Pediatric blood & cancer
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Pediatric blood & cancer · Nov 2008
Randomized Controlled TrialPediatric oncology sedation trial (POST): A double-blind randomized study.
There is limited evidence to support the use of an anti-emetic with the administration of intra-thecal chemotherapy. Nor is there adequate clarity on analgesic strategies for children with cancer undergoing painful procedures. ⋯ This study provides evidence that the addition of an analgesic (fentanyl) and an anti-emetic (ondansetron) to the combination of a sedative (midazolam) and an anesthetic (propofol) is of measurable benefit in children who undergo procedures that are painful and risk the consequence of nausea and vomiting.
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Pediatric blood & cancer · May 2008
Randomized Controlled TrialInitial testing of cisplatin by the pediatric preclinical testing program.
Cisplatin is one of the most widely used drugs for the treatment of solid tumors in adults and children. Here, we report the activity of cisplatin against the PPTP panels of childhood cancer xenografts. ⋯ Cisplatin exhibits significant antitumor activity against a broad range of solid tumor xenograft models and limited activity against ALL xenografts. This preclinical pattern of activity is generally consistent with cisplatin's clinical activity.
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Pediatric blood & cancer · Mar 2008
Randomized Controlled TrialAdrenal axis function after high-dose steroid therapy for childhood acute lymphoblastic leukemia.
A 4-week course of high-dose glucocorticoids may cause prolonged adrenal suppression even after a 9-day tapering phase. In this study, adrenal function and signs and symptoms of adrenal insufficiency were prospectively assessed in children with acute lymphoblastic leukemia (ALL) after induction treatment including high-dose prednisone (PDN) or dexamethasone (DXM). ⋯ High-dose glucocorticoid therapy in ALL children may cause prolonged adrenal suppression and related clinical symptoms. Laboratory monitoring of cortisol levels and steroid coverage during stress episodes may be indicated.
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Pediatric blood & cancer · Jan 2008
Randomized Controlled Trial Comparative StudyComparison of results of a pilot study of alternating vincristine/doxorubicin/cyclophosphamide and etoposide/ifosfamide with IRS-IV in intermediate risk rhabdomyosarcoma: a report from the Children's Oncology Group.
Over 50% of patients with rhabdomyosarcoma (RMS) have intermediate risk disease, with a 3-year failure-free survival (FFS) of 50%-70% depending on histology. Doxorubicin is active against RMS, but its role in improving outcome remains controversial. Ifosfamide is as active as cyclophosphamide in RMS, with the Fourth Intergroup RMS Study (IRS-IV) showing equivalent outcomes for patients treated with ifosfamide for the first 28 weeks compared to cyclophosphamide. Treatment with alternating cycles of non-cross-resistant chemotherapy has been used in a number of diseases with good results. ⋯ VDC/IE is as effective therapy for intermediate risk RMS as IRS-IV therapy. It is being explored along with irinotecan in relapsed patients and newly diagnosed high-risk patients.
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Pediatric blood & cancer · Nov 2007
Randomized Controlled Trial Comparative StudyEarly hospital discharge versus continued hospitalization in febrile pediatric cancer patients with prolonged neutropenia: A randomized, prospective study.
Hospitalization with single or multi-agent antibiotic therapy has been the standard of care for treatment of febrile neutropenia in cancer patients. We hypothesized that an empiric antibiotic regimen that is effective and that can be administered once-daily will allow for improved hospital utilization by early transition to outpatient care. ⋯ We conclude that pediatric febrile cancer patients initially considered at risk for sepsis due to prolonged neutropenia can be re-evaluated at 72 hr for outpatient therapy. The convenience, low incidence of adverse effects, and cost benefit of the once-daily regimen of C + A may be particularly useful to reduce the overall treatment costs and duration of hospitalization.