摘要:

Purpose: A large cell anaplastic lynphoma that developed after treatment of a Ewinig sarcoma (ES) is described.Patient: An II-year-old girl with a pelvie ES developed a large cell. Ki-1+. anaplastic lymphoma in the same anatomic location 10 months alter multimodal therapyResults: ES recurred in the primarv site 16 months alter allogeneic marrow transplantation and 3.5 years alter initial diagnosis, but the patient remains m remission from her lymphoma. Conclusion: The occurrenee of lymphoma and ES in a short time interval in the same patient is very unusual. Whether etiologic factors other than chemoradiotherapy. including genetic disposition. play a role remains to he elucidated.

ISSN:1077-4114    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Abstract: The clinical course of a 31–month-old patient with advanced (stage IV) rhabdoid tumor of the kidney (RTK) and an analysis of treatment variables that may impact survival are presented. Treatment included complete resection of abdominal disease, radiation therapy to the abdomen and chest, and chemotherapy on a schedule of dose intensification by reduction of the interval between cycles. Inclusion of doxorubicin in treatment was associated with survival among patients in published series (P = 0.002). The patient was in continuous complete remission 60 months from diagnosis. Stage IV rhabdoid tumor of the kidney can be effectively treated with intensive multimodal therapy. Doxorubicin may be an important component of a successful therapeutic regimen.

ISSN:1077-4114    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose: Report the unusual presentation, clinical course, and cytogenetic abnormalities in a child with multifocal osteosarcoma.Patients and Methods: A 10–year-old boy had multifocal osteosarcoma involving the entire skeleton, pleura, bone marrow, and lungs. He had marked anemia, thrombocytopenia, and severe hypocalcemia at diagnosis.Results: Despite aggressive chemotherapy, he died from progressive disease 1 month after diagnosis. Cytogenetic analysis of tumor cells within the pleural fluid showed multiple chromosomal abnormalities with amplification of the c-myc oncogene.Conclusion: Multifocal osteosarcoma should be considered in the differential diagnosis of a child with pancytopenia and multiple bone lesions. Amplification of the c-myc oncogene may have had a significant role in the pathogenesis, etiology, and rapid progression of this patient's multifocal disease. Additional studies will be needed to determine the biologic significance of c-myc amplification in multifocal osteosarcoma.

ISSN:1077-4114    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose: Transient leukemia and extreme basophilia occurred in a phenotypically normal newborn with expression of isochromosome (21)(q10) in the blast population.Patients and Methods: A newborn boy was found to have an elevated white blood cell count of 120,800 with 33% blasts. The peripheral blood also contained elevated numbers of basophils and neutrophils with unusual staining properties. The blasts, evaluated by flow cytometry and light and electron microscopy, had the properties of megakaryoblasts. Cytogenetic studies revealed 46,XY karyotype in peripheral blood lymphocytes; however, analysis of the blast cells from the bone marrow showed an abnormal chromosome 21.Results: The blast cells in the peripheral blood disappeared by day 42 without chemotherapy. The red blood cell count and platelet count normalized by 2 months. Chromosomal analysis of skin fibroblasts and bone marrow after the disappearance of the blast cells in the peripheral blood showed a 46,XY phenotype.Conclusions: The leukemic cell of transient leukemia has the potential of forming cells of basophil and megakaryocyte lineages. Trisomy of the q arm of chromosome 21 contains sufficient genetic information for the development of transient leukemia in a phenotypically normal newborn.

ISSN:1077-4114    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose: The treatment and outcome of a patient with sickle cell trait and metastatic renal medullary carcinoma is described.Patient and Methods: A 12–year-old boy with sickle cell trait had metastatic renal medullary carcinoma. After surgical resection of the primary tumor, he received chemotherapy with methotrexate, vinblastine, doxorubicin, and cisplatin. The carcinoma progressed after a 6–month period of stable disease. At that time, he received chemotherapy including ifosfamide, etoposide, carboplatin, and topotecan.Results: The patient died of progressive disease 15 months from diagnosis. The patient's tumor in this report showed no progression while he was receiving methotrexate, vinblastine, doxorubicin, and cisplatin, but eventually became refractory to these and other cytotoxic agents.Conclusion: Renal medullary carcinoma is a highly chemotherapy-resistant tumor. Average survival after diagnosis is 15 weeks; the longest survival reported in the literature is 12 months from diagnosis. The patient in this report survived longer than the previously described patients before dying from progressive disease.

ISSN:1077-4114    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Purpose: Signs and symptoms of delayed hemolytic transfusion reaction (DHTR) may resemble those of vaso-occlusive crises in patients with sickle cell anemia (SCA). The diagnosis of DHTR therefore presents a challenge to the clinician when treating such patients. The current study describes a patient with SCA and DHTR secondary to red cell anti-s antibody, manifesting as painful extremeties, severe hemolytic anemia, and acute oliguric renal failure.Patient and Methods: A 17–year-old patient with homozygous hemoglobin S presented 8 days after partial exchange transfusions with severe anemia and signs and symptoms resembling vaso-occlusive crisis. Clinical course was complicated by intravascular hemolysis and acute renal failure.Results: Anti-s antibody was detected in the eluate. Diagnosis of DHTR was made. Treatment included single volume whole blood exchange transfusion and continuous veno-venous hemofiltration with dialysis.Conclusions: The possibility of DHTR should be considered in a patient with SCA with hemolytic anemia. Acute renal failure is a rare complication of anti-s antibody-associated DHTR. Such reactions can be successfully managed with exchange transfusion and continuous hemofiltration with dialysis.

ISSN:1077-4114    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Background: Modern plasma-derived clotting factor concentrates are produced using various virus-inactivation protocols and are assumed to be safer than they were previously with regard to the risk for transmitting viral infections such as human immunodeficiency virus, hepatitis B, and hepatitis C. The risks from viruses that are relatively resistant to the current inactivation procedures remain uncertain.Patient: A 7–year-old boy with mild hemophilia A who had not been previously infused with any blood products was treated with a plasma-derived, monoclonal antibody-purified factor VIII concentrate to cover orthopedic surgery after traumatic fracture of his left arm.Results: A typical primary human parvovirus (HPV)-B19 infection was observed associated with transient hypoplastic anemia. Retrospective studies including serologic examination and poly-merase chain reaction analysis confirmed that the HPV-B19 infection was transmitted by the factor VIII concentrate.Conclusions: Clotting factor concentrates for the treatment of hemophilia retain a risk for HPV-B19 contamination. HPV-B19 viral infection might induce hypoplastic anemia in these patients, particularly during enhanced hemopoiesis after acute blood loss.

ISSN:1077-4114    

出版商:OVID    

年代:1999

数据来源: OVID

摘要:

Abstract: Although splenectomy is the most effective treatment for chronic idiopathic thrombocytopenic purpura (ITP), many post-splenectomy patients have recurrent thrombocytopenia refractory to multiple medical therapies. Three consecutive patients with relapsed ITP after splenectomy and who were refractory to multiple medical therapies were treated with low dose cyclosporin A (CsA). In all 3 patients, the platelet count increased dramatically within 1 month from the onset of CsA therapy. The only detectable toxicity was hypomagnesemia and mild hypertension in 1 patient. CsA may be efficacious in treating patients with chronic ITP, which is refractory to all medical and surgical therapies currently being used.

ISSN:1077-4114    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1077-4114    

出版商:OVID    

年代:1999

数据来源: OVID

ISSN:1077-4114    

出版商:OVID    

年代:1999

数据来源: OVID