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Toret E, Ozdemir ZC, Zengin Ersoy G, Oztunali C, Bozkurt C, Kebudi R. Tandem high-dose chemotherapy followed by autologous stem cell transplantation: An infant with trilateral retinoblastoma. Pediatr Transplant 2023; 27:e14504. [PMID: 36919672 DOI: 10.1111/petr.14504] [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: 04/28/2022] [Revised: 01/26/2023] [Accepted: 02/28/2023] [Indexed: 03/16/2023]
Abstract
BACKGROUND Retinoblastoma (RB) is the most common intraocular malignancy in childhood. Advanced RB, associated with exceedingly poor prognosis, requires more intensive multiagent chemotherapy than conventional regimens. Rescue of the bone marrow after intensive chemotherapy is achieved with stem cell transplantation. The sequential courses (tandem transplantation) of high-dose chemotherapy followed by autologous stem cell transplantation allow for even greater dose intensity in consolidation with the potential to use different active chemotherapeutics at each transplant and have proven feasible and successful in treating children with recurrent/refractory solid tumors. CASE DESCRIPTION We report an infant with trilateral high-risk RB who received tandem high-dose chemotherapy (HDC) followed by autologous stem cell transplantation after the conventional chemotherapy. A 5-month-old female patient presented with strabismus, and the ophthalmoscopic examination showed intraocular tumoral lesions in both eyes. Magnetic resonance imaging (MRI) concluded the trilateral retinoblastoma diagnosis due to a tumoral mass in the optic chiasm. The follow-up ophthalmologic examinations and the MRI detected stable disease after six cycles of multiagent chemotherapy. CONCLUSIONS Rescue with autologous stem cell transplantation after HDC allows for an increase in chemotherapy intensity. Tandem transplantation provides the chance to perform different chemotherapeutics at each transplant and enables an increase in the chemotherapy intensity, thus providing a positive effect on disease-free survival.
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Affiliation(s)
- Ersin Toret
- Department of Pediatric Hematology-Oncology, Eskisehir Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Zeynep Canan Ozdemir
- Department of Pediatric Hematology-Oncology, Eskisehir Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Gizem Zengin Ersoy
- Department of Pediatric Hematology-Oncology, Altinbas University, School of Medicine, Medicalpark Bahcelievler Hospital, Istanbul, Turkey
| | - Cigdem Oztunali
- Department of Pediatric Radiology, Eskisehir Osmangazi University, School of Medicine, Eskisehir, Turkey
| | - Ceyhun Bozkurt
- Department of Pediatric Hematology-Oncology, Istinye University, School of Medicine, Altınbas University Medicalpark Bahcelievler Hospital, Istanbul, Turkey
| | - Rejin Kebudi
- Department of Pediatric Hematology-Oncology, Istanbul University Oncology Institute, Cerrahpasa School of Medicine, Istanbul, Turkey
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Choo H, Yoo SY, Moon S, Park M, Lee J, Sung KW, Cha WC, Shin SY, Son MH. Deep-learning-based personalized prediction of absolute neutrophil count recovery and comparison with clinicians for validation. J Biomed Inform 2023; 137:104268. [PMID: 36513332 DOI: 10.1016/j.jbi.2022.104268] [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: 06/10/2022] [Revised: 11/27/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
Neutropenia and its complications are major adverse effects of cytotoxic chemotherapy. The time to recovery from neutropenia varies from patient to patient, and cannot be easily predicted even by experts. Therefore, we trained a deep learning model using data from 525 pediatric patients with solid tumors to predict the day when patients recover from severe neutropenia after high-dose chemotherapy. We validated the model with data from 99 patients and compared its performance to those of clinicians. The accuracy of the model at predicting the recovery day, with a 1-day error, was 76%; its performance was better than those of the specialist group (58.59%) and the resident group (32.33%). In addition, 80% of clinicians changed their initial predictions at least once after the model's prediction was conveyed to them. In total, 86 prediction changes (90.53%) improved the recovery day estimate.
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Affiliation(s)
- Hyunwoo Choo
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Seoul, Republic of Korea
| | - Su Young Yoo
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea
| | - Suhyeon Moon
- Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Minsu Park
- Department of Information and Statistics, Chungnam National University, Korea 99 Daehak-ro, Yuseong-gu, Daejeon, Republic of Korea
| | - Jiwon Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Ki Woong Sung
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Chul Cha
- Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Soo-Yong Shin
- Department of Digital Health, SAIHST, Sungkyunkwan University, Seoul, Republic of Korea; Department of Intelligent Precision Healthcare Convergence, Sungkyunkwan University, Seoul, Republic of Korea; Research Institute for Future Medicine, Samsung Medical Center, Seoul, Republic of Korea.
