24 research outputs found
Successful Treatment in a Child with Anaplastic Large Cell Lymphoma and Coexistence of Pulmonary Tuberculosis
A 13-year-old girl was admitted to our department with a history of severe pain of her left axilla and fever. On physical examination, a block of lymph nodes in her left axilla, diffuse papular rash, and red-violet swelling of her supraclavicular and subclavian region were noted. Imaging investigations revealed left axillar and supraclavicular lymphadenopathy and a small nodular shade in the upper lobe of her left lung. A biopsy from an axillary lymph node established the diagnosis of anaplastic large cell lymphoma (ALCL), whereas DNA of Mycobacterium tuberculosis was detected by polymerase chain reaction (PCR) in the same tissue biopsy. Patient was started on chemotherapy for ALCL and achieved remission of all initially involved fields. Nevertheless, two new nodular lesions were detected in the left lower lobe. Biopsy revealed granulomas, and PCR was positive for M. tuberculosis. Our patient received treatment with the combination of isoniazid and rifampin (12 months), pyrazinamide (the first 2 months), and maintenance chemotherapy for her ALCL for one year simultaneously. Four years later, she is disease free for both mycobacterial infection and lymphoma. We are reporting this successful management of mycobacterial infection in a patient with ALCL despite intensive chemotherapy that the patient received at the same time
Multifocal Aeromonas Osteomyelitis in a Child with Leukemia
Aeromonas hydrophila is a Gram negative organism causing both intestinal and extraintestinal disease. The case of a 14-year-old girl with underlying immunodeficiency and leukemia who developed systemic A. hydrophila infection is described in this report. While in deep bone marrow aplasia she developed fever, severe pain in the lower extremities, and swelling of the left femur. Blood culture showed Escherichia coli and A. hydrophila whereas pus culture from the soft tissue swelling showed the presence of A. hydrophila. Imaging studies showed diffuse osteolytic lesions. Patient received 5 months of intravenous and oral antibiotics and she improved clinically whereas the radiology findings persisted
Multifocal Aeromonas Osteomyelitis in a Child with Leukemia.
Aeromonas hydrophila is a Gram negative organism causing both intestinal and extraintestinal disease. The case of a 14-year-old girl with underlying immunodeficiency and leukemia who developed systemic A. hydrophila infection is described in this report. While in deep bone marrow aplasia she developed fever, severe pain in the lower extremities, and swelling of the left femur. Blood culture showed Escherichia coli and A. hydrophila whereas pus culture from the soft tissue swelling showed the presence of A. hydrophila. Imaging studies showed diffuse osteolytic lesions. Patient received 5 months of intravenous and oral antibiotics and she improved clinically whereas the radiology findings persisted
Predictive Factors for Gram-negative Versus Gram-positive Bloodstream Infections in Children With Cancer
Background: Identifying potential predictive factors for the type of
bacteremia (Gram-negative vs. Gram-positive) in children with cancer
would be crucial for the timely selection of the appropriate empiric
antibiotic treatment. Materials and Methods: Demographic, clinical, and
laboratory characteristics of children with cancer and a bacterial
bloodstream infection (BSI) (February 1, 2011 to February 28, 2018) in a
tertiary pediatric oncology department were retrospectively examined and
were correlated with the type of isolated bacteria. Results: Among 224
monomicrobial bacterial BSI episodes, Gram-negative and Gram-positive
bacteria were isolated in 110 and 114 episodes, respectively.
