Journal of Pediatric Hematology/Oncology最新文献

{"title":"Comment on: Pathological and Molecular Diagnosis of Ewing Sarcoma: A Multicenter Analysis From the Latin American Cooperative Group Trial. What Next?","authors":"Ian J Cohen, Shifra Ash","doi":"10.1097/MPH.0000000000003266","DOIUrl":"10.1097/MPH.0000000000003266","url":null,"abstract":"","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"364"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148813289","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Oral Cyanocobalamin Treatment in Infants Under 1 Year With Nutritional Vitamin B12 Deficiency: A Retrospective Comparison of 500 and 1000 µg Dose Regimens.","authors":"Gökçe P Reis İskenderoğlu, Erol Erduran, Nilgün Eroğlu, Ayşenur Bahadır","doi":"10.1097/MPH.0000000000003251","DOIUrl":"10.1097/MPH.0000000000003251","url":null,"abstract":"<p><strong>Background: </strong>Vitamin B12 deficiency is a significant health problem in infancy, particularly in developing countries. Oral treatment has emerged as an alternative to intramuscular therapy, but optimal dosing in infants remains unclear.</p><p><strong>Methods: </strong>This retrospective study included 93 infants aged 1 to 12 months diagnosed with nutritional vitamin B12 deficiency. Patients received either 500 or 1000 µg oral cyanocobalamin. Laboratory parameters were evaluated at baseline, 2 months, and 4 months.</p><p><strong>Results: </strong>Both treatment groups demonstrated significant increases in serum vitamin B12 levels and decreases in homocysteine levels ( P <0.001). No significant difference was observed between the 500 and 1000 µg groups regarding hematological or biochemical response. Treatment was well tolerated with no reported adverse effects.</p><p><strong>Conclusions: </strong>Oral cyanocobalamin was associated with biochemical improvement and was well tolerated in infants under 1 year of age. Although no significant difference was observed between the 500 and 1000 µg regimens in this retrospective cohort, prospective noninferiority studies are needed to determine whether the lower dose is comparable with the higher dose.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"e323-e328"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148887820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term Survival and Relapse Patterns in Pediatric Hepatoblastoma: A 20-year Single-center Experience.","authors":"Mehtap Ertekin, Aytul Temuroglu, Fatih Celik, Metin Demirkaya, Betul Sevinir","doi":"10.1097/MPH.0000000000003257","DOIUrl":"10.1097/MPH.0000000000003257","url":null,"abstract":"<p><strong>Background: </strong>Despite advancements, managing high-risk and metastatic hepatoblastoma remains challenging. This study evaluates 2 decades of clinical experience to identify long-term prognostic drivers and the evolving role of event-free survival (EFS).</p><p><strong>Methods: </strong>This cohort consisted of 39 children with hepatoblastoma from 2004 to 2024. The clinical characteristics, PRETEXT, risk group, alpha-fetoprotein level, pulmonary metastasis, and treatment modalities were reviewed. The overall and event-free survival were estimated using the Kaplan-Meier method and log-rank tests. Univariable Cox regression was performed to evaluate the impact of pulmonary metastasis on EFS.</p><p><strong>Results: </strong>The mean age at diagnosis was 3.6±4.3 years. The 5-year OS and EFS rates were 81.2% and 75.0%, respectively. Six deaths and 9 events were recorded. OS was not significantly influenced by risk group ( P =0.093), PRETEXT stage ( P =0.177), and AFP ( P =0.214). Pulmonary metastasis at diagnosis was associated with poor EFS (log-rank P =0.048). In the univariable Cox model for EFS, pulmonary metastasis was associated with a higher risk for events (HR 3.83, 95% CI 0.91-16.10, P =0.067).</p><p><strong>Conclusions: </strong>Long-term overall survival was favorable in this cohort. Pulmonary metastasis emerged as the variable most closely linked to inferior event-free survival, whereas traditional clinical and staging variables were not significantly associated with overall survival.