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Chinese Medical Journal 2017年第11期130卷 1320-1326页

作者： Yan-Ling Ge Xiao-Wen Zhai Yan-Feng Zhu Xiang-Shi Wang Ai-Mei Xia Yue-Fang Li Mei Zeng Department of Infectious Diseases Children's Hospital of Fudan University Shanghai 201102 China Department of hematology Children's Hospital of Fudan University Shanghai 201102 China

Background： Despite substantial progress toward measles control are making in China, measles outbreaks in immunocompromised population still pose a challenge to interrupt endemic transmission. This study aimed to investigate the features of measles in pediatric hematology and oncology patients and explore the reasons behind the outbreak. Methods： We collected demographic, epidemiological, and clinical data ofimmunocompromised measles children. All suspected measles cases were laboratory-confirmed based on the presence of measles lgM and/or identification of measles RNA. The clinical data were statistically analyzed by t-test for continuous variables and Fisher＇s exact test for categorical variables. Results： From March 9 to July 25 in 2015, a total of 23 children with malignancies and post hematopoietic stem cell transplantation （post- HSCT） were notified to develop measles in Shanghai. Of these 23 patients with the median age of 5.5 years （range： 11 months 14 years）, 20 （87.0%） had received 1-3 doses of measles vaccine previously; all patients had fever with the median lever duration of 8 days; 21 （91.3%） had cough; 18 （78.3%） had rash; 13 （56.5%） had Koplik＇s spot; 13 （56.5%） had complications including pneumonia and acute liver failure： and five （21.7%） vaccinated patients died from severe pneumonia or acute liver failure. Except the first patient, all patients had hospital visits within 7-21 days beibre measles onset and 20 patients were likely to be exposed to each other. Conclusions： The outcome of measles outbreak in previously vaccinated oncology and post-HSCT pediatric patients during chemotherapy and imnaunosuppressant medication was severe. Complete loss of protective immunity induced by measles vaccine during chemotherapy was the potential reason. Improved infection control practice was critical tbr the prevention of measles in rnalignancy patients and transplant recipients.

关键词： Children Measles oncology Vaccination

Physician approaches to drug shortages: Results of a national survey of pediatric hematologist/oncologists

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World Journal of Clinical oncology 2017年第4期8卷 336-342页

作者： Jill C Beck Baojiang Chen Bruce G Gordon Department of pediatric hematology/oncology University of Nebraska Medical Center

AIM To evaluate personnel involved in scarce drug prioritization and distribution and the criteria used to inform drug distribution during times of shortage among pediatric hematologists/oncologists. METHODS Using the American Society of pediatric hematology/oncology(ASPHO) membership list, a 20 question survey of pediatric hematologists/oncologists was conducted via email to evaluate personnel involved in scarce drug prioritization and distribution and criteria used to inform scarce drug distribution. RESULTS Nearly 65% of the 191 study respondents had patients directly affected by drug shortages. Most physicians find out about shortages from the pharmacist(n = 179, 98%) or other doctors(n = 75, 41%). One third of respondents do not know if there is a program or policy for handling drug shortages at their institution. The pharmacist was the most commonly cited decision maker for shortage drug distribution(n = 128, 70%), followed by physicians(n = 109, 60%). One fourth of respondents did not know who makes decisions about shortage drug distribution at their institution. The highest priority criterion among respondents was use of the shortage drug for curative, rather than palliative intent and lowest priority criterion was order of arrival or first-come *** Despite pediatric hematology/oncology physicians and patients being heavily impacted by drug shortages, institutional processes for handling shortages are lacking. There is significant disparity between how decisions for distribution of shortage drugs are currently made and how study respondents felt those decisions should be made. An institution-based, and more importantly, a societalapproach to drug shortages is necessary to reconcile these disparities.

