Colorectal carcinoma (CRC) is rare in children with extremely poor prognosis. Proper management is obscure because of deficient data. The aim of the current study is to assess the clinical characteristics and to determine the different prognostic factors leading to dismal outcome. It is a retrospective study included all CRC patients, below 18 years, treated in Children's Cancer Hospital of Egypt (CCHE) between 2007 and 2016. Demographic data, clinical characteristics, diagnostics, histological subtypes, disease stage, treatment methods, and survival outcome were collected. The result showed that, 15 patients below 18 years. All had unfavorable histopathology (mucinous adenocarcinoma) and 10 cases had metastatic disease. Initial surgical resection was done in 8/15 cases, all patients received neo adjuvant/adjuvant chemotherapy. Four patients had rectal adenocarcinoma and were treated with chemo-radiotherapy while 11 had colonic adenocarcinoma. Ten patients had progression or relapse, while 12 died at the end of follow up period; 3-years Overall Survival (OS) and Event Free Survival (EFS) were 17.8% and 16.5% respectively, the only three surviving patients were of lower stage disease. In Conclusions, Clinical presentation of CRC in pediatrics is similar to adults but delayed diagnosis and advanced stages contribute to poor outcome which is due to the absence of familiarity to CRC. The high frequency of mucinous adenocarcinoma may explain the poor outcome. Surgery remains the mainstay of treatment as in adults. Preoperative radiotherapy for rectal adenocarcinoma, offers better prognosis. Chemotherapy plays a role in the metastatic disease and can downstage the primary tumor for better local control.

PET scan is significantly more sensitive than conventional CT in the management of aggressive pediatric mature B cell NHL. PET negativity is an excellent indicator of tumor response.

Introduction Lymphoblastic lymphoma (LBL) and acute lymphoblastic leukemia (ALL) are neoplasms of immature B or T-cell precursors. They are considered as a unique biological entity in the 2008 World Health Organization Classification of Hematologic Neoplasm. Both entities are arbitrarily separated by a cut-off point of 20-25% of blast cells in the bone marrow. Treatment of LBL has evolved over time from conventional high-grade NHL schedules to ALL-derived protocols. The aim of this work is to report the clinical characteristics, overall survival (OS), event free survival (EFS), and common chemotherapy toxicities of lymphoblastic lymphoma (LBL) patients during a 5.5year period. Patients and methods A Retrospective review of patient's charts diagnosed and treated as LBL during the period between July 2007 and end of December 2012 was done. Patients were treated according to St. Jude Children Research Hospital ALL Total Therapy XV protocol, standard risk arm. Results This study included 77 patients. T-cell LBL patients were 67, while 10 were of B-cell origin. The median age at diagnosis was 9years (95% CI: 7-10). The majority were males 54/77. Stage III patients were 51, stage IV 13, stage II 11 and stage I 2 patients. Two patients were excluded from analysis as they died before receiving chemotherapy. Complete remission post induction chemotherapy was seen in 22 patients considered early responders, and partial remission in 55 considered late responders. With a median follow up duration of 47months (95% CI: 38-56), the 4year overall survival and event free survival were 86.45% (95% CI: 73.78-94.09) and 82.18% (95% CI: 69.25-90.61) respectively. Twelve patients died during the study period; 2 early deaths before starting chemotherapy from disease progression, 2 in CR due to chemotherapy related toxicity and 8 from disease progression. All the relapsed patients were T-cell, had advanced disease at presentation (6 with stage III; 2 with stage IV). Two patients (2.6%) had isolated local, BM, and CNS relapse each, while 1 (1.3%) had both local and CNS relapse. Disease recurrence was local in 3 patients (3.9%), and systemic in 5 (6.4%), while it was early in 6 (7.8%), and late in 2 (2.6%) patients. Median time to disease progression was 20months (range 5-39months). All relapsed patients did not survive salvage chemotherapy. The most common chemotherapy toxicities were cerebral venous thrombosis (20%), followed by bone infarcts (10.6%), and avascular necrosis (AVN) of head of femur (9.3%). One patient developed secondary acute myeloid leukemia after 3years of FU with unfavorable cytogenetic abnormalities. Conclusion Results of treatment of LBL on the St Jude's total therapy XV study are comparable to most of the similar reported studies. Outcome of relapsing patients is extremely poor, hence there is a need to identify biologic or clinical prognostic factors including minimal residual tumor to better evaluate chemotherapy response. Steroid induced AVN, and cerebral vascular thrombosis were the main chemotherapeutic advers...

Background: During the last decades, the prognosis of Hodgkin lymphoma (HL) has been improved significantly with the introduction of effective chemotherapy and the implementation of risk-adapted treatment approaches. Identification of reliable risk factors is crucial to guide treatment throughout the disease. Objectives: We aimed to identify independent predictors of event-free survival (EFS) in pediatric/ adolescent HL using clinical data known at diagnosis and treated with the ABVD regimen at our hospital. Design/Method: This is a retrospective study done at Children's cancer hospital Egypt from July 2007 to December 2017. ALL Patients with Classical HL were enrolled in the analysis. The chemotherapy backbone was ABVD +/- RTH. Data analysis included all pretreatment Demographics, clinicopathological characteristics, and Laboratory findings. PET scan was performed at baseline and after two cycles of chemotherapy. Treatment was not changed according to the results of the interim scan. Results: A total of 737 patients were eligible for analysis.The Five-years OS 94.9% and the EFS 87.8% in these patients. Pretreatment Significant univariate predictive factors for the EFS were: Age<9.5 (HR 0.421; p = 0.002),, ESR (HR 0.421; p = 0.002), Hemoglobin <10.5 (HR 1.373; p = 0.014), TLC >11,000 (HR 0.368; p = 0.000), Stage IV( p = 0.000) and treatment groups (HR 0.180; p = 0.000). Although the pathological subtypes has a diverse EFS;NS: 86.6% MS: 92.9% Lymphocyte rich: 87.5% and Lymphocyte depleted: 41.7%, Histology has shown to be a powerful independent predictor of outcome ( p = 0.000).In the multiple regression model, NS Histology and stage remained strong predictive factors with a p-value of 0.011and 0.026 respectively, In addition to the significance of the Albumin level (HR 0.047, p= 0.011). The interim PET, as well as RTH, were highly significant on both univariate (p= 0.000 and 0.0002 respectively) as well as multivariate analysis (p= 0.001and 0.000 respectively). Conclusion: Age; stage IV disease; white blood cell count, and hemoglobin level are independent predictors of survival that can significantly impact survival. Optimizing initial therapy may improve overall EFS for these patients. Although CHL pathology is a significant independent predictor of EFS, its subtypes have different EFS and OS, which should be translated into changes in the treatment approach. Disclosures No relevant conflicts of interest to declare.