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"346-352"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620490","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Impact of Pandemic-Related Social Distancing Mandates on Bloodstream Infection Rates in Children With Chemotherapy-Induced Febrile Neutropenia.","authors":"Rachel Offenbacher, Helen S Tian, Sara Kaswan, Hailey Reisert, Kasra J Moghaddam, Marc Foca, Juan Lin, Howard Dean Hosgood, Daniel A Weiser","doi":"10.1097/MPH.0000000000003255","DOIUrl":"10.1097/MPH.0000000000003255","url":null,"abstract":"<p><p>Children with severe neutropenia are advised to avoid activities and public spaces where they may be exposed to potential sources of infection, due to the risk of neutropenic fever, an oncologic emergency. The influence of exposure to environmental infectious disease risk factors (IDRFs) on the incidence of bacteremia has been difficult to study. Lockdowns enforced during the COVID-19 pandemic resulted in widespread social distancing and were associated with reduced opportunities for exposure to such environmental risk factors. We performed a retrospective chart review to compare the incidence of fever and bloodstream infection in patients with chemotherapy-induced neutropenia before (March 15, 2019 to March 14, 2020) and during the COVID-19 pandemic (March 15, 2020 to March 14, 2021). Before COVID-19, there were 219 episodes of neutropenia, 79 episodes with fever, and 12 episodes with bacteremia. During COVID-19, there were 236 episodes of neutropenia, 80 episodes with fever, and 13 episodes with bacteremia. In this small retrospective study, we did not observe a statistically significant difference in the incidence of either febrile neutropenia or febrile neutropenic bloodstream infection across 2 years with differing levels of exposure to environmental IDRFs (febrile neutropenia: IRR=0.89, P =0.38; bloodstream infection: IRR=1.01, P =0.99). Further multicenter studies are needed to better define the risks of exposure to potential environmental sources of infection, which may ultimately impact provider guidance for children with severe neutropenia.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"e349-e356"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620519","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Racial and Ethnic Disparities in Treatment Cost and Utilization in Pediatric and Young Adult Acute Lymphoblastic Leukemia.","authors":"Luke Remme, Dave Watson, Paige Reimche, Alex Hoover, Lynn Tanner, Laura Gilchrist, Yoav Messinger, Mike Finch, Lucie M Turcotte","doi":"10.1097/MPH.0000000000003241","DOIUrl":"10.1097/MPH.0000000000003241","url":null,"abstract":"<p><p>Racial and ethnic survival disparities exist in pediatric and young adult acute lymphoblastic leukemia (ALL), with differential treatment toxicity and setting of care as possible drivers. Whether treatment cost and utilization disparities exist, or how they may contribute to differences in ALL survival, is unknown. Patients with ALL diagnosed between 2000 and 2019 at ages 1 to 24 years were identified using ICD-9/10 codes in the administrative claims data from the OptumLabs Data Warehouse and the Surveillance, Epidemiology, and End Results program. Sex, race and ethnicity, age, year, and subtype of ALL diagnosis were collected. Reimbursed treatment cost and utilization (number of inpatient and outpatient days) were computed over the initial 8 months of treatment. Regression models assessed associations with demographic and clinical characteristics. Survival analyses assessed associations between race and ethnicity and overall survival. Among 374 individuals with ALL, treatment costs were 57% lower for Black patients than for White patients (estimate 0.43, 95% CI: 0.19-0.96; P=0.04). Utilization was similar across groups, though Black patients had 24% fewer outpatient visits (estimate 0.76, 95% CI: 0.58-0.99; P=0.04). No significant differences in survival were detected, but observations are consistent with previous reports. Despite a small sample size, the statistically significantly lower cost and utilization among Black relative to White ALL patients are concerning and warrant further research.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":"48 7","pages":"e332-e338"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149081152","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real World Outcomes of Metastatic Rhabdomyosarcoma in Children Treated With a Multimodal Protocol: A Single Center Experience.","authors":"Kruti Shah, Badira Cheriyalinkal Parambil, Venkata R M Gollamudi, Maya Prasad, Siddhartha Laskar, Nehal Khanna, Jifmi J Manjali, Sajid Qureshi, Mukta Ramadwar, Poonam Panjwani, Vasundhara Patil, Akshay Baheti, Sneha Shah, Myvizhi Kannan, Girish Chinnaswamy","doi":"10.1097/MPH.0000000000003256","DOIUrl":"10.1097/MPH.0000000000003256","url":null,"abstract":"<p><strong>Background and aims: </strong>Metastatic rhabdomyosarcoma (RMS) at diagnosis has poor outcomes. We audited these outcomes in children at a tertiary sarcoma unit.</p><p><strong>Methods: </strong>Children aged 15 years or younger with RMS at first diagnosis staged by FDG-PET CECT scan between January 2013 and December 2024 were retrospectively analyzed. Pulmonary, lymph node, and oligometastatic bone disease were treated with curative intent on a multimodal protocol comprising chemotherapy and local therapy to the primary and metastatic sites.