-dose chemotherapy was well tolerated and might enhance hematological recovery in the smallest children showing the excellent efficacy of PBSCT. J. Clin. Apheresis © 2005 Wiley-Liss, Inc. [source] Vitiligo Treatment in Childhood: A State of the Art ReviewPEDIATRIC DERMATOLOGY, Issue 5 2010Marion Eunice B. Tamesis M.D. Approximately half of the affected individuals develop the disease before adulthood. Etiologic hypotheses for vitiligo include biochemical, neural and autoimmune mechanisms. The most compelling of these suggests a combination of genetic and immunologic factors that result in an autoimmune melanocyte destruction. We reviewed studies carried out on various treatment modalities used in childhood vitiligo. Topical corticosteroids were found to have excellent repigmentation rates, whereas calcineurin inhibitors have comparable efficacy and a better safety profile compared with topical corticosteroids. These two groups of topical medications are good first-line treatment modalities for localized vitiligo. For the treatment of generalized vitiligo, phototherapy has excellent efficacy. Narrow-band ultraviolet B (UVB) has better overall repigmentation rates and safety profile than either topical or oral psoralens and ultraviolet A (PUVA). Other treatment modalities may be considered depending on a patient's specific condition, such as surgical options and depigmentation. With adequate sun protection, the option of no treatment with or without corrective camouflage, is an innocuous alternative to any of these treatment modalities. [source] High response rate and manageable toxicity with an intensive, short-term chemotherapy programme for Burkitt's lymphoma in adultsBRITISH JOURNAL OF HAEMATOLOGY, Issue 6 2004Massimo Di Nicola Summary A very short, intensive paediatric chemotherapy programme was tested in a consecutive monoinstitutional group of 22 adult Burkitt's lymphoma (BL) patients. After a 5-week induction phase of weekly infusions consisting of vincristine, cyclophosphamide, doxorubicin, high-dose (HD) methotrexate (MTX) plus leukovorin rescue, and intrathecal MTX or cytarabine (ARA-C), a consolidation phase including HD ARA-C plus cisplatin was given. Responding patients achieving less than complete response (CR) after completion of the initial induction phase, were promptly shifted to a high-dose, stem cell supported sequential chemotherapy schema (R-HDS). Patient characteristics: median age, 35·5 (range 18,76) years; Ann Arbor stage I,II/III,IV, 11/11; bulky disease, 15 patients; LDH , 460 U/l, 11 patients. The median duration of the chemotherapy programme was 62 d (range, 43,94 d). Seventeen patients achieved a CR (77%), one patient died of progressive disease and four partial responders following induction were converted to CR following R-HDS. Of 17 patients in CR, one died of infectious toxicity while in CR, and one relapsed at 30 months and died of progressive disease. After a median follow-up of 28·7 months (range, 6,158 months), 16 patients (73%) were in continued CR. Overall survival and progression-free survival were 77% [95% confidence interval (CI), 52,99%] and 68% (95% CI, 43,99%) respectively. Confirmation of these excellent efficacy and feasibility results by larger, multicentre and prospective studies is warranted. [source] Bacteraemia in children in Iceland 1994,2005ACTA PAEDIATRICA, Issue 10 2010Sigurđur Árnason Abstract Aim:, To investigate the aetiology of bacteraemia in children in Iceland, the antibiotic resistance and possible preventive measures. Methods:, All positive bacterial blood cultures from children 0,18 years old isolated at Landspítali University Hospital Iceland from 1994 to 2005 were included in the study. Epidemiological and microbiological data were registered. The blood cultures were categorized according to likelihood of infection or contamination. Results:, During the study period 1253 positive blood cultures were obtained from 974 children; 647 from boys and 606 from girls. Positive blood cultures were most common during the first year of life (594; 47.4%) with 252 of them from neonates. Coagulase negative staphylococci were most common (37%). Of probable or definite infections Streptococcus pneumoniae was the most common (19.3%) followed by Staphylococcus aureus (17.6%) and Neisseria meningitidis (13.5%). The most common pneumococcal serogroups were 23, 6, 7, 19 and 14. Commercially available vaccines contain up to 88% of all pneumococcal strains and 67% of all multi-resistant strains. N. meningitidis group C was not isolated after vaccinations were started in 2002. Conclusion:, Our study provides important epidemiological data on bacterial bloodstream infections in children in Iceland. The results demonstrate the excellent efficacy of meningococcal group C vaccination. [source] Induction therapy by anti-thymocyte globulin (rabbit) in renal transplantation: a 1-yr follow-up of safety and efficacyCLINICAL TRANSPLANTATION, Issue 6 2003Matthias Büchler Abstract: Background: Two hundred and forty cadaveric renal transplant recipients given anti-thymocyte globulin (Thymoglobulin®) as induction immunotherapy were followed up prospectively to review safety and efficacy. Methods: The median number of infusions was 10 [2,21] with a cumulative dose of 8.8 mg/kg [2.0,23.2 mg/kg]. During the fortnight following transplantation, 231 patients (96%) received a calcineurin inhibitor; all patients were given steroids and azathioprine or mycophenolate mofetil. At 1 yr, 60% of patients were on tripletherapy, 38% on bitherapy, and 2% on monotherapy; 20% had discontinued steroids. Results: Tolerance was excellent with no cases of anaphylaxis. The commonest adverse event was fever (55%). Eighteen patients developed serum sickness on median day 11 [10,14]. Seven patients had thrombocytopenia; six patients had severe neutropenia. All of these adverse events recovered spontaneously. The overall incidence of delayed graft function was 24%. At 1 yr patient and graft survival were 98 and 95%, respectively, and creatinine was 135 ± 43 ,mol/L. Clinically suspected and biopsy-proven acute rejection were observed in 65 patients (27%) and 34 patients (14%), respectively. There were 62 non-cytomegalovirus (CMV) infections (two fatal) and 81 episodes of CMV infections. Eight malignancies were reported; two possibly related to immunosuppression. Conclusions: These results demonstrate that anti-thymocyte globulin has a safety profile with good tolerability and excellent efficacy. [source] | ||||||||||