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second malignant neoplasms in childhood cancer survivors in a tertiary paediatric oncology centre in Hong Kong, China

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Chinese Medical Journal 2011年第22期124卷 3686-3692页

作者： SUN Wai-fun CHENG Frankie Wai-tsoi LEE Vincent LEUNGWing-kwan SHING Ming-kong YUEN Patrick Man-pan LI Chi-kong Department of Paediatrics and Adolescent Medicine Pamela Youde Nethersole Eastern Hospital Hong Kong China

Background Childhood cancer survivors were at risk of development of second malignant neoplasms. The aim of this study is to evaluate the incidence, risk factors and outcome of second malignant neoplasms in childhood cancer survivors in a tertiary paediatric oncology centre in Hong Kong, China. Methods We performed a retrospective review of patients with childhood cancer treated in Children＇s Cancer Centre in Prince of Wales Hospital, Hong Kong, China between May 1984 and June 2009. Case records of patients who developed second malignant neoplasms were reviewed. Results Totally 1374 new cases aged less than 21-year old were treated in our centre in this 25-year study period. Twelve cases developed second malignant neoplasms with 10-year and 20-year cumulative incidence of 1.3% （95% confidence interval 0.3%-2.3%） and 2.9% （95% confidence interval 1.1%-4.7%） respectively. Another 4 cases were referred to us from other centres for the management of second malignant neoplasms. In this cohort of 16 children with second malignant neoplasms, the most frequent second malignant neoplasms were acute leukemia or myelodysplastic syndrome （n--6） and central nervous system tumor （n=4）. Median interval between diagnosis of primary and second malignant neoplasms was 7.4 years （range 2.1-13.3 years）. Eight patients developed second solid tumor within the previous irradiated field. Radiotherapy significantly increased the risk of development of second solid tumor in patients with acute lymphoblastic leukemia （P=0.027）. Seven out of 16 patients who developed second malignant neoplasms had a family histo＇ry of cancer among the first or second-degree relatives. Nine patients died of progression of second malignant neoplasms, mainly resulted from second central nervous system tumor and osteosarcoma. Conclusions Cumulative incidence of second cancer in our centre was comparable to western countries. Radiotherapy was associated with second solid tumour among patients with acute lymphoblast

关键词： second neoplasm oncology paediatric

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Neurological complications of hematopoietic cell transplantation in children and adults

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Neural Regeneration Research 2018年第6期13卷 945-954页

作者： Adriana Octaviana Dulamea Ioana Gabriela Lupescu University of Medicine and Pharmacy Carol Davila Bucharest Romania Department of Neurology Fundeni Clinical Institute Bucharest Romania Radiology and Medical imaging Department Fundeni Clinical Institute Bucharest Romania

Hematopoietic cell transplantation（HCT） is widely performed for neoplastic and non-neoplastic diseases. HCT involves intravenous infusion of hematopoietic progenitor cells from human leukocyte antigen（HLA）-matched donor（allogeneic） or from the patient（autologous）. Before HCT, the patient is prepared with high dose chemotherapy and/or radiotherapy to destroy residual malignant cells and to reduce immunologic resistance. After HCT, chemotherapy is used to prevent graft rejection and graft versus host disease（Gv HD）. Neurological complications are related to the type of HCT, underlying disease, toxicity of the conditioning regimens, immunosuppression caused by conditioning regimens, vascular complications generated by thrombocytopenia and/or coagulopathy, Gv HD and inappropriate immune response. In this review, neurological complications are presented according to time of onset after HCT：（1） early complications（in the first month）-related to harvesting of stem cells, during conditioning（drug toxicity, posterior reversible encephalopathy syndrome）, related to pancytopenia,（2） intermediate phase complications（second to sixth month）-central nervous system infections caused by prolonged neutropenia and progressive multifocal leukoencephalopathy due to JC virus,（3） late phase complications（after sixth month）-neurological complications of Gv HD, second neoplasms and relapses of the original disease.

关键词： neurological complications hematopoietic cell transplantation posterior reversible encephalopathy syndrome central nervous system infections progressive multifocal leukoencephalopathy graft versus host disease second neoplasm immune reconstitution inflammatory syndrome post-transplant acute limbic encephalitis drug reaction with eosinophiIia and systemic symptoms

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