RESUMO
BACKGROUND: Few epidemiological studies of pediatric central nervous system (CNS) tumors have been performed using data from Southeast Asian national registries. Therefore, we aimed to examine data on CNS tumors from the first national childhood CNS tumor registry in Thailand. METHODS: Newly diagnosed children with benign and malignant primary CNS tumors from 20 nationwide hospitals were included. Two eras in the Thai registry were studied to compare national protocol effectiveness, including 2003-2005 (before establishment of a pediatric CNS tumor protocol) and 2011-2012 (post-establishment). RESULTS: The first study period had 300 patients with an incidence of 7.5/1,000,000 person-years and the second had 168 patients with an incidence of 13.24/1,000,000 person-years. The three most common tumors were gliomas, medulloblastoma/primitive neuroectodermal tumor (PNET), and germ cell tumors. The most common tumor site was the cerebellum, followed by the brainstem and pineal region. Five- and 10-year overall survival (OS) rates were 46.62% (95% confidence interval [CI] 40.85-52.18) and 41.78% (95% CI 36.11-47.34), respectively, for the first period. The second period had a 5-year OS of 64.75% (95% CI 56.70-71.68). OS rates for gliomas, germ cell tumors, medulloblastoma/PNET, and ependymomas were better in the second period than in the first period. CONCLUSIONS: The incidence of primary childhood CNS tumors in our study is lower compared with other reports. Improvement of OS in the second study period might be because of establishment of the Thai Pediatric Oncology Group, and national protocols for childhood CNS tumors.
Assuntos
Neoplasias do Sistema Nervoso Central/epidemiologia , Tumores Neuroectodérmicos Primitivos/epidemiologia , Sistema de Registros/estatística & dados numéricos , Adolescente , Neoplasias do Sistema Nervoso Central/diagnóstico , Criança , Pré-Escolar , Feminino , Seguimentos , Humanos , Incidência , Lactente , Recém-Nascido , Masculino , Tumores Neuroectodérmicos Primitivos/diagnóstico , Prognóstico , Taxa de Sobrevida , Tailândia/epidemiologiaRESUMO
BACKGROUND: The incidences of thromboembolism (TE) in neonates were reported to be around 0.51 per 10,000 live births per year for overall TE and 24 per 10,000 NICU admissions per year. As the incidences of TE in children and adults are lower in Asian populations, the incidences, risk factors, and outcomes of neonatal TE may be different to those reports from other countries. OBJECTIVES: To determine the incidences, risk factors, and outcomes of neonatal TE in a tertiary care hospital in Thailand. MATERIALS AND METHODS: A retrospective study between the years 1998 and 2015. RESULTS: From a total of 2463 neonatal admissions, 28 patients were diagnosed with TE. The female/male ratio was 1:1.2. The breakdown of diagnoses of neonatal TE were arterial ischemic stroke (AIS; 36%), arterial TE (ATE; 29%), deep vein thrombosis (DVT; 14%), cerebral venous sinus thrombosis (CVST; 11%), renal vein thrombosis (RVT; 3%), and purpura fulminans (2%). Underlying diseases were identified 57.1% of patients. The most common thrombophilic risk factor was protein C (PC) deficiency (14.3%). The overall mortality rate was 14.3%. CONCLUSION: The most common TE was AIS. PC deficiency was the most prevalent inherited risk factor, especially in neonates without precipitating factors.
Assuntos
Tromboembolia/epidemiologia , Feminino , Humanos , Incidência , Recém-Nascido , Masculino , Estudos Retrospectivos , Fatores de Risco , Centros de Atenção Terciária , Tailândia/epidemiologiaRESUMO
The prevalence of protein S (PS) deficiency in Asian patients with venous thromboembolism is around 8-30%, higher than that in Caucasian populations. The present study reports the genotypes (including one novel mutation) and phenotypes of children with PS deficiency at a tertiary care institute. A total of six patients were included, three with arterial ischemic stroke, two with cerebral venous sinus thrombosis, and one with deep vein thrombosis. PS mutations were identified in four patients: p.R355C, p.G336D, p.E67A, and p.N188KfsX9. p.N188KfsX9 is a novel mutation with less than 20% PS activity noted in heterozygotes.
Assuntos
Deficiência de Proteína S/epidemiologia , Deficiência de Proteína S/genética , Trombose dos Seios Intracranianos/genética , Acidente Vascular Cerebral/genética , Tromboembolia/epidemiologia , Tromboembolia/genética , Trombose Venosa/genética , Adolescente , Criança , Pré-Escolar , Feminino , Genótipo , Humanos , Masculino , Fenótipo , Reação em Cadeia da Polimerase , Deficiência de Proteína S/patologia , Estudos Retrospectivos , Tailândia/epidemiologiaRESUMO
Survivors of childhood acute lymphoblastic leukemia (ALL) are at risk of long-term late effects. Therefore, systematic screenings of the late complications are essential. The objective of this study was to determine the prevalence of late effects of Thai children and adolescents after completion of ALL therapy. We performed a cross-sectional study for evaluation of the late effects in ALL survivors who came for follow-up at 10 pediatric oncology centers in Thailand. We evaluated the treatment-related late complications of children and adolescents who had finished ALL treatment for at least 2 years. Demographic data, treatment modalities, and late effects were recorded and analyzed. There were 258 survivors with a median age of 12.2 years (range 3.6-23.3 years). The median follow-up time was 7.2 years (range 2-17.5 years). Forty-seven percent (122 cases) suffered from at least one late effect. Overweight/obesity was the most common late effect. Radiation of central nervous system was a significant risk factor for overweight/obesity (OR 1.97, 95% CI 1.02-3.81) and educational problems (OR 4.3, 95% CI 1.32-14.02). Our data have demonstrated a significant prevalence of late effects after childhood ALL therapy. A long-term follow-up program for survivors of childhood cancer is therefore needed in our country.
