RESUMO
BACKGROUND: Encouraging results have been reported with high dose chemotherapy and total body radiation followed by bone marrow autotransplantation in children with advanced neuroblastoma; however, relapse remains a significant problem. METHODS: The authors treated 22 children with advanced neuroblastoma with high dose chemotherapy, surgery, intraoperative radiation, and a bone marrow autotransplant (treated in vitro to remove tumor cells) followed by 13-cis-retinoic acid. RESULTS: The 3-year relapse rate was 25% (95% confidence interval [CI], 6-44%). The 3-year disease free survival rate was 72% (95% CI, 52-92%). Toxicities included hemolytic uremic syndrome, herpes infection, and hepatic venoocclusive disease. CONCLUSION: These data suggest that this treatment strategy offers an increased rate of 3-year disease free survival. The nonrandomized nature of this study and its use of multiple modalities precludes the analysis of the specific contribution of each treatment component and comparison with conventional therapy.
Assuntos
Transplante de Medula Óssea , Neuroblastoma/cirurgia , Purging da Medula Óssea , Transplante de Medula Óssea/efeitos adversos , Criança , Pré-Escolar , Terapia Combinada , Feminino , Humanos , Lactente , Masculino , Transplante Autólogo , Resultado do TratamentoRESUMO
To establish mineral and trace element requirements for very low birth it is important to prevent bone mineral disorder. Those infants fed mother's milk only are thought to be at higher risk of this disorder. Both calcium and phosphorus supplementation were thought to be needed to prevent it. Copper and zinc are important as cofactors of major enzymes involved in the synthesis of collagen. These trace elements especially zinc may not be enough for very low birth weight infants fed mother's milk. At present however the relationship between these trace elements and minerals, and bone metabolic disease in preterm infants is not completely clear.
Assuntos
Recém-Nascido de Baixo Peso/metabolismo , Doenças do Prematuro/metabolismo , Minerais/metabolismo , Necessidades Nutricionais , Raquitismo/metabolismo , Oligoelementos/metabolismo , Humanos , Incidência , Fenômenos Fisiológicos da Nutrição do Lactente , Recém-Nascido , Doenças do Prematuro/epidemiologia , Raquitismo/epidemiologiaRESUMO
As fracture is known to occur more easily in severely handicapped children (SHC), bone mineral content, serum zinc level and serum vitamin C level were determined in 65 SHC. These parameters were found to be greatly reduced in all patients. The decreases in zinc and vitamin C in the serum appeared to be associated with that in bone mineral content. Supplements of zinc and vitamin C may be important to decrease the chance of fracture due to diminished bone mineral content in SHC.