18F-FDG PET/CT in pediatric lymphoma: Comparison of the deauville criteria with semiquantitative analysis and ct in interim and post-treatment nodal evaluation

2-s2.0-85077032145Objectives: To investigate and compare the role of visual assessment according to the Deauville Criteria (DC) and semiquantitative assessment by maximum standardized uptake value (SUVmax) and CT, in interim and post-therapy 18F-FDG PET/CT scans in the nodal involvement of pediatric lymphoma. Design: Retrospective study Setting: Training and Research Hospital Subjects: Forty-nine PET/CT scans (15 interim, 34 posttherapy) of 30 pediatric patients [19 Hodgkin Lymphoma (HL)/11 non-Hodgkin Lymphoma (NHL)] were retrospectively reviewed. Unenhanced low-dose CT component of PET/CT were compared with data derived from DC and SUVmax and all were correlated with radiologic, pathological, laboratory records and clinical follow-up. Main outcome measures: SUVmax, DC scores and CT findings in interim and/or post-therapy PET/CT scan Results: In 15 interim PET/CT scans, 23 and 12 nodal disease sites were detected by CT and PET (with SUVmax and DC), respectively. In 34 post-therapy scans, 36 regions were detected by CT and metabolic assessment revealed 31 regions. In HL, specificity to predict therapy response was 77.7% and 64.4% for interim evaluation and 95.1% and 75.8% for post-therapy evaluation by metabolic assessment methods and CT, respectively. Negative predictive value (NPV) was 100% for each interim and post-therapy evaluation method. Sensitivity was 100% for post-therapy metabolic evaluation and CT. In NHL, specificity to predict therapy response was 100% and 28.5% for interim evaluation and 75% and 62.5% for post-therapy evaluation by metabolic assessment methods and CT, respectively. NPV was 100% for each interim evaluation method, 42.8% for post-therapy metabolic evaluation, 26.3% for post-therapy CT; sensitivity was 75% for post-therapy metabolic evaluation and 56.2% for post-therapy CT. Conclusions: Our study demonstrated that the assessment according to DC and SUVmax showed concordant results and could be safely used both in interim and post-therapy PET/CT scans of pediatric patients with lymphoma. Even if metabolic evaluation is superior to CT, these methodologies are complementary to each other, and one should review them both synchronously. © 2019, Kuwait Medical Association. All rights reserved

Immune deficiencies following cancer treatment in children

WOS: 000186274000006PubMed ID: 14604161The aim of this study was to determine serum immunoglobulins, IgG subclasses, lymphocyte subsets, and serum protective antitoxin levels of tetanus and diphtheria, and to investigate specific antibody response to tetanus and diphtheria vaccines in children with cancer who have been treated for leukemias and solid tumors. Forty patients with different types of childhood malignancies were enrolled in this study and their lymphocyte subsets, serum Ig A, M, G and IgG subclass concentrations were determined at completion of chemotherapy and 6 months later. We measured serum diphtheria (D) and tetanus (T) antitoxin levels and investigated specific antibody responses against DT vaccines at 6 months. Only the leukemic children had low CD19+ cells at completion of chemotherapy and 6 months later. The patients with solid tumors had reduced CD4+ cells, but increased natural killer cells at completion of chemotherapy. Serum IgA and IgM levels were decreased in leukemic patients after chemotherapy. There were no IgG subclass deficiency. Forty-two per cent of the patients did not have protective serum T antitoxins. All patients produced high levels of DT antibodies by vaccination. Immune system changes recover by 6 months after cancer therapy in children. Children with solid tumors, as well as leukemias, should be followed-up in terms of immune deficiencies. A repeat dose of tetanus toxoid should be recommended at 6 months

Investigation of Quality of Life and Healthy Life Style Behaviors of Adolescents Having Undergone Cancer Treatment

WOS: 00044519500513

Plasma concentrations of granulocyte-macrophage colony-stimulating factor and interleukin-6 in septic and healthy preterms

WOS: 000085963200005PubMed ID: 10664226Plasma granulocyte-macrophage colony-stimulating factor (GM-CSF) and interleukin-6 (IL-6) concentrations were determined in 21 preterm infants with sepsis and nine healthy preterm neonates of the same postnatal age at sampling. Plasma GM-CSF levels were elevated at diagnosis in the septic preterms as compared to the healthy preterms (P = 0.01), but did not differ significantly on recovery. IL-6 levels were also elevated markedly at diagnosis (P = 0.0003), but decreased to normal on recovery as compared to the healthy preterm infants. GM-CSF levels were more prominent in septic preterms with neutropenia than those of non-neutropenic infants (P = 0.03). Conclusion Preterm infants can produce high levels of granulocyte-macrophage colony- stimulating factor and interleukin-6 in response to bacterial sepsis

Recombinant human erythropoietin trial in thalassemia intermedia

WOS: A1996WB43100005PubMed ID: 9009557It has been shown that high doses of human recombinant erythropoietin (r epo) increase haemoglobin levels by augmentation of F-cells, and Hb-F production in animal models and in human trials. In this study, r epo was used in patients with beta thalassemia intermedia. Our purpose was to improve haemoglobin levels by at least 2 g and maintain an average level between 10 and 12 g/dl. Ten patients aged 6-29 years (mean 14 +/- 7.6 years) with thalassemia intermedia were treated with r epo, It was given subcutaneously in rising doses from 500 to 1000 U/kg three times weekly for 3 months. During r epo therapy eight cases (80 per cent) showed an increase in haemoglobin, haematocrit, and reticulocyte levels, and an increase of at least 2 g of haemoglobin was obtained, Blood transfusion was not needed during the study except in one case, Five cases (50 per cent) improved life quality with therapy, Hb levels of all patients returned to baseline values over 1 or 2 months after r epo was discontinued. There was no significant change in absolute Hb-F, F-cells, and ferritin levels during treatment. Generally, the drug was well tolerated. No patient had hypertension, Recombinant erythropoietin seems to be an effective treatment for anaemia of beta-thalassemia intermedia, but longer term randomized trials are needed especially in patients with beta thalassemia major