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Zheng Y, Zhang C, Sun X, Kang K, Luo R, Zhao A, Wu Y. Survival trend and outcome prediction for pediatric Hodgkin and non-Hodgkin lymphomas based on machine learning. Clin Exp Med 2024; 24:132. [PMID: 38890203 PMCID: PMC11189314 DOI: 10.1007/s10238-024-01402-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2024] [Accepted: 06/12/2024] [Indexed: 06/20/2024]
Abstract
Pediatric Hodgkin and non-Hodgkin lymphomas differ from adult cases in biology and management, yet there is a lack of survival analysis tailored to pediatric lymphoma. We analyzed lymphoma data from 1975 to 2018, comparing survival trends between 7,871 pediatric and 226,211 adult patients, identified key risk factors for pediatric lymphoma survival, developed a predictive nomogram, and utilized machine learning to predict long-term lymphoma-specific mortality risk. Between 1975 and 2018, we observed substantial increases in 1-year (19.3%), 5-year (41.9%), and 10-year (48.8%) overall survival rates in pediatric patients with lymphoma. Prognostic factors such as age, sex, race, Ann Arbor stage, lymphoma subtypes, and radiotherapy were incorporated into the nomogram. The nomogram exhibited excellent predictive performance with area under the curve (AUC) values of 0.766, 0.724, and 0.703 for one-year, five-year, and ten-year survival, respectively, in the training cohort, and AUC values of 0.776, 0.712, and 0.696 in the validation cohort. Importantly, the nomogram outperformed the Ann Arbor staging system in survival prediction. Machine learning models achieved AUC values of approximately 0.75, surpassing the conventional method (AUC = ~ 0.70) in predicting the risk of lymphoma-specific death. We also observed that pediatric lymphoma survivors had a substantially reduced risk of lymphoma after ten years b,ut faced an increasing risk of non-lymphoma diseases. The study highlights substantial improvements in pediatric lymphoma survival, offers reliable predictive tools, and underscores the importance of long-term monitoring for non-lymphoma health issues in pediatric patients.
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Grants
- No. 82303773, No. 82303772, No. 82204490, No. 82303694 National Natural Science Foundation of China
- No. 82303773, No. 82303772, No. 82204490, No. 82303694 National Natural Science Foundation of China
- No. 82303773, No. 82303772, No. 82204490, No. 82303694 National Natural Science Foundation of China
- No. 82303773, No. 82303772, No. 82204490, No. 82303694 National Natural Science Foundation of China
- No. 2023NSFSC1885 Natural Science Foundation of Sichuan Province
- No. 2023NSFSC1885 Natural Science Foundation of Sichuan Province
- No. 2023YFS0306 Key Research, Development Program of Sichuan Province
- No. 2023YFS0306 Key Research, Development Program of Sichuan Province
- No. GZB20230481 Postdoctoral Fellowship Program of CPSF
- No. 2024HXBH149, No. 2024HXBH006 Post-Doctor Research Project, West China Hospital, Sichuan University
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Affiliation(s)
- Yue Zheng
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, China
| | - Chunlan Zhang
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Xu Sun
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China
| | - Kai Kang
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, China
| | - Ren Luo
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, China
| | - Ailin Zhao
- Department of Hematology, West China Hospital, Sichuan University, Chengdu, China.
| | - Yijun Wu
- Division of Thoracic Tumor Multimodality Treatment, Cancer Center, West China Hospital, Sichuan University, Chengdu, China.
- Laboratory of Clinical Cell Therapy, West China Hospital, Sichuan University, Chengdu, China.
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2
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Harris JE, Patel NN, Wai K, Rosbe KW. Management of Pediatric Persistent Asymptomatic Cervical Lymphadenopathy. Otolaryngol Head Neck Surg 2024; 170:69-75. [PMID: 37418178 DOI: 10.1002/ohn.420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 12/29/2022] [Accepted: 06/17/2023] [Indexed: 07/08/2023]
Abstract
OBJECTIVE Persistent asymptomatic cervical lymphadenopathy (PACL) is a common outpatient referral diagnosis for pediatric otolaryngologists. Historically, excisional biopsy under general anesthesia has been the gold standard for diagnosis but is associated with some risks. Current literature provides little guidance on less invasive monitoring. Our hypothesis is that the majority of children who present with PACL can be safely monitored with ultrasound and avoid the risks of excisional biopsy. STUDY DESIGN A retrospective review was performed of patients <18 years of age, referred to a tertiary care children's hospital for PACL who also underwent at least 1 neck ultrasound from 2007 to 2021. Patients with acute neck infections, congenital masses, or known rheumatologic, immunologic, or malignant conditions were excluded. A multivariate logistic regression model was used to determine patient and nodal factors associated with the decision for operative management. SETTING University of California, San Francisco Pediatric Otolaryngology Department. RESULTS Among the 197 patients meeting inclusion criteria, 30 (15.2%) underwent surgical biopsy. Overall, 26% underwent repeat ultrasound with a mean interval of 6.6 months, and a mean decrease in nodal size of 0.34 cm. Of the 30 surgical cases, 27 (90%) patients had benign pathology. Multivariate regression analysis revealed pain (p = .04), firmness (p < .001), and lack of a normal fatty hilum on ultrasound (p = .04) as statistically significantly correlated with decisions for surgical management. CONCLUSION The majority of pediatric PACL is benign and does not require an excisional biopsy to rule out lymphoma. Serial clinical follow-up with neck ultrasound can be used to safely monitor patients.
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Affiliation(s)
- Jacqueline E Harris
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco Benioff Children's Hospital, San Francisco, California, USA
| | - Neil N Patel
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco Benioff Children's Hospital, San Francisco, California, USA
| | - Katherine Wai
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco Benioff Children's Hospital, San Francisco, California, USA
| | - Kristina W Rosbe
- Department of Otolaryngology-Head and Neck Surgery, University of California San Francisco Benioff Children's Hospital, San Francisco, California, USA
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Ebrahimi S, Habibzadeh A, Khojasteh-Kaffash S, Valizadeh P, Samieefar N, Rezaei N. Immune checkpoint inhibitors therapy as the game-changing approach for pediatric lymphoma: A brief landscape. Crit Rev Oncol Hematol 2024; 193:104225. [PMID: 38049077 DOI: 10.1016/j.critrevonc.2023.104225] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/06/2023] Open
Abstract
Lymphoma is known as the third most common malignancy in children, and its prevalence and mortality are increasing. Common treatments, including chemotherapy, radiotherapy, and also surgery, despite their efficacy, have many side effects and, have a high chance of disease relapse. Immune Checkpoint Inhibitors (ICIs) offer a promising alternative with potentially fewer risks of relapse and toxicity. This review article aims to investigate the efficacy and safety of ICIs, either as monotherapy or in combination, for pediatric lymphoma patients. ICIs have revolutionized cancer treatment in recent years and have shown remarkable results in several adult cancers. However, their efficacy in treating pediatrics requires further investigation. Nevertheless, some ICIs, including nivolumab, pembrolizumab, and ipilimumab, have demonstrated encouraging outcomes. ICIs therapy is not without risks and can cause side effects, including rash, itching, vitiligo, abdominal pain, diarrhea, dysphagia, epigastric pain, nausea, vomiting, thyroid, and pituitary dysfunction. Overall, this review article highlights the potential benefits and risks of ICIs in treating pediatric lymphoma.
