By Paul Imbach, Thomas Kühne, Robert J. Arceci
This is the 3rd version of a well-received compendium of data and assistance at the analysis and administration of many of the oncological illnesses which are encountered in kids and kids. within the new version a bankruptcy on infrequent Tumors used to be additional. for every disorder entity, basic proof are only if might be correct for quite a number execs – health facility physicians, professional nurses, psycho-oncologists, physiotherapists, kin medical professionals and pediatricians. in comparison with the 1st version all chapters were up to date. all through, speedy orientation is ensured by way of the transparent, constant format and the concise, lucid sort. Pediatric Oncology: A complete consultant is a superb, easy-to-use reference that belongs at the shelf of each practitioner who encounters or treats malignancies within the pediatric age team. Pediatric Oncology is teamwork! basic evidence for all these inquisitive about analysis and administration – even social employee, pedagogic lecturers, spiritual care persons.
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Extra resources for Pediatric Oncology: A Comprehensive Guide
1). 1 Epidemiology • Incidence: 15–20 % of all leukemias in children. • Seven in one million children develop AML each year. • The frequency of AML remains stable throughout childhood, with increases under age 2 and during adolescence; the incidence increases dramatically after 55 years of age. • There is no gender difference in the incidence of AML. • There is a slightly higher incidence in Caucasian children than in other groups. 2 Predisposing Factors See Chap. 1. 3 Differential Diagnosis • • • • • • • • • Infectious mononucleosis Juvenile rheumatoid arthritis Aplastic anemia Acquired neutropenia Megaloblastic anemia Autoimmune cytopenia Leukemoid reaction Transient myeloproliferative syndrome in infants with Down syndrome Acute mixed-lineage leukemia (AMLL): Combination of ALL and AML characteristics in children with ALL or in children with AML • Metastatic neuroblastoma, rhabdomyosarcoma, retinoblastoma, non-Hodgkin lymphoma • Myelodysplastic syndrome (MDS) • Myeloproliferative syndrome (MPS) • Juvenile myelomonocytic leukemia (JMML) • Chronic myelogenous leukemia (CML) In cases of difficult bone marrow aspiration (“dry” taps), bone marrow biopsy is recommended.
40 T. Kühne • Risk of first-degree relatives of adults with MDS is approximately 15 times higher than in the general population. • Although children with familial MDS do not exhibit specific morphological forms of MDS, monosomy 7 is frequently observed. 6 Constitutional chromosomal aberrations Trisomy 8 mosaicism Trisomy 21 mosaicism, Down syndrome Klinefelter syndrome t(2;11), t(7;16), t(13;14), ins(16), fragile X syndrome, Turner syndrome Syndromes associated with disturbed DNA repair Fanconi anemia Ataxia telangiectasia Bloom syndrome Xeroderma pigmentosum Neurofibromatosis Constitutional p53 mutation (Li–Fraumeni syndrome) Aplastic anemia Congenital neutropenia (Shwachman syndrome) Pearson syndrome First-degree relatives of patients with MDS Alkylating agents and/or radiotherapy Miscellaneous conditions Werner syndrome Pierre Robin syndrome Adams–Oliver syndrome Congenital vitium Hypospadias Endocrine dysfunctions Platelet storage-pool disorders Miscellaneous physical and psychological disorders Etiology • Like other malignant tumors, a process with multiple steps is suspected, with the accumulation of genetic lesions.
Granulocyte colony-stimulating factor (G-CSF) or granulocyte-macrophage CSF (GM-CSF) shortens the periods of neutropenia and diminishes the frequency of infections and days of hospitalization, but do not influence the rate of remission or overall outcome. MRD detection at the end of induction or in the postremission setting is associated with a poor prognosis. 2 Remission and Postremission Therapy • Consolidation and intensification therapy over the course of approximately 6–12 months result in an overall survival between 50 and 60 %.