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The article presents information the research conducted on the correlation of radiotherapy and no radiotherapy with the chemotherapy regimens namely vinblastine, adriamycin (doxorubicin), methotrexate, and prednisone with respect to the survival of the children with the favorable-risk Hodgkin lymphoma. The late toxic effect of the therapy resulted in the increase in the mortality rate of the children who got their Hodgkin lymphoma diagnosis. Information on the use of limited radiotherapy for the increase in the survival of the children is also presented.

The article describes the case of a five-day-old-baby girl who was hospitalized due to worsening rash from births and leukocytosis with blasts. Body temperature of the infant on admission was 37.2° Celsius. Periorbital edema was discovered during physical examination. Vancomycin, cefotaxime, gentamicin, acyclovir as well as fluids containing glucose and sodium bicarbonate were administered intravenously. Lesions consistent with herpes simplex were found by an ophthalmologic consultant. Differential diagnosis is provided.

The article offers information on the children and adolescents outcomes with CNS-positive (CNS+) Burkitt lymphoma (BL) or other mature B-NHL by using intrathecal and systemic chemoimmunotherapy; and mentions both trials illustrate that children, adolescents and young adults with high-risk CNS+ mature B-NHL have outstanding outcomes when CNS radiation is replaced with CNS-directed systemic and IT chemotherapy.

Patient-specific primers from 10 children/adolescents with Burkitt leukaemia (BL) ± central nervous system disease who were treated with French-British-American/Lymphome Malins de Burkitt 96 C1 plus rituximab were developed from diagnostic blood/bone marrow. Minimal residual disease ( MRD) was assessed by real-time polymerase chain reaction at the end of induction ( EOI) and consolidation ( EOC). Seventy per cent (7/10) and 71% (5/7) were MRD-positive at EOI and EOC, respectively, with no disease recurrences. MRD after induction and consolidation did not predict relapse and subsequent therapy appeared to eliminate MRD. Thus, assessing MRD at a later time point is warranted in future trials to determine its clinical significance. [ABSTRACT FROM AUTHOR]

Children and adolescents with Burkitt Lymphoma ( BL) and combined central nervous system ( CNS) and bone marrow involvement still have a poor prognosis with chemotherapy alone. We therefore investigated in children and adolescents with bone marrow (≥25% blasts) and/or CNS-positive Burkitt lymphoma the chemoimmunotherapy combination of rituximab (375 mg/m2) and the standard chemotherapy arm of our previously reported French- American- British ( FAB) Lymphome Malins de Burkitt ( LMB) 96 trial. Central pathological and cytogenetic characterization was also performed. There were 40 evaluable patients with Burkitt histology (25 with leukaemia and 15 with CNS disease ± leukaemia). The chemoimmunotherapy regimen was well tolerated. The incidence of grade III/ IV mucositis during induction cycles with combined chemotherapy and rituximab was 31% and 26%, respectively. The 3-year event-free survival ( EFS)/overall survival ( OS) was 90% (95% confidence interval [ CI], 76-96%) in the entire cohort and 93% (95% CI, 61-99%) in patients with CNS disease. Based on the results of this trial, an international randomized study of FAB/ LMB 96 chemotherapy ± rituximab for high-risk patients is currently under investigation. [ABSTRACT FROM AUTHOR]

