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Meral Günes A, Millot F, Kalwak K, Lausen B, Sedlacek P, Versluys AB, Dworzak M, De Moerloose B, Suttorp M. Features and outcome of chronic myeloid leukemia at very young age: Data from the International Pediatric Chronic Myeloid Leukemia Registry. Pediatr Blood Cancer 2021; 68:e28706. [PMID: 33034135 DOI: 10.1002/pbc.28706] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 08/14/2020] [Accepted: 08/24/2020] [Indexed: 12/18/2022]
Abstract
INTRODUCTION Chronic myeloid leukemia (CML) is rare in the first two decades of life comprising only 3% of newly diagnosed pediatric and adolescent leukemias. We studied the epidemiologic and clinical features of patients with CML diagnosed at younger than 3 years of age and evaluated treatment and long-term outcome. METHOD Data from the International Pediatric I-BFM/CML Registry were retrospectively analyzed using the European LeukemiaNet criteria of the year 2006. Characteristics and treatment outcome of patients <3 years old at diagnosis were evaluated from standardized forms. RESULTS Twenty-two patients (n = 22/479; 4.6%, male/female:14/8) were enrolled with a median age of 22 months (range, 10-34 m). Major symptoms comprised asthenia (30%), fever (30%), abdominal pain (20%), extramedullary signs (14%), hemorrhage (5%), and weight loss (5%). The extramedullary signs were specified in eight children: blueberry muffin (n = 1), sudden swollen abdomen (n = 1), sustained vomiting (n = 1), and cervical and inguinal lymph nodes (n = 5). Two of five children with cervical and inguinal lymph nodes were categorized as accelerated phase. Overall, 19 of 22 (86%) children were diagnosed in chronic phase, while the remaining three patients were in advanced phase. Median follow-up was 78 months (range, 7-196 m). Twenty-one out of 22 patients initially received imatinib, while one child received IFN + ARA-C. Imatinib was changed to second-line tyrosine kinase inhibitors (TKIs) in 29% of cases. During follow-up, 41% patients underwent stem cell transplantation (SCT). While on TKI, major molecular response (MMR) was achieved in 48% of children. Among the remaining patients, 21% are alive on TKI without MMR and 22% achieved complete molecular response following SCT. Twenty-one of 22 (95%) children are alive, while one patient died of posttransplant complications. CONCLUSION This report demonstrates for the first time the efficacy and long-term effects of upfront imatinib in the so far largest cohort of children with CML diagnosed at very young age.
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Affiliation(s)
- Adalet Meral Günes
- Department of Pediatric Hematology, Medical Faculty, Uludag University, Nilüfer, Bursa, Turkey
| | - Frédéric Millot
- Pediatric Oncology Unit, University Hospital, Poitiers, France
| | - Krzysztof Kalwak
- Department of Pediatric Hematology, Oncology and BMT, Wroclaw Medical University, Wroclaw, Poland
| | - Birgitte Lausen
- Department of Pediatric and Adolescent Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Petr Sedlacek
- Department of Pediatric Hematology and Oncology, University Hospital Motol, Prague, Czech Republic
| | - A Birgitta Versluys
- Department of Blood and Marrow Transplantation, Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands
| | - Michael Dworzak
- Children's Cancer Research Institute and St. Anna Children's Hospital, Pediatric Clinic, Medical University of Vienna, Vienna, Austria
| | - Barbara De Moerloose
- Department of Pediatric Hematology-Oncology, Ghent University Hospital, Ghent, Belgium
| | - Meinolf Suttorp
- Medical Faculty, Pediatric Hematology-Oncology, Technical University of Dresden, Dresden, Germany
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de Robles P, Fiest KM, Frolkis AD, Pringsheim T, Atta C, St Germaine-Smith C, Day L, Lam D, Jette N. The worldwide incidence and prevalence of primary brain tumors: a systematic review and meta-analysis. Neuro Oncol 2014; 17:776-83. [PMID: 25313193 DOI: 10.1093/neuonc/nou283] [Citation(s) in RCA: 172] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 08/21/2014] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Primary brain tumors are a heterogeneous group of benign and malignant tumors arising from the brain parenchyma and its surrounding structures. The epidemiology of these tumors is poorly understood. The aim of our study is to systematically review the latest literature on the incidence and prevalence of primary brain tumors. METHODS The systematic review and meta-analysis were conducted according to a predetermined protocol and established guidelines. Only studies reporting on data from 1985 onward were included. Articles were included if they met the following criteria: (i) original research, (ii) population based, (iii) reported an incidence or prevalence estimate of primary brain tumors. RESULTS From the 53 eligible studies overall, 38 were included in the meta-analysis. A random-effects model found the overall incidence rate of all brain tumors to be 10.82 (95% CI: 8.63-13.56) per 100 000 person-years. The incidence proportion estimates were heterogeneous, even among the same tumor subtypes, and ranged from 0.051 per 100 000 (germ cell tumors) to 25.48 per 100 000 (all brain tumors). There were insufficient data to conduct a meta-analysis of the prevalence of primary brain tumors. CONCLUSIONS There is a need for more accurate and comparable incidence and prevalence estimates of primary brain tumors across the world. A standardized approach to the study of the epidemiology of these tumors is needed to better understand the burden of brain tumors and the possible geographical variations in their incidence.
