Antifungal Agents ; administration & dosage ; therapeutic use ; Candidiasis ; complications ; diagnosis ; drug therapy ; Child ; Echinocandins ; administration & dosage ; therapeutic use ; Hematologic Diseases ; complications ; Humans ; Lipopeptides ; Mycoses ; complications ; diagnosis ; drug therapy ; Neoplasms ; complications ; Pediatrics ; Practice Guidelines as Topic ; Voriconazole ; administration & dosage ; therapeutic use

OBJECTIVETo investigate the clinical manifestations, diagnosis, and treatment of peripheral primitive neuroectodermal tumor (pPNET) in children and the survival of patients treated with the CCG7942/POG9354 protocol.

METHODSA retrospective analysis was performed on the clinical data of 10 patients with pPNET admitted from October 2008 to October 2013. Of the 10 patients, 3 had metastasis, while others had no metastasis. The 7 patients without metastasis were treated with the Children's Cancer Study Group 7942 (CCG7942) protocol, and the other 3 patients with metastasis with the Pediatric Oncology Group 9354 (POG9354) protocol. The therapeutic response and chemotherapy-related toxicities were evaluated by WHO criteria and Common Terminology Criteria for Adverse Events (version 4.0).

RESULTSIn the 7 patients treated with the CCG7942 protocol, 4 achieved a complete remission (CR), 1 had stable disease, 2 developed progressive disease (PD), and 2 had recurrence. In the 3 patients treated with the POG9354 protocol, 1 achieved a CR, 2 developed PD, 2 had recurrence, and 2 died. For the 7 patients without metastasis, the survival time was 5-60 months, and the event-free survival rate was 71%. For the 3 patients with metastasis, the survival time was 13-25 months, and the event-free survival rate was 33%. All patients developed grade 4 bone marrow suppression, and other grade 1-2 toxicities, including gastrointestinal reactions, liver function impairment, and renal function impairment, were also seen.

CONCLUSIONSCCG7942 protocol is effective and safe for children with non-metastatic pPNET. However, POG9354 protocol has unsatisfactory efficacy in children with metastatic pPNET, so further studies are needed to improve the therapy for this disease.

Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Clinical Protocols ; Female ; Humans ; Infant ; Male ; Neuroectodermal Tumors, Primitive, Peripheral ; drug therapy ; Retrospective Studies

OBJECTIVETo study the treatment and outcome of childhood endodermal sinus tumor.

METHODSThe clinical data of twelve children with endodermal sinus tumor between April 2000 and July 2013 were reviewed. The basic demographics, stages of the lesion and the treatment outcome were analyzed. Of the twelve patients, seven were boys and five were girls. The age of the disease onset was between 1 and 3.3 years, except one in 11 years. Two patients were in Brodeur Stage I, four in Stage II, two in Stage III, and four in Stage IV. One patient underwent surgery alone, one underwent surgery plus a combination therapy with vincristine, actinomycin and cyclophosphamide (VAC), and the other ten were treated by surgery with the use of cisplatin, etoposide and bleomycin (PEB) before or after the operation.

RESULTSEleven patients were successfully followed up and ten were alive. The length of survival was 4.5 to 66 months in the 10 patients. In the 10 patients treated with PEB before or after surgery, 8 achieved complete remission, one achieved partial remission and one was not followed up. The major complications associated with the PEB regimen included myelosuppression and gastrointestinal upset symptoms and no late toxicity was observed.

CONCLUSIONSPreoperative or postoperative administration of PEB may be an effective and safe management modality for childhood endodermal sinus tumor. Nevertheless, further validation is warranted in prospective studies involving a larger sample size.

Antineoplastic Combined Chemotherapy Protocols ; therapeutic use ; Child ; Child, Preschool ; Combined Modality Therapy ; Endodermal Sinus Tumor ; mortality ; pathology ; therapy ; Female ; Humans ; Infant ; Male ; Neoplasm Staging ; alpha-Fetoproteins ; analysis

So far treatment of advanced neuroblastoma is still difficult, due to its high malignancy. Currently comprehensive therapies, including high-dose multi-drug chemotherapy, surgery, stem cell transplantation, radiation, biological therapy and immune therapy as well as target therapy dominant the treatment of this disease, and we hereby introduce the latest development of treatment protocols for this disease.
Combined Modality Therapy ; Female ; Humans ; Male ; Neoplasm Recurrence, Local ; therapy ; Neuroblastoma ; therapy

OBJECTIVETo evaluate chemotherapy-related toxicity and the short-term efficacy of topotecan and cyclophosphamide as maintenance chemotherapy for stage IV neuroblastoma in complete remission.

METHODSThe clinical data of 16 children with stage IV neuroblastoma received 3 cycles of maintenance chemotherapy with topotecan (0.75 mg·m(-2)·day(-1), infused on days 0-4) and cyclophosphamide 250 mg·m(-2)·day(-1), infused on days 0-4). The two-year event-free survival after complete remission was recorded and the chemotherapy-related toxicities were evaluated according to the Common Terminology Criteria for Adverse Events of the National Cancer Institute.

RESULTSThe most common chemotherapy-related toxicity was bone marrow suppression and suppressions of neutrophils, hemoglobin and platelets, which occurred in all the patients mostly of grade III and IV. All the patients experienced episodes of infections, which were controlled effectively with antibiotics. Impairment of gastrointestinal and liver functions in these cases was mostly mild (grade I and II) and recovered after corresponding treatments. None of the patients exhibited damages in the nervous system or the renal or cardiac functions. After complete remission, the two-year event-free survival rate of these patients was 68.75% (11/16).

CONCLUSIONTopotecan plus cyclophosphamide for maintenance chemotherapy can be effective and relative safe for stage IV neuroblastoma in complete remission, thus giving a chance to those patients who choose not to have stem cell transplantation.

Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Cyclophosphamide ; administration & dosage ; adverse effects ; Female ; Humans ; Infant ; Maintenance Chemotherapy ; Male ; Neoplasm Staging ; Neuroblastoma ; drug therapy ; pathology ; Topotecan ; administration & dosage ; adverse effects ; Treatment Outcome

Objective To screen the differential expression proteins in the children with neuroblastoma (NB) by proteomics tools.Methods Three specimens were collected from the patients diagnosed Ⅳstage NB by biopsy at Department of Pediatric Surgery of Chinese PLA General Hospital in Beijing from July to December,2011.Another three specimens were acquired from the same patients underwent tumor excision.Average age was 3.17 years.Proteins in neuroblastoma before and after chemotherapy were separated by two dimensional gel electrophoresis,analyzed by high performance liquid chromatography-eleetrospray tandem MS (Nano-UPLC-ESIMS/MS).Results After two dimensional gel electrophoresis,we obtained the maps about tissues before and after chemotherapy.There were 7 differential protein spots identified by using the Image Master two dimensional gel electrophoresis software,in which 2 were up-regulated,including Nm23 protein and neuropolypeptide h3,5were down-regulated after chemotherapy,including stathminl,heat shock protein 27,mitochondrial short-chain enoyl-coenzyme A,peroxiredoxin 1 and peroxiredoxin 3.Conclusion The differential expression proteins of children neuroblastoma before and after chemotherapy were successfully identified by two dimensional gel electrophoresis and Nano-UPLC-ESI-MS/MS.