The Children's Oncology Group's A5971 trial examined central nervous system ( CNS) prophylaxis and early intensification in paediatric patients diagnosed with CNS-negative Stage III and IV lymphoblastic lymphoma. Using a 2 × 2 factorial design, the study randomized patients to Children's Cancer Group ( CCG) modified Berlin-Frankfurt-Muenster ( BFM) acute lymphoblastic leukaemia ( ALL) regimen with intensified intrathecal ( IT) methotrexate ( MTX) (Arm A1) or an adapted non-Hodgkin lymphoma/ BFM-95 therapy with high dose MTX in interim maintenance but no IT- MTX in maintenance (Arm B1) . Each cohort was randomized ± intensification (cyclophosphamide/anthracycline) (Arms A2/B2). For the 254 randomized patients, there was no difference in 5-year event-free survival ( EFS) for the four arms: Arm A1 , 80% [95% confidence interval ( CI) 67-89%] and Arm A2 , 81% (95% CI 69-89%); Arm B1 , 80% (95% CI 68-88%) and Arm B2 , 84% (95% CI 72-91%). The cumulative incidence of CNS relapse was 1·2%. Age <10 years and institutional imaging response at 2 weeks was associated with improved outcomes ( P < 0·001 and P = 0·014 for overall survival). CNS positive patients ( n = 12) did poorly [5-year EFS of 63% (95% CI 29-85%)]. For CNS-negative patients, there was no difference in outcome based on CNS prophylaxis ( IT- MTX versus HD- MTX) or with intensification. [ABSTRACT FROM AUTHOR]

Pediatric follicular lymphoma (PFL) Is a variant of follicular lymphoma (FL) pre-senting as localized lymphadenopathy in children. Unlike conventional adult FL, PFL typically does not recur or progress. Clear diagnostic criteria for PFL are lack-ing, and it is uncertain whether this indo-lent lymphoma is defined by age or may occur In adults. We analyzed 27 FL in patients < 40 years of age and found that all 21 cases that lacked a BCL2 gene abnormality (BCL2-N; P < .0001) and had > 30% Ki67 fraction (high proliferation index, HPI; P = .0007) were stage I and did not progress or recur; in comparison, all 6 cases with BCL2 rearrangement and/or PI < 30% were stage lll/IV, and 5 of 6 recurred or progressed. In a separate cohort of 58 adult FL (> 18 years of age), all 13 BCL2-N/HPI cases were stage I, and none progressed or relapsed, whereas 11 of 15 stage I cases with BCL2 gene abnormality and/or LPI relapsed or progressed (P = .0001). The adult and pediatric BCL2-N/ HPI FL cases had similar morphologic fea-tures. Our results confirm the highly indo-lent behavior of PFL and suggest that these are characterized by HPI and absence of BCL2 gene abnormality. PFL-like cases also occur in adults and are associated with indolent behavior in this patient population. [ABSTRACT FROM AUTHOR]

Summary Relapse remains the leading cause of death in patients with acute myeloid leukaemia (AML). Relatively few new chemotherapy agents have been proven to be effective in this population. We report on a Phase 2 clinical trial using the novel combination of 2-chlorodeoxyadenosine (2-CDA) (8 mg/m2 per d × 5 d) plus idarubicin (Ida) (10 mg/m2 per d × 3 d). The study involved 109 paediatric patients with AML at first relapse, of whom 104 were available for analysis. The overall response rate was 51% (complete response [CR] + partial response) with a CR rate of 46%. 2-year event-free survival (EFS) and overall survival (OS) were 20% and 26%. The only significant variable in determining response, EFS and OS was duration of initial remission, with patients who had an initial remission >1 year having much worse outcomes overall (response rate 74% vs. 25%, EFS 8% vs. 37% and OS of 16% vs. 39%, P < 0·01 for all). There was an acceptable toxicity profile with one neurological event and no cardiac events observed. The most common grade 3-4 toxicities observed were neutropenia (59%) and thrombocytopenia (68%). This study demonstrated that the novel combination of 2-CDA/Ida was effective and should be considered for incorporation in front line therapy for children with AML. [ABSTRACT FROM AUTHOR]

The outcome for children with acute megakaryoblastic leukemia (AMKL) remains poor, except for cases associated with Down syndrome (DS). This study compared immunophenotypic and drug sensitivity patterns of childhood AMKL cases with or without DS. All DS-AMKL cases showed high expression of CD36 and were very sensitive to cytarabine and daunorubicin in vitro. In children without DS, high expression of CD36 on AMKL blasts identified a sub-group with immunophenotypic and drug sensitivity patterns similar to that of DS AMKL. Among non-DS AMKL patients, CD36-high cases had a superior outcome compared with CD36-negative cases. CD36 expression in acute myeloid leukemia cases other than AMKL was not associated with increased in vitro drug sensitivity. CD36 expression in AMKL may be an indicator of megakaryoblast maturation and chemotherapy sensitivity. [ABSTRACT FROM AUTHOR]

