Pediatric blood & cancer
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Pediatric blood & cancer · Jan 2012
Randomized Controlled Trial Multicenter Study Comparative StudyThe utility of performing the initial lumbar puncture on day 8 in remission induction therapy for childhood acute lymphoblastic leukemia: TCCSG L99-15 study.
Traumatic lumbar puncture with leukemic blasts (TLP+), which has been reported to occur 5-10%, in the previous studies, adversely affects the outcome of children with acute lymphoblastic leukemia (ALL). Based on the results from our previous study, we deferred the initial lumbar puncture until day 8 in remission induction therapy in order to reduce the frequency of cases with TLP+. ⋯ Our strategy reduced the frequency of CNS-positive patients who required reinforcement of CNS-directed therapy without compromising overall outcome.
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Pediatric blood & cancer · Dec 2011
Randomized Controlled Trial Comparative StudyComparison of propofol versus propofol-ketamine combination in pediatric oncologic procedures performed by non-anesthesiologists.
Limited data are available on the best option (short acting sedatives, opioids, or ketamine) in oncologic procedural sedation performed by non-anesthesiologists. The aim of the present prospective study is to compare the safety and efficacy of propofol-ketamine versus propofol alone, managed by trained pediatricians, in children with cancer undergoing painful procedures. ⋯ The combination of propofol and ketamine produced statistically significant clinical advantages combined with a higher profile of safety in children with cancer undergoing painful procedures.
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Pediatric blood & cancer · Jul 2011
Randomized Controlled Trial Multicenter Study Comparative StudyComparison of ¹²³I-metaiodobenzylguanidine (MIBG) and ¹³¹I-MIBG semi-quantitative scores in predicting survival in patients with stage 4 neuroblastoma: a report from the Children's Oncology Group.
¹²³I-metaiodobenzylguanidine (MIBG) scans are preferable to ¹³¹I-MIBG for neuroblastoma imaging as they deliver less patient radiation yet have greater sensitivity in disease detection. Both ¹²³I-MIBG and ¹³¹I-MIBG scans were used for disease assessments of neuroblastoma patients enrolled on Children's Oncology Group (COG) high-risk study A3973. The hypothesis was that ¹²³I-MIBG and ¹³¹I-MIBG scans were sufficiently similar for clinical purposes in terms of ability to predict survival. ⋯ We found no evidence of a statistically significant difference in outcome by type of scan. For future survival analyses of MIBG Curie scores, ¹²³I-MIBG and ¹³¹I-MIBG results may be combined and analyzed overall, without adjustment for scan type.
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Pediatric blood & cancer · Dec 2009
Randomized Controlled Trial Comparative StudyLow-dose oral midazolam reduces fear and distress during needle procedures in children with cancer.
Children with cancer often mention needle procedures as the most frightening, distressing, and sometimes painful aspect of the disease and treatment. The aim was to investigate whether children experience less fear, distress, and/or pain according to parents, nurses, and children >or=7 years of age when they receive oral midazolam versus placebo before a needle is inserted in a subcutaneously implanted intravenous port. ⋯ Low-dose oral midazolam was effective in reducing fear and distress in pediatric oncology patients, especially in younger children, undergoing subcutaneous port needle insertion.
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Pediatric blood & cancer · Feb 2009
Randomized Controlled TrialAprepitant in adolescent patients for prevention of chemotherapy-induced nausea and vomiting: a randomized, double-blind, placebo-controlled study of efficacy and tolerability.
The neurokinin-1 receptor antagonist aprepitant, plus a 5HT3 antagonist and corticosteroid is well-tolerated and effective in preventing chemotherapy-induced nausea and vomiting in adults but has not been formally assessed in adolescents. ⋯ Aprepitant triple therapy was generally well tolerated; CR were greater with aprepitant, although not statistically significant. Pharmacokinetics suggest that the adult dosing regimen is appropriate for adolescents.