</p><p><strong>Results: </strong>Of 126 patients, 19% had isolated pulmonary, 81% had extrapulmonary metastases, with bone marrow involvement in 3.1%. After neoadjuvant chemotherapy in 73 patients (treated with curative intent), 74% had complete response (CR), 19% partial response (PR), 4% stable disease, and 3% progression. Local therapy to the primary was given to 68 patients (radiotherapy: 70.5%, surgery+radiotherapy: 22.1%, surgery: 7.3%), and metastatic sites were treated in 61.8%. At a median follow-up of 11 months (IQR: 3.31, 20.8), 2-year EFS and OS probabilities were 30.2% (95% CI: 19.8-41.2) and 44.4% (95% CI: 32.5-55.6), respectively; survival did not differ by metastasis site. Complete response at primary (HR: 0.09, 95% CI: 0.30-0.29, P <0.001), baseline tumor size ≥3.3 cm (HR: 4.93, 95% CI: 1.51-16.08, P =0.008), and bone marrow involvement (HR: 1.98, 95% CI: 1.01-3.91, P =0.050) affected EFS.</p><p><strong>Conclusions: </strong>Despite multimodal therapy, metastatic rhabdomyosarcoma continues to have poor outcomes. Tumor size ≥3.3 cm in oligometastatic disease and bone marrow involvement predicted poor prognosis, while complete primary site response after neoadjuvant chemotherapy was associated with improved survival.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"313-322"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148673875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cardiometabolic Risk and Awareness of Anthracycline-Related Cardiotoxicity in Survivors of Childhood Cancer: A Population-Based Study.","authors":"Vigdís H Viggósdóttir, Hróðmar Helgason, Helga Jónsdóttir, Thor Aspelund, Ragnar Bjarnason, Marianne Jarfelt","doi":"10.1097/MPH.0000000000003245","DOIUrl":"10.1097/MPH.0000000000003245","url":null,"abstract":"<p><p>Anthracycline chemotherapy is associated with cardiotoxicity, underscoring the importance of minimizing modifiable cardiac risk factors in affected individuals. This study evaluated cardiac function, prevalence of metabolic syndrome and smoking, and awareness of prior cardiotoxic treatment among adult survivors of childhood cancer treated with anthracyclines at the pediatric oncology service in Iceland between 1981 and 2011 (n=89). Data were collected from medical records, self-reported questionnaires, and clinical assessments conducted between 2016 and 2019. Of 76 eligible survivors, 60 participated (29 females, 31 males; aged 20 to 48 y). Two individuals were excluded before enrollment due to previously diagnosed heart failure. Left ventricular dilation was observed in 15 participants (25%), predominantly mild to moderate, with 1 severe case. The prevalence was lower after BSA indexing. Metabolic syndrome was present in 20% of participants, and 20% reported current smoking. Approximately half of the participants reported undergoing echocardiography within the past 10 years, while only 10% were aware that their cancer treatment could cause cardiotoxicity. These findings suggest that survivors treated with anthracyclines require systematic surveillance and targeted interventions to address modifiable cardiovascular risk factors. Increasing awareness of prior cardiotoxic cancer treatment among survivors and health care providers may facilitate cardiovascular risk reduction.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"e299-e307"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13608293/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148620524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Catatonia in a 13-Year-Old With T-Cell Lymphoblastic Lymphoma Following Intrathecal Methotrexate.","authors":"Raquel Lazarowitz, Jennifer Picado, Jitka Stankova","doi":"10.1097/MPH.0000000000003265","DOIUrl":"10.1097/MPH.0000000000003265","url":null,"abstract":"<p><strong>Background: </strong>Methotrexate neurotoxicity is a recognized complication in pediatric lymphoid malignancies, presenting with seizures, stroke-like episodes, or leukoencephalopathy. Catatonia is a rare and underrecognized manifestation.</p><p><strong>Observation: </strong>A 13-year-old girl with T-cell lymphoblastic lymphoma developed agitation, confusion, and catatonia 5 days after intrathecal methotrexate. Investigations excluded structural, infectious, metabolic, and malignant causes. Psychiatry confirmed catatonia (Bush-Francis Catatonia Rating Scale 21-22). Lorazepam led to rapid improvement. Intrathecal methotrexate was later reintroduced with leucovorin rescue without recurrence.