Gram-negative bacteria were isolated significantly more frequently in
girls (Gram-negative/Gram-positive ratio 1.7:1) versus boys
(Gram-negative/Gram-positive ratio 0.72:1), P=0.002, in patients with
previous BSI episodes (1.4:1) versus those without (0.8:1), P=0.042, and
in children with hematologic malignancy (1.3:1) versus those who
suffered from solid tumors (0.52:1), P=0.003. Gram-negative BSI episodes
were more frequently correlated with a lower count of leukocytes,
P=0.009, neutrophils, P=0.009 and platelets, P=0.002, but with
significantly higher C-reactive protein (CRP) levels, P=0.049. Female
sex, hematologic malignancy, and higher CRP levels remained independent
risk factors for Gram-negative BSI in the multivariate analysis. Among
neutropenic patients, boys with solid tumors and a recent central venous
catheter placement appear to be at increased risk for Gram-positive BSI
in the multivariate analysis. Conclusions: Although Gram-negative and
Gram-positive BSIs are close to balance in children with cancer,
Gram-negative bacteria are more likely to be isolated in girls, children
with hematologic malignancies and those with higher CRP level at
admission. In contrast, neutropenic boys with solid tumors and a
recently placed central venous catheter may be at increased risk for
Gram-positive BSI indicating probably the need for initially adding
antibiotics targeting Gram-positive bacteria
Acinar cell carcinoma in childhood: A case report of a very rare tumor
Pancreatic tumors are reported rarely in childhood and represent an extremely rare entity in Pediatric Oncology. One of the least common types of pediatric pancreatic tumor is acinar cell carcinoma (ACC). We aim to present a rare case of ACC and the difficulties we faced during diagnosis and treatment
Serum Adiponectin As a Predictor of Childhood Non-Hodgkin's Lymphoma: A Nationwide Case-Control Study
Purpose
To our knowledge, this is the first study exploring the association of
childhood non-Hodgkin’s lymphoma (NHL) with serum adiponectin and leptin
levels in a nationwide case-control series. In addition, expression of
adiponectin receptors in NHL specimens was assessed, and the association
between adipokines and childhood NHL survival and prognosis was
examined.
Patients and Methods
We studied 121 incident childhood (0 to 14 years) NHL cases registered
in the Nationwide Registry for Childhood Hematological Malignancies
(1996 to 2006) and an equal number of matched controls, for whom
sociodemographic, lifestyle, prenatal characteristics, and fasting blood
serums were collected. Serum adiponectin and leptin levels were
determined. Immunohistochemisty for adiponectin receptors expression was
performed on commercially available adult NHL specimens (n = 30) and in
a subset of childhood NHL cases (n = 6) that were available. Summary
statistics, multiple conditional logistic regression analyses, and
survival analysis were performed.
Results
Higher serum adiponectin, but not leptin, levels were independently
associated with childhood NHL (odds ratio, 1.82; 95% CI, 1.30 to 2.56),
after adjusting for obesity and established risk factors. Higher
adiponectin levels at diagnosis were positively associated with relapse
and poor survival, but hormone levels did not differ among NHL subtypes.
Adiponectin receptors 1 and 2 were present in 90% and 57% of adult
samples and in 83% and 100% of childhood NHL samples, respectively.
Conclusion
Elevated serum adiponectin, but not leptin, levels are independently
associated with childhood NHL and poor prognosis. Adiponectin receptors
are expressed in NHL, suggesting that adiponectin may represent not only
a potential clinically significant diagnostic and prognostic marker but
also a molecule that may be implicated in NHL pathogenesis
Immune response to influenza vaccination in children with cancer
The aim of this study was to evaluate the ability of influenza immunization to evoke a protective immune response among children with cancer. We evaluated 75 children with cancer who received influenza vaccination. Hemagglutination Inhibition Antibody titers were determined before and after vaccination. The protective rates after vaccination were 79% for H1N1, 75% for H3N2 and 59% for influenza B virus whereas the seroconversion rates were 54%, 44% and 43% respectively. The differences pre- and post-vaccination were significant regardless the method which was used: seroprotection changes, seroconversion and geometric mean titers analyses. Variables such as the pre-vaccination antibody titers, the time when the responses were measured after the vaccination, the age and the type of malignancy as well as the absolute lymphocyte count were found to be correlated with the immune response but the findings were different for each vaccine subunit. In conclusion, influenza vaccination provides protection in a remarkable proportion of pediatric cancer patients whereas this protection is more obvious against H1N1 and H3N2 compared to influenza B. The immune response after vaccination is significant and seems to be influenced by a variety of factors