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Affiliation(s)
- Sara Ebrahimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Adrina Habibzadeh
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Student Research Committee, Fasa University of Medical Sciences, Fasa, Iran
| | - Soroush Khojasteh-Kaffash
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Student Research Committee, School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Parya Valizadeh
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran; School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Noosha Samieefar
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran; USERN Office, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Nima Rezaei
- Network of Interdisciplinarity in Neonates and Infants (NINI), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Research Center for Immunodeficiencies, Pediatrics Center of Excellence, Children's Medical Center Hospital, Tehran University of Medical Sciences, Tehran, Iran; Department of Immunology, School of Medicine, Tehran University of Medical Science, Tehran, Iran.
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Panda K, Biswal B, Mohanty MD, Choudhury J, Narayan J, Beura S, Behera BK, Pati GK. A pancreatic puzzle: A T-cell non-Hodgkin lymphoma in a 3-year-old child with acute pancreatitis. Indian J Gastroenterol 2023:10.1007/s12664-023-01499-6. [PMID: 38159194 DOI: 10.1007/s12664-023-01499-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2024]
Affiliation(s)
- Kalpana Panda
- Department of Paediatric Gastroenterology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India
| | - Basudev Biswal
- Department of Paediatrics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India
| | - Mamata Devi Mohanty
- Department of Paediatrics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India
| | - Jasashree Choudhury
- Department of Paediatrics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India
| | - Jimmy Narayan
- Department of Gastroenterology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India
| | - Subhasree Beura
- Department of Paediatrics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India
| | - Braja Kishore Behera
- Department of Paediatrics, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India
| | - Girish Kumar Pati
- Department of Gastroenterology, Institute of Medical Sciences and SUM Hospital, Bhubaneswar, 751 003, India.
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Garbin A, Contarini G, Damanti CC, Tosato A, Bortoluzzi S, Gaffo E, Pizzi M, Carraro E, Lo Nigro L, Vinti L, Pillon M, Biffi A, Lovisa F, Mussolin L. MiR-146a-5p enrichment in small-extracellular vesicles of relapsed pediatric ALCL patients promotes macrophages infiltration and differentiation. Biochem Pharmacol 2023; 215:115747. [PMID: 37591448 DOI: 10.1016/j.bcp.2023.115747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2023] [Revised: 08/10/2023] [Accepted: 08/14/2023] [Indexed: 08/19/2023]
Abstract
Anaplastic large cell lymphoma (ALCL) is a CD30-positive lymphoma accounting for 20% of all pediatric T-cell lymphomas. Current first line treatment can cure most of ALCL patients but 10-30% of them are resistant or relapse. In this context, liquid biopsy has the potential to help clinicians in disease screening and treatment response monitoring. Small-RNA-sequencing analysis performed on plasma small-extracellular vesicles (s-EVs) from 20 pediatric anaplastic lymphoma kinase positive (ALK + ) ALCL patients at diagnosis revealed a specific miRNAs cargo in relapsed patients compared to non-relapsed, with seven miRNAs enriched in s-EVs of relapsed patients. MiR-146a-5p and miR-378a-3p showed a negative prognostic impact both in univariate and multivariate analysis, possibly representing, together with let-7 g-5p, a miRNA panel for the early identification of high-risk patients. Among them, miR-146a-5p is known to modulate tumor supporting-M2 macrophages differentiation, but the role of these cells in pediatric ALK + ALCL is still unknown. To elucidate the role of miR-146a-5p and M2 macrophages in pediatric ALCL disease, THP-1-derived macrophages were treated with s-EVs from ALK + ALCL cell lines, showing increased miR-146a-5p intracellular expression, migrating capability and M2-markers CD163 and Arginase-1 upregulation. In turn, conditioned media from M2 macrophages or miR-146a-5p-transfected THP-1 increased ALCL cells' aggressive features and were enriched in interleukin-8. Overall, these data suggest a role of miR-146a-5p in promoting macrophage infiltration and M2-like polarization in ALCL. Our findings incite further investigation on the role of M2 macrophages in ALCL aggressiveness and dissemination, also considering the novel treatment options targeting tumor associated macrophages.
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Affiliation(s)
- Anna Garbin
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy; Istituto di Ricerca Pediatrica "Città della Speranza", Padua, Italy
| | - Giorgia Contarini
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy; Istituto di Ricerca Pediatrica "Città della Speranza", Padua, Italy
| | - Carlotta C Damanti
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy; Istituto di Ricerca Pediatrica "Città della Speranza", Padua, Italy
| | - Anna Tosato
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy; Istituto di Ricerca Pediatrica "Città della Speranza", Padua, Italy
| | | | - Enrico Gaffo
- Department of Molecular Medicine, University of Padua, Padua, Italy
| | - Marco Pizzi
- General Pathology and Cytopathology Unit, Department of Medicine-DMED, University of Padua, Padua, Italy
| | - Elisa Carraro
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy
| | - Luca Lo Nigro
- Centro di Riferimento Regionale di Ematologia ed Oncologia Pediatrica, Azienda Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Luciana Vinti
- Department of Pediatric Hematology and Oncology, Cell and Gene Therapy, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy
| | - Marta Pillon
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy
| | - Alessandra Biffi
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy; Istituto di Ricerca Pediatrica "Città della Speranza", Padua, Italy
| | - Federica Lovisa
- Istituto di Ricerca Pediatrica "Città della Speranza", Padua, Italy
| | - Lara Mussolin
- Maternal and Child Health Department Pediatric Hematology, Oncology and Stem Cell Transplant Center, University of Padua, Padua, Italy; Istituto di Ricerca Pediatrica "Città della Speranza", Padua, Italy.