关键词： pediatric hematology/oncology Chemotherapy Ethics

Haploidentical hematopoietic stem cell transplantation for pediatric patients with chronic active Epstein-Barr virus infection:a retrospective analysis of a single center

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World Journal of pediatrics 2021年第6期17卷 626-636页

作者： Yan-Hui Luo Jun Yang Ang Wei© Guang-Hua Zhu Bin Wang Rui Zhang Chen-Guang Jia Yan Yan Kai Wang Sidan Li Xuan Zhou Mao-Quan Qin Tian-You Wang Beijing Key Laboratory of pediatric hematology oncology National Key Discipline of Pediatrics(Capital Medical University)Key Laboratory of Major Diseases in ChildrenMinistry of EducationHematology Oncology CenterDepartment of Hematology and OncologyBeijing Children's HospitalCapital Medical UniversityNational Center for Children’s HealthNanlishi Road No.56Beijing 100045China

Background This study aimed to evaluate the feasibility and clinical effect of haploidentical hematopoietic stem cell transplantation(haplo-HSCT)for the treatment of pediatric patients with chronic active Epstein-Barr virus infection(CAEBV).Methods Children with CAEBV who did not have matched donors and underwent haplo-HSCT in Beijing Children's Hospital,Capital Medical University,from October 2016 to June 2020 were analyzed *** relating to the clinical manifestations,engraftment,and prognosis of the children were extracted from medical *** Twenty-five patients,including 16 males and 9 females,with an onset age of 5.0±2.6 years and a transplantation age of 6.9±2.9 years,were enrolled irnhis *** mean time from diagnosis to transplantation was 3.8(2.0-40.2)*** mean observation time was 19.0±12.0 *** patients received the reduced intensity conditioning regimen,and the remaining patients all received the modified myeloablative conditioning *** the end of the follow-up,23 patients were characterized by disease-free survival(DFS),22 were characterized by event-free survival(EFS).and two *** of the patients died of thrombotic microangiopathy(TMA),and another died of graft versus host disease(GVHD);this patient discontinued the treatment for economic *** 3-year overall survival(OS)rate was estimated to be 92.0%±5.4%,and the 3-year EFS rate was estimated to be 87.4%±6.8%.All active patients survived after HSCT *** GVHD degrees 1-3 were observed in ten patients(40.0%),and degree IV was observed in six(24.0%),who were all cured except for one *** GVHD was observed in nine(36.0%),and most of these cases were *** incidence of TMA and veno-occlusive disease(VOD)was 28.0%and 4.0%.Conclusions Haploidentical hematopoietic stem cell transplantation is safe and effective in the treatment of pediatric CAEBV and can be used as an alternative therapy without matched donors or emergency tr

关键词： Chronic active Epstein-Barr virus infection Haploidentical hematopoietic stem cell transplantation Prognosis Graft versus host diseases Thrombotic microangiopathy

IMPACT de la déprivation sociale sur les difficultés psychosociales au décours d’un cancer pédiatrique:uneétude prospective IMPACT of the Social Deprivation on Psychosocial Difficulties of pediatric Cancer Survivors:A Prospective Study

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Psycho-Oncologie 2024年第2期18卷 117-126页

作者： Fanny Delehaye Olivier Dejardin Isabelle Pellier Ludivine Launay Maxime Esvan Damien Bodet Liana Carausu Julien Lejeune Frédéric Millot Caroline Thomas Virginie Gandemer Arnaud Alves Julien Rod U1086 INSERM“Anticipe” Caen14000France Department of pediatric hematology and oncology University Hospital of CaenCaen14000France Research Department University Hospital of CaenCaen cedex14000France Department of pediatric hematology and oncology University Hospital of AngersAngers49000France Centre François Baclesse Caen14000France CIC 1414(Centre d’Investigation Clinique de Rennes) Rennes UniversityCHU RennesInsermRennes35000France Department of pediatric hematology and oncology University Hospital of BrestBrest29200France Department of pediatric hematology-oncology Clocheville HospitalUniversity Hospital of ToursTours37000France pediatric oncology Unit CIC 802 INSERMUniversity Hospital of PoitiersPoitiers86000France Department of pediatric hematology-oncology University Hospital of NantesNantes44000France Department of pediatric hematology and oncology University Hospital of RennesRennes35000France Service de Chirurgie Digestive CHU CaenUniversitéde Caen-NormandieCaen14000France Department of pediatric Surgery Caen University HospitalAvenue de la Côte de NacreCaen14000France

