Journal of Pediatric Hematology/Oncology最新文献

{"title":"Antifungal Use in Immunocompromised Children in Europe: A 12-Week Multicenter Weekly Point Prevalence Survey (CALYPSO).","authors":"Elisavet Chorafa, Elias Iosifidis, Andrea Oletto, Adilia Warris, Elio Castagnola, Roger Bruggemann, Andreas H Groll, Thomas Lehrnbecher, Laura F Antolin, Alessio Mesini, Aisha A Alkhaaldi, Fernando Baquero-Artigao, Benhur S Cetin, Daniel Ebrahimi-Fakhari, Marieke Emonts, Susanna Esposito, Valentina Fainardi, Elisabetta Ghimenton-Walters, Manuel Gijón, Alba G Guerrero, Carlos D Grasa, Igne Kairiene, Kornelija Kildonaviciute, Maria Kourti, Angela Manzanares, Natalia Mendoza-Palomar, Maria Noni, Eugenia Papakonstantinou, Stéphane Paulus, Thomas Perwein, Jelena Rascon, Elena Rincón-López, Pere Soler-Palacin, Galina Solopova, Vassiliki Spoulou, Volker Strenger, Kara Tedford, Christina Tzika, Borbala Zsigmond, Emmanuel Roilides","doi":"10.1097/MPH.0000000000003070","DOIUrl":"10.1097/MPH.0000000000003070","url":null,"abstract":"<p><p>We prospectively analyzed antifungal use in immunocompromised children through a multicenter 12-week weekly point-prevalence survey in 31 hematology-oncology (HO) and hematopoietic stem cell/solid organ transplant (HSCT/SOT) units of 18 hospitals in 11 European countries. All patients hospitalized and receiving systemic antifungals were included. Ward policies, and weekly ward/patient data were collected. All 21 HO and 10 HSCT/SOT units had prophylaxis policies for high-risk patients (27/31 used azoles, 14/31 echinocandins and 15/31 liposomal amphotericin B [LAMB]). Among 572 courses recorded, prophylaxis was indicated in 439/572 (77%) and treatment in 133/572 (62/133 empirical, 43/133 pre-emptive, 28/133 targeted). Among patients receiving prophylaxis, 56% belonged to the non-high-risk group. Most common reasons for empirical, pre-emptive and targeted treatment were antibiotic-resistant febrile neutropenia (52%), abnormalities on chest-CT with/without positive galactomannan (77%) and candidiasis (82%), respectively. Fluconazole and LAMB were the most frequently prescribed agents both for prophylaxis (31%, 21%) and treatment (32%, 23%). Underdosing of micafungin for treatment in 50% of prescriptions and of fluconazole for treatment and prophylaxis in 70% of cases was noticed. In conclusion, most antifungal prescribing was for prophylaxis, with fluconazole being the main antifungal prescribed. Inadequate doses of antifungal prescribing and prophylaxis of non-high-risk patients could be targets for improvement.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"e222-e230"},"PeriodicalIF":0.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475739","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":"GATA2 Deficiency in an Adolescent With Disseminated Herpes Simplex Virus Hemophagocytic Lymphohistiocytosis.","authors":"Rajvee Sanghavi, Karen S Fernandez, Vini Vijayan","doi":"10.1097/MPH.0000000000003088","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003088","url":null,"abstract":"","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144753640","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":"Exploration of Psychosocial Issues of Parents in Pediatric Oncology.","authors":"Joel Mathew Jose, Gautam Gawali","doi":"10.1097/MPH.0000000000003085","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003085","url":null,"abstract":"<p><p>Pediatric cancer not only affects the child but also casts a profound shadow on their families, entangling them in emotional turmoil, financial strain, and disruptions to daily life. Although the psychosocial challenges faced by parents of children with cancer are extensively documented, there is a significant gap in understanding how these needs are addressed. This research aims to bridge this void by delving into the psychosocial issues experienced by these parents. Existing literature highlights the psychological distress, financial hardship, and social isolation that parents endure. Stress, anxiety, depression, guilt, and post-traumatic stress disorder (PTSD) emerge as pervasive issues. Parents often grapple with stress stemming from prognosis uncertainty, financial burdens, and the emotional toll of caregiving. Anxiety manifests through constant worry and sleep disturbances, whereas depression brings persistent sadness and appetite changes. Guilt arises from perceived responsibility for the illness, and PTSD symptoms include vivid flashbacks and hypervigilance. These psychosocial issues significantly impact parents' quality of life, leading to sleep disturbances, strained relationships, and compromised self-care. Interventions such as individual and group therapy, along with support groups, play a crucial role in equipping parents with coping skills and stress management strategies. In conclusion, comprehensive support for parents of children with cancer should address emotional distress, practical caregiving, and provide information about the child's diagnosis and treatment. Acknowledging the multifaceted impact of cancer on the family, this research underscores the necessity for tailored interventions to navigate the emotional complexities of parenting and foster resilience amidst adversity.