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Brizini M, Michon B, Bédard MA. Unveiling the Uncommon: A Unique Case of ALPS-Like Syndrome Complicated by Plasma Cell Disorder. J Pediatr Hematol Oncol 2024:00043426-990000000-00403. [PMID: 38652075 DOI: 10.1097/mph.0000000000002859] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Accepted: 03/14/2024] [Indexed: 04/25/2024]
Abstract
Multiple myeloma is a rare disease in pediatrics, where about 30 cases are described under 15 years old. It is even rarer when atypical multiple myeloma occurs in the context of autoimmunity. This case describes a 9-year-old female with autoimmune lymphoproliferative-like disease and combined immune deficiency that developed acute kidney failure with monoclonal peak associated with RAC2 and TNFRSF9 variants. An adapted protocol from the backbone adult multiple myeloma standard of care with the addition of an allogeneic hematopoietic stem cell transplant was used. The patient, now nearly a year posttransplant, shows 100% chimerism with no sign of relapse.
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Affiliation(s)
| | - Bruno Michon
- Department of Pediatrics Hematology-Oncology, CHU de Québec, Université Laval
| | - Marc-Antoine Bédard
- Department of Immunology and Allergy, CHU de Québec, Université Laval, Québec, Canada
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Brizini M, Naccache L, Tibout P, Goudie C, Budd C, Vairy S, Brisson MC, Tran TH, Santiago R. Multicenter real-world experience of the clinical efficacy and tolerance of pazopanib in high-risk pediatric solid tumors (PazoPed). Pediatr Hematol Oncol 2023; 40:643-658. [PMID: 36825687 DOI: 10.1080/08880018.2023.2182854] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/05/2023] [Accepted: 01/20/2023] [Indexed: 02/25/2023]
Abstract
Pazopanib, a receptor tyrosine kinase inhibitor, exhibits anti-tumor activity in adult bone and soft-tissue sarcomas (STS), but has not yet been approved for pediatric tumors. The primary objective was to evaluate pazopanib efficacy when used alone or in combination with topotecan. This real-world multicenter retrospective study included patients with solid tumors, aged 25 years or less at the time of initial diagnosis, treated with pazopanib outside of a clinical trial. Nineteen patients were eligible for efficacy analysis: 14 bone tumors and 5 STS. At pazopanib initiation, the median age was 16.9 years, 18 patients had metastatic disease with a median of 2 prior therapeutic lines. With 6.2 months of median follow-up, no objective response was observed, but 10 patients (52.6%) had stable disease at 8 weeks and the 6-month disease control rate was 26.3%. The median progression free (PFS) and overall survival (OS) were 3.0 months and 6.2 months, respectively. Multivariate analysis showed an inverse relationship between the number of prior treatment lines and PFS and OS (hazard ratio = 1.73 (p = 0.04) and 1.76 (p = 0.03), respectively). Our study showed a potential tumor control activity of pazopanib in pediatric bone and soft tissue sarcomas. Further studies are warranted to determine the optimal timing and condition for pazopanib introduction to maximize the effect.
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Affiliation(s)
- Meziane Brizini
- Department of Pediatrics, CHU de Québec, Université Laval, Québec, Québec, Canada
| | - Lamia Naccache
- Department of Pediatrics, Division of Hematology-Oncology, CHU de Québec, Université Laval, Québec, Québec, Canada
| | - Pauline Tibout
- Department of Pediatrics, Division of Hematology-Oncology, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Catherine Goudie
- Department of Pediatrics, Division of Hematology-Oncology, Montreal Children's Hospital, McGill University Health Centre, Montréal, Québec, Canada
| | - Crystal Budd
- Division of Hematology-Oncology, Montreal Children's Hospital, McGill University Health Centre, Montréal, Québec, Canada
| | - Stéphanie Vairy
- Department of Pediatrics, Division of Hematology-Oncology, CHU de Sherbrooke, Université de Sherbrooke, Québec, Canada
| | - Marie-Claude Brisson
- Department of Pediatrics, Division of Hematology-Oncology, CHU de Québec, Université Laval, Québec, Québec, Canada
| | - Thai Hoa Tran
- Department of Pediatrics, Division of Hematology-Oncology, CHU Sainte Justine, Université de Montréal, Montréal, Québec, Canada
| | - Raoul Santiago
- Department of Pediatrics, Division of Hematology-Oncology, CHU de Québec, Université Laval, Québec, Québec, Canada
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