Incidence trends of acute leukemia among the children of Mexico City: 1982-1991.

The objective of this study was to identify the tendency of acute leukemia among children in Mexico City from 1982 to 1991. A hospital survey was performed. Medical records of children under 15 years of age with a diagnosis of acute leukemia were reviewed. The cases were chosen from hospitals which provide medical attention to children with cancer in Mexico City. The annual incidence rate (AIR) was calculated in general, by sex, age groups (under 1 year of age, from 1 to 4 years, 5 to 9 years and 10 to 14 years) and standardized with the world population. The trend was evaluated with Spearman's correlation method. Acute lymphoblastic leukemia showed a significantly increasing trend during the study period. The AIR was 7.75 (per million) in 1982 and 22.19 (per million) in 1991. For age groups a tendency to increase was observed in females of age group 1 to 4 years and in males of age group 10 to 14 years. Acute non-lymphoblastic leukemia did not display a specific trend. In conclusion, acute lymphoblastic leukemia shows a tendency to increase in the children of Mexico City.

[Results of severe aplastic anemia treated with antilymphocytic globulin]. / Resultados del tratamiento de la anemia aplástica grave con globulina antilinfocitaria.

The best results of the therapeutic immunosuppression in a plastic anemia have been obtained with antilymphocyte globulin (ALG). Considering this, 14 patients with this disease, 9 females and 5 males, from 8 to 60 years of age, were given ALG (40 mg/K/day/4 days) and corticosteroids. Fifty one percent of them, older than 30 years of age, showed partial or minimal remissions of the disorder. According to this result ALG administration together with bone-marrow transplantation in younger patients may offer effective treatment for a generally fatal disease to a greater number of patients.

[Factors that influence non-donation of blood in relatives of patients at a pediatric hospital]. / Factores que influyen en la no-donación de sangre en los familiares de pacientes de un hospital pediátrico.

OBJECTIVE: To identify factors that influence refusing to donating blood. MATERIAL AND METHODS: Prospective case and control study. Hospitalized patients' relatives were interviewed with a questionnaire to evaluate their knowledge of blood and personal attitudes toward blood donation. Cases were all relatives who did not donate blood and controls who did. RESULTS: A total of 121 individuals was studied, 30 cases and 91 controls. Age of the cases was 32.3 +/- 8.1 years and controls was 28.8 +/- 7.9 years (p = 0.04). Risk factors were female sex (OR = 6.3; 95%CI 2.4 to 17.1), being married (OR = 3.7 95%CI 1.3 to 10.5). No differences were present between the two groups in level of knowledge concerning blood. The average of positive attitudes toward blood donation was greater among relatives who donated blood (cases 5.9 +/- 1.6; controls 6.4 +/- 1.2; P = 0.049). Among the attitudes that influence refusing to donate blood were fear of getting dizzy at the sight of blood (OR = 5.2, 95%CI 1.3-21.4), fear of donating blood (OR = 2.2, 95%C, 0.8-6.0), and getting nervous at the sight of blood (OR = 4.1, 95%CI% 1.5-10.9). CONCLUSIONS: Among patient's relatives who donate blood positive personal attitudes toward blood donation have more weight than knowledge on the subject.

[The transfusion of blood and its derivatives in the neonate]. / Transfusiones de sangre y sus derivados en el neonato.

Blood and its products are valuable therapeutic resources for the pediatrician who care for newborns with severe illnesses. The use of blood and its products requires for the hospital personnel working at neonatal care units to be precise and up to date on the indications and complications of total blood, the globular package, albumin, plasma, the concentration of granulocytes, platelets and immunoglobulins for intravenous use. This review gathers, on the one hand, accumulated experiences by the members of the Commission of Blood and its Products from the Pediatric Hospital of the National Medical Center and on the other hand, a selection of the more important concepts which have been judged so by the authors and expressed in the current medical literature.

[Risk factors associated with the development of leukemia in children]. / Factores de riesgo asociados al desarrollo de leucemia en niños.

