Testicular Relapse in Acute Lymphoblastic Leukemia (ALL): Guidelines Must be Changed

Martins, António Gentil

doi:10.4172/2329-6917.1000248

Cited by 3 publications

(6 citation statements)

References 8 publications

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“…The suspect arises in children treated for ALL who present enlarged testis. The confirmation of diagnosis can be obtained through a fine needle aspiration (FNA) biopsy, both of the affected testis and the contralateral, and the treatment is based on the orchiectomy or on radiation therapy (RT), both causing castration [ 29 ].…”

Section: Scrotal Massmentioning

confidence: 99%

International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines

Abib¹,

Chui²,

Cox³

et al. 2022

ecancer

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Most children with tumors will require one or more surgical interventions as part of the care and treatment, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumors (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life. It is important for surgeons to adhere to sound pediatric surgical oncology principles, as they are closely associated with improved local control and survival. Unfortunately, there is a significant disparity in survival rates in low and middle income countries, when compared to those from high income countries.The International Society of Paediatric Surgical Oncology (IPSO) is the leading organization that deals with pediatric surgical oncology worldwide. This organization allows experts in the field from around the globe to gather and address the surgical needs of children with cancer. IPSO has been invited to contribute surgical guidance as part of the World Health Organization Initiative for Childhood Cancer. One of our goals is to provide surgical guidance for different scenarios, including those experienced in High-(HICs) and Low-and Middle-Income Countries (LMICs). With this in mind, the following guidelines have been developed by authors from both HICs and LMICs. These have been further validated by experts with the aim of providing evidence-based information for surgeons who care for children with cancer.We hope that this initiative will benefit children worldwide in the best way possible.

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Section: Scrotal Massmentioning

confidence: 99%

International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines

Abib¹,

Chui²,

Cox³

et al. 2022

ecancer

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“…The testes have long been considered a sanctuary site for leukemic cells [6]. Testicular relapses in acute lymphoblastic leukaemia, tends to account for a major proportion of the poor outcome of disease in boys compared with girls.…”

Section: Discussionmentioning

confidence: 99%

“…Leukemic cells are able to infiltrate various extramedullary tissues during the disease process [5]. Studies have showed that testis is a sanctuary site [6,7] Testicular infiltration more commonly occurs later during the course of disease and at relapse [7]. Initial presentation with primarily testicular disease is exceedingly rare [8,9].…”

Section: Introductionmentioning

confidence: 99%

Acute Lymphoblastic Leukemia with Primary Testicular Involvement in a Pre-pubertal Male: A Case Report

Osho¹,

Ojo²,

Osho³

et al. 2020

CRJ

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Acute lymphoblastic leukaemia is the most common malignancy in paediatric patients; its diagnosis is usually easy to establish as malignant lymphoblasts invade the bone marrow and peripheral blood. Patients with Acute lymphoblastic leukaemia (ALL) may initially present with pancytopenia and a hypoplastic or hyperplastic bone marrow. Fever is common at presentation, and despite neutropenia, sepsis is rarely seen. Other common clinical manifestations include fatigue, pallor, petechiae, bleeding, lymphadenopathy and hepatosplenomegaly. Presentation with primarily testicular disease is exceedingly rare in acute lymphoblastic leukemia. The unusual presentation of a primary left testicular involvement in ALL is being highlighted in this case report. We present an 11 year old boy who presented with fever, generalized body pain, abdominal discomfort as well as left testicular swelling. Bone marrow studies, Full blood count and peripheral blood film appearance were typical of acute lymphoblastic leukaemia. Ultrasound findings showed left scrotal enlargement with reduced and coarse parenchymal echotexture, while cytogenetic studies revealed positive Philadelphia chromosomes. There was good response to standard ALL therapy. Clinical remission with normal left testicular size was noted at the end of induction phase of therapy.

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“…Three publicly available cancer images datasets are used in this paper, including (1) LUNA16 [40] with X-ray images for lung nodule classification, (2) the Kaggle (CE-MRI) [41] dataset with MRI high contrast-colored images, and (3) the Acute Lymphoblastic Leukemia (ALL) [42] dataset with microscopic images. To verify that the proposed adversary defense model described in the previous section is generally appropriate for the AI-based cancer classification domain.…”

Section: Datasets Characteristicsmentioning

confidence: 99%

“…Acute Lymphoblastic Leukemia (ALL) [42]: This dataset is used to classify and identify ALL blasts in the most common cancer type of childhood and is publicly available at the Kaggle website. This dataset contains 3256 PBS images from 89 patients collected in the bone marrow laboratory of Taleqani Hospital (Tehran, Iran).…”

Section: Datasets Characteristicsmentioning

confidence: 99%

RDMAA: Robust Defense Model against Adversarial Attacks in Deep Learning for Cancer Diagnosis

A. Abd El-Aziz,

A. El-Khoribi,

Khalifa

2024

IJCDS

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Attacks against deep learning (DL) models are considered a significant security threat. However, DL especially deep convolutional neural networks (CNN) has shown extraordinary success in a wide range of medical applications, recent studies have recently proved that they are vulnerable to adversarial attacks. Adversarial attacks are techniques that add small, crafted perturbations to the input images that are practically imperceptible from the original but misclassified by the network. To address these threats, in this paper, a novel defense technique against white-box adversarial attacks based on CNN fine-tuning using the weights of the pre-trained deep convolutional autoencoder (DCAE) called Robust Defense Model against Adversarial Attacks (RDMAA), for DL-based cancer diagnosis is introduced. Before feeding the classifier with adversarial examples, the RDMAA model is trained where the perpetuated input samples are reconstructed. Then, the weights of the previously trained RDMAA are used to fine-tune the CNN-based cancer diagnosis models. The fast gradient method (FGSM) and the project gradient descent (PGD) attacks are applied against three DL-cancer modalities (lung nodule X-ray, leukemia microscopic, and brain tumor magnetic resonance imaging (MRI)) for binary and multiclass labels. The experiment's results proved that under attacks, the accuracy decreased to 35% and 40% for X-rays, 36% and 66% for microscopic, and 70% and 77% for MRI. In contrast, RDMAA exhibited substantial improvement, achieving a maximum absolute increase of 88% and 83% for X-rays, 89% and 87% for microscopic cases, and 93% for brain MRI. The RDMAA model is compared with another common technique (adversarial training) and outperforms it. Results show that DL-based cancer diagnoses are extremely vulnerable to adversarial attacks, even imperceptible perturbations are enough to fool the model. The proposed model RDMAA provides a solid foundation for developing more robust and accurate medical DL models.

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Testicular Relapse in Acute Lymphoblastic Leukemia (ALL): Guidelines Must be Changed

Cited by 3 publications

References 8 publications

International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines

International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines

Acute Lymphoblastic Leukemia with Primary Testicular Involvement in a Pre-pubertal Male: A Case Report

RDMAA: Robust Defense Model against Adversarial Attacks in Deep Learning for Cancer Diagnosis

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