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Ibrahim F, Gabelloni M, Faggioni L, Padma S, Visakh AR, Cioni D, Neri E. Are Semiquantitative Methods Superior to Deauville Scoring in the Monitoring Therapy Response for Pediatric Hodgkin Lymphoma? J Pers Med 2023; 13:445. [PMID: 36983627 PMCID: PMC10055884 DOI: 10.3390/jpm13030445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 02/05/2023] [Accepted: 02/27/2023] [Indexed: 03/05/2023] Open
Abstract
Tailoring treatment in patients with Hodgkin lymphoma (HL) is paramount to maximize outcomes while avoiding unnecessary toxicity. We aimed to compare the performance of SUVmax reduction (ΔSUVmax%) and the PET ratio (rPET) versus the Deauville score (DS) for assessing the chemotherapy response in pediatric HL patients undergoing 18F-FDG PET-CT. Fifty-two patients with biopsy-proven HL (aged 8-16 years) were enrolled at baseline, interim (after the second or third chemotherapy round) and post-therapy (on completion of first-line chemotherapy). Interim and post-therapy DS, ΔSUVmax% and rPET were compared as response predictors. Patients were classified as responders or non-responders based on a 24-month clinical follow-up. Interim DS showed a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) and diagnostic accuracy of 100%, 80.4%, 100%, 40% and 82.7%, respectively, in predicting the therapy response. Post-therapy DS showed a sensitivity, specificity, PPV, NPV and accuracy of 66.7%, 97.8%, 95.7%, 80% and 94.2%, repsectively. Interim ΔSUVmax% showed a sensitivity, specificity, PPV, NPV and accuracy of 83.3%, 82.6%, 97.4%, 38.5% and 82.7%, respectively, with a 56.3% cutoff. Post-therapy ΔSUVmax% showed a sensitivity, specificity, PPV, NPV and accuracy of 83.3%, 84.8%, 97.5%, 41.7% and 84.6%, respectively, with a 76.8% cutoff. Compared to ΔSUVmax%, DS showed a significantly higher sensitivity, specificity (p < 0.05) and NPV (p < 0.01). The sensitivity, specificity, PPV, NPV and accuracy of rPET in predicting the therapy response at 24 months were 76.1%, 100%, 100%, 35.3% and 78.8%, respectively, with a cut-off of 1.31. DS and rPET showed comparable predictive performance (p > 0.58). In conclusion, DS is an easier method with better performance than ΔSUVmax% and rPET in predicting the chemotherapy response in pediatric HL patients.
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Affiliation(s)
- Firuz Ibrahim
- Department of Nuclear Medicine and PET-CT, Burjeel Medical City, Abu Dhabi 92510, United Arab Emirates
| | - Michela Gabelloni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
| | - Lorenzo Faggioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
| | | | - Arun R. Visakh
- Department of Nuclear Medicine, VPS Lakeshore Hospital, Kochi 682040, Kerala, India
| | - Dania Cioni
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
| | - Emanuele Neri
- Academic Radiology, Department of Translational Research, University of Pisa, 56126 Pisa, Italy
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Zijtregtop EAM, Winterswijk LA, Beishuizen TPA, Zwaan CM, Nievelstein RAJ, Meyer-Wentrup FAG, Beishuizen A. Machine Learning Logistic Regression Model for Early Decision Making in Referral of Children with Cervical Lymphadenopathy Suspected of Lymphoma. Cancers (Basel) 2023; 15:cancers15041178. [PMID: 36831520 PMCID: PMC9954739 DOI: 10.3390/cancers15041178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 02/08/2023] [Indexed: 02/16/2023] Open
Abstract
While cervical lymphadenopathy is common in children, a decision model for detecting high-grade lymphoma is lacking. Previously reported individual lymphoma-predicting factors and multivariate models were not sufficiently discriminative for clinical application. To develop a diagnostic scoring tool, we collected data from all children with cervical lymphadenopathy referred to our national pediatric oncology center within 30 months (n = 182). Thirty-nine putative lymphoma-predictive factors were investigated. The outcome groups were classical Hodgkin lymphoma (cHL), nodular lymphocyte-predominant Hodgkin lymphoma (NLPHL), non-Hodgkin lymphoma (NHL), other malignancies, and a benign group. We integrated the best univariate predicting factors into a multivariate, machine learning model. Logistic regression allocated each variable a weighing factor. The model was tested in a different patient cohort (n = 60). We report a 12-factor diagnostic model with a sensitivity of 95% (95% CI 89-98%) and a specificity of 88% (95% CI 77-94%) for detecting cHL and NHL. Our 12-factor diagnostic scoring model is highly sensitive and specific in detecting high-grade lymphomas in children with cervical lymphadenopathy. It may enable fast referral to a pediatric oncologist in patients with high-grade lymphoma and may reduce the number of referrals and unnecessary invasive procedures in children with benign lymphadenopathy.
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Affiliation(s)
- Eline A. M. Zijtregtop
- Department of Pediatric Hemato-Oncology, Princess Máxima Centre for Pediatric Oncology, Heidelberglaan 25, 3585 CS Utrecht, The Netherlands
- Department of Pediatric Hematology and Oncology, Erasmus Medical Centre-Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - Louise A. Winterswijk
- Department of Pediatric Hemato-Oncology, Princess Máxima Centre for Pediatric Oncology, Heidelberglaan 25, 3585 CS Utrecht, The Netherlands
- Department of Pediatric Hematology and Oncology, Erasmus Medical Centre-Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - Tammo P. A. Beishuizen
- Department of Pediatric Hemato-Oncology, Princess Máxima Centre for Pediatric Oncology, Heidelberglaan 25, 3585 CS Utrecht, The Netherlands
| | - Christian M. Zwaan
- Department of Pediatric Hemato-Oncology, Princess Máxima Centre for Pediatric Oncology, Heidelberglaan 25, 3585 CS Utrecht, The Netherlands
- Department of Pediatric Hematology and Oncology, Erasmus Medical Centre-Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - Rutger A. J. Nievelstein
- Department of Pediatric Hemato-Oncology, Princess Máxima Centre for Pediatric Oncology, Heidelberglaan 25, 3585 CS Utrecht, The Netherlands
- Division Imaging & Oncology, Department of Radiology & Nuclear Medicine, University Medical Centre Utrecht, Heidelberglaan 100, 3584 CX Utrecht, The Netherlands
| | - Friederike A. G. Meyer-Wentrup
- Department of Pediatric Hemato-Oncology, Princess Máxima Centre for Pediatric Oncology, Heidelberglaan 25, 3585 CS Utrecht, The Netherlands
| | - Auke Beishuizen
- Department of Pediatric Hemato-Oncology, Princess Máxima Centre for Pediatric Oncology, Heidelberglaan 25, 3585 CS Utrecht, The Netherlands
- Department of Pediatric Hematology and Oncology, Erasmus Medical Centre-Sophia Children’s Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
- Correspondence: ; Tel.: +31-88-9727272
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Marcoux S, Soullane S, Lee GE, Auger N. Association between caesarean birth and childhood cancer: An age-lagged approach. Acta Paediatr 2023; 112:313-320. [PMID: 35298043 DOI: 10.1111/apa.16335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 03/14/2022] [Accepted: 03/15/2022] [Indexed: 01/13/2023]
Abstract
AIM We assessed the association between caesarean birth and age-specific risks of childhood cancer. METHODS We followed a cohort of 1 034 049 children between 2006 and 2020 in Quebec, Canada, from birth until age 14 years. The exposure was caesarean, operative vaginal, or spontaneous vaginal birth. The outcome included haematopoietic or solid tumours. We calculated hazard ratios (HR) and 95% confidence intervals (CI) for the association between mode of delivery and childhood cancer in age-lagged analyses, adjusted for potential confounders. RESULTS A total of 249 415 (24.1%) children were born by caesarean and 97 411 (9.4%) by operative vaginal delivery. Compared with spontaneous vaginal birth, caesarean was associated with 1.16 times the risk of any cancer (95% CI 1.04-1.30), 1.12 times the risk of haematopoietic cancer (95% CI 0.92-1.36) and 1.21 times the risk of solid tumours (95% 1.06-1.39). Associations strengthened at 2 years of age and were greatest for lymphoma and sarcoma. Operative vaginal birth was not significantly associated with the risk of cancer. CONCLUSION Caesarean birth may be associated with selected childhood cancers, including lymphoma and sarcoma early in childhood. The underlying reasons for the associations require further investigation, including whether mucosal dysbiosis or labour hormone exposure explain the excess risk.
