Anemia and survival in childhood acute lymphoblastic leukemia

Teuffel, Oliver; Stanulla, Martin; Cario, Gunnar; Ludwig, Wolf Dieter; Röttgers, Silja; Schäfer, Beat W.; Zimmermann, Martin; Schrappe, Martin; Niggli, Felix

doi:10.3324/haematol.13156

Cited by 25 publications

(22 citation statements)

References 38 publications

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“…30 Teuffel et al, found a very low hemoglobin levels at diagnosis are associated with more advanced disease in these subgroups, this may be related to the late diagnosis. 31 Initial WBC count is one of the important prognostic factors in ALL and the count above 50.0×109cells/L was considered unfavorable criteria and classified as high risk of relapse, more than 70% of enrolled patients had a count below 50×109cells/L and 29% patients were having WBC count >50.0×109cells/L which was also observed by other study. 10,11 Patients with severe leukocytosis at diagnosis may present bulky tumor mass, mediastinal enlargement, hepatosplenomegaly and significant lymphadenopathy, this finding is usually associated with the unfavorable chromosomal translocations t (4;11) and t (9;22), this association was not proved in the current study and this may be due to small sample size.…”

Section: Discussionsupporting

confidence: 64%

Clinical, hematological, and laboratory presentation of acute lymphoblastic leukemia of children in Diyala province/Eastern Iraq

Shalal¹,

Mahmood

Alchalabi³

2017

Int J Res Med Sci

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Background: To show the initial presenting features the children of acute lymphoblastic leukemia presented till the diagnosis at oncology Center/ Diyala/ Iraq.Methods: A retrospective study, carried out during 2016-2017. The data include constitutional, hematological, and infiltrative features with laboratory findings registered at patient’s files until the diagnosis. Data were analyzed by Statistical Package of Social Sciences v. 20.Results: The total patients were 55, distributed into: T- cell (10.9%) and B- cell leukemia (89.1%), FAB classification include L1 (11%), L 2 (89%) and L3 (0%). Most of patients presented at 1- 10 years of age (p value= 0.000); M: F= 1.3:1 (p value= 0.345). Fever and pallor were the most common features, 81.8% (p value=0.000) and 67.3% (p value=0.010), respectively. Other features were bone pain (40%), anorexia (36.4%), fatigability (30.9%), muco-cutaneous bleeding (27.3%), hepatosplenomegaly (56.4%), lymphadenopathy (49.1%), and facial palsy (1.8%). Hemoglobin was < 8 gm/ dl in 70.9 %, white cell count was < 50×109 cells/L in 70.9 %; 12.3% has severe leukocytosis, and platelets' count was between 20- 100 × 109 cells/L in 49%. Mediastinal infiltration (7.2%), pleural effusion (1.8%), pericardial effusion (1.8%), and positive cytospin (5.4%).Conclusions: L2 subtype was the dominant subtype; this contrary to all other studies and may be related to the prognosis. Most of the initial features were general and may indicate more common illnesses, but their constellation with complete blood picture should rise the possibility of leukemia. A rare complication, pleural effusion, was detected as initial feature.

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Section: Discussionsupporting

confidence: 64%

Clinical, hematological, and laboratory presentation of acute lymphoblastic leukemia of children in Diyala province/Eastern Iraq

Shalal¹,

Mahmood

Alchalabi³

2017

Int J Res Med Sci

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“…1 a , left). As cell lines grown in culture may have acquired additional mutations and epigenetically induced changes in gene expression, we further compared the list of 32 genes to data derived from patient samples of Ewing's sarcoma, neuroblastoma, rhabdomyosarcoma and acute lymphoblastic leukemia (ALL29–31; see Material and Methods). Three hundred and thirteen probesets were identified to be differentially expressed in Ewing's patients with a p ‐value of <0.001 and a fold change of >3.5 compared to the other tumor types (Fig.…”

Section: Resultsmentioning

confidence: 99%

Small‐molecule screen identifies modulators of EWS/FLI1 target gene expression and cell survival in Ewing's sarcoma

Boro

Prêtre

Rechfeld

et al. 2012

Intl Journal of Cancer

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Ewing's sarcoma family of tumors (EFT) is characterized by the presence of chromosomal translocations leading to the expression of oncogenic transcription factors such as, in the majority of cases, EWS/FLI1. Because of its key role in Ewing's sarcoma development and maintenance, EWS/FLI1 represents an attractive therapeutic target. Here, we characterize PHLDA1 as a novel direct target gene whose expression is repressed by EWS/FLI1. Using this gene and additional specific well‐characterized target genes such as NROB1, NKX2.2 and CAV1, all activated by EWS/FLI1, as a read‐out system, we screened a small‐molecule compound library enriched for FDA‐approved drugs that modulated the expression of EWS/FLI1 target genes. Among a hit‐list of nine well‐known drugs such as camptothecin, fenretinide, etoposide and doxorubicin, we also identified the kinase inhibitor midostaurin (PKC412). Subsequent experiments demonstrated that midostaurin is able to induce apoptosis in a panel of six Ewing's sarcoma cell lines in vitro and can significantly suppress xenograft tumor growth in vivo. These results suggest that midostaurin might be a novel drug that is active against Ewing's cells, which might act by modulating the expression of EWS/FLI1 target genes.

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“…Multidrug chemotherapy allows effective treatment of more than 70% of children with neoplasms, independently of the disease type or stage [1–9]. Unfortunately, chemotherapeutics are not selective and have a low therapeutic index, which results in damaging also healthy cells.…”

Section: Introductionmentioning

confidence: 99%

Antineoplastic chemotherapy and congenital tooth abnormalities in children and adolescents

Krasuska-Sławińska

Brożyna

Dembowska‐Bagińska

et al. 2016

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Aim of the studyChemotherapeutic treatment in children and adolescents carries a risk of congenital tooth disorders and dentinoma. Study objective is to assess the correlation between tooth abnormalities, early complications of multidrug chemotherapy, and chemotherapeutics used in different antineoplastic therapies in children and adolescents.Material and methodsEnamel defects (developmental defects of enamel index – DDE index) and defects in tooth number, size, and structure were assessed clinically and radiologically in 60 patients who underwent chemotherapy on average 4.9 ±3.4 years earlier (PCH), and 60 generally healthy subjects (control group – CG), aged 6–18 years. Höltta’s defect index (DeI) was calculated. Medical files provided information on neoplasm type, age at treatment start and chemotherapy duration, chemotherapeutic type and dose, vomiting, and mucositis (CTCAE v4.0). Statistical significance of differences between groups was assessed with the Mann-Whitney U test and the correlation between dental defects and chemotherapy with Spearman’s rank correlation coefficient (significance p ≤ 0.05).ResultsEnamel defects, tooth agenesis, microdontia, root resorption, taurodontism, and dentinoma occurred statistically significantly more often in the PCH group. A correlation was established between vincristine use and dose and all types of dental defects; cyclophosphamide, doxorubicin, and isophosphamide and hypodontia; microdontia, root resorption, and enamel defects; etoposide and cisplatin and microdontia, root resorption, and enamel defects; methotrexate root resorption and enamel defects; carboplatin and dentinoma and enamel defects. Mucositis and vomiting promoted root resorption, microdontia, and enamel defects.ConclusionsDental defects are related to both the use of respective chemotherapeutics, especially vincristine, cyclophosphamide, doxorubicin, and isophosphamide, and to early complications in multidrug chemotherapy – mucositis and vomiting. Vincristine and carboplatin use may promote dentinoma.

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Anemia and survival in childhood acute lymphoblastic leukemia

Cited by 25 publications

References 38 publications

Clinical, hematological, and laboratory presentation of acute lymphoblastic leukemia of children in Diyala province/Eastern Iraq

Clinical, hematological, and laboratory presentation of acute lymphoblastic leukemia of children in Diyala province/Eastern Iraq

Small‐molecule screen identifies modulators of EWS/FLI1 target gene expression and cell survival in Ewing's sarcoma

Antineoplastic chemotherapy and congenital tooth abnormalities in children and adolescents

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