Articole semnate de acelasi autor in Revista Romana de Pediatrie:

MANIFESTARI CLINICE IN PERIOADELE DE APLAZIE SECUNDARA CHIMIOTERAPIEI

Revista Romana de PEDIATRIE | Volumul LXIV, Nr. 4, An 2015

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

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Zsuzsanna Erzsebet Papp and Maria-Adriene Horvath

REZUMAT

Obiectiv. Evidenţierea semnelor şi simptomelor clinice ale aplaziilor medulare secundare chimioterapiei anticanceroase de atac.
Material şi metodă. Lotul de studiu cuprinde 20 copii (9 luni-18 ani) spitalizaţi în compartimentul hematooncologie pediatrică al Spitalului Clinic Judeţean Mureş – secţia clinică de Pediatrie, cu următoarele diagnostice: Leucemia acută limfoblastică – LAL, tumoră Wilms – WT, Leucemie acută mieloblastică – LAM, Limfom Hodgkin – LH, Limfom cu celule mari anaplastice non-Hodgkin – LNH, tumoră cu celule mici rotunde desmoplazice – TD, Neuroblastom presacrat tratat şi recidivate – NB. Criteriul de includere în studiu a fost chimioterapia de atac, iar de excludere tratamentul citostatic de întreţinere. S-a alcătuit un protocol de supraveghere clinico-biologică în dinamică, adresat cu precădere reflectării clinice a aplaziilor induse de fiecare bloc citostatic. Aplazia medulară a fost atestată de prezenţa neutropeniei, anemiei şi trombocitopeniei.
Rezultate şi discuţii. În studiu s-au încadrat 20 copii (9 fete, 11 băieţi) cu tratament intens citostatic. Patologia majoritară a fost LAL (60%), apoi a urmat WT (3 cazuri) şi câte un caz de LAM, LH, LNH, TD, NB. Vârsta copiilor era cuprinsă între 9 luni şi 18 ani (VM-7.18), distribuţia grupelor de vârstă respectând datele din literatura de specialitate. Toţi pacienţii au fost trataţi conform protocoalelor internaţionale. După fiecare bloc citostatic a urmat o perioadă de aplazie. Patologia aferentă a constat din anemii, trombocitopenii, mucozită, infecţii cu diferite lo ca lizări, reactivare zona zoster secundară imunodeprimării.
Concluzii. Aplazia medulară postcitostatică a avut durată şi severitatea diferită în funcţie de tipul de cancer. Durata, severitatea complicaţiilor clinice şi rezistenţa la tratament au fost severe în LAL şi leucemia mieloblastică. Complicaţiile infecţioase au evoluat cu nuanţe individualizate generate probabil de particularităţile imunologice.

Cuvinte cheie: aplazie secundară, copil, chimioterapie, cancer

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Zsuzsanna Erzsebet Papp

CLINICAL MANIFESTATIONS OF SECONDARY APLASIA AFTER CHEMOTHERAPY

ISSN 1454-0398 | e-ISSN 2069-6175
ISSN-L 1454-0398
DOI: 10.37897/RJP

National Awards “Science and Research”

NEW! RJP has announced the annually National Award for "Science and Research" for the best scientific articles published throughout the year in the official journal.

ICMJE- Recommendations

Read the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly work in Medical Journals.

Promoting Global Health

Zsuzsanna Erzsebet Papp and Maria-Adriene Horvath

ABSTRACT

Objectives. Our aims were to highlight the clinical signs and symptoms of secondary bone marrow aplasia after intensive chemotherapy. Material and methods. We included in the study group 20 children with intensive cytostatic treatment aged between 9 months and 18 years, all the patients were hospitalized in the hemato-oncology department of the Pediatric Clinic Targu-Mures with the following diagnoses: acute lymphoblastic leukemia, Wilms tumor, acute myelogenous leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, neuroblastoma, and round small cell desmoplastic tumor. The inclusion criteria was the intensive chemotherapy, exclusion criteria was maintenance cytostatic treatment. It was made a dynamic clinical-biological observation protocol to note the clinical considerations of the aplastic periods after each cytostatic treatment. Bone marrow aplasia was certified by the neutropenia, anemia and thrombocytopenia. Results and discussions. The majority pathology in our study group was lymphoblastic acute leukemia (60%), followed by Wilms tumor, and one case of acute myelogenous leukemia, Hodgkin lymphoma, non-Hodgkin lymphoma, neuroblastoma, and round small cell desmoplastic tumor the distribution of age groups respecting literature data. All the patients were treated with international protocols, and after each cure followed the secondary bone marrow aplasia with the afferent pathologies: anemia, thrombocytopenia, mucositis, infections with different localizations, zona zoster reactivation. Conclusions. Secondary bone marrow aplasia duration and severity differ by cancer type. We observed the most severe clinical complications in the ALL and AML patients. Infectious complications have evolved with the individualized shades probably generated by immunological peculiarities.

Keywords: aplasia, child, chemotherapy, cancer

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Zsuzsanna Erzsebet Papp