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Affiliation(s)
- Sophie Marcoux
- Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada.,University of Montreal Hospital Research Centre, Montreal, Quebec, Canada.,Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Safiya Soullane
- Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Ga Eun Lee
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada.,Institut national de santé publique du Québec, Montreal, Quebec, Canada
| | - Nathalie Auger
- University of Montreal Hospital Research Centre, Montreal, Quebec, Canada.,Institut national de santé publique du Québec, Montreal, Quebec, Canada.,Department of Social and Preventive Medicine, School of Public Health, University of Montreal, Montreal, Quebec, Canada.,Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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Elhamady HY, Mostafa HM, Elsayed HF, Abo-ElAzm OM, Hussein MH. Deauville score versus ratio Deauville score in the interpretation of interim 18F-FDG PET-CT and in prediction of outcome in children with FDG-avid extra-nodal lymphomas. THE EGYPTIAN JOURNAL OF RADIOLOGY AND NUCLEAR MEDICINE 2022. [DOI: 10.1186/s43055-022-00899-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
Abstract
Abstract
Background
Pediatric lymphoma is a common hematological neoplasm, representing the third most frequent childhood malignancy. 18F-fluoro-2-deoxyglucose–positron emission tomography has been found to be useful in lymphoma staging, prediction of prognosis and risk stratification of lymphoma patients. Although the interpretation of interim PET (after two cycles of chemotherapy) using the qualitative visual method of 5-point Deauville score has been widely accepted, semiquantitative methods of interpretation were evaluated by many studies and showed a better prediction of prognosis. The purpose of this study was to evaluate the prognostic role of the semiquantitative ratio Deauville score (rDS), defined as the ratio between target lesion and liver maximum standardized uptake values in children with FDG-avid extra-nodal lymphomas, undergoing interim FDG-PET/CT, and to compare it with the 5-point Deauville score (5p-DS).
Methods
This prospective study included 89 children with FDG-avid extra-nodal lymphoma. Interim PET was interpreted using both visual (5p-DS) and the semiquantitative method (rDS). The visual method depends on visual comparison of FDG uptake between lesions and liver as a reference organ for activity and considered lesions with activity higher than liver to be positive, while the semiquantitative method depends on making a ratio between the most active lesion and liver SUVmax. Receiver operating characteristic approach was applied to identify the optimal cut-point of rDS with respect to response to therapy and prognosis, and the prognostic significance of rDS was compared with 5p-DS.
Results
The ROC analysis for rDS as a predictor of progression showed an optimal cut-point of 1.25. Both 5p-DS and rDS were strong outcome predictors. Patients with negative 5p-DS and patients with rDS < 1.25 had a similar 3-year PFS (87%). Patients with a positive 5p-DS had a 3-year PFS of 67.4%, while patients with rDS > 1.25 had a 3-year PFS of 60%.
Conclusions
rDS could be suggested as an accurate prognostic factor in children with lymphoma undergoing interim FDG-PET/CT. However, larger studies with more homogenous sample regarding histopathological subtypes and chemotherapy lines are needed to confirm these data.
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10
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Guja KE, Nadel H, Iagaru A. Overview and Recent Advances in 18F-FDG PET/CT for Evaluation of Pediatric Lymphoma. Semin Nucl Med 2022. [DOI: 10.1053/j.semnuclmed.2022.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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11
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Zhang Y, Ning H, Zheng W, Liu J, Li F, Chen J. Lung microbiome in children with hematological malignancies and lower respiratory tract infections. Front Oncol 2022; 12:932709. [PMID: 36212487 PMCID: PMC9533145 DOI: 10.3389/fonc.2022.932709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2022] [Accepted: 08/25/2022] [Indexed: 11/22/2022] Open
Abstract
Background Respiratory infectious complications remain a major cause of morbidity and mortality in children with hematological malignancies. Knowledge regarding the lung microbiome in aforementioned children is limited. Methods A prospective cohort was conducted, enrolling 16 children with hematological malignancies complicated with moderate-to-severe lower respiratory tract infections (LRTIs) versus 21 LRTI children with age, gender, weight, and infection severity matched, with no underlying malignancies, to evaluate the lung microbiome from bronchoalveolar lavage fluid samples in different groups. Results The lung microbiome from children with hematological malignancies and LRTIs showed obviously decreased α and β diversity; increased microbial function in infectious disease:bacteria/parasite; drug resistance:antimicrobial and human pathogenesis than the control group; a significantly reduced proportion of Firmicutes, Bacteroidota, Actinobacteriota; increased Proteobacteria at the phylum level; and distinctly elevated Parabacteroides, Klebsiella, Grimontia, Escherichia_Shigella, unclassified_Enterobacteriaceae at the genus level than the control group. Furthermore, it was revealed that α diversity (Shannon), β diversity (Bray-Curtis dissimilarity), Proteobacteria at the phylum level, and unclassified_Enterobacteriaceae and Escherichia_Shigella at the genus level were significantly negatively associated with hospitalization course whereas Firmicutes at the phylum level was established positively correlated with the hospitalization course. Conclusions Children with hematological malignancies and LRTIs showed obviously decreased α and β diversity, significantly increased function in infectious disease pathogenesis, antimicrobial drug resistance, and unfavorable environment tolerance. Moreover, α diversity (Shannon), β diversity (Bray-Curtis dissimilarity), and Proteobacteria may be used as negative correlated predictors for hospitalization course in these children whereas Firmicutes may be utilized as a positive correlated predictor.
