Catalogo Articoli (Spogli Riviste)

OPAC HELP

Titolo:
TOXICITIES OF TOTAL-BODY IRRADIATION FOR PEDIATRIC BONE-MARROW TRANSPLANTATION
Autore:
CHOU RH; WONG GB; KRAMER JH; WARA DW; MATTHAY KK; CRITTENDEN MR; SWIFT PS; COWAN MJ; WARA WM;
Indirizzi:
UNIV CALIF SAN FRANCISCO,DEPT RADIAT ONCOL,505 PARNASSUS,ROOM L-08 SAN FRANCISCO CA 94143 UNIV CALIF SAN FRANCISCO,DEPT RADIAT ONCOL SAN FRANCISCO CA 94143 UNIV CALIF SAN FRANCISCO,DEPT PEDIAT SAN FRANCISCO CA 94143
Titolo Testata:
International journal of radiation oncology, biology, physics
fascicolo: 4, volume: 34, anno: 1996,
pagine: 843 - 851
SICI:
0360-3016(1996)34:4<843:TOTIFP>2.0.ZU;2-X
Fonte:
ISI
Lingua:
ENG
Soggetto:
SEVERE COMBINED IMMUNODEFICIENCY; ACUTE LYMPHOBLASTIC-LEUKEMIA; SOYBEAN AGGLUTININ; RADIATION; DISEASE; CYCLOPHOSPHAMIDE; FRACTIONATION; CHILDHOOD; REMISSION; DONORS;
Keywords:
TOTAL BODY IRRADIATION; TOXICITY; PEDIATRIC BONE MARROW TRANSPLANTATION;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Science Citation Index Expanded
Citazioni:
45
Recensione:
Indirizzi per estratti:
Citazione:
R.H. Chou et al., "TOXICITIES OF TOTAL-BODY IRRADIATION FOR PEDIATRIC BONE-MARROW TRANSPLANTATION", International journal of radiation oncology, biology, physics, 34(4), 1996, pp. 843-851

Abstract

Purpose: To determine the acute and tate effects, including cognitivefunction, of total body irradiation (TBI) and chemotherapy for bone marrow transplant (BMT) in children with immunodeficiency or hematologic disorders. Methods and Materials: At UCSF, 15 children with immunodeficiency disorders and 58 children with leukemia received chemoradiotherapy between July 1982 and November 1993 and were evaluated for toxicity. Patients with severe combined immunodeficiency disorder (SCID) received 7 Gy TBI while leukemia patients received 12 Gy TBI. Results: Eight immunodeficient patients (53%) are alive at 4 months to 11 years posttransplant. Acute toxicity was limited and treatment well tolerated. Most patients developed mild nausea and vomiting, skin rash, or erythema. Transient fever/chills, oral mucositis, and alopecia were notedin approximately 50% of patients. Seventy-three percent of patients demonstrated acute liver dysfunction, but only four (27%) developed veno-occlusive disease. All children had decreased growth velocity but normal growth hormone levels. Other endocrinologic evaluations includingadrenocorticotropic hormone (ACTH), cortisol, and thyroid hormones were normal. Only one evaluable girl had delayed puberty with late onsetof secondary sexual characteristics. Neuropsychological testing demonstrated an intelligence quotient (IQ) reduction between the baseline and 1 year post-BMT, with some recovery at 3 years. Only one patient developed a clinically significant cataract. Thirteen percent of patients had chronic interstitial lung disease. Four children developed exostosis. Only 1 of the 15 children developed a second malignancy (acute myelogenous leukemia) at age 5, 51 months posttransplant for SCID. For patients with leukemia, similar toxicities were observed, Twenty-nine percent disease-free survival was noted with a mean follow-up of 4.7 years. Twenty-two percent had chronic interstitial lung disease and twopatients were diagnosed with cataracts. Graft-vs.-host-disease (GVHD), pubertal developmental arrest, and delayed puberty were seen. One child developed papillary thyroid carcinoma, 49 months post-BMT. Similarneuropsychological testing decrements were also observed, Conclusion:Our experience suggests that intensive chemoradiotherapy, even at a young age, does not cause severe, acute, or late toxicities but does result in a small IQ decrement and the risk of second malignancy in children with long-term follow-up.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 13/07/20 alle ore 19:53:21