</p><p><strong>Conclusions: </strong>Catatonia may represent an uncommon presentation of methotrexate neurotoxicity. Early recognition and lorazepam treatment are critical, and cautious methotrexate rechallenge may be feasible.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"361-363"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Digital Clinical Management Platform in a Tertiary Pediatric Hemato-Oncology Center: Impact on Clinical Outcomes and Patient Safety.","authors":"Michal Singer, Uri Ilan, Guy Dolinski, Nitsan Halabi, Yuliana Edri, Nisim Rahman, Sigal Sina, Maor Sagi, Sivan Tam, Moshe Ashkenazi","doi":"10.1097/MPH.0000000000003267","DOIUrl":"10.1097/MPH.0000000000003267","url":null,"abstract":"<p><strong>Introduction: </strong>Healthcare delivery is increasingly challenged by rising demand, escalating costs, and the need for efficiency. Contributing factors such as the nursing workforce crisis, fragmented and excessive clinical data, outdated IT infrastructures, and the growing complexity of care exacerbate the risk of medical errors, treatment delays, and staff burnout. To address these challenges, we evaluated AMIT, a novel digital platform designed to support nursing practice in pediatric oncology.</p><p><strong>Methods: </strong>AMIT is a web-based platform developed in 2022 and implemented in Q4 2023 in the pediatric oncology day care unit. It integrates data from 5 hospital IT systems, applying predefined rules based on local practice to highlight only clinically relevant information requiring intervention or safety event prevention. In addition, analytic and diagnostic alerts were generated. Primary outcomes included prevention of safety events, reduction in urgent PICU referrals, and shorter patient journey times; the secondary outcome was nursing satisfaction, assessed by questionnaire.</p><p><strong>Results: </strong>Following implementation, 61 safety events, including 2 potentially fatal cases, were identified and addressed. The incidence of urgent PICU referrals decreased by 78%, timely antibiotic administration (≤3 h) improved by 47%, and patient journey times for electrolytes and transfusions decreased by 58% (104 to 44 min). Nurse surveys indicated 100% satisfaction with workflow integration.</p><p><strong>Conclusions: </strong>AMIT improved patient safety, accelerated treatment, and streamlined nursing workflow, underscoring the value of rule-based digital platforms in clinical care. Future integration of large language models will enable automated translation of guidelines into validated clinical rules and support feedback loops to identify patient-specific deterioration patterns, fostering more harmonized and timely interventions across institutions.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"e279-e284"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Solid Malignant Tumors in Infancy: A Single-Center Experience.","authors":"Öykü D Kanbur, Nilgün Kurucu, Hilal Susam Şen, G Burça Aydin, Bilgehan Yalçın, Ali Varan, Tezer Kutluk","doi":"10.1097/MPH.0000000000003258","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003258","url":null,"abstract":"<p><p>Infantile tumors are rare and different from those in older children in terms of anatomic site, histologic features, and behavior. Thus, they require adapted multimodality approaches for diagnosis and treatment. We aimed to evaluate the characteristics and outcomes of different tumor types in children under 1 year of age who were referred to the Hacettepe University Pediatric Oncology Department over 20 years. There were 515 infants, with a mean age of 6.1±3.4 months, diagnosed with malignant tumors. The male/female ratio was 1.15. Thirty-three (6.4%) of them were diagnosed in the newborn period. Prenatal diagnosis was made in 4.9% of the patients. The most common finding was a mass and symptoms related to the mass (81.6%). The mean time to diagnosis was 31.3±44.7 days. The most common histopathologic diagnoses were retinoblastomas (33.6%), neuroblastomas (27.1%), renal tumors (10.3%), and central nervous system (CNS) tumors (9.7%). Forty patients (7.8%) had congenital anomalies, genetic syndromes and diseases, and metabolic and immune deficiency disorders. Multimodal treatment was administered according to diagnosis, stage, and risk group. The 5-year overall survival (OS) was 86.6% in the whole group and 83.4% in newborns. The best 5-year OS (>91.5%) was observed for renal tumors, retinoblastomas, and neuroblastomas. Conversely, the lowest OS was observed for CNS tumors (52.5%). Our results contribute to a better understanding of the characteristics and outcomes of the tumors in this age group.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":"48 7","pages":"339-345"},"PeriodicalIF":0.9,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}