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Affiliation(s)
- Yun Zhang
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Haonan Ning
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Wenyu Zheng
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Jing Liu
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fuhai Li
- Department of Pediatrics, Qilu Hospital of Shandong University, Jinan, China
| | - Junfei Chen
- Department of Pediatric Surgery, Qilu Hospital of Shandong University, Jinan, China
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12
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Maleki Z, Saoud C, Viswanathan K, Kilic I, Tommola E, Griffin DT, Heider A, Petrone G, Jo VY, Centeno BA, Saieg M, Mikou P, Fadda G, Ali SZ, Kholová I, Wojcik EM, Barkan GA, Eisele DW, Bellevicine C, Vigliar E, Wiles AB, Al-Ibraheemi A, Allison DB, Dixon GR, Chandra A, Walsh JM, Baloch ZW, Faquin WC, Krane JF, Rossi ED, Pantanowitz L, Troncone G, Callegari FM, Klijanienko J. Application of the Milan System for Reporting Salivary Gland Cytopathology in pediatric patients: An international, multi-institutional study. Cancer Cytopathol 2022; 130:370-380. [PMID: 35081269 DOI: 10.1002/cncy.22556] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 12/06/2021] [Accepted: 12/13/2021] [Indexed: 12/15/2022]
Abstract
BACKGROUND Pediatric salivary gland fine-needle aspiration (FNA) is uncommon with a higher frequency of inflammatory lesions and a small proportion of malignancies. This international, multi-institutional cohort evaluated the application of the Milan System for Reporting Salivary Gland Cytopathology (MSRSGC) and the risk of malignancy (ROM) for each diagnostic category. METHODS Pediatric (0- to 21-year-old) salivary gland FNA specimens from 22 international institutions of 7 countries, including the United States, England, Italy, Greece, Finland, Brazil, and France, were retrospectively assigned to an MSRSGC diagnostic category as follows: nondiagnostic, nonneoplastic, atypia of undetermined significance (AUS), benign neoplasm, salivary gland neoplasm of uncertain malignant potential (SUMP), suspicious for malignancy (SM), or malignant. Cytology-histology correlation was performed where available, and the ROM was calculated for each MSRSGC diagnostic category. RESULTS The cohort of 477 aspirates was reclassified according to the MSRSGC as follows: nondiagnostic, 10.3%; nonneoplastic, 34.6%; AUS, 5.2%; benign neoplasm, 27.5%; SUMP, 7.5%; SM, 2.5%; and malignant, 12.4%. Histopathologic follow-up was available for 237 cases (49.7%). The ROMs were as follows: nondiagnostic, 5.9%; nonneoplastic, 9.1%; AUS, 35.7%; benign neoplasm, 3.3%; SUMP, 31.8%; SM, 100%; and malignant, 100%. Mucoepidermoid carcinoma was the most common malignancy (18 of 237; 7.6%), and it was followed by acinic cell carcinoma (16 of 237; 6.8%). Pleomorphic adenoma was the most common benign neoplasm (95 of 237; 40.1%). CONCLUSIONS The MSRSGC can be reliably applied to pediatric salivary gland FNA. The ROM of each MSRSGC category in pediatric salivary gland FNA is relatively similar to the ROM of each category in adult salivary gland FNA, although the reported rates for the different MSRSGC categories are variable across institutions.
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Affiliation(s)
- Zahra Maleki
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Carla Saoud
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Kartik Viswanathan
- Department of Pathology, Emory University Hospital Midtown, Atlanta, Georgia
| | - Irem Kilic
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - Erkka Tommola
- Fimlab Laboratories, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Daniel T Griffin
- Department of Pathology, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Amer Heider
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Gianluigi Petrone
- Department of Pathology, Catholic University of Sacred Heart University, Rome, Italy
| | - Vickie Y Jo
- Department of Pathology, Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Mauro Saieg
- Department of Pathology, A. C. Camargo Cancer Center, São Paulo, Brazil
| | | | - Guido Fadda
- Department of Pathology, University of Messina, Messina, Italy
| | - Syed Z Ali
- Department of Pathology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Ivana Kholová
- Fimlab Laboratories, Tampere, Finland.,Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Eva M Wojcik
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - Güliz A Barkan
- Department of Pathology, Loyola University Medical Center, Maywood, Illinois
| | - David W Eisele
- Department of Otolaryngology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Claudio Bellevicine
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Elena Vigliar
- Department of Public Health, University of Naples Federico II, Naples, Italy
| | - Austin B Wiles
- Department of Pathology, Virginia Commonwealth University Health System, Richmond, Virginia
| | - Alyaa Al-Ibraheemi
- Department of Pathology, Boston Children's Hospital, Harvard Medical School, Boston, Massachusetts
| | - Derek B Allison
- Department of Pathology, University of Kentucky College of Medicine, Lexington, Kentucky
| | - Glen R Dixon
- HCA Laboratories, HCA Healthcare, London, United Kingdom
| | - Ashish Chandra
- Department of Pathology, Guy's and St. Thomas' Hospital NHS Foundation Trust, London, United Kingdom
| | - Jonathan M Walsh
- Department of Otolaryngology, Johns Hopkins Hospital, Baltimore, Maryland
| | - Zubair W Baloch
- Department of Pathology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - William C Faquin
- Department of Pathology, Massachusetts General Hospital, Boston, Massachusetts
| | - Jeffrey F Krane
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Esther Diana Rossi
- Department of Pathology, Catholic University of Sacred Heart University, Rome, Italy
| | - Liron Pantanowitz
- Department of Pathology, University of Michigan, Ann Arbor, Michigan
| | - Giancarlo Troncone
- Department of Public Health, University of Naples Federico II, Naples, Italy
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13
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Patel K, Phipps WS, Luu HS, Rakheja D. Laboratory testing in pediatric cancer patients. Cancer Biomark 2022. [DOI: 10.1016/b978-0-12-824302-2.00010-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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14
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Boguszewski MCS, Cardoso-Demartini AA, Boguszewski CL, Chemaitilly W, Higham CE, Johannsson G, Yuen KCJ. Safety of growth hormone (GH) treatment in GH deficient children and adults treated for cancer and non-malignant intracranial tumors-a review of research and clinical practice. Pituitary 2021; 24:810-827. [PMID: 34304361 PMCID: PMC8416866 DOI: 10.1007/s11102-021-01173-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 11/24/2022]
Abstract
Individuals surviving cancer and brain tumors may experience growth hormone (GH) deficiency as a result of tumor growth, surgical resection and/or radiotherapy involving the hypothalamic-pituitary region. Given the pro-mitogenic and anti-apoptotic properties of GH and insulin-like growth factor-I, the safety of GH replacement in this population has raised hypothetical safety concerns that have been debated for decades. Data from multicenter studies with extended follow-up have generally not found significant associations between GH replacement and cancer recurrence or mortality from cancer among childhood cancer survivors. Potential associations with secondary neoplasms, especially solid tumors, have been reported, although this risk appears to decline with longer follow-up. Data from survivors of pediatric or adult cancers who are treated with GH during adulthood are scarce, and the risk versus benefit profile of GH replacement of this population remains unclear. Studies pertaining to the safety of GH replacement in individuals treated for nonmalignant brain tumors, including craniopharyngioma and non-functioning pituitary adenoma, have generally been reassuring with regards to the risk of tumor recurrence. The present review offers a summary of the most current medical literature regarding GH treatment of patients who have survived cancer and brain tumors, with the emphasis on areas where active research is required and where consensus on clinical practice is lacking.
