Refine
Has Fulltext
- yes (14)
Is part of the Bibliography
- yes (14)
Document Type
- Journal article (14)
Language
- English (14) (remove)
Keywords
- therapy (3)
- children (2)
- pediatric (2)
- pediatric adrenocortical cancer (2)
- pediatric adrenocortical tumor (2)
- B cell (1)
- Central venous access (1)
- Cushing (1)
- ESPED (1)
- Hickman catheter (1)
- IL-10 (1)
- MDSC (1)
- MTL30 (1)
- PLAG1 rearrangement (1)
- Pediatric malignancy (1)
- Port (1)
- Thrombosis (1)
- Varizellen-Virus (1)
- acute ITP (1)
- adolescents (1)
- adrenal surgery (1)
- adrenalectomia (1)
- adrenocortical adenocarcinoma (1)
- autoimmunity (1)
- bleding disorders other than hemophilia (1)
- bleeding score (1)
- case report (1)
- central venous catheter (1)
- childhood leukemia (1)
- cidofovir (1)
- coagulopathy (1)
- complication (1)
- exercise testing (1)
- exercise tolerance (1)
- factor XIII deficiency (1)
- forearm (1)
- hematology (1)
- hemostasis and thrombosis (1)
- hyperfibrinolysis (1)
- interventional radiology (1)
- intravenous immunoglobulins (1)
- leukemia (1)
- lipoblastoma (1)
- macrophages (1)
- monocyte-derived DC (1)
- neuroblastoma – diagnosis (1)
- newly diagnosed ITP (1)
- outcome (1)
- pediatric adrenocortical adenoma (1)
- pediatric adrenocortical carcinoma (1)
- pediatric immune thrombocytopenia (1)
- pediatric stem cell transplantation (1)
- pediatrics (1)
- perioperative bleeding (1)
- physical activity (1)
- platelet disorders (1)
- prognostic factors (1)
- radiotherapy (1)
- regulatory dendritic cells (1)
- retroperitoneal tumor (1)
- totally implantable venous access port (1)
- treatment (1)
- treatment guidelines (1)
- tumor (1)
- varicella-zoster virus immunosuppression (1)
- vascular access (1)
- volume (1)
Institute
- Kinderklinik und Poliklinik (14)
- Klinik und Poliklinik für Allgemein-, Viszeral-, Gefäß- und Kinderchirurgie (Chirurgische Klinik I) (5)
- Comprehensive Cancer Center Mainfranken (4)
- Medizinische Klinik und Poliklinik I (4)
- Theodor-Boveri-Institut für Biowissenschaften (3)
- Institut für diagnostische und interventionelle Radiologie (Institut für Röntgendiagnostik) (2)
- Institut für Experimentelle Biomedizin (1)
- Institut für Humangenetik (1)
- Klinik und Poliklinik für Nuklearmedizin (1)
- Pathologisches Institut (1)
B cells and DCs are suspected to play an important role in the pathogenesis of cGvHD, which is a serious complication of HSCT with high morbidity. It is characterized by immune responses of donor immune cells against recipient-derived antigens. athogenesis is not yet fully understood, however reconstitution of B cells after HSCT has similarities to physiologic ontogeny. Immunophenotyping and co-cultivation-experiments of B cells and DCs from pediatric patients with cGvHD as well as healthy donors were conducted. Significant differences between patients and healthy donors were observed with increased memory, transitional, CD69+ and CD86+ phenotype and lower levels of naïve B cells due to apoptosis. Co-cultivation revealed this to be primarily B cell-dependent without major effects of and with DCs. There was a decreased CD11c- phenotype in patients and less apoptosis of DCs. Our data suggest a disturbed homeostasis in B cells with increased memory phenotype in patients, whereas DCs could not influence these differences, therefore DCs are not imposing as promising targets. B cell-dependent approaches should be further investigated.
Background
Reliable central venous access (CVC) is essential for hematology–oncology patients since frequent puncture of peripheral veins—e.g., for chemotherapy, antibiotic administration, repeated blood sampling, and monitoring—can cause unacceptable pain and psychological trauma, as well as severe side effects in cases of extravasation of chemotherapy drugs. However, CVC lines still carry major risk factors, including thrombosis, infection (e.g., entry site, tunnel, and luminal infections), and catheter dislocation, leakage, or breakage.
Methods
Here we performed a retrospective database analysis to determine the incidence of CVC-associated thrombosis in a single-center cohort of 448 pediatric oncologic patients, and to analyze whether any subgroup of patients was at increased risk and thus might benefit from prophylactic anticoagulation.
Results
Of the 448 patients, 269 consecutive patients received a CVC, and 55 of these 269 patients (20%) also had a thrombosis. Of these 55 patients, 43 had at least one CVC-associated thrombosis (total number of CVC-associated thrombosis: n = 52). Among all patients, the median duration of CVC exposure was 464 days. Regarding exposure time, no significant difference was found between patients with and without CVC-associated thrombosis. Subclavia catheters and advanced tumor stages seem to be the main risk factors for the development of CVC-associated thrombosis, whereas pharmacologic prophylaxis did not seem to have a relevant impact on the rate of thrombosis.
Conclusions
We conclude that pediatric surgeons and oncologists should pay close attention to ensuring optimal and accurate CVC placement, as this appears the most effective tool to minimize CVC-associated complications.
Varicella-zoster virus infections in immunocompromised patients - a single centre 6-years analysis
(2011)
Background: Infection with varicella-zoster virus (VZV) contemporaneously with malignant disease or immunosuppression represents a particular challenge and requires individualized decisions and treatment. Although the increasing use of varicella-vaccines in the general population and rapid initiation of VZVimmunoglobulins and acyclovir in case of exposure has been beneficial for some patients, immunocompromised individuals are still at risk for unfavourable courses. Methods: In this single center, 6-year analysis we review incidence, hospitalization and complication rates of VZVinfections in our center and compare them to published data. Furthermore, we report three instructive cases. Results: Hospitalization rate of referred children with VZV-infections was 45%, among these 17% with malignancies and 9% under immunosuppressive therapy. Rate of complications was not elevated in these two high-risk cohorts, but one ALL-patient died due to VZV-related complications. We report one 4-year old boy with initial diagnosis of acute lymphoblastic leukemia who showed a rapidly fatal outcome of his simultaneous varicella-infection, one 1.8-year old boy with an identical situation but a mild course of his disease, and an 8.5-year old boy with a steroiddependent nephrotic syndrome. This boy developed severe hepatic involvement during his varicella-infection but responded to immediate withdrawl of steroids and administration of acyclovir plus single-dose cidofovir after nonresponse to acyclovir after 48 h. Conclusion: Our data show that patients with malignant diseases or immunosuppressive therapy should be hospitalized and treated immediately with antiviral agents. Despite these measures the course of VZV-infections can be highly variable in these patients. We discuss aids to individual decision-making for these difficult situations.