Seven morphologists examined 382 slide and 82 non-slide, post-Chernobyl pediatric acute leukemia (AL) cases in radiation-exposed areas of Belarus, Russia and Ukraine; part of a case-control study by the International Consortium for Research on the Health Effects of Radiation. Among the slide cases, 99% were confirmed as AL: 92% acute lymphoid leukemia (ALL) and 86% acute myeloid leukemia (AMD demonstrating the utility of FAB classification for distinguishing ALL and AML. Among the non-slide cases, 79% were confirmed as AL: 84% ALL, and 71% AML. This study affirms AL diagnostic accuracy during a time of social upheaval in the former Soviet Union. [Copyright &y& Elsevier]

Assesses the adaption of histology-based approach in the management of pediatric non-Hodgkin lymphomas. Determination of overall and event free survival of children with lymphomas; Incidence of bone marrow suppression; Efficacy of cyclophosphamide in the treatment of the disease.

Discusses results of a phase III trial in the management of advanced stage diffuse large cell non Hodgkin's lymphoma (DLCL) in children and adolescents. Patient characteristics; Overall and event free survival; Effects of cyclophosphamide treatment; Mortality; Drug side effects.

Reports a case in which a natural-killer-cell lymphoma was transferred from mother to fetus. Nature of the placenta; Avoidance of immune rejection of the allogeneic fetus by the mother's body; Rarity of vertical transmission of cancer; Transmission of malignant melanoma; Case reports on the mother and infant; Methods; Results; Discussion; Death of the infant.

Background: The value of autologous bone marrow transplantation in the treatment of children with acute myeloid leukemia (AML) is unknown. We compared autologous bone marrow transplantation with intensive consolidation chemotherapy as treatments for children with AML in first remission. Methods: We induced remission with one course of daunorubicin, cytarabine, and thioguanine, followed by one course of high-dose cytarabine (3 g per square meter of body-surface area for six doses). Patients in remission after the second course of induction therapy were eligible for randomization. Between June 1988 and March 1993, 552 of 649 enrolled patients who could be evaluated (85 percent) entered remission. A total of 209 patients were not eligible for randomization; of the remaining 343 patients, 232 were randomly assigned to receive six courses of intensive chemotherapy (117 patients) or autologous transplantation (115 patients). Of the original 649 patients, 189, including 21 with Down's syndrome, were nonrandomly assigned to receive intensive chemotherapy. Results: The mean (±SE) rates of event-free survival and overall survival for the entire group at three years were 34±2.5 percent and 42±2.6 percent, respectively. For patients who were randomly assigned to one of the two treatment groups, the rates of event-free survival three years after randomization were not significantly different in the two groups when examined by intention-to-treat analysis: 36±5.8 percent for the intensive-chemotherapy group as compared with 38±6.4 percent for the autologous-transplantation group; and the relative risk of treatment failure for the chemotherapy group as compared with the autologous-transplantation group was 0.81 (P = 0.20 by the log-rank test; 95 percent confidence interval, 0.58 to 1.12). Overall survival at three years followed a similar pattern. There was a lower relapse rate (31 percent vs. 58 percent, P<0.001) but a higher rate of treatment-related mortality (15 percent vs. 2.7 percent, P = 0.005) in the group treated with autologous transplantation than in the intensive-chemotherapy group. The event-free survival at three years for the nonrandomized intensive-chemotherapy group was 39±5.1 percent, and for a contemporaneous group of patients each of whom received a histocompatible bone marrow transplant from a sibling, it was 52±8.0 percent. Conclusions: Treatment of children with AML in first remission with either autologous bone marrow transplantation or intensive chemotherapy prolongs event-free survival equally. (N Engl J Med 1996;334:1428-34.) [ABSTRACT FROM AUTHOR]