The posttreatment period is a key part of the management of pediatric *** this time,school and psychological difficulties have been described in childhood cancer survivors(CCS)and can be prognostic for the success of social *** study estimated the inﬂuence of the household’s socioeconomic status(SES)on these psychosocial *** study is based on a prospective multicentric database and focused on children who received a psychosocial evaluation during their follow-up from 2013 to *** retrieved data on school and psychological *** SES was estimated by a social deprivation *** from1003 patients were *** difficulties were noted in 22%of CCS.A greater social deprivation was significantly associated with school *** relapse,treatment with hematopoietic stem cell transplantation,and central nervous system(CNS)tumors remained significant risk *** the subgroup of CNS tumors,school difficulties were increased and associated with greater social *** difficulties were not associated with the deprivation *** is a link between SES and school difficulties in *** investigations should be carried out for children with CNS tumors,which is the population of the greatest concern.

关键词： Psychosocial difficulties contextual socioeconomic status deprivation cancer children

Association of image-defined risk factors,tumor resectability,and prognosis in children with localized neuroblastoma

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World Journal of pediatrics 2019年第6期15卷 572-579页

作者： An-An Zhang Ci Pan Min Xu Xiao-Xia Wang Qi-Dong Ye Yi-Jin Gao Jing-Yan Tang Key Laboratory of pediatric hematology and oncology Ministry of HealthDepartment of Pediatric Hematology and OncologyShanghai Children's Medical CenterShanghai Jiaotong University School of Medicine(SJTU-SM)ShanghaiChina

Background Although localized neuroblastoma has a good prognosis,some cases have undergone treatment failure or *** from biologic features such as MYCN status,we wondered whether some characteristics of growing tumors are prognostic,such as a well-encapsulated mass without infiltration of vital *** analyzed the diagnostic utility of image-defined risk factors(IDRFs)to predict successful treatment and *** overall goal was to achieve maximum cure rates for patients with localized neuroblastoma through a better understanding of clinical *** We retrospectively reviewed the images of patients with localized neuroblastoma who were enrolled between June 1998 and December 2012 at a single institution in Shanghai,*** categorization regarding IDRFs was available in 67 *** was assessed at diagnosis and after four cycles of neoadjuvant chemotherapy,on *** median follow-up period was 84 months(range: 48-132 months)after *** MRI and CT indicated a total of 177 IDRFs in these 67 *** regression analysis revealed a highly significant negative correlation between the numbers of IDRFs and the possibility of complete removal of *** extension of the tumor,compression of the trachea,and encasement of the main artery in localized neuroblastoma were predictors for incomplete tumor *** to univariate analysis,≥4 IDRFs and intraspinal extension of the tumor were significant indicators of poor *** The number of IDRFs was useful in predicting surgical outcome and event-free *** number of IDRFs should be considered in protocol planning,instead of IDRF presence or absence.

关键词： Image-defined risk factors Localized neuroblastoma Prognosis Surgery

pediatric acute myeloid leukemia patients with i(17)(q10)mimicking acute promyelocytic leukemia:Two case reports

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World Journal of Clinical Cases 2022年第16期10卷 5446-5455页

作者： Hong-Xia Yan Wei-Hua Zhang Jin-Quan Wen Yan-He Liu Bao-Juan Zhang A-Duo Ji Department of Healthcare Rainbow Hospital of XianyangXianyang 721000Shaanxi ProvinceChina Department of pediatric Intensive Care Unit Rainbow Hospital of XianyangXianyang 721000Shaanxi ProvinceChina Department of pediatric hematology/oncology Rainbow Hospital of XianyangXianyang 721000Shaanxi ProvinceChina Department of pediatric Hemato-logy/oncology Rainbow Hospital of XianyangXianyang 721000Shaanxi ProvinceChina