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Affiliation(s)
- Paula de Robles
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.M.F., C.A., T.P., C.S., L.D., D.L., N.J.); Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.F., T.P., D.L., N.J.); Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada (K.F., A.D.F., T.P., N.J.); Institute for Public Health, University of Calgary, Calgary, Alberta, Canada (K.F, A.D.F., T.P., N.J.); Department of Oncology, University of Calgary, Calgary, Alberta, Canada (P.d.R.)
| | - Kirsten M Fiest
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.M.F., C.A., T.P., C.S., L.D., D.L., N.J.); Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.F., T.P., D.L., N.J.); Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada (K.F., A.D.F., T.P., N.J.); Institute for Public Health, University of Calgary, Calgary, Alberta, Canada (K.F, A.D.F., T.P., N.J.); Department of Oncology, University of Calgary, Calgary, Alberta, Canada (P.d.R.)
| | - Alexandra D Frolkis
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.M.F., C.A., T.P., C.S., L.D., D.L., N.J.); Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.F., T.P., D.L., N.J.); Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada (K.F., A.D.F., T.P., N.J.); Institute for Public Health, University of Calgary, Calgary, Alberta, Canada (K.F, A.D.F., T.P., N.J.); Department of Oncology, University of Calgary, Calgary, Alberta, Canada (P.d.R.)
| | - Tamara Pringsheim
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.M.F., C.A., T.P., C.S., L.D., D.L., N.J.); Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.F., T.P., D.L., N.J.); Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada (K.F., A.D.F., T.P., N.J.); Institute for Public Health, University of Calgary, Calgary, Alberta, Canada (K.F, A.D.F., T.P., N.J.); Department of Oncology, University of Calgary, Calgary, Alberta, Canada (P.d.R.)
| | - Callie Atta
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.M.F., C.A., T.P., C.S., L.D., D.L., N.J.); Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.F., T.P., D.L., N.J.); Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada (K.F., A.D.F., T.P., N.J.); Institute for Public Health, University of Calgary, Calgary, Alberta, Canada (K.F, A.D.F., T.P., N.J.); Department of Oncology, University of Calgary, Calgary, Alberta, Canada (P.d.R.)
| | - Christine St Germaine-Smith
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.M.F., C.A., T.P., C.S., L.D., D.L., N.J.); Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.F., T.P., D.L., N.J.); Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada (K.F., A.D.F., T.P., N.J.); Institute for Public Health, University of Calgary, Calgary, Alberta, Canada (K.F, A.D.F., T.P., N.J.); Department of Oncology, University of Calgary, Calgary, Alberta, Canada (P.d.R.)
| | - Lundy Day
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.M.F., C.A., T.P., C.S., L.D., D.L., N.J.); Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.F., T.P., D.L., N.J.); Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada (K.F., A.D.F., T.P., N.J.); Institute for Public Health, University of Calgary, Calgary, Alberta, Canada (K.F, A.D.F., T.P., N.J.); Department of Oncology, University of Calgary, Calgary, Alberta, Canada (P.d.R.)
| | - Darren Lam
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.M.F., C.A., T.P., C.S., L.D., D.L., N.J.); Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.F., T.P., D.L., N.J.); Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada (K.F., A.D.F., T.P., N.J.); Institute for Public Health, University of Calgary, Calgary, Alberta, Canada (K.F, A.D.F., T.P., N.J.); Department of Oncology, University of Calgary, Calgary, Alberta, Canada (P.d.R.)
| | - Nathalie Jette
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.M.F., C.A., T.P., C.S., L.D., D.L., N.J.); Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada (P.d.R., K.F., T.P., D.L., N.J.); Department of Community Health Sciences, University of Calgary, Calgary, Alberta, Canada (K.F., A.D.F., T.P., N.J.); Institute for Public Health, University of Calgary, Calgary, Alberta, Canada (K.F, A.D.F., T.P., N.J.); Department of Oncology, University of Calgary, Calgary, Alberta, Canada (P.d.R.)
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