Journal of Pediatric Hematology/Oncology最新文献

{"title":"Comparison of Safety and Outcomes Between Laparoscopic and Open Resection of Small Hepatoblastoma Tumors in Children.","authors":"Yuelan Zheng, Chenyao Wang, Yuxin Hu, Qi Feng","doi":"10.1097/MPH.0000000000003287","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003287","url":null,"abstract":"<p><p>Hepatoblastoma, a rare malignant tumor, predominantly affects children under 2 years of age. Surgical resection remains the primary treatment, but the benefits of laparoscopic surgery (LAP) compared with open surgery (OPEN) are debated. This retrospective study analyzed 76 pediatric hepatoblastoma patients with tumors ≤5 cm treated between February 2020 and February 2022, most of whom received neoadjuvant chemotherapy to facilitate tumor shrinkage and resectability. Patients who underwent LAP (n=37) or OPEN (n=39) were compared based on surgical outcomes, liver function, postoperative complications, and oncologic outcomes, including event-free survival (EFS) and overall survival (OS). Laparoscopic surgery was performed only in carefully selected patients with peripheral tumors without major vascular involvement. The LAP group had a longer operative time (237.4±26.7 vs. 183.7±23.9 min, P<0.001) but less estimated blood loss (75.7±9.8 vs. 108.1±14.0 mL, P<0.001), shorter time to regular diet (1.35±0.18 vs. 2.55±0.26 d, P<0.001), lower postoperative opioid requirement (36.2±5.1 vs. 52.8±7.3 MME, P<0.001), and shorter hospital stays (6.8±0.9 vs. 11.4±1.1 d, P<0.001). Postoperative liver function indicators, including alanine aminotransferase, aspartate aminotransferase, and total bilirubin, were lower in the LAP group (P<0.001). After a median follow-up of 29 months, there was no significant difference in event-free survival (82.2% vs. 75.1%), overall survival (93.7% vs. 90.1%), recurrence, or complication rates between groups (P>0.05). LAP appears safe and effective for selected hepatoblastoma with tumors ≤5 cm, offering quicker recovery and less invasiveness. Open surgery remains essential for central or larger tumors not amenable to safe laparoscopic resection. However, selection bias favoring LAP for smaller and peripheral tumors may limit generalizability. Prospective studies are needed to confirm these results.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039417","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":"Ovarian Dysfunction After Gonadotoxic Therapy in Childhood Cancer Survivors: A Cross-Sectional Study From a Resource-Limited Setting.","authors":"Heena Gajiwala, Gauri Kapoor, Sandeep Jain, Payal Malhotra, Pooja Sharma, Richa Arora, Anurag Sharma","doi":"10.1097/MPH.0000000000003282","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003282","url":null,"abstract":"<p><p>Ovarian dysfunction is a life-altering late effect in female childhood cancer survivors (CCS), yet early identification of ovarian injury remains challenging. This study aimed to evaluate the burden and determinants of ovarian dysfunction in CCS, with a specific focus on treatment-related amenorrhea (TRA) persisting for ≥4 months. Demographic, clinical, and treatment exposure data were obtained from the hospital medical records. Menstrual and hormonal information was collected using a structured proforma. In this single-center cross-sectional study, 186 female CCS (mean age: 21±5 y) were evaluated after a mean follow-up of 10±5.6 years. Gonadotoxic exposures included chemotherapy (100%) with a mean cumulative cyclophosphamide equivalent dose (CED) of 5.1 g/m2, pelvic or craniospinal radiotherapy (6.45%), and hematopoietic stem cell transplantation (4.8%). Hypergonadotropic TRA was observed in 24% (45/186) of survivors, and 20% (9/45) of them progressed to acute ovarian failure (AOF). On multivariable analysis, independent predictors of TRA included postpubertal status at diagnosis (OR: 20.45; CI: 4-101.5), solid tumor diagnosis (OR: 5.98; CI: 1.7-8), and CED of ≥7.5 g/m2 (OR: 4.56; CI: 1.4-14). Prevalence of AOF aligned with established risk categories. As an easily identifiable clinical feature, TRA may help identify survivors suitable for fertility preservation counselling and surveillance for premature ovarian failure.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017012","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":"Self-Efficacy and Knowledge in Cardiotoxicity Management Among Pediatric Oncology Nurses: A Cross-Sectional Mediation Analysis.","authors":"Aslı Akdeniz Kudubeş, Remziye Semerci Şahin, Eyşan Hanzade Savaş, Ayşe Ay","doi":"10.1097/MPH.0000000000003283","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003283","url":null,"abstract":"<p><strong>Background: </strong>Cardiotoxicity is a serious adverse effect of cancer treatment in children and can be reversible or irreversible, with irreversible forms involving permanent loss of cardiac muscle cells.</p><p><strong>Objective: </strong>This study aimed to examine pediatric oncology nurses' self-efficacy and knowledge levels regarding the management of cancer treatment-related cardiotoxicity, to identify the sociodemographic and professional factors associated with self-efficacy, and to test whether knowledge functions as a mediator in the association between cardiotoxicity-related training and self-efficacy.</p><p><strong>Methods: </strong>In this descriptive, cross-sectional study, 122 nurses working in pediatric oncology units for at least 6 months (July 2024 to February 2025) completed the Information Form, the Nursing Self-Efficacy Scale for Managing Cancer Treatment-Induced Cardiotoxicity (NSS-CTC), and the Cardiotoxicity Knowledge Level Form for Pediatric Oncology Nurses (CKLF-PON). Data were analyzed with descriptive statistics, t tests, 1-way ANOVA, and hierarchical multiple linear regression. Three simple mediation models then tested whether CKLF-PON knowledge mediated the effects of training, literature engagement, and postgraduate education on NSS-CTC self-efficacy, with 95% bias-corrected accelerated confidence intervals from 5000 bootstrap resamples.</p><p><strong>Results: </strong>The hierarchical model explained 72.0% of the variance in self-efficacy. Female sex (β=0.172, P=0.003), years of experience in pediatric oncology (β=0.139, P=0.030), cardiotoxicity-specific training (β=0.209, P=0.003), engagement with current literature (β=0.315, P<0.001), and CKLF-PON knowledge (β=0.336, P<0.001) were independent correlates. Knowledge partially mediated the effects of cardiotoxicity-specific training and literature engagement, but not of postgraduate pediatric-nursing education.</p><p><strong>Conclusions: </strong>Clinical experience alone does not guarantee effective cardiotoxicity management. Structured, content-specific education and continuous professional development improve self-efficacy partly by enhancing objective knowledge.</p><p><strong>Clinical relevance: </strong>Among pediatric oncology nurses, self-efficacy for managing cancer treatment-related cardiotoxicity was associated not with accumulated clinical experience but with 2 modifiable behaviors: participation in cardiotoxicity-specific training and regular engagement with the current literature, both of which operated partly through objectively measured knowledge.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149016947","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":"Foscarnet-associated Hypercalcemia in an Infant With Cytomegalovirus Myocarditis and Severe Combined Immunodeficiency: An Unusual Therapeutic Challenge.","authors":"Nesli Ağralı Eröz, Şilem Özdem Alataş, Berna Eroğlu Filibeli, Dilek Yılmaz","doi":"10.1097/MPH.0000000000003286","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003286","url":null,"abstract":"","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002019","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":"AI-Assisted Generation of Long-Term Follow-Up Recommendations for Survivors of Childhood Cancer and Hematopoietic Stem Cell Transplantation.","authors":"Bao Truong, Natalie Wu, Patricia Murphy, Robert Goldsby","doi":"10.1097/MPH.0000000000003281","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003281","url":null,"abstract":"<p><strong>Background: </strong>Survivors of childhood cancer and hematopoietic stem cell transplantation (HSCT) require individualized long-term follow-up (LTFU) care to monitor for treatment-related late effects. Development of survivorship care plans is labor-intensive and requires integration of complex guideline-based recommendations. We evaluated the feasibility of using a large language model (LLM) to generate draft LTFU care recommendations for childhood cancer and HSCT survivors.</p><p><strong>Methods: </strong>Survivors seen in the UCSF Benioff Children's Hospitals Survivorship Program between January 2021 and December 2023 were eligible. Clinicians created individualized LTFU plans using institutional standards and Children's Oncology Group Long-Term Follow-Up Guidelines (version 5). Deidentified treatment summaries were provided to OpenAI GPT-4o to generate AI-assisted draft recommendations using structured prompts. Prompt refinement was performed iteratively in 2 development cohorts of 20 patients each. Final evaluation used an independent validation cohort of 40 survivors. AI-generated recommendations were compared with clinician-generated recommendations using clinician-generated plans as the operational reference standard. Agreement between AI-generated and clinician-generated recommendations was assessed by determining the proportion of clinician-generated recommendations identified by AI and the proportion of AI-generated recommendations also present in clinician-generated plans.</p><p><strong>Results: </strong>Among 40 survivors, AI-generated recommendations contained 467 items compared with 446 in clinician-generated recommendations. Among 446 clinician-generated recommendations, 385 (86.3%) were also identified in the AI-generated recommendations. Conversely, 385 (82.4%) of the 467 AI-generated recommendations were also present in clinician-generated plans. Most discordant recommendations involved radiation-related exposures and survivorship scenarios requiring nuanced clinical interpretation.</p><p><strong>Conclusions: </strong>AI-assisted generation of survivorship care recommendations demonstrated substantial concordance with clinician-generated recommendations and may support clinician-supervised survivorship care workflows.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990459","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":"Influenza-Like Illness in Children With Cancer: Incidence, Predictors, and Outcomes From a Tertiary Cancer Center in India.","authors":"Jithin T K, Kaduveetil G Gopakumar, Sarath K E","doi":"10.1097/MPH.0000000000003277","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003277","url":null,"abstract":"<p><strong>Background: </strong>Influenza-like illness (ILI) is a clinical syndrome caused by multiple respiratory pathogens and does not necessarily represent laboratory-confirmed influenza. Children receiving cancer therapy may experience substantial morbidity and treatment interruption from ILI, but data from low- and middle-income countries remain limited.</p><p><strong>Objective: </strong>To estimate the incidence of ILI, describe its clinical characteristics, management, treatment impact, and outcomes, and identify independent predictors of inpatient management and inpatient duration in children receiving cancer therapy.</p><p><strong>Methods: </strong>We retrospectively reviewed children aged 14 years or younger who received cancer-directed therapy at a tertiary cancer center in Kerala, India, from January through December 2022. ILI was defined using World Health Organization criteria. Patient time was calculated from the exact time receiving active therapy and under observation. Episode-level logistic and Poisson generalized estimating-equation models accounted for repeated episodes within children.</p><p><strong>Results: </strong>Seventy-nine of 110 children (71.8%) developed 209 ILI episodes over 68.95 patient-years, corresponding to 3.03 episodes per patient-year (95% CI: 2.63-3.47). The median age of affected children was 4 years (IQR=2 to 6), and 62 (78.5%) had hematological malignancies. Seventy-four episodes (35.4%) were managed as inpatients, including 30 hospital-onset episodes; 44 of 179 community-onset episodes (24.6%) resulted in admission. Lower respiratory tract infection occurred in 33 episodes (15.8%). Severe pneumonia occurred during 9 episodes involving 7 children; all required intensive care. Two children developed multiple organ dysfunction syndrome, required ventilation, and died, corresponding to an ILI-related mortality of 2.5% among affected children. Chemotherapy was delayed in 64 episodes (30.6%); among 62 episodes with assessable duration, the median delay was 7 days (IQR=4 to 7). Viral testing was performed in 26 episodes (12.4%); SARS-CoV-2 was detected in 9 of 24 rapid antigen tests (37.5%). Younger age independently predicted inpatient management (adjusted odds ratio=0.78 per year; 95% CI: 0.65-0.93; P=0.006). Female sex (adjusted incidence rate ratio=0.77; 95% CI: 0.63-0.94; P=0.012) and solid-tumor diagnosis (adjusted incidence rate ratio=0.71; 95% CI: 0.57-0.89; P=0.003) were associated with shorter inpatient duration.</p><p><strong>Conclusions: </strong>Syndromic ILI was frequent and was associated with inpatient care, severe complications, and chemotherapy interruption. Younger children had higher odds of inpatient management. Limited pathogen testing restricts etiological interpretation and supports improved access to respiratory diagnostics, risk-adapted antimicrobial stewardship, and age- and treatment-appropriate vaccination against preventable respiratory infections.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982855","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":"Sex Differences in Complications and Outcomes of Wilms Tumor: Is There a Role for Sex-based Approaches in Nephroblastoma Management?","authors":"Angelo Zarfati, Giorgia Romano, Giorgio Persano, Ilaria Buconi, Gaia Brunetti, Piercesare Grimaldi, Cristina Martucci, Annalisa Serra, Chiara Grimaldi, Alessandro Crocoli","doi":"10.1097/MPH.0000000000003280","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003280","url":null,"abstract":"<p><strong>Background: </strong>Sex-specific differences in complications and outcomes among patients with Wilms tumor (WT) during treatment and follow-up remain poorly understood. This study aimed to investigate these differences, hypothesizing that outcomes may be improved through sex-based management considerations.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center comparative study of patients treated between 2009 and 2024 at a pediatric tertiary care center.</p><p><strong>Results: </strong>One hundred thirty-four patients with WT were included. No significant sex differences were observed in age, weight, height, or presenting symptoms. Bilateral WT was significantly more frequent in females (13 [18%] vs. 2 [3%], P = 0.011), whereas left-sided WT in males (35 [57%] vs. 28 [38%], P = 0.037). At diagnosis, no sex-related differences were noted in imaging findings (metastases, renal or caval vein thrombus, tumor size) or laboratory values. A caval thrombus was identified in 9 patients (7%), with no initial sex difference. After neoadjuvant therapy, persistent thrombus was significantly more common in females (6 [8%] vs. 0 [0%], P = 0.007). No sex differences were found in intraoperative renal vein thrombosis, but intraoperative caval thrombosis occurred significantly more often in females (6 [8%] vs. 0 [0%], P = 0.007). Tumor rupture/spillage, nodal sampling, and nodal involvement were comparable between groups. Histologic subtype and risk distribution were comparable between sexes, whereas local stage differed significantly, with stage III disease more frequent in females (45% vs. 17%, P = 0.001) and stage II disease more frequent in males (34% vs. 12%, P = 0.004). Follow-up included 131 patients (3 lost). Median age at last follow-up was 9.2 years (range: 2.3 to 25.7). Event-free survival (EFS) was significantly higher in males than in females (56 boys [94%] vs. 57 girls [80%], P = 0.040). Females experienced significantly more events (14 [20%] vs. 4 [6%], P = 0.040), although no differences were observed in event type, relapse site, overall survival (OS), or mortality.</p><p><strong>Conclusions: </strong>Female patients with WT may experience a more complex clinical course, reflected by higher rates of bilateral disease, persistent and intraoperative caval thrombus, inferior EFS, and a greater frequency of events during follow-up.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982893","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":"Effect of Conscious Connected Breathing Added to Sleep Hygiene Education on Sleep Quality and Anxiety in Mothers of Pediatric Oncology Patients: A Pilot Randomized Controlled Trial.","authors":"Hatice Yanar Uysal, Gülsüm Uysal, Ganiye Begül Yağcı","doi":"10.1097/MPH.0000000000003274","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003274","url":null,"abstract":"<p><strong>Background: </strong>Mothers of pediatric oncology patients face high psychosocial burden, poor sleep, and anxiety. Evidence for simple breathing interventions is limited; this study evaluated their impact.</p><p><strong>Materials and methods: </strong>In this single-center, prospective pilot randomized controlled trial, 38 mothers of children undergoing active cancer treatment were allocated 1:1 to the intervention group (conscious connected breathing [CCB] plus sleep hygiene, n = 19) or the control group (sleep hygiene alone, n = 19). The intervention group received weekly 45-minute face-to-face CCB sessions for 3 weeks, with home practice encouraged. CCB consisted of continuous, deep breathing through the mouth without an intentional pause between inhalation and exhalation. Controls received standardized sleep hygiene education at baseline. Assessments were performed at baseline (T0), week 4 (T1), and week 8 (T2). Sleep quality and anxiety were measured using the PSQI and STAI, with between-group comparisons based on change scores (Δ).</p><p><strong>Results: </strong>Baseline characteristics were comparable, except for higher STAI-II in the intervention group (P = 0.015). Sleep quality improved in both groups, with greater reductions in the intervention group (ΔT0 to T1: Z = -4.371, P < 0.001, r = 0.71; ΔT0 to T2: Z = -4.612, P < 0.001, r = 0.75). State anxiety decreased over time, with greater reductions observed in the intervention group across all time points (pre-post: Z = -5.116; pre to T1: Z = -5.177; pre to T2: Z = -4.883; all P < 0.001; r = 0.79 to 0.84). Despite higher baseline levels, trait anxiety also decreased more in the intervention group (ΔT0 to T1: Z = -4.635; ΔT0 to T2: Z = -4.544; both P < 0.001).</p><p><strong>Conclusion: </strong>CCB added to sleep hygiene education appears to be a feasible and promising complementary approach associated with improved sleep quality and reduced anxiety among mothers of pediatric oncology patients. Given the pilot nature of the study and the small sample size, these findings should be considered preliminary and require confirmation in larger, adequately powered randomized controlled trials.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148982816","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":"Pediatric Gastroenteropancreatic Neuroendocrine Tumors in Jordan: A 19-Year Experience From a Tertiary Oncology Center.","authors":"Dana Kanaan, Khalil Ghandour, Maha Barbar, Iyad Sultan, Hadeel Halalsheh","doi":"10.1097/MPH.0000000000003273","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003273","url":null,"abstract":"<p><strong>Background: </strong>Pediatric gastroenteropancreatic neuroendocrine tumors (GEP-NETs) are exceedingly rare. Data from Jordanian and Arab world populations are absent from international registries, with only limited data available from Türkiye, leaving management strategies largely extrapolated from adult and Western literature. This study documents the clinical features, management, and outcomes at a tertiary oncology center in Jordan.</p><p><strong>Methods: </strong>We conducted a retrospective, single-center cohort study of patients 18 years or younger diagnosed with GEP-NETs at the King Hussein Cancer Center (January 2006 to May 2025). We analyzed demographics, presentation, tumor characteristics, treatment, and survival.</p><p><strong>Results: </strong>Ten patients were identified (8 male, median age 13 y). Primary sites were the appendix (8/10) and pancreatic head (2/10). Nine patients presented with abdominal pain; one with a pancreatic primary presented with obstructive jaundice. Histologically, 9 were low- or intermediate-grade (grade 1 to 2) and 9 were localized. Nine patients underwent surgery (8 appendectomy±hemicolectomy; 1 Whipple procedure). One patient with metastatic pancreatic NET was managed nonsurgically. Two patients with advanced/metastatic pancreatic NETs received systemic therapy. Appendiceal tumors were universally indolent with excellent outcomes postsurgery, whereas pancreatic tumors exhibited aggressive clinical behavior, including nodal involvement and distant metastasis. After a median follow-up of 46.6 months, 1 patient died of metastatic disease and 1 developed recurrence; both had pancreatic primaries.</p><p><strong>Conclusions: </strong>Pediatric appendiceal NETs carry excellent prognoses following conservative surgery. Pancreatic NETs represent a high-risk subgroup with aggressive behavior. As the first documented GEP-NET from Jordan and the Arab world, these findings align with international patterns and support site-specific, risk-adapted management while highlighting the need for multicenter collaboration across the region.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977087","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":"Clinical and Economic Impact of 70% Isopropyl Alcohol-Impregnated Disinfecting Caps on CLABSI Rates in Ambulatory Pediatric Hematology-Oncology Patients.","authors":"İlker Devrim, Deniz Ergun, Hincal Ozbakir, Pınar Çiçek, Selma Uslu, Canan Dinc, Yeliz Oruc, Şerife Ş Ö Göktepe, Begümhan D Gündoğan, Hamiyet H Özdemir, Bengu Demirag, Yeşim Oymak, Tuba H Karapınar","doi":"10.1097/MPH.0000000000003272","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003272","url":null,"abstract":"<p><strong>Background: </strong>Totally implantable venous access devices are essential for long-term care in pediatric cancer patients, but they can cause catheter-associated bloodstream infections (CLABSIs). While central line bundles have proven effective in preventing CLABSIs in inpatient settings, data on adjunct prevention strategies, such as 70% isopropyl alcohol-impregnated disinfecting caps, in ambulatory pediatric oncology patients are limited.</p><p><strong>Objective: </strong>To assess the impact of 70% isopropyl alcohol-impregnated disinfecting caps on the rate and cost of CLABSIs in ambulatory pediatric hematology-oncology patients with ports.</p><p><strong>Methods: </strong>This study compared 2 distinct periods at an outpatient clinic: control group (n=58) and a study group using 70% isopropyl alcohol-impregnated disinfecting caps (n=34). The primary outcome was the CLABSI rate per 1000 catheter-days. Secondary outcomes included attributable health care costs and cost-effectiveness analysis.</p><p><strong>Results: </strong>The CLABSI rate was 13.55/1000 catheter-days in the control group and 2.05/1000 catheter-days in the study group, reflecting an 84.9% reduction. The cost analysis demonstrated that the intervention was cost-effective, with estimated savings ranging from $2637.68 to $10,916.67 and a return on investment of up to 9.641%.</p><p><strong>Conclusion: </strong>Implementation of 70% isopropyl alcohol-impregnated disinfecting caps resulted in a substantial clinical reduction in ambulatory CLABSI incidence and yielded significant cost savings in this high-risk population.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977054","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}