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Affiliation(s)
- Margaret C S Boguszewski
- Departamento de Pediatria, Universidade Federal do Paraná, Avenida Agostinho Leão Junior, 285 - Alto da Glória, Curitiba, PR, 80030-110, Brazil.
| | | | - Cesar Luiz Boguszewski
- SEMPR, Serviço de Endocrinologia e Metabologia, Departamento de Clínica Médica, Hospital de Clínicas da Universidade Federal do Paraná, Curitiba, Brazil
| | - Wassim Chemaitilly
- Departments of Pediatric Medicine-Endocrinology and Epidemiology-Cancer Control, St. Jude Children's Research Hospital, Memphis, USA
| | - Claire E Higham
- Department of Endocrinology, Christie Hospital NHS Foundation Trust and University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Gudmundur Johannsson
- Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Kevin C J Yuen
- Barrow Pituitary Center, Barrow Neurological Institute, Departments of Neuroendocrinology and Neurosurgery, University of Arizona College of Medicine and Creighton School of Medicine, Phoenix, AZ, USA
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15
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Wojtal EK. Chronic Lateral Neck Mass in an Adolescent Female. J Pediatr Health Care 2021; 35:548-551. [PMID: 34304967 DOI: 10.1016/j.pedhc.2021.04.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2021] [Revised: 04/21/2021] [Accepted: 04/29/2021] [Indexed: 11/18/2022]
Abstract
Neck masses are a common finding in the pediatric population, with a broad differential diagnosis resulting in real diagnostic challenges. They are most frequently caused by reactive lymphadenopathy, infectious lymphadenitis, or congenital anomalies of the neck. This case report describes a 16-year-old female presenting to the pediatric emergency department with 5 weeks of right-sided neck mass. Based on her history, physical examination, and prolonged clinical course, the differential diagnosis included infectious, congenital, and neoplastic causes. The patient was ultimately diagnosed with a branchial cleft cyst and referred to a pediatric head and neck surgeon.
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16
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Li Z, Li C, Chen B, Shi L, Gao F, Wang P, Sun W. FDG-PET/CT versus bone marrow biopsy in bone marrow involvement in newly diagnosed paediatric lymphoma: a systematic review and meta-analysis. J Orthop Surg Res 2021; 16:482. [PMID: 34372894 PMCID: PMC8351102 DOI: 10.1186/s13018-021-02521-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/02/2021] [Indexed: 11/28/2022] Open
Abstract
Background Bone marrow infiltration (BMI) is a devastating stage of paediatric lymphoma. Prompt diagnosis of BMI in newly diagnosed paediatric lymphoma patients is critical but can be very challenging at present. Methods We systematically retrieved studies from PubMed, EMBASE, and the Cochrane Library. Data extraction and quality assessment were performed by two reviewers independently. A total of nine eligible studies were included in the quantitative analysis. Results The pooled sensitivity and specificity of FDG-PET/CT for diagnosing BMI in newly diagnosed paediatric lymphoma patients were 0.97 (95% confidence interval [CI], 0.93 to 0.99) and 0.99 (95% CI, 0.98 to 0.99), respectively. The pooled PLR, NLR, and DOR were 79.9 (95% CI, 42.7 to 149.6), 0.03 (95% CI, 0.01 to 0.17), and 2414.6 (95% CI, 989.6 to 5891.4), respectively. The AUC of FDG-PET/CT for BMI was 1.00 (95% CI, 0.99 to 1.00). Compared with FDG-PET/CT, BMB had a lower pooled sensitivity (0.44, 95% CI, 0.34 to 0.55) and comparable pooled specificity (1.00, 95% CI, 0.92 to 1.00). Conclusion Compared with BMB, FDG-PET/CT was a more valuable diagnostic method for evaluating BMI in paediatric Hodgkin and non-Hodgkin lymphoma patients with extremely high diagnostic accuracy.
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Affiliation(s)
- Zhizhuo Li
- Department of Orthopedics, Peking University China-Japan Friendship School of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Chengxin Li
- Department of Orthopedics, Peking University China-Japan Friendship School of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Bingrong Chen
- Department of Orthopedics, Peking University China-Japan Friendship School of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Lijun Shi
- Department of Orthopedics, Graduate School of Peking Union Medical College, China-Japan Friendship institute of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Fuqiang Gao
- Beijing Key Laboratory of Immune Inflammatory Disease, China-Japan Friendship Hospital, Peking Union Medical College, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Peixu Wang
- Department of Orthopedics, Graduate School of Peking Union Medical College, China-Japan Friendship institute of Clinical Medicine, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China
| | - Wei Sun
- Beijing Key Laboratory of Immune Inflammatory Disease, China-Japan Friendship Hospital, Peking Union Medical College, 2 Yinghuadong Road, Chaoyang District, Beijing, 100029, China.
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17
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Sun H, Chen N, Wang X, Li N, Wang S, Zhang Z, Zhou Y, Yang J. The Study on the Pathogenesis of Pediatric Lymphoma Based on the Combination of Pseudotargeted and Targeted Metabolomics. BIOMED RESEARCH INTERNATIONAL 2021; 2021:9984357. [PMID: 34124268 PMCID: PMC8172287 DOI: 10.1155/2021/9984357] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Accepted: 05/17/2021] [Indexed: 12/03/2022]
Abstract
Pediatric lymphoma is a kind of malignant tumor with high mortality. The complexity of pediatric lymphoma shows a great challenge for effective diagnosis and treatment. In order to meet the challenge, the combination of pseudotargeted and targeted metabolomics was used to analyze the serum metabolites in pediatric lymphoma patients and healthy controls for discovering the metabolites related to pediatric lymphoma. The serum samples were obtained from the treatment group (n = 43), the control group (n = 26), and the patients group (n = 18). A total of 17 serum metabolites, including carnitine, leucine, creatine, urea, (6Z,9Z,12Z)-octadecatrienoic acid, linoleate, octadecenoic acid, L-palmitoylcarnitine, hexadecanoic acid, tetradecanoic acid, (9Z)-hexadecenoic acid, uric acid, glucose, 1-methylnicotinamide, hypoxanthine, L-glutamine, and taurine, were found to be related to pediatric lymphoma. They could provide a scientific diagnostic basis and therapeutic target for pediatric lymphoma and elucidate the mechanism of pediatric lymphoma.
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Affiliation(s)
- Hongqi Sun
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China
| | - Nan Chen
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China
| | - Xuchen Wang
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China
| | - Na Li
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China
| | - Shanshan Wang
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China
| | - Zhengyan Zhang
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China
| | - Ying Zhou
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China
| | - Junmei Yang
- Zhengzhou Key Laboratory of Children's Infection and Immunity, Children's Hospital Affiliated to Zhengzhou University, Zhengzhou 450018, China
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18
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D'mello KP, Zhao L, Kaser EC, Zhu Z, Xiao H, Wakefield MR, Bai Q, Fang Y. The role of interleukins and the widely studied TNF-α in non-Hodgkin's lymphoma. Med Oncol 2021; 38:56. [PMID: 33835307 DOI: 10.1007/s12032-021-01504-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/27/2021] [Indexed: 11/25/2022]
Abstract
Non-Hodgkin's lymphoma is a relatively common cancer with malignant tendencies. Although there is no current cure for the disease, research has been successful in figuring out the mechanisms of how the disease progresses, however, there is still a lot of unknowns, and more research must be done to find the ultimate cause of the disease. Interleukins and various cytokines play unique roles in the development of cancer. This review article summarizes the pathophysiology between certain interleukins and non-Hodgkin's lymphoma. Although TNF-α is not an interleukin, the article examines TNF-α due to its high correspondence with cancer. The article also describes a promising immunotherapy for the disease, while looking at immunotherapies that have been successful in other types of cancer and disease.