INTRODUCTION: Leukemia is the most frequent neoplasia in children; in our country it is the main cause of medical attention in children with cancer. The are different risk factors associated with the development of this kind of cancer. OBJECTIVE: To identify which of the already known factors described in the literature associated with the development of leukemia are most frequent in the pediatric population of Mexico City. MATERIAL AND METHODS: A protective case-control study was carried out using prevalent and incident cases. In two third level hospitals of Mexico City, a total of 81 children who had been diagnosed as suffering from different kind of leukemia, confirmed by biopsy of bone marrow, were select and studied. The control were 154 children from two different sources: 77 of them came from the same hospital where the cases received medical care, the selection criteria was not to have any kind of neoplasia; and 77 came from the same community where those diagnosed children cases lived, the selection criteria for this group was that they were healthy children. Both cases and community controls were visited at home and interview to complete precoded questionnaire with the different variables of the study. The information from the hospital controls was obtained during the time they stayed in the hospital. Odds ratio (OR's) for the different associations were calculated, as well as its confidence intervals at 95% (IC) accord to Cornfield and unconditioned logistic regression was carried out to control confounding variables. RESULTS: OR greater than 1 was found in those with familiar cancer background 1.93 (1.2-3.63); the mother being exposed to X-ray during pregnancy 1.89 (0.84-4.22); previous abortions before the child with leukemia was born 2.44 (1-06-5.68); being born from full term birth 2.42 (0.47-16.65); being born with weight greater that 3500 g 2.21 (1.04-4.33); being exposed to fertilizers 4.73 (1.04-24.14) and insecticides 1.93 (1.05-3.56). OR smaller than 1 was found in those who have been in a hospital because of an infectious disease during the first year of life 0.57 (0.17-1.74); to have suffered from chicken pox 0.59 (0.32-1.08). No association to parent's age or job was found. Multivariated analysis shows that the exposure to insecticide is the most important risk factor associated with the development of leukemia in children. CONCLUSIONS: We obtained positive associations to different risk factors described in the literature, having found that exposure to fertilizers is the most important risk factor and finding no association with the parent's occupation. This leads to the need of carrying out further studies to investigate, in more detail, the occupation of the father to confirm whether or not this is a risk factor.

[Rosette forming lymphocytes as prognostic indices in idiopathic thrombocytopenic purpura]. / Linfocitos formadores de rosetas como índices pronósticos en la trombocitopenia idiopática.

The study included 12 patients with acute ITP to whom subpopulations of rosette forming lymphocytes were determined in peripheral blood and in serial form, the number of platelets to establish a correlation as prognostic index in the evolution of the disease. No correlation was found between the progressive increment of platelets in the evolution of the disease. However, in patients with a tendency to remission, the percentage of E(T) rosette forming lymphocytes was low and normal that of EAC (B) lymphocytes. Dissimilarly, it was seen that in patients without tendency to remission, the percentage of T and B rosette forming lymphocytes was within normal limits. This seems to show that determination of the subpopulations of lymphocytes may be useful as a prognostic index in this stage of the disease.

[Blastic crisis and cerebral leukotaxis in a case of lymphoblastic acute leukemia]. / Crisis blástica y leucostásis cerebral en un caso de leucemia aguda linfoblástica

The present report deals with the case of an eleven-years-old child with acute lymphoblastic leukemia who showed blastic crises, leukostasis and cerebral hemorrhage. The pathogenesis of these complications is analyzed and some therapeutic rules are outlined.

[Hemangiolymphangioma of the abdominal cavity complicated with consumption coagulopathy]. / Hemangiolinfangioma de cavidad abdominal complicado con coagulopatía por consumo

A case of giant hemangiolymphangioma of abdominal cavity is reported. It showed severe bleeding from consumption coagulopathy and secondary fibrinolysis. (Kasabach-Merritt syndrome). A review is made of the production mechanism of coagulation abnormalities that may accompany vascular neoplasias, the usefulness of anticoagulants and the selective treatment in this type of disease.