Spectrum and presentation of pediatric malignancies in the HIV era: Experience from Blantyre, Malawi, 1998–2003

Sinfield, Rebecca; Molyneux, Elizabeth; Banda, Kondwani Joseph; Borgstein, Eric; Broadhead, Robin L.; Hesseling, Peter; Newton, Robert; Casabonne, Delphine; Mkandawire, Nyengo; Nkume, H.; Hodgson, TA; Liomba, George N.

doi:10.1002/pbc.20917

Cited by 95 publications

(83 citation statements)

References 14 publications

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“…HIV infection and tuberculosis). [12] Children from low-income countries are often malnourished when a malignancy is diagnosed. Malnutrition in children with cancer renders them vulnerable to chemotherapy-related toxicity and infections, and ultimately increases the risk of death.…”

Section: Discussionmentioning

confidence: 99%

Childhood cancer survival rates in two South African units

et al. 2014

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Introduction. Childhood cancer is relatively rare, but there is a very good chance of cure. While overall survival rates of >70% are reported from developed countries, survival is much less likely in developing countries and unknown in many countries in Africa. Objective. To analyse survival rates of childhood cancers in two South African paediatric oncology units. Methods. This retrospective review included all children (0 -15 years) admitted with a malignancy at two paediatric oncology units (Universitas Hospital Academic Complex in Bloemfontein, Free State, and Tygerberg Hospital in Cape Town, Western Cape) between 1987 and 2011. The protocols used in the units were similar, and all the diagnoses were confirmed histologically.Results. There were 3 241 children, 53.5% of whom were males. Median follow-up was 17 months. The most common cancers were leukaemia (25.0%), brain tumours (19.5%), lymphoma (13.0%) and nephroblastoma (10.0%). The prevalences of neuroblastoma and retinoblastoma were similar at 5.8% and 5.7%, respectively. Overall survival was calculated to be 52.1%. Lymphoma and nephroblastoma had the highest survival rates at 63.9% and 62.6%, respectively. Brain tumours had the lowest survival rate at 46.4%. A comparison between ethnic groups showed white children to have the highest survival rate (62.8%); the rate for children of mixed racial origin was 53.8% and that for black children 48.5%. Conclusions. Overall survival rates for children admitted to two paediatric cancer units in South Africa were lower than data published from developed countries, because many children presented with advanced disease. New strategies to improve cancer awareness are urgently required.

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Section: Discussionmentioning

confidence: 99%

Childhood cancer survival rates in two South African units

et al. 2014

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“…65 Kaposi's sarcoma lesions may produce upper airway obstruction. Pulmonary dissemination may result in chronic progressive dyspnea, cough, and fever; hemoptysis may occur with endobronchial lesions.…”

Section: Malignancymentioning

confidence: 99%

“…Pulmonary dissemination may result in chronic progressive dyspnea, cough, and fever; hemoptysis may occur with endobronchial lesions. 65 Chest radiograph abnormalities include bilateral adenopathy, perihilar infiltrates, pleural effusion or combinations of interstitial, alveolar, or nodular patterns.…”

Section: Malignancymentioning

confidence: 99%

Chronic lung disease in human immunodeficiency virus (HIV) infected children

Zar

2007

Pediatric Pulmonology

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The development of chronic lung disease is common in HIV‐infected children. The spectrum of chronic HIV‐associated lung disease includes lymphocytic interstitial pneumonia (LIP), chronic infections, immune reconstitution inflammatory syndrome (IRIS), bronchiectasis, malignancies, and interstitial pneumonitis. Chronic lung disease may result from recurrent or persistent pneumonia due to bacterial, mycobacterial, viral, fungal or mixed infections. In high tuberculosis (TB) prevalence areas, M. tuberculosis is an important cause of chronic respiratory illness. With increasing availability of highly active antiretroviral therapy (HAART) for children in developing countries, a rise in the incidence of IRIS due to mycobacterial or other infections is being reported. Diagnosis of chronic lung disease is based on chronic symptoms and persistent chest X‐ray changes but definitive diagnosis can be difficult as clinical and radiological findings may be non‐specific. Distinguishing LIP from miliary TB remains a difficult challenge in HIV‐infected children living in high TB prevalence areas. Treatment includes therapy for specific infections, pulmonary clearance techniques, corticosteroids for children with LIP who are hypoxic or who have airway compression from tuberculous nodes and HAART. Children who are taking TB therapy and HAART need adjustments in their drug regimes to minimize drug interactions and ensure efficacy. Preventative strategies include immunization, chemoprophylaxis, and micronutrient supplementation. Early use of HAART may prevent the development of chronic lung disease. Pediatr Pulmonol. 2008; 43:1–10. © 2007 Wiley‐Liss, Inc.

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“…It affected young people of both sexes and was aggressive, multifocal and widespread [4,5]. As the HIV epidemic increased in Africa so did the incidence of KS and it is now one of the most prevalent cancers in men, women and children in many parts of the continent [6][7][8]. It is an AIDS defining disease.…”

Section: Introductionmentioning

confidence: 99%

The management of children with Kaposi sarcoma in resource limited settings

Molyneux

Davidson

Orem

et al. 2012

Pediatric Blood & Cancer

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Kaposi sarcoma (KS) is common where HIV infection is endemic. Antiretroviral therapy (ART) has reduced the incidence in well‐resourced settings but in some parts of the world access to ART is delayed. These recommendations are for use where only minimal requirements for treatment are available. Consensus was sought for the management of childhood HIV‐associated KS in this setting. There are no randomised controlled studies of chemotherapy for KS in children and these recommendations have drawn on consensus of a group of experts and published reports from studies in adults. Pediatr Blood Cancer 2013; 60: 538–542. © 2012 Wiley Periodicals, Inc.

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Spectrum and presentation of pediatric malignancies in the HIV era: Experience from Blantyre, Malawi, 1998–2003

Cited by 95 publications

References 14 publications

Childhood cancer survival rates in two South African units

Childhood cancer survival rates in two South African units

Chronic lung disease in human immunodeficiency virus (HIV) infected children

The management of children with Kaposi sarcoma in resource limited settings

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