BACKGROUND Chromosome i(17)(q10)abnormality is mainly associated with chronic myeloid leukemia(CML),myelodysplastic syndrome/myeloproliferative tumors(MDS/MPD),and acute myeloid leukemia(AML).The role of i(17)(q10)in AML is still unknown,the differences between AML and acute promyelocytic leukemia(APL)-like AML with i(17)(q10)need more *** study aimed to investigate the clinical characteristics and laboratory evidence of 2 AML cases with i(17)(q10),similar to APL *** SUMMARY Both pediatric patients were males;case 1 had newly diagnosed AML,and case 2 showed relapsed tumor after 1 year of drug *** marrow cell morphology,chromosome karyotype analysis,Fully-instrumented submersible housing test,immunological assays,molecular biological methods,and blood tumor panoramic gene test were ***-trans retinoic acid(ATRA)combined with arsenic acid(As2O3)were used in the first course of *** marrow was dominated by abnormal promyelocytic *** test revealed i(17)(q10)*** phenotype mainly included positive expressions of CD9,CD13,CD33,and *** 1 suffered intracranial hemorrhage after re-chemotherapy and died on *** case 2,on D145 and D265,bone marrow promyelocytic granulocytes accounted for 2%.Flow cytometric residual lesion detection showed no abnormal immunophenotype *** copy number of WT1 gene in two cases were 1087 and 1010,respectively,and the expression rates were 55.29% and 59.5%,*** ATRA,As2O3,and chemotherapy may be ineffective in treating APL-like AML with i(17)(q10)but without t(15;17)and PML-RARA fusion gene.

关键词： Chromosome i(17)(q10) Gene mutations Acute promyelocytic leukemia Acute myeloid leukemia Case report

Homoharringtonine is a safe and effective substitute for anthracyclines in children younger than 2 years old with acute myeloid leukemia

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Frontiers of Medicine 2019年第3期13卷 378-387页

作者： Xiaoxiao Chen Yanjing Tang Jing Chen Ru Chen Longjun Gu Huiliang Xue Ci Pan Jingyan Tang Shuhong Shen Key Laboratory of pediatric hematology and oncology Ministry of Health Department of Hematology and OncologyPediatric Translational Medicine InstituteShanghai Children's Medical CenterShanghai Jiao Tong University School of MedicineShanghai 200127China

Homoharringtonine (HHT),a plant alkaloid from Cephalotaxus harringtonia,exhibits a unique anticancer mechanism and has been widely used in China to treat patients with acute myeloid leukemia (AML) since the *** SCMC-AML-2009 presented herein was a randomized clinical study designed based on our previous findings that pediatric AML patients younger than two years old may benefit from HHT-containing chemotherapy *** randomized to arm A were treated with a standard chemotherapy regimen comprising mainly of anthracyclines and cytarabine (Ara-C),whereas patients in arm B were treated with HHTcontaining regimens in which anthracyclines in all but the initial induction therapy were replaced by *** February 2009 to November 2015,59 patients less than 2 years old with de novo AML (other than acute promyelocytic leukemia) were recruited.A total of 42 patients achieved a morphologic complete remission (CR) after the first course,with similar rates in both arms (70.6% vs.72.0%).At the end of the follow-up period,40 patients remained in CR and 5 patients underwent hematopoietic stem cell transplantation in CR,which could not be considered as events but *** 5-year event-free survival (EFS) was 60.2%± 9.6% for arm A and 88.0%± 6.5% for arm B (P=0.024).Patients in arm B experienced shorter durations of leukopenia,neutropenia,and thrombocytopenia and had a lower risk of infection during consolidation chemotherapy with high-dosage ***,the homoharringtonine-based regimen achieved excellent EFS and alleviated hematologic toxicity for children aged younger than 2 years with de novo AML compared with the anthracycline-based regimen.

