Childhood lymphomas/leukemias

The Phase I studies of vindesine determined the maximum tolerated dose of the compound to be 3-4 mg/m (body surface area) when given once weekly (i.v.) 78). Mild leukopenia ensues, reaching a nadir after about 4 days, and is accompanied by neurotoxicity. Several patients responded to drug treatment during this initial trial, including several complete responders with acute leukemias and partial responders with malignant melanoma and non-Hodgkin s lymphoma. Subsequent studies indicated that vindesine was active in vincristine-resistant childhood lymphocytic leukemia and, when combined with cisplatin, was effective in... 

Catharanthus alkaloids, particularly vinblastine (Al) and vincristine (A2), are well known anticancer drugs, which are used clinically to treat Hodgkin s lymphoma and acute childhood lymphoblastic leukemia, respectively. These alkaloids interact with tubulin, a protein necessary for cell division, and are inhibitors of mitosis (the process of cell division). 

The small round cell tumors of soft tissue (Fig. 4.9 see Table 4.4) compose a heterogeneous group of neoplasms that predominate in childhood and adolescence and share similar morphologