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Maradiegue E, Pascual C, Vasquez L, Maza I, Ugaz C, Montoya J, Zapata A, García H, Chavez S, Ordoñez K, Rossi J, Diaz R, Morales R, Trigoso V, Ames R, Celis E, Barzola I, Torres L, Cosme M, Tarrillo F, Rojas N, Santillan C, Quispe Y, Palacios V, Godoy V, Tello M, Tarco D, Wachtel A, Malaver E, Diaz E, Goyburu M, Perez V, Talavera I, Baca ME, Maza M, Saldaña L, Holguin A, Jarquin M, Loggetto P, Metzger M, Friedrich P, Lam C, Rodriguez Galindo C. Strengthening public health policies for childhood cancer: Peru's achievements through the WHO Global Initiative for Childhood Cancer. Rev Panam Salud Publica 2023; 47:e132. [PMID: 37750053 PMCID: PMC10516323 DOI: 10.26633/rpsp.2023.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Accepted: 07/05/2023] [Indexed: 09/27/2023] Open
Abstract
Objective To report the progress in Peru, since June 2019, in the implementation of the World Health Organization Global Initiative for Childhood Cancer using the CureAll framework, which can be replicated in low- and middle-income countries. Methods A mixed method was used of participatory and documentary evaluation. The participatory evaluation included stakeholders from various government institutions, nonprofit organizations, and international partners. The documentary aspect consisted of a review of data on the regulatory environment, national projects, and interventions implemented. The Ministry of Health engaged more than 150 participants to form working committees, which have developed policy and regulatory documents to strengthen care services. Results Achievements include a decrease in the national treatment abandonment rate from 18.6% to 8.5%, the approval of the Childhood Cancer Law, improvements in the management of patients with febrile neutropenia, and a reduction in rates of events of clinical deterioration and mortality of hospitalized patients. The Cure All implementation framework allows local teams to implement specific strategies and monitor early outcomes in pediatric oncology. Conclusions The results obtained reflect the teamwork, the leadership of the authorities, the technical support of professionals, and the support of involved organizations. Further actions will be needed to guarantee sustainability, and monitoring tools are needed to assure success in the planned activities.
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Affiliation(s)
- Essy Maradiegue
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Claudia Pascual
- Pan American Health OrganizationLimaPeruPan American Health Organization, Lima, Peru
| | - Liliana Vasquez
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Ivan Maza
- Hospital Nacional Edgardo Rebagliati MartinsLimaPeruHospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Cecilia Ugaz
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Jackeline Montoya
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Arturo Zapata
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Henry García
- Instituto Regional de Enfermedades Neoplásicas del SurLimaPeruInstituto Regional de Enfermedades Neoplásicas del Sur, Lima, Peru
| | - Sharon Chavez
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Katy Ordoñez
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Jonathan Rossi
- Ronald McDonald House CharitiesLimaPeruRonald McDonald House Charities, Lima, Peru
| | - Rosdali Diaz
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Roxana Morales
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Viviana Trigoso
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Romy Ames
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Edinho Celis
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Isela Barzola
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Liliana Torres
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Melitta Cosme
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Fanny Tarrillo
- Hospital Nacional Edgardo Rebagliati MartinsLimaPeruHospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Ninoska Rojas
- Hospital Nacional Edgardo Rebagliati MartinsLimaPeruHospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Carlos Santillan
- Pan American Health OrganizationLimaPeruPan American Health Organization, Lima, Peru
| | - Yuly Quispe
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Víctor Palacios
- Regional Health ManagementLambayequePeruRegional Health Management, Lambayeque, Peru
| | - Victoria Godoy
- Instituto Nacional de Salud del NiñoLimaPeruInstituto Nacional de Salud del Niño, Lima, Peru
| | - Mariela Tello
- Instituto Nacional de Salud del NiñoLimaPeruInstituto Nacional de Salud del Niño, Lima, Peru
| | - Duniska Tarco
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Antonio Wachtel
- Pediatric Oncology Association of PeruLimaPeruPediatric Oncology Association of Peru, Lima, Peru
| | - Estela Malaver
- Ministry of Health of PeruLimaPeruMinistry of Health of Peru, Lima, Peru
| | - Elizabeth Diaz
- National School of Public HealthLimaPeruNational School of Public Health, Lima, Peru
| | - Marlene Goyburu
- Ministry of Health of PeruLimaPeruMinistry of Health of Peru, Lima, Peru
| | - Vivian Perez
- Pan American Health OrganizationLimaPeruPan American Health Organization, Lima, Peru
| | - Ivy Talavera
- Pan American Health OrganizationLimaPeruPan American Health Organization, Lima, Peru
| | - Maria Edith Baca
- Pan American Health OrganizationLimaPeruPan American Health Organization, Lima, Peru
| | - Mauricio Maza
- Pan American Health OrganizationWashington, D.C.United States of AmericaPan American Health Organization, Washington, D.C., United States of America
| | - Lily Saldaña
- Instituto Nacional de Salud del NiñoLimaPeruInstituto Nacional de Salud del Niño, Lima, Peru
| | - Alexis Holguin
- Instituto Nacional de Enfermedades NeoplásicasLimaPeruInstituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Marta Jarquin
- Saint Jude Children’s Research HospitalMemphisUnited States of AmericaSaint Jude Children’s Research Hospital, Memphis, United States of America
| | - Patricia Loggetto
- Saint Jude Children’s Research HospitalMemphisUnited States of AmericaSaint Jude Children’s Research Hospital, Memphis, United States of America
| | - Monika Metzger
- Saint Jude Children’s Research HospitalMemphisUnited States of AmericaSaint Jude Children’s Research Hospital, Memphis, United States of America
| | - Paola Friedrich
- Saint Jude Children’s Research HospitalMemphisUnited States of AmericaSaint Jude Children’s Research Hospital, Memphis, United States of America
| | - Cath Lam
- Saint Jude Children’s Research HospitalMemphisUnited States of AmericaSaint Jude Children’s Research Hospital, Memphis, United States of America
| | - Carlos Rodriguez Galindo
- Saint Jude Children’s Research HospitalMemphisUnited States of AmericaSaint Jude Children’s Research Hospital, Memphis, United States of America
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Vasquez L, Maradiegue E, Rojas N, Montoya J, Zapata A, Ugaz C, Pascual C, Santillán C, Wachtel A, Celis E, Bernedo H, Rossi J, Saldaña L, Diaz R, Morales R, Perez V, Metzger ML, Luciani S. Catalyzing Childhood Cancer Care in Peru After One Year of the Global Initiative for Childhood Cancer. JCO Glob Oncol 2021; 7:187-189. [PMID: 33539174 PMCID: PMC8081553 DOI: 10.1200/go.20.00601] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Liliana Vasquez
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Lima, Peru
| | - Essy Maradiegue
- Department of Pediatrics, National Institute of Neoplastic Diseases, Lima, Peru
| | - Ninoska Rojas
- Pediatric Hematology Unit, Hospital Nacional Edgardo Rebagliati Martins, Lima, Peru
| | - Jacqueline Montoya
- Department of Pediatrics, National Institute of Neoplastic Diseases, Lima, Peru
| | - Arturo Zapata
- Department of Pediatrics, National Institute of Neoplastic Diseases, Lima, Peru
| | - Cecilia Ugaz
- Department of Pediatrics, National Institute of Neoplastic Diseases, Lima, Peru
| | - Claudia Pascual
- Pediatric Oncology Unit, Hospital Nacional Guillermo Almenara, Lima, Peru
| | - Carlos Santillán
- Department of Epidemiology, National Institute of Children, San Borja, Lima, Peru
| | | | - Edinho Celis
- Department of Nursing, National Institute of Neoplastic Diseases, Lima, Peru
| | - Hernan Bernedo
- Department of Psychology, National Institute of Neoplastic Diseases, Lima, Peru
| | - Jonathan Rossi
- Executive Director, Ronald McDonald Association in Peru, Lima, Peru
| | - Lily Saldaña
- Department of Surgery, National Institute of Children, San Borja, Lima, Peru
| | - Rosdali Diaz
- Department of Pediatrics, National Institute of Neoplastic Diseases, Lima, Peru
| | - Roxana Morales
- Department of Pediatrics, National Institute of Neoplastic Diseases, Lima, Peru
| | - Vivian Perez
- Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Lima, Peru
| | - Monika L Metzger
- Department of Global Pediatric Medicine, St Jude Children's Research Hospital, Memphis, TN
| | - Silvana Luciani
- Unit of Noncommunicable Diseases, Department of Noncommunicable Diseases and Mental Health, Pan American Health Organization, Washington, DC
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Hol JA, Jongmans MCJ, Sudour‐Bonnange H, Ramírez‐Villar GL, Chowdhury T, Rechnitzer C, Pal N, Schleiermacher G, Karow A, Kuiper RP, de Camargo B, Avcin S, Redzic D, Wachtel A, Segers H, Vujanic GM, van Tinteren H, Bergeron C, Pritchard‐Jones K, Graf N, van den Heuvel‐Eibrink MM. Clinical characteristics and outcomes of children with WAGR syndrome and Wilms tumor and/or nephroblastomatosis: The 30-year SIOP-RTSG experience. Cancer 2021; 127:628-638. [PMID: 33146894 PMCID: PMC7894534 DOI: 10.1002/cncr.33304] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 09/14/2020] [Accepted: 09/21/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND WAGR syndrome (Wilms tumor, aniridia, genitourinary anomalies, and range of developmental delays) is a rare contiguous gene deletion syndrome with a 45% to 60% risk of developing Wilms tumor (WT). Currently, surveillance and treatment recommendations are based on limited evidence. METHODS Clinical characteristics, treatments, and outcomes were analyzed for patients with WAGR and WT/nephroblastomatosis who were identified through International Society of Pediatric Oncology Renal Tumor Study Group (SIOP-RTSG) registries and the SIOP-RTSG network (1989-2019). Events were defined as relapse, metachronous tumors, or death. RESULTS Forty-three patients were identified. The median age at WT/nephroblastomatosis diagnosis was 22 months (range, 6-44 months). The overall stage was available for 40 patients, including 15 (37.5%) with bilateral disease and none with metastatic disease. Histology was available for 42 patients; 6 nephroblastomatosis without further WT and 36 WT, including 19 stromal WT (52.8%), 12 mixed WT (33.3%), 1 regressive WT (2.8%) and 2 other/indeterminable WT (5.6%). Blastemal type WT occurred in 2 patients (5.6%) after prolonged treatment for nephroblastomatosis; anaplasia was not reported. Nephrogenic rests were present in 78.9%. Among patients with WT, the 5-year event-free survival rate was 84.3% (95% confidence interval, 72.4%-98.1%), and the overall survival rate was 91.2% (95% confidence interval, 82.1%-100%). Events (n = 6) did not include relapse, but contralateral tumor development (n = 3) occurred up to 7 years after the initial diagnosis, and 3 deaths were related to hepatotoxicity (n = 2) and obstructive ileus (n = 1). CONCLUSIONS Patients with WAGR have a high rate of bilateral disease and no metastatic or anaplastic tumors. Although they can be treated according to existing WT protocols, intensive monitoring of toxicity and surveillance of the remaining kidney(s) are advised. LAY SUMMARY WAGR syndrome (Wilms tumor, aniridia, genitourinary anomalies, and range of developmental delays) is a rare genetic condition with an increased risk of developing Wilms tumor. In this study, 43 patients with WAGR and Wilms tumor (or Wilms tumor precursor lesions/nephroblastomatosis) were identified through the international registry of the International Society of Pediatric Oncology Renal Tumor Study Group (SIOP-RTSG) and the SIOP-RTSG network. In many patients (37.5%), both kidneys were affected. Disease spread to other organs (metastases) did not occur. Overall, this study demonstrates that patients with WAGR syndrome and Wilms tumor can be treated according to existing protocols. However, intensive monitoring of treatment complications and surveillance of the remaining kidney(s) are advised.
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Affiliation(s)
- Janna A. Hol
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
| | - Marjolijn C. J. Jongmans
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
- Department of GeneticsUniversity Medical Center Utrecht/Wilhelmina Children's HospitalUtrechtthe Netherlands
| | | | | | - Tanzina Chowdhury
- Great Ormond Street Institute of Child HealthUniversity College LondonLondonUnited Kingdom
| | | | - Niklas Pal
- Department of Pediatric OncologyKarolinska University HospitalSolnaSweden
| | | | - Axel Karow
- Department of Pediatrics and Adolescent MedicineFriedrich‐Alexander University Erlangen‐NürnbergErlangenGermany
| | - Roland P. Kuiper
- Princess Máxima Center for Pediatric OncologyUtrechtthe Netherlands
| | - Beatriz de Camargo
- Pediatric Hematology‐Oncology ProgramInstituto Nacional de CancerRio de JaneiroBrazil
| | - Simona Avcin
- Department of Pediatric OncologyUniversity Children's HospitalLjubljanaSlovenia
| | - Danka Redzic
- Department of Hemato‐OncologyMother and Child Health Care Institute of SerbiaBelgradeSerbia
| | - Antonio Wachtel
- Pediatric OncologyInstituto Nacional de Enfermedades NeoplásicasLimaPeru
| | - Heidi Segers
- Department of Pediatric Hemato‐OncologyUniversity Hospital LeuvenLeuvenBelgium
| | | | - Harm van Tinteren
- Department of BiometricsNetherlands Cancer InstituteAmsterdamthe Netherlands
| | - Christophe Bergeron
- Institut d'Hematologie et d'Oncologie PédiatriqueCentre Léon BérardLyonFrance
| | - Kathy Pritchard‐Jones
- Great Ormond Street Institute of Child HealthUniversity College LondonLondonUnited Kingdom
| | - Norbert Graf
- Department of Pediatric Oncology and HematologySaarland UniversityHomburgGermany
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Kovács G, Wachtel A, Basharova E, Spinelli T, Nicolas P, Kabickova E. Palonosetron compared with ondansetron in pediatric cancer patients: multicycle analysis of a randomized Phase III study. Future Oncol 2017; 13:1685-1698. [DOI: 10.2217/fon-2017-0189] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Aim: To investigate across multiple cycles the efficacy and safety of palonosetron in the prevention of chemotherapy-induced nausea and vomiting in pediatric cancer patients receiving highly or moderately emetogenic chemotherapy (HEC/MEC). Patients & methods: Patients were randomly assigned to 10, 20 μg/kg palonosetron or 3 × 150 μg/kg ondansetron for up to four cycles of HEC/MEC. Results: In all on-study chemotherapy cycles, complete response rates were higher in patients in the 20 μg/kg palonosetron group than the ondansetron group. Treatment-emergent adverse events were comparable between the palonosetron 20 μg/kg and ondansetron groups. Conclusion: Over four cycles of HEC/MEC, 20 μg/kg palonosetron was an efficacious and safe treatment for the prevention of chemotherapy-induced nausea and vomiting in pediatric cancer patients.
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Affiliation(s)
- Gábor Kovács
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - Antonio Wachtel
- Department of Pediatrics, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Elena Basharova
- Oncohematology Center, Chelyabinsk Pediatric Regional Clinical Hospital, Chelyabinsk, Russia
| | | | | | - Edita Kabickova
- Department of Pediatric Haematology & Oncology, Charles University & University Hospital Motol, Prague, Czech Republic
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Affiliation(s)
- M. Polettini
- Complex Systems and Statistical Mechanics, Physics and Materials Science Research Unit, University of Luxembourg, 162a Avenue de la Faïencerie, Luxembourg L-1511, Luxembourg
| | - A. Wachtel
- Complex Systems and Statistical Mechanics, Physics and Materials Science Research Unit, University of Luxembourg, 162a Avenue de la Faïencerie, Luxembourg L-1511, Luxembourg
| | - M. Esposito
- Complex Systems and Statistical Mechanics, Physics and Materials Science Research Unit, University of Luxembourg, 162a Avenue de la Faïencerie, Luxembourg L-1511, Luxembourg
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Kabickova E, Wachtel A, Basharova E, Spinelli T, Nicolas P, Kovacs G. 1598 A multicycle phase III study evaluating palonosetron vs ondansetron at preventing chemotherapy-induced nausea and vomiting in pediatric patients. Eur J Cancer 2015. [DOI: 10.1016/s0959-8049(16)30686-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kabickova E, Wachtel A, Basharova E, Spinelli T, Nicolas P, Kovacs G. Palonosetron vs ondansetron: Prevention of chemotherapy-induced nausea and vomiting in pediatric patients in a multicycle study. J Clin Oncol 2015. [DOI: 10.1200/jco.2015.33.15_suppl.10077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Edita Kabickova
- Department of Paediatric Haematology and Oncology, Charles University 2nd Medical School, Prague, Czech Republic
| | - Antonio Wachtel
- Department of Pediatrics, Instituto Nacional de Enfermedades Neoplásicas, Lima, Peru
| | - Elena Basharova
- Oncohematology Center, Chelyabinsk Pediatric Regional Clinical Hospital, Chelyabinsk, Russia
| | | | | | - Gabor Kovacs
- Second Department of Pediatrics, Semmelweis University, Budapest, Hungary
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Kovacs G, Wachtel A, Basharova E, Spinelli T, Nicolas P, Kabickova E. Efficacy/Safety of Palonosetron Vs Ondansetron in Preventing Chemotherapy-Induced Nausea and Vomiting (Cinv) in Pediatric Patients Receiving Moderately or Highly Emetogenic Chemotherapy (Mec/Hec). Ann Oncol 2014. [DOI: 10.1093/annonc/mdu356.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Barrionuevo C, Anderson VM, Zevallos-Giampietri E, Zaharia M, Misad O, Bravo F, Cáceres H, Taxa L, Martínez MT, Wachtel A, Piris MA. Hydroa-like cutaneous T-cell lymphoma: a clinicopathologic and molecular genetic study of 16 pediatric cases from Peru. Appl Immunohistochem Mol Morphol 2002; 10:7-14. [PMID: 11893040 DOI: 10.1097/00129039-200203000-00002] [Citation(s) in RCA: 83] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Hydroa-like cutaneous T-cell lymphoma (hydroa-like CTCL) is an unusual pediatric malignancy with a poor prognosis. An impressive cutaneous rash characterized by edema, blisters, ulcers, crusts, and scars, resembling hidroa vacciniforme, is seen mainly on the face and sometimes on the extremities. The lesion consists of lymphomatous T-cell infiltration of the skin and subcutis with variable exocytosis and angiocentricity. It has been also called edematous, scarring vasculitic panniculitis and hydroa-like lymphoma. An association with Epstein-Barr virus has been suggested. The differential diagnosis includes other cutaneous lymphomas, particularly the cutaneous nasal type T/natural killer-cell lymphoma, mycosis fungoides, precursor T-cell lymphoblastic lymphoma, nonspecific peripheral T-cell lymphoma, cutaneous anaplastic large cell lymphoma, and subcutaneous panniculitic T-cell lymphoma. Other differential diagnoses are inflammatory dermatopathies and panniculitides. Based on a series of 16 such cases referred to the Institute of Neoplastic Diseases, the objective of this report is not only to provide a better clinicopathologic understanding of this entity but also a reappraisal of it as a malignancy. The male/female frequency ratio was 1:1. The median age was 10 years old. All cases showed predominant facial involvement with edema, blisters, ulcers, crusts, and scars. Chemotherapy and/or radiotherapy had little or no benefit. The prognosis was usually dismal. The lymphoma extended from the epidermis to the subcutis, with frequent angiocentric and periadnexal array. Lymphoma cells were mostly of intermediate size with dense hyperchromatic nuclei, inconspicuous nucleoli, and infrequent mitosis. A scanty and variable inflammatory background was found. The lymphoma cells displayed T-cell cytotoxic phenotype. In addition, they were negative for the natural killer cell antigens CD56 and CD57. Epstein-Barr virus in situ hybridization was positive in the six cases in which it was assayed. T-cell receptor gamma (TCRgamma) displayed monoclonal-type rearrangement in four cases studied. Our findings indicate that hydroa-like CTCL is an independent clinicopathologic entity that affects children. Consequently, it should be considered an independent subset of CTCLs and be included as such in the classification of neoplastic diseases of the lymphoid tissues.
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Affiliation(s)
- Carlos Barrionuevo
- Department of Pathology, The Institute of Neoplastic Diseases, Lima, Peru
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Santillana S, Leon J, Samanez C, Campana F, Wachtel A, Ferreyros G, Flores C, Vallejos C, Lopez Berestein A, Williams T. Molecular biology of acute promyelocytic leukemia (APL) in peruvian patients: PML/RAR alfa isoforms distribution in latino patients. Eur J Cancer 2001. [DOI: 10.1016/s0959-8049(01)80816-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Affiliation(s)
- D Arbaiza
- Department of Pediatrics, Instituto Nacional De Enfermedades Neoplasicas, Lima, Peru
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Henrich S, Seifart U, Jaques G, Wachtel A, Loechelt C, Wolf M, Havemann K. 646 Detection of tumor cells in bone marrow, peripheral blood and peripheral blood stem cells of patients with small cell lung cancer (SCLC). Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)80026-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Seifart U, Henrich S, Jaques G, Loechelt C, Wachtel A, Wolf M, Havemann K. 901 Single disseminated tumor cells in bone marrow and PBSC in patients with small cell lung cancer. Lung Cancer 1997. [DOI: 10.1016/s0169-5002(97)80278-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Wachtel A. Helmets and preventing motorcycle and bicycle injuries: comments and a correction. JAMA 1995; 274:939-40; author reply 940-1. [PMID: 7674516 DOI: 10.1001/jama.1995.03530120031022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Wachtel A. Cycle helmets. Do not separate bicycles from motor vehicles. BMJ 1994; 309:541-2. [PMID: 8086928 PMCID: PMC2542753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Bradbury S, Evennett PJ, Sanderson JB, Wachtel A. Numerical apertures of light microscope objectives. J Microsc 1993. [DOI: 10.1111/j.1365-2818.1993.tb03384.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Rank EL, Wachtel A. Electron microscopic evidence of Treponema pallidum and Helicobacter pylori in gastric tissue. Am J Clin Pathol 1992; 97:898. [PMID: 1595613 DOI: 10.1093/ajcp/97.6.898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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Abstract
Sixty-three pediatric patients with germ cell tumors are presented with details of symptoms, histological findings, staging, serological markers, treatment, and response to therapy. The primary sites were: ovarian 32, testicular 17, presacral 7, mediastinal 3, intraabdominal 2, vaginal 1, and right inguinal canal 1. These patients were treated with T2 (sequential use of dactinomycin, doxorubicin, vincristine, and cyclophosphamide, with or without radiation), T6 (combination chemotherapy with cyclophosphamide, bleomycin, dactinomycin, doxorubicin, methotrexate, vincristine), or VAB treatment protocols (velban, dactinomycin, bleomycin, cisplatin). The cure rate for stage I ovarian and testicular germ cell tumors was 100%; for stage III, all primary sites, 82% and for stage IV, all primary sites, 75%. Histology was prognostic in ovarian tumors of the immature malignant teratoma type; the neural type immature teratoma, grades II and III, had the worst prognosis. Initial debulking surgery in combination with chemotherapy and radiation plays an important role in germ cell tumors. Stages II, III, and IV germ cell tumors require aggressive treatment with surgery, radiation, and chemotherapy. For stage I patients, with primary ovarian malignant tumor, cure with surgery alone can be achieved in 50% of the cases and in testicular tumors in about 70% of the patients. For those with stage I and elevated serological markers, it is feasible to follow these markers and give no treatment until there is evidence of persistent elevation or a rise in titers after an initial fall. In those without elevated serological markers, one should take into consideration the size of the tumor and the histological type before taking the "wait and see" approach. These stage I tumors are highly curable when they first present but, if allowed to recur, chemotherapy may not offer the patient such a favorable response and cure rate.
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Affiliation(s)
- N Wollner
- Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, New York 10021
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Hill DL, Yang TJ, Wachtel A. Canine transmissible venereal sarcoma: tumor cell and infiltrating leukocyte ultrastructure at different growth stages. Vet Pathol 1984; 21:39-45. [PMID: 6710811 DOI: 10.1177/030098588402100107] [Citation(s) in RCA: 19] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Electron microscopic study of the canine transmissible venereal sarcoma (N = 26) at different stages of growth showed that tumors in a progressive phase of growth (N = 12) were comprised mostly of large, round cells with prominent nuclei and nucleoli, a few spindle-shaped cells and collagen fibers, focal areas of necrosis, and lymphocyte infiltrates. Regressing tumors (N = 9) had the fewest viable round cells, greater numbers of infiltrating leukocytes, and were comprised almost entirely of connective tissue (collagen bundles) in the latest stages of regression. The infiltrating leukocytes consisted primarily of lymphocytes, some eosinophils, and neutrophils, but very few macrophages. Round-cell nuclei contained numerous perichromatin and interchromatin granules. Their cytoplasm often had annulate lamellae complexes and large deposits of glycogen. Loosely packed tumor cells had extensive proliferation and elongation of cytoplasmic extensions (filopodia). Evidence for cell-mediated tumor cell lysis was demonstrated by degenerative changes in tumor cells which were closely apposed to lymphocytes. Spindle-shaped cells in regressing tumors had intravacuolar collagen fragments, suggesting a possible degradative capacity by these cells.
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Wachtel A. Nonsteroidal anti-inflammatory agents and acute renal failure. Mayo Clin Proc 1982; 57:601. [PMID: 7109689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
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Yang TJ, Haddad-Khairallah L, Wachtel A. Morphologic changes in the murine leukemia L5178Y cells treated with antibodies in the absence of complement activity. Exp Mol Pathol 1981; 35:137-52. [PMID: 6166498 DOI: 10.1016/0014-4800(81)90013-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
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Abstract
A seven-year-old girl was successfully treated for acute lymphoblastic leukemia. Despite clinical remission she developed a monocular hypopyon which was treated successfully with topical and subtenons steroids. When the hypopyon reappeared, a diagnostic paracentesis revealed leukemic cells and a normal aqueous lactate dehydrogenase. Leukemic ocular infiltration may clinically mimic both neoplastic and inflammatory ocular conditions. The combination of paracentesis and lactate dehydrogenase assay greatly aid in the correct diagnosis.
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Abstract
The authors used a videotape-based objective examination ingeneral psychiatry to assess the clinical competence of medical students who had completed their third-year clerkship. The test has been shown to be a reliable, valid measure of clinical competence. Subjective faculty grading related positively to test scores. Students on one ward had significantly lower overall test scores, with particularly low scores on clinical judgement questions. However, faculty grades for these students were not significantly different. This suggests that the faculty was unable to assess the relative efficacy of its own teaching. The test can provide objective assessment of student clinical competence and is a means of program evaluation.
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Chilungu SW, Barnes JA, Copans J, Fabian J, Hirabayashi J, Jacobs SE, Jorgensen JG, Katz N, Lwanga-Lunyiigo S, Nakhleh K, Owusu M, Panoff M, Quarcoo AK, Saberwal S, Scholte B, Southall AW, Studdert-Kennedy WG, Tax S, Wachtel A. Issues in the Ethics of Research Method: An Interpretation of the Anglo-American Perspective [and Comments and Reply]. Current Anthropology 1976. [DOI: 10.1086/201759] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Abstract
Histochemical studies of adenosine triphosphatase and acid phosphatase activity were performed on Mycoplasma gallisepticum. The adenosine triphosphatase activity appears to be localized in the bleb and infrableb regions exclusively and is associated with the cell membrane; acid phosphatase activity is localized in the infrableb region and does not appear to be membrane-associated. These findings are consistent with data from biochemical studies of Mycoplasma cell fractions but, unlike them, reveal that adenosine triphosphatase activity is restricted to a particular part of the cell membrane.
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