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Affiliation(s)
- Kyle P D'mello
- Department of Microbiology, Immunology and Pathology, Des Moines University College of Osteopathic Medicine, Des Moines, IA, 50312, USA
| | - Lei Zhao
- The Department of Respiratory Medicine, The 2nd People's Hospital of Hefei and Hefei Hospital Affiliated to Anhui Medical University, Hefei, China
| | - Erin C Kaser
- Department of Microbiology, Immunology and Pathology, Des Moines University College of Osteopathic Medicine, Des Moines, IA, 50312, USA
| | - Ziwen Zhu
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO, 65212, USA
| | - Huaping Xiao
- Department of Microbiology, Immunology and Pathology, Des Moines University College of Osteopathic Medicine, Des Moines, IA, 50312, USA.,The Affiliated Hospital of Xiangnan University, Chenzhou, Hunan, China
| | - Mark R Wakefield
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO, 65212, USA
| | - Qian Bai
- Department of Surgery, University of Missouri School of Medicine, Columbia, MO, 65212, USA
| | - Yujiang Fang
- Department of Microbiology, Immunology and Pathology, Des Moines University College of Osteopathic Medicine, Des Moines, IA, 50312, USA. .,Department of Surgery, University of Missouri School of Medicine, Columbia, MO, 65212, USA.
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19
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Hoenk K, Torno L, Feaster W, Taraman S, Chang A, Weiss M, Pugh K, Anderson B, Ehwerhemuepha L. Multicenter study of risk factors of unplanned 30-day readmissions in pediatric oncology. Cancer Rep (Hoboken) 2021; 4:e1343. [PMID: 33533203 PMCID: PMC8222549 DOI: 10.1002/cnr2.1343] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 01/11/2021] [Accepted: 01/12/2021] [Indexed: 02/06/2023] Open
Abstract
Background Pediatric oncology patients have high rates of hospital readmission but there is a dearth of research into risk factors for unplanned 30‐day readmissions among this high‐risk population. Aim In this study, we built a statistical model to provide insight into risk factors of unplanned readmissions in this pediatric oncology. Methods We retrieved 32 667 encounters from 10 418 pediatric patients with a neoplastic condition from 16 hospitals in the Cerner Health Facts Database and built a mixed‐effects model with patients nested within hospitals for inference on 75% of the data and reserved the remaining as an independent test dataset. Results The mixed‐effects model indicated that patients with acute lymphoid leukemia (in relapse), neuroblastoma, rhabdomyosarcoma, or bone/cartilage cancer have increased odds of readmission. The number of cancer medications taken by the patient and the administration of chemotherapy were associated with increased odds of readmission for all cancer types. Wilms Tumor had a significant interaction with administration of chemotherapy, indicating that the risk due to chemotherapy is exacerbated in patients with Wilms Tumor. A second two‐way interaction between recent history of chemotherapy treatment and infections was associated with increased odds of readmission. The area under the receiver operator characteristic curve (and corresponding 95% confidence interval) of the mixed‐effects model was 0.714 (0.702, 0.725) on the independent test dataset. Conclusion Readmission risk in oncology is modified by the specific type of cancer, current and past administration of chemotherapy, and increased health care utilization. Oncology‐specific models can provide decision support where model built on other or mixed population has failed.
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Affiliation(s)
- Kamila Hoenk
- Children's Hospital of Orange County, Orange, California, USA.,Beckman Research Institute, City of Hope, Duarte, California, USA
| | - Lilibeth Torno
- Children's Hospital of Orange County, Orange, California, USA
| | - William Feaster
- Children's Hospital of Orange County, Orange, California, USA
| | - Sharief Taraman
- Children's Hospital of Orange County, Orange, California, USA
| | - Anthony Chang
- Children's Hospital of Orange County, Orange, California, USA
| | - Michael Weiss
- Children's Hospital of Orange County, Orange, California, USA
| | - Karen Pugh
- Children's Hospital of Orange County, Orange, California, USA
| | | | - Louis Ehwerhemuepha
- Children's Hospital of Orange County, Orange, California, USA.,Schmid College of Science and Technology, Chapman University, Orange, California, USA
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20
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Lin P, Zhou B, Yao H, Guo YP. Effect of carboplatin injection on Bcl-2 protein expression and apoptosis induction in Raji cells. Eur J Histochem 2020; 64:3134. [PMID: 32643899 PMCID: PMC7366131 DOI: 10.4081/ejh.2020.3134] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/19/2020] [Indexed: 01/05/2023] Open
Abstract
To investigate the effects of carboplatin (CBP) injection on apoptosis induction in the human lymphoma cell line Raji and to explore the underlying mechanism, Raji cells were randomly divided into two treatment groups. Cells in the experimental groups were treated with 15 μM CBP injection, those in the control groups were treated with solvent, and both groups were treated for 24, 48 and 72 h. Cells from each group were collected for subsequent assays. For each group, the relative expression of B-cell lymphoma-2 (Bcl-2) was determined by Western blot (WB), the expression pattern of Bcl-2 was observed by immunocytochemistry (ICC), and cell apoptosis was observed after Hoechst 33342 staining. Real-time PCR detection of the relative expression levels of the Bax and caspase-3 genes in each group of cells were performed. The WB results showed that the relative expression of the Bcl-2 protein significantly decreased 48 and 72 h after treatment in the CBP groups compared with the control groups (P<0.001), and a significant decrease in the expression of this protein was also noted at 48 h vs 24 h, 72 h vs 48 h, and 72 h vs 24 h with extremely significant differences (P<0.001). Moreover, the expression of the Bcl-2 protein decreased as the duration of CBP treatment increased, showing a time-dependent manner. The ICC results were consistent with the WB findings. The expression of the Bcl-2 protein in the CBP treatment group was significantly reduced 48 h and 72 h after treatment compared with the control group (P<0.001). A time-dependent manner was also noted in the expression of this protein, i.e., the expression level decreased gradually at 24, 48, and 72 h after treatment with statistically significant differences (P<0.001). Hoechst 33342 staining showed that the apoptosis rates at the three time points in the treatment groups were significantly higher than those in the control groups (P<0.001), and a time-effect relationship was observed. The apoptosis rate increased over time with a significant difference (P<0.05). The PCR results showed that the Bax and caspase-3 gene expression trend was the same but opposite that of Bcl-2. After treatment for 24 h and 48 h, the gene expression of the medication groups decreased with a very significant difference (P<0.001), and with prolonged action time, the relative expression of the genes in the medication groups showed an upward trend. Comparing 48 h with 72 h and 24 h with 72 h, the gene expression levels also increased, reaching a very significant difference (P<0.001), and there was a certain time dependence. CBP injection significantly reduced the expression of the Bcl-2 protein and induced apoptosis of Raji cells in a time-dependent manner. Moreover, CBP injection can increase the expression levels of the Bax and caspase-3 genes.
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Affiliation(s)
- Peng Lin
- Department of Hematology, Baoding First Central Hospital, Baoding, Hebei.
| | - Boliang Zhou
- Department of General Surgery, Baoding First Central Hospital, Baoding, Hebei.
| | - Haiying Yao
- Department of Hematology, Baoding First Central Hospital, Baoding, Hebei.
| | - Ya-Ping Guo
- Department of Laboratory, Baoding First Central Hospital, Baoding, Hebei.
