The Onset of Puberty Presents Unique Management Issues in Penile Chronic Graft-versus-Host Disease Requiring Circumcision in Male Pediatric Patients.

IF 1.2 4区 医学 Q4 HEMATOLOGY
Pediatric Hematology and Oncology Pub Date : 2024-05-01 Epub Date: 2023-11-07 DOI:10.1080/08880018.2023.2277765
Chia Huan Ng, Juliana P Roden, Jefferson Terry, Kirk R Schultz
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引用次数: 0

Abstract

Chronic GvHD of the penile tract in male pediatric patients has not been described well in the literature and is often under-diagnosed. We report three cases of penile chronic GvHD in adolescent male patients who received HSCT before the onset of puberty. Their penile cGvHD became symptomatic upon the onset of penile growth associated with puberty in combination with the fibrotic changes in the foreskin. Symptoms did not respond to systemic chronic GvHD medication but require circumcision for alleviation of symptoms. This case series highlights the need for frequent monitoring of the prepubertal pediatric HSCT patient who has the presence of sclerotic cGvHD and enters puberty. This population is particularly reluctant to allow a thorough examination of the genitalia. In addition, optimization of systemic and topical immunosuppression treatment for patients with chronic GvHD of the penile tract potentially with the introduction of novel agents that target the tissue repair and fibrosis pathway is needed to prevent circumcision as the only option in the future.

青春期的发病为男性儿科患者需要包皮环切术的阴茎慢性移植物抗宿主疾病提供了独特的管理问题。
男性儿科患者阴茎道慢性GvHD在文献中没有得到很好的描述,并且经常被低估。我们报告了三例在青春期开始前接受HSCT治疗的青少年男性患者的阴茎慢性GvHD。他们的阴茎cGvHD在与青春期相关的阴茎生长开始时出现症状,并伴有包皮的纤维化变化。症状对系统性慢性GvHD药物没有反应,但需要进行包皮环切术来缓解症状。该病例系列强调了对患有硬化性cGvHD并进入青春期的青春期前儿童HSCT患者进行频繁监测的必要性。这一群体尤其不愿意对生殖器进行彻底检查。此外,需要优化阴茎道慢性GvHD患者的全身和局部免疫抑制治疗,并可能引入针对组织修复和纤维化途径的新药物,以防止包皮环切术成为未来的唯一选择。
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来源期刊
CiteScore
2.60
自引率
5.90%
发文量
71
审稿时长
6-12 weeks
期刊介绍: PHO: Pediatric Hematology and Oncology covers all aspects of research and patient management within the area of blood disorders and malignant diseases of childhood. Our goal is to make PHO: Pediatric Hematology and Oncology the premier journal for the international community of clinicians and scientists who together aim to define optimal therapeutic strategies for children and young adults with cancer and blood disorders. The journal supports articles that address research in diverse clinical settings, exceptional case studies/series that add novel insights into pathogenesis and/or clinical care, and reviews highlighting discoveries and challenges emerging from consortia and conferences. Clinical studies as well as basic and translational research reports regarding cancer pathogenesis, genetics, molecular diagnostics, pharmacology, stem cells, molecular targeting, cellular and immune therapies and transplantation are of interest. Papers with a focus on supportive care, late effects and on related ethical, legal, psychological, social, cultural, or historical aspects of these fields are also appreciated. Reviews on important developments in the field are welcome. Articles from scientists and clinicians across the international community of Pediatric Hematology and Oncology are considered for publication. The journal is not dependent on or connected with any organization or society. All submissions undergo rigorous peer review prior to publication. Our Editorial Board includes experts in Pediatric Hematology and Oncology representing a wide range of academic and geographic diversity.
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