RESUMO
We present the first case of concomitant hip and jaw osteonecrosis in a 10-year-old child with aplastic anemia undergoing a transplant. Biphosphonate treatment may be beneficial for hip osteonecrosis but harmful for jaw osteonecrosis. Our experience suggests that clinicians should be cautious when prescribing bisphosphonate to children with simultaneous hip and jaw osteonecrosis. They should be aware of the osteonecrosis locations and treatment choices.
Assuntos
Acidose Láctica , Beriberi , Deficiência de Tiamina , Encefalopatia de Wernicke , Humanos , Deficiência de Tiamina/complicações , Deficiência de Tiamina/diagnóstico , Encefalopatia de Wernicke/diagnóstico , Encefalopatia de Wernicke/etiologia , Encefalopatia de Wernicke/tratamento farmacológico , Acidose Láctica/etiologia , Acidose Láctica/diagnóstico , Beriberi/diagnóstico , Beriberi/complicações , Beriberi/tratamento farmacológico , Beriberi/etiologia , Masculino , Tiamina/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Protocolos de Quimioterapia Combinada Antineoplásica/efeitos adversos , Criança , Leucemia-Linfoma Linfoblástico de Células Precursoras/complicações , Leucemia-Linfoma Linfoblástico de Células Precursoras/diagnóstico , FemininoAssuntos
Anemia Aplástica , Antifúngicos , Mucormicose , Rhizopus , Humanos , Mucormicose/diagnóstico , Mucormicose/microbiologia , Anemia Aplástica/complicações , Anemia Aplástica/terapia , Rhizopus/isolamento & purificação , Antifúngicos/uso terapêutico , Masculino , Criança , Diabetes Mellitus , Resultado do Tratamento , Complicações do Diabetes/microbiologiaRESUMO
Hematopoietic stem cell transplantation is a curative treatment for many malignant and nonmalignant diseases in children and adults. It is performed with peripheral blood stem cells, bone marrow, and umbilical cord blood. Anaphylaxis may occur during hematopoietic stem cell transplantation, similar to that shown with blood transfusions. In children, although a few cases of anaphylaxis have been reported with cord blood transplantation, no cases of anaphylaxis have been reported with other hematopoietic stem cell transplantations. In this case report, we present the cases of 2 children, one diagnosed with thalassemia major and the other with aplastic anemia, both of whom developed anaphylaxis associated with bone marrow transplantation products cryopreserved with dimethyl sulfoxide and hydroxyethyl starch. Hematopoietic stem cell transplantation-induced anaphylaxis could be associated with cryoprotective agents, especially dimethyl sulfoxide, and alloantigens. In both anaphy-lactic reactions, dimethyl sulfoxide was thought to be the trigger, but it could not be excluded that it was related to stem cell components, plasma, or hydroxyethyl starch.
Assuntos
Anafilaxia , Dimetil Sulfóxido , Transplante de Células-Tronco Hematopoéticas , Humanos , Anafilaxia/diagnóstico , Anafilaxia/terapia , Anafilaxia/etiologia , Anafilaxia/imunologia , Transplante de Células-Tronco Hematopoéticas/efeitos adversos , Masculino , Dimetil Sulfóxido/efeitos adversos , Feminino , Anemia Aplástica/terapia , Anemia Aplástica/imunologia , Anemia Aplástica/diagnóstico , Talassemia beta/terapia , Talassemia beta/imunologia , Talassemia beta/complicações , Talassemia beta/diagnóstico , Crioprotetores/efeitos adversos , Criopreservação , Resultado do Tratamento , Transplante Homólogo , Criança , Derivados de Hidroxietil Amido/efeitos adversos , Pré-EscolarRESUMO
PURPOSE: The aim of this study was to evaluate the prognostic value of PET-derived metabolic features and textural parameters of primary tumors in pediatric sarcoma patients. METHODS: The imaging findings of 43 patients (14 girls and 29 boys; age 11.4 ± 4.4 years) who underwent 18-fluorodeoxyglucose positron emission tomography (PET)/computed tomography for primary staging prior to therapy between 2005 and 2020 were retrospectively evaluated. The diagnoses were osteosarcoma in 10, rhabdomyosarcoma in 10, and Ewing sarcoma in 23 patients. PET metabolic data and textural features of primary tumors were obtained. Cox proportional hazards regression models were used to identify predictors for progression-free survival and overall survival. Survival curves were estimated by using the Kaplan-Meier method. RESULTS: Distant metastases were detected in primary staging in 13 patients (30.2%). The median follow-up duration after diagnosis was 28 months (range: 10-171 months). In multivariate Cox regression analysis, the presence of distant metastasis and neighborhood grey-level difference matrix_Contrast (ngldm_Contrast) were found as independent predictors for both progression-free survival and overall survival. Grey-level zone length matrix_Zone-length nonuniformity (glzlm_ZLNU) was also found as an independent predictor for overall survival. The Kaplan-Meier survival analysis showed that higher ngldm_Contrast and glzlm_ZLNU values of primary tumors were significantly associated with shorter progression-free survival and overall survival. CONCLUSION: In addition to the presence of distant metastasis at initial diagnosis, textural features of primary tumors may be used as prognostic biomarkers to identify patients with worse prognosis in pediatric sarcoma. Higher tumor heterogeneity is significantly associated with shorter progression-free survival and OS.