The purpose of this retrospective review of the charts of 6 children who underwent surgical treatment of chylous ascites refractory to conservative measures between 1993 and 2006 was to evaluate the efficiency of fibrin glue application for control of lymph leakage. Five children had postoperative chylous ascites (neuroblastoma, 4; cystic lymphangioma, 1) and 1 had a congenital malformation. Surgical exploration revealed large areas of diffuse lymphatic leakage in all of the patients. Lymphatic fistula was not identified intraoperatively in any patient. Ingestion of lipophilic dye in a concentrated fatty meal was not helpful in locating a lymph fistula. Absorbable mesh was used in association with glue application in the last 3 patients treated. Control of ascites was achieved immediately in 2 patients and within 3 weeks in 2 patients. Repeat surgery was required in the remaining 2 patients. The mean follow-up time was 4.3 years. One patient died of tumor recurrence 12 months after surgical treatment without relapse of the ascites. Two mild late recurrences were observed at 6 and 11 months after surgery and were managed conservatively. The findings of this study show that fibrin glue application on absorbable mesh after dissection of the leakage zones is easy, safe, and effective. We recommend that surgery with glue application be repeated until control of ascites is achieved. We suggest fibrin glue application as a preventive measure against postoperative chylous ascites.

The myelotoxicity of most chemotherapeutic regimens used to treat children and adolescents with cancer require the use of daily subcutaneous administration of hematological growth factors (mainly granulocyte colony-stimulating factor). Recently, pegfilgrastim (Neulasta), a product with a long half-life, resulting in once-per-cycle dosage, was introduced to prevent neutropenia in adults, and provided safety and efficacy similar to that provided by daily injection of filgrastim. To evaluate retrospectively the use of pegfilgrastim in children with cancer, we conducted a single-center retrospective study evaluating the use of pegfilgrastim in patients over 40 kg, who received chemotherapy for cancer from September 2003 to December 2005. A single subcutaneous injection of pegfilgrastim 100 microg/kg (maximum dose 6 mg) per chemotherapy cycle in children receiving myelosuppressive chemotherapy was given. One hundred and twenty-six administrations of pegfilgrastim were analyzed in 28 pediatric patients treated for cancer (11 girls, 17 boys) with a median age of 14.5 years (range 12-18 years) and median weight of 50.5 kg (range 40-82 kg). Patients received a median dose of pegfilgrastim of 100 microg/kg (range 73-117). The median total number of injections per patient was 4 (range 1-14). The incidence of grade 4 neutropenia by cycle was 48%, the mean duration of neutropenia was 3 days (range 1-13 days). The median values of absolute neutrophil count nadir was 0.425 x 10(9)/l (range 0-9.9 x 10(9)). Febrile neutropenia occurred in 18 of the 126 patients on pegfilgrastim use (14%) with full recovery in all patients. The median total duration of intravenous antibiotic therapy was 5 days (range 2-14 days). Bone pain (four) and headaches (two) were the most frequent adverse events reported. No correlation was found between the administered dose of Neulasta and hematological data. In conclusion, the use of pegfilgrastim was safe and well tolerated in children with cancer treated with myelosuppressive chemotherapy. Safety and efficacy of pegfilgrastim must be compared with filgrastim and evaluated in younger children with lower body weight.

Background and Aims COVID-19 infection in pediatric cancer patients is severe or critical in 20% of the patients. It can therefore directly affect pediatric cancer patients and/or their care. We aimed at evaluating the safety and efficacy of BNT162b2 mRNA Covid-19 vaccine in AYA with solid tumor. Methods Retrospective analysis of safety and efficacy of BNT162b2 mRNA Covid-19 vaccine administered to patients, >= 16 years old, under treatment for a solid tumor or within 6 months’ post-treatment from 15/2/2021 to 15/4/2021. Two administrations of the vaccine 3 weeks apart were given. Sera were tested for anti-SARS-Cov-2 IgG antibodies directed against the S1 domain of the spike protein. In case of positive serology, neutralization of SARS-Cov-2 was tested. Results Twenty-three patients with solid tumors were identified and proposed to get vaccinated. Nine patients refused and 1 previously developed COVID-19 infection with positive serology. At time of writing, 13 patients (10 M/2F); median age: 17) started vaccination. All patient received 2 injections except 2 patients who stopped vaccination because of tumor progression. Ten patients were under treatment (chemotherapy-7pts, immunotherapy-2 pts, targeted therapy-2 pts-follow-up 3 patients). Overall, vaccines were well tolerated. Five patients did not report any side-effect after the first injection and 4 after the second injection. Main local reactivity symptom was mild pain at the site of injection (6 and 2 pts). Fatigue (2pts and 5 pts) was the most frequent systemic symptom. One patient refused serology testing. All patients but 1 had pre-vaccination negative serology, 7/10 tested had positive serology before second vaccine injection, 9/10 had positive serology one month after the second injection. All patients with seroconversion had positive COVID-19 neutralization test. No patient developed COVID infections. Conclusions We report the good safety profile and good efficacy BNT162B2 vaccine in AYA with solid tumors. Larger series and monitoring of the kinetics of anti-Sars-Cov-2 IgG antibodies for several months are mandatory to confirm these preliminary results and to determine long-term vaccination.

Background: Rhabdomyosarcoma (RMS) in infants is a particular entity with various clinical presentations and outcomes. To better understand the clinical heterogeneity of RMS in infants, an integrative clinical, histological, and molecular analysis was performed. | 2699BUTEL ET aL.

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