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21
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Imaging Musculoskeletal Manifestations of Pediatric Hematologic Malignancies. AJR Am J Roentgenol 2020; 214:455-464. [DOI: 10.2214/ajr.19.21833] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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22
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CE: Hematologic Childhood Cancers: An Evidence-Based Review. Am J Nurs 2019; 119:34-44. [PMID: 31764050 DOI: 10.1097/01.naj.0000615784.09785.ab] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Every year in the United States, thousands of children and adolescents are diagnosed with a hematologic cancer. That diagnosis and the prescribed course of treatment profoundly affect both the child and the family. This article provides a brief overview of the therapies used to treat such cancers, describes the presentations and diagnoses of the various hematologic cancers, and explains the treatments specific to each. Nursing care of the child and family is discussed, with an emphasis on education and supportive care.
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23
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FDG PET/CT Demonstrated Precursor B-cell Lymphoblastic Lymphoma in a Pediatric Patient With Hemophilia B. Clin Nucl Med 2019; 44:683-685. [PMID: 31274624 DOI: 10.1097/rlu.0000000000002582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
A 4-year-old boy with history of hemophilia B presented with increasingly enlarged scalp masses. Although they were initially thought as hematomas, unresponsiveness to the therapy lead to suspicion of malignancy, which prompted FDG PET/CT. The FDG PET/CT images demonstrated increased FDG uptake in the scalp masses and cervical lymph nodes. The pathology from the left scalp mass and the left cervical lymph nodes revealed precursor B-cell lymphoblastic lymphoma.
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24
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Zamor R, Emberesh M, Absalon MJ, Koberlein GC, Hariharan S. Abdominal Lymphoma Presenting as Terminal Ileitis: A Case Report. J Emerg Med 2019; 57:e13-e16. [PMID: 31003819 DOI: 10.1016/j.jemermed.2019.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2018] [Revised: 02/27/2019] [Accepted: 03/04/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND Most pediatric patients with lymphoma do not have classic symptoms of fever, night sweats, and weight loss. Lymphoma can present as vague symptoms and may mimic common pediatric abdominal emergencies. In this case report, we present a child who presented with abdominal pain and who was initially misdiagnosed as having a surgical emergency. CASE REPORT An 11-year-old previously healthy male was referred to the pediatric emergency department after he presented to an outside hospital with 3 days of right lower quadrant pain and 1 episode of diarrhea. The initial concern was appendicitis. He had a computed tomography scan of the abdomen and pelvis that showed thickening of the bowel wall, peritoneal thickening, and a right pleural effusion. His laboratory assessments were only notable for a mildly elevated lactate dehydrogenase level of 506 units/L. He had a colonoscopy, and biopsy specimens obtained from the terminal ileum and cecum were negative. He developed worsening symptoms, and subsequently underwent laparoscopic biopsy procedures of the omentum and terminal ileum, which were consistent with Burkitt lymphoma. WHY SHOULD AN EMERGENCY PHYSICIAN BE AWARE OF THIS?: We discuss the important oncologic findings of pediatric lymphoma, including oncologic emergencies and important laboratory and imaging tests that providers should consider while in the emergency department. This case highlights how pediatric lymphoma can mimic common pediatric pathologies providers often encounter in the emergency department.
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Affiliation(s)
- Ronine Zamor
- Department of Emergency Medicine, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Myesa Emberesh
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Cancer and Blood Diseases Institute, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio
| | - Michael J Absalon
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Cancer and Blood Diseases Institute, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio
| | - George C Koberlein
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio; Department of Radiology, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio
| | - Selena Hariharan
- Department of Emergency Medicine, Cincinnati Children's Hospital and Medical Center, Cincinnati, Ohio; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, Ohio
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25
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Arendt CT, Beeres M, Leithner D, Tischendorf P, Langenbach M, Kaltenbach B, Dalgicdir J, Vogl TJ, Gruber-Rouh T. Gadolinium-enhanced imaging of pediatric thoracic lymphoma: is intravenous contrast really necessary? Eur Radiol 2018; 29:2553-2559. [PMID: 30547199 DOI: 10.1007/s00330-018-5859-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Revised: 09/27/2018] [Accepted: 10/25/2018] [Indexed: 01/15/2023]
Abstract
OBJECTIVES Increasing awareness of potential side effects from gadolinium-based contrast agents has underlined the need for contrast-free magnetic resonance imaging (MRI). Numerous recent articles evaluated the risk of potential brain deposits, with the result that research is putting the focus more on alternative unenhanced imaging techniques. The aim of this study was to determine the need for contrast media for chest MRI in primary staging and follow-up care of lymphoma. METHODS This monocentric, retrospective study encompassed patients under 25 years of age who had undergone histopathological examination of thoracic lymph nodes and at least one chest MRI examination with unenhanced and contrast-enhanced sequences. Seven different thoracic lymph node stations including mediastinal, hilar, periclavicular, and axillary regions were evaluated by two readers regarding lesion diameter, number, shape, necrosis, and infiltration of surrounding structures. Findings were categorized into suspicious (> 1 cm; round; necrosis; infiltration) or non-suspicious. RESULTS Fifty-one patients (mean age, 16.0 ± 3.7 yrs) with thoracic Hodgkin (70.6%) and non-Hodgkin lymphoma (25.5%) and lymphadenopathy (3.9%) were retrospectively included. Most lymph nodes categorized as suspicious were located in the mediastinal station (86.4%). High agreement (κ = 0.81) between unenhanced and contrast-enhanced sequences was found for both suspicious and non-suspicious lymph nodes. Significant (p < 0.001), but small difference (1 mm) was observed only in sizing mediastinal lymph nodes (all other p > 0.05). No significant difference (smallest p = 0.08) was shown for the use of five different types of contrast media. CONCLUSION MRI in young patients with thoracic lymphoma can safely be done without the use of contrast agent. KEY POINT • Thoracic magnetic resonance imaging in young lymphoma patients can safely be done without gadolinium-based contrast agents.
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Affiliation(s)
- Christophe T Arendt
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.
| | - Martin Beeres
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Doris Leithner
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Patricia Tischendorf
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Marcel Langenbach
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Benjamin Kaltenbach
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Jasmin Dalgicdir
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Thomas J Vogl
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
| | - Tatjana Gruber-Rouh
- Department of Diagnostic and Interventional Radiology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany
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26
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Abstract
Precursor B-cell lymphoblastic lymphoma, a type of non-Hodgkin lymphoma, is common in children. It is mostly extranodal; skin, bone and soft tissue are more often involved. However, isolated peritoneal presentation is rare. In this article a unique pediatric case of isolated omental precursor B-cell lymphobastic lymphoma is presented.
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Affiliation(s)
- Zarmina Javed
- Internal Medicine, Shifa College of Medicine/Shifa International Hospital, Islamabad, PAK
| | - Faiza Hanif
- Pathology, Shifa International Hospital Islamabad, Islamabad, PAK
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