关键词： homoharringtonine acute myeloid leukemia pediatrics

Clinical Characteristics of Bloodstream Infections in pediatric Acute Leukemia： A Single-center Experience with 231 Patients

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Chinese Medical Journal 2017年第17期130卷 2076-2081页

作者： Jia-Feng Yao Nan Li Jin Jiang hematology oncology Center Beijing Key Laboratory of Pediatric Hematology OncologyNational Key Discipline of PediatricsMinistry of EducationBeijing Children's HospitalCapital Medical UniversityBeijing 100045China

Background：Acute leukemia is the most common pediatric hematological *** infections （BSIs） are severe complications in these patients during *** study aimed to explore the clinical presentation and etiology of BSI,as well as the common sites of infection,and to provide a basis for the rational regarding antibiotic ***：We performed a retrospective chart review of all pediatric patients who had acute leukemia accompanied by a BSI in our hospital from December 2011 to September *** patients were selected based on clinical presentation and had to have at least one positive blood culture for *** basic clinical characteristics,blood culture results,and antimicrobial susceptibilities were ***：All 231 patients had a fever;of them,12 patients continued to have a ***-five patients had nonremitting （NR） leukemia,and 206 patients achieved complete remission （CR）.Differences in the duration of fever between the NR and CR groups were significant （9.6 ＆#177; 7.9 vs.5.1 ＆#177; 3.8 days,P =0.016）.One hundred and eighty patients had *** in fever duration between the agranulocytosis and nonagranulocytosis groups were significant （6.2 ＆#177; 5.1 vs.4.1 ＆#177; 2.6 days,P =0.001）.The other sites of infection in these 231 patients were the lung,mouth,digestive tract,and *** culture comprised 2635 *** were 619 samples,which were *** the 619 positive blood culture samples,59.9% had Gram-negative bacteria,39.3% had Gram-positive bacteria,and 0.8% had *** primary pathogens were Pseudomonas aeruginosa,Enterobactercloacae,Escherichia coli,and Klebsiella *** these 231 patients,217 patients were *** effective treatment ratio was 94%.Conclusions：Gram-negative bacteria were the main pathogenic bacteria in patients with acute leukemia in our *** primary illness,agranulocytosis,and drug-resistant pathogenic bacteria were all risk factors for poo

关键词： Acute Leukemia Agranulocytosis Bloodstream Infection Etiology pediatric

Feasibility,efficacy,and safety of animal-assisted activities with visiting dogs in inpatient pediatric oncology

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World Journal of pediatrics 2024年第9期20卷 915-924页

作者： Katja Steff Maximilian Grasemann Kira Ostermann Sarah Christina Goretzki Peter-Michael Rath Dirk Reinhardt Michael M.Schündeln pediatric hematology and oncology Department of Pediatrics ⅢUniversity of Duisburg-EssenHufelandstr.5545122EssenGermany Department of Psychology Medical School HamburgHamburgGermany pediatric Infectiology Department of Pediatrics ⅠUniversity of Duisburg-EssenEssenGermany Institute of Medical Microbiology University of Duisburg-EssenEssenGermany

Background Childhood cancer entails a heavy burden for patients and their *** advances in overall survival rates have increasingly brought long-term quality of life into ***-assisted activities(AAAs)have long been hypothesized to alleviate the burden on pediatric patients and their peers in the hospital ***,their use in inpatient pediatric oncology has been a sensitive issue mainly due to the fear of infections,resulting in a lack of *** study presents data on the feasibility,safety,and efficacy of AAAs from a single German *** Between 2018 and 2022,60 patients(median age=10.3 years)diagnosed with malignancy and undergoing treatment were visited by an intervention dog(total visits=100).Patients were screened for infections as per hospital policy,with additional microbiological testing performed based on *** dog was screened for human pathogens and *** data and hospitalizations were analyzed from two months prior to the first visit until two months after the last *** of being in the hospital,both with and without planned animal-assisted interventions and pre-and post-intervention state stress,were measured using a validated visual analogue scale(0-10).Results Patients benefited from AAAs,showing increased acceptance of being in the hospital(median:7.25 vs.4.50,Ppediatric oncology are feasible and *** they hold promise for enhancing patients’well-being,further prospective studies are needed.

关键词： Animal-assisted activities Animal-assisted interventions Animal-assisted therapy Feasibility Infection control Inpatient pediatric oncology Safety Stress response Therapy dog Visiting dog