BACKGROUND: Methoxy polyethylene glycol (mPEG) is a kind of amphotedc compound with no immunogenicity that has been used to modify various proteins covalently and to prepare versatile blood types. If mPEG modification blocks the activation of T cells in grafts, graft versus host disease (GVHD) reaction probably becomes less serious and transplantation may become successful. OBJECTIVE: To construct haploidentical bone marrow transplantation mudne model and to observe the effects of mPEG modification to grafts on acute GVHD following haploidentical bone marrow transplantation, DESIGN, TIME AND SETTING: A randomized paired design experiment was performed at the Laboratory Animal Center and Pediatric Laboratory of the General Hospital of Chinese PLA between March and November 2003. MATERIALS: Twenty 8-10 week old male BALB/cH-2d mice served as donors and sixty 8-10 week old female CBe F1H-2d/b mice served as recipients, mPEG was provided by Sigma, USA. METHODS: Mixture of donor bone marrow and spleen cells was routinely prepared. After irradiated with 60Co γ ray at a total dose of 8.0 Gy, recipient mice were randomly divided into 3 groups, with 20 rats per group: irradiation control, non-modification, and mPEG modification. Within 12 hours after irradiation, the irradiation control group was injected with 0.5 mL RPMI-1640 culture medium via caudal vein, the non-modification group was administered with 0.5 mL non-modified mixture of bone marrow and spleen cells via caudal vein, and mice from the group were given 0.5 mL mPEG-modified mixture of bone marrow and spleen cells via caudal vein. MAIN OUTCOME MEASURES: After transplantation, hematopoietic recovery, survival rate, acute GVHD and chromosomal karyotype were studied and compared with controls. RESULTS: All mice from the irradiation control groups died within 2 weeks. The 30-day survival rate was significantly higher in the mPEG modification group than in the non-modffication group (75% vs. 40%, x2 = 5.01, P= 0.025). Histopathological examinations of skin, liver and intestine showed typical signs of acute GVHD. The mPEG modification group exhibited less severe pathological presentation and lower Thomas grading than the non-modification group. Cheimedsm examination revealed complete donor-type implantation in living recipient mice at 75 days after transplantation. CONCLUSION: mPEG modification to grafts can greatly alleviate acute GVHD and enhance the survival rate of mice after haploidentical bone marrow transplantation.

OBJECTIVENeuroblastoma is a highly malignant tumor. Stage IV neuroblastoma has a very poor long-term outcome by conventional chemotherapy and surgery and better therapies are essential. This study aimed to explore the long-term effect of high dose induction chemotherapy combined with autologous peripheral blood stem cell transplantation and 13-cis retinoid acid treatment on stage IV neuroblastoma in children.

METHODSTwenty-eight children with stage IV neuroblastoma, aged 2.1-11.5 years (mean 3.3 +/- 1.9 years), were employed for the study. Primary sites of the tumors included adrenal (n=23), chest (n=3), chest-abdomen (n=1) and sacrum (n=1). Before autologous peripheral blood stem cell transplantation the patients received 6 courses of intensive induction chemotherapy. During chemotherapy the autologous peripheral blood stem cells were harvested and the tumor excision was done. After transplantation the local radiation and 13-cis retinoid acid therapy were administered.

RESULTSAfter 6 courses of induction chemotherapy 13 patients got complete remission (CR), 11 got partial remission (PR), and 4 had no response. The 24 patients who received CR or PR completed the full therapy. A 3.5 +/- 0.7 years follow-up showed that the 4-year event-free survival of the CR and PR patients was 29.2%. The median no-relapse survival time in CR patients was 4.1 +/- 0.7 years but 2.8 +/- 0.5 years in PR patients (t= 3.9, P < 0.01).

CONCLUSIONSHigh dose chemotherapy combined with autologous peripheral stem cell transplantation and 13 cis-retinoid acid treatment can improve the long-term outcome of patients with stage IV neuroblastoma. The patients in CR before transplantation had better outcomes than those in PR.

Antineoplastic Combined Chemotherapy Protocols ; adverse effects ; therapeutic use ; Child ; Child, Preschool ; Combined Modality Therapy ; Female ; Humans ; Male ; Neoplasm Staging ; Neuroblastoma ; pathology ; therapy ; Peripheral Blood Stem Cell Transplantation ; Transplantation, Autologous

0.05),and the antifebric time of group A was shorter than that of group B.No significant difference was found in the incidence rate of side reaction between two groups. CONCLUSIONS Ceftazidime and vancomycin combination is more effective than ceftazidime alone.

OBJECTIVE To analyze the treating efficacy of meropenem on blood tumor combined with the infection in children. METHODS A retrospective study protocol was adopted,totally 80 acute leukemia and other subjects complicated with infection were observed.The dosage of meropenem was 10-20 mg/kg,q8-12 h for all the patients and the treatment course in most patients was less than 10-14 days. RESULTS The effectiveness rate was 78.8%.The effectiveness rate was 80% for hematological system diseases complicated with septicemia and was 77.0% for hematological system diseases complicated with agranulocytosis.The occurrence rate of side effect of meropenem in this group was 0. CONCLUSIONS Meropenem is significantly effective and safe in the treatment of hematological system diseases complicated with infections.