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.8,"publicationDate":"2025-07-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144731893","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":"Evaluation of Febrile Episodes in Children With or Without Neutropenia Undergoing Chemotherapy.","authors":"Mehmet B Beyter, Mehmet Kantar, Eda Ataseven, Zumrut S Bal, Alper Tunger, Dilek Y Metin, Melike Yasar-Duman, Nevin Turgay","doi":"10.1097/MPH.0000000000003082","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003082","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to analyze the clinical and microbiologic characteristics of febrile episodes in pediatric oncology patients undergoing chemotherapy, with and without neutropenia.</p><p><strong>Patients and methods: </strong>A retrospective analysis was conducted on 212 febrile episodes in 94 pediatric cancer patients hospitalized between January 2015 and December 2018. Patients with fever ≥38°C were included. Data were extracted from electronic health records. Infection diagnoses were established based on clinical examination and microbiologic studies.</p><p><strong>Results: </strong>Among the 212 febrile episodes, 117 (55.1%) were classified as febrile neutropenia. Infection foci were identified in 51.4% of cases, with catheter infections being the most common (18.4%), followed by viral upper respiratory tract infections (16%). Microbiologic analysis identified bacterial agents in 69 cases. The most frequently identified bacteria were Coagulase-negative Staphylococcus and Escherichia coli. Septic shock occurred in 7 febrile episodes (3.3%), all in neutropenic patients. There was no statistically significant difference in infection rates between neutropenic and non-neutropenic groups (P>0.05), except for septic shock, which was significantly higher in neutropenic patients (P=0.02).</p><p><strong>Conclusions: </strong>Our data suggest that infections remain a major cause of morbidity in pediatric oncology patients regardless of neutropenic status. We believe that prospective and multicenter studies are also necessary to optimize infection management strategies in non-neutropenic patients with fever as well as neutropenic ones.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675084","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":"Teratoid Wilms Tumor Masquerading as a Cystic Dysplastic Kidney: A Diagnostic Challenge.","authors":"Shalini G Hegde, Prasanna Kumar, Renuka Malipatel, Yutika Amin, Jyothi M","doi":"10.1097/MPH.0000000000003084","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003084","url":null,"abstract":"<p><p>Teratoid Wilms Tumor (TWT) is a rare renal malignancy that can masquerade as a cystic dysplastic kidney in young children. We report a 3-month-old child with a prenatally detected left renal cystic lesion initially diagnosed as multicystic dysplastic kidney (MCDK). Atypical imaging findings prompted further evaluation, revealing TWT. Histopathology confirmed heterologous elements and focal Wilms tumor components. This case underscores the need for vigilance in cystic renal lesions, as early recognition of malignancy alters management and improves outcomes.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":""},"PeriodicalIF":0.9,"publicationDate":"2025-07-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144663962","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":"Universal Premedication Does Not Impact Transition to Short-acting Asparaginase or Incidence of Hypersensitivity to Pegylated Asparaginase: A Single-institution Experience.","authors":"Lindsey A Murphy, Zanette K Bradley, Allie N Elozory, Dexiang Gao, Kelly E Faulk","doi":"10.1097/MPH.0000000000003034","DOIUrl":"10.1097/MPH.0000000000003034","url":null,"abstract":"<p><p>Asparaginase is a critical component of therapy for acute lymphoblastic leukemia/lymphoma but is associated with hypersensitivity reactions. Severe reactions necessitate a transition to an Erwinia asparaginase product, which requires more frequent dosing and higher costs. Children's Hospital Colorado implemented universal pegaspargase premedication in May 2020 and a retrospective analysis was conducted to compare the rates of transition to Erwinia products and hypersensitivity reactions between the preimplementation and postimplementation cohorts. In this large single-institution experience, universal premedication did not impact rates of Erwinia transition or hypersensitivity reactions.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"e181-e186"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022926","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":"Use of Animal-assisted Therapy in Children With Cancer.","authors":"Hüseyin Çaksen","doi":"10.1097/MPH.0000000000003041","DOIUrl":"10.1097/MPH.0000000000003041","url":null,"abstract":"","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"e209"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031411","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":"Tracing a Rare Genetic Disease: Familial Congenital CD59 Deficiency and Carrier Cases Identified through Village Screening: Erratum.","authors":"Şefika Lknur Kökcü Karadağ, Medine Karadağ Alparslan, Hüseyin Karadağ, Eda Turgut Uğurtay, Cansu Can, Alisan Yildiran","doi":"10.1097/MPH.0000000000003054","DOIUrl":"https://doi.org/10.1097/MPH.0000000000003054","url":null,"abstract":"","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":"47 5","pages":"e214"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144475748","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":"Comparison of Consolidation Strategies for Pediatric Patients With Acute Myeloid Leukemia: Results of the Randomized GATLA 8-LMA-P'07 Trial.","authors":"Alejandra Deana, Sergio M Gomez, Alcira Beatriz Fynn, Daniel Freigeiro, Maria Cecilia Riccheri, Lorena Elizabeth Moran, Monica Leonor Makiya, Lilian Sung","doi":"10.1097/MPH.0000000000003028","DOIUrl":"10.1097/MPH.0000000000003028","url":null,"abstract":"<p><strong>Objective: </strong>The primary objective was to determine whether consolidation (CONS) with 2 short chemotherapy cycles using cytarabine plus idarubicin and high dose cytarabine plus mitoxantrone (2-cycle) reduced the cumulative incidence of relapse compared with the standard regimen of a 6-week CONS phase among newly diagnosed pediatric patients with acute myeloid leukemia (AML).