| | - Meong Hi Son
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
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Yan H, Zhang DY, Li X, Yuan XQ, Yang YL, Zhu KW, Zeng H, Li XL, Cao S, Zhou HH, Zhang W, Chen XP. Long non-coding RNA GAS5 polymorphism predicts a poor prognosis of acute myeloid leukemia in Chinese patients via affecting hematopoietic reconstitution. Leuk Lymphoma 2016; 58:1948-1957. [PMID: 27951730 DOI: 10.1080/10428194.2016.1266626] [Citation(s) in RCA: 44] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- Han Yan
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, PR China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, PR China
| | - Dao-Yu Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, PR China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, PR China
| | - Xi Li
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, PR China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, PR China
- Hunan Province Cooperation Innovation Center for Molecular Target New Drug Study, Hengyang, PR China
| | - Xiao-Qing Yuan
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, PR China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, PR China
| | - Yong-Long Yang
- Haikou People's Hospital and Affiliated Haikou Hospital of Xiangya Medical School, Central South University, Haikou, PR China
| | - Ke-Wei Zhu
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, PR China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, PR China
| | - Hui Zeng
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, PR China
| | - Xiao-Lin Li
- Department of Hematology, Xiangya Hospital, Central South University, Changsha, PR China
| | - Shan Cao
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, PR China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, PR China
- Hunan Province Cooperation Innovation Center for Molecular Target New Drug Study, Hengyang, PR China
| | - Hong-Hao Zhou
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, PR China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, PR China
- Hunan Province Cooperation Innovation Center for Molecular Target New Drug Study, Hengyang, PR China
| | - Wei Zhang
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, PR China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, PR China
- Hunan Province Cooperation Innovation Center for Molecular Target New Drug Study, Hengyang, PR China
| | - Xiao-Ping Chen
- Department of Clinical Pharmacology, Xiangya Hospital, Central South University, Changsha, PR China
- Institute of Clinical Pharmacology, Central South University, Hunan Key Laboratory of Pharmacogenetics, Changsha, PR China
- Hunan Province Cooperation Innovation Center for Molecular Target New Drug Study, Hengyang, PR China
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Infectious Complications during Tandem High-Dose Chemotherapy and Autologous Stem Cell Transplantation for Children with High-Risk or Recurrent Solid Tumors. PLoS One 2016; 11:e0162178. [PMID: 27627440 PMCID: PMC5023107 DOI: 10.1371/journal.pone.0162178] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Accepted: 08/18/2016] [Indexed: 11/19/2022] Open
Abstract
We retrospectively analyzed infectious complications during tandem high-dose chemotherapy and autologous stem cell transplantation (HDCT/auto-SCT) in children and adolescents with high-risk or recurrent solid tumors. A total of 324 patients underwent their first HDCT/auto-SCT between October 2004 and September 2014, and 283 of them proceeded to their second HDCT/auto-SCT (a total of 607 HDCT/auto-SCTs). During the early transplant period of 607 HDCT/auto-SCTs (from the beginning of HDCT to day 30 post-transplant), bacteremia, urinary tract infection (UTI), respiratory virus infection, and varicella zoster virus (VZV) reactivation occurred in 7.1%, 2.3%, 13.0%, and 2.5% of HDCT/auto-SCTs, respectively. The early transplant period of the second HDCT/auto-SCT had infectious complications similar to the first HDCT/auto-SCT. During the late transplant period of HDCT/auto-SCT (from day 31 to 1 year post-transplant), bacteremia, UTI, and VZV reactivation occurred in 7.5%, 2.5%, and 3.9% of patients, respectively. Most infectious complications in the late transplant period occurred during the first 6 months post-transplant. There were no invasive fungal infections during the study period. Six patients died from infectious complications (4 from bacterial sepsis and 2 from respiratory virus infection). Our study suggests that infectious complications are similar following second and first HDCT/auto-SCT in children.
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Sung KW, Chueh HW, Lee NH, Kim DH, Lee SH, Yoo KH, Koo HH, Kang ES, Kim DW. Optimal time to start peripheral blood stem cell collection in children with high-risk solid tumors. J Korean Med Sci 2014; 29:110-6. [PMID: 24431914 PMCID: PMC3890460 DOI: 10.3346/jkms.2014.29.1.110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2013] [Accepted: 11/06/2013] [Indexed: 12/02/2022] Open
Abstract
In order to clarify the optimal timing for peripheral blood stem cell (PBSC) collection, PBSC collection records of 323 children who were scheduled to undergo autologous stem cell transplantation from two study periods differing in the timing of PBSC collection were analyzed. In the early study period (March 1998 to August 2007, n=198), PBSC collection was initiated when the peripheral WBC count exceeded 1,000/µL during recovery from chemotherapy. Findings in this study period indicated that initiation of PBSC collection at a higher WBC count might result in a greater CD34(+) cell yield. Therefore, during the late study period (September 2007 to December 2012, n=125), PBSC collection was initiated when the WBC count exceeded 4,000/µL. Results in the late study period validated our conclusion from the early study period. Collection of a higher number of CD34(+) cells was associated with a faster hematologic recovery after transplant in the late study period. Initiation of PBSC collection at WBC count > 4,000/µL was an independent factor for a greater CD34(+) cell yield. In conclusion, PBSC collection at a higher WBC count is associated with a greater CD34(+) cell yield, and consequently a faster hematologic recovery after transplant.
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Affiliation(s)
- Ki Woong Sung
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hee Won Chueh
- Department of Pediatrics, Dong-A University Medical Center, Dong-A University College of Medicine, Busan, Korea
| | - Na Hee Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dong Hwan Kim
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Soo Hyun Lee
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Keon Hee Yoo
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hong Hoe Koo
- Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Suk Kang
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Dae Won Kim
- Department of Laboratory Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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