</p><p><strong>Patients and methods: </strong>GATLA 8-LMA-P'07 was a phase 3 trial conducted in 26 centers in Argentina. We included newly diagnosed pediatric patients with AML 0 to 18 years of age. Patients with M3 AML were excluded. After 2 cycles of induction, patients in remission were randomized to either CONS or 2-cycle CONS chemotherapy. High-risk patients received matched family stem cell transplantation or maintenance therapy for 12 months.</p><p><strong>Results: </strong>One hundred seven patients younger than 18 years with de novo AML were randomized to CONS (n = 52) or 2-cycle (n = 57). Cumulative incidence (SE) of relapse was not significantly different between CONS (31% [0.1]) and 2-cycle (39% [0.1]) CONS ( P = 0.25). There was no significant difference in 5-year event-free survival (53.6% [0.8] vs 44.3 [0.7], P = 0.31) or 5-year overall survival (55.0% [0.8] vs 53.7% [0.7], P = 0.91) for CONS and 2-cycle CONS respectively.</p><p><strong>Conclusions: </strong>CONS with 2 cycles of chemotherapy was not significantly better than the standard CONS in reducing the cumulative risk of relapse among newly diagnosed children with AML from Argentina. Future research should evaluate new approaches to improve outcomes for pediatric patients with AML.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"250-256"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144078677","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":"Managing and Preventing Hypofibrinogenemia in Pediatric and AYA Leukemia Patients: Insights From MD Anderson Cancer Center.","authors":"Jiasen He, Faryal Munir, Camila Ayerbe, Samantha Dickson, Samanta Catueno, Branko Cuglievan, Amber Gibson, David McCall, Cesar Nunez, Michael Roth, Priti Tewari, Miriam B Garcia, Nidra Rodriguez, Jose Cortes","doi":"10.1097/MPH.0000000000003042","DOIUrl":"10.1097/MPH.0000000000003042","url":null,"abstract":"<p><strong>Background: </strong>Cryoprecipitate is often used to prevent and treat complications associated with low fibrinogen levels in pediatric leukemia patients. Cryoprecipitate, rich in fibrinogen, is administered to augment fibrinogen levels and mitigate the risk of bleeding in these patients. The use of cryoprecipitate is often strategic, involving both prophylactic measures and interventions in response to bleeding events. This approach plays a crucial role in the comprehensive care of pediatric leukemia patients, particularly during periods of heightened vulnerability to bleeding complications. However, data regarding the use of cryoprecipitate in children with leukemia are lacking.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of children, adolescents, and young adults with leukemia who received cryoprecipitate at the University of Texas MD Anderson Cancer Center from 2020 to 2022. We gathered baseline clinical and demographic data, cryoprecipitate usage details, and fibrinogen levels. Paired-samples t tests were used to compare fibrinogen levels before and after cryoprecipitate infusion.</p><p><strong>Results: </strong>We identified 36 patients who received cryoprecipitate, 1 to 25 years of age, 67% of whom (24/36) were male. In this cohort, 27/36 (75%) were recently exposed to asparaginase, 2/36 (6%) had a history of venous thromboembolism, and 6/36 (17%) had a history of major bleeding. Cryoprecipitate was used to treat active bleeding (11/36, 31%), bleeding prevention (22/36, 61%), and preoperatively (3/36, 8%). Patients frequently required transfusions of other blood products. Common comorbidities in patients receiving cryoprecipitate included disseminated intravascular coagulation (10/36, 28%) and sepsis (10/36, 28%). The median baseline fibrinogen level across the entire study population was 85.5 mg/dL (IQR: 59.8 to 113). The median dose of cryoprecipitate infused was 6.6 mL/kg (IQR: 3.09 to 14.6), and the median postinfusion peak fibrinogen level was 185 mg/dL (IQR: 155 to 292) ( P <0.001). No major direct treatment-related adverse events were reported.</p><p><strong>Conclusion: </strong>Cryoprecipitate is commonly administered to children with leukemia, effectively raising fibrinogen levels with minimal associated side effects. However, further research, ideally through randomized trials, is needed to assess its true clinical benefits in this population. Currently, there is a notable lack of pediatric-focused randomized transfusion medicine trials. Integrating these studies into ongoing oncologic trials could be a practical and valuable approach that warrants careful consideration and planning.</p>","PeriodicalId":16693,"journal":{"name":"Journal of Pediatric Hematology/Oncology","volume":" ","pages":"235-241"},"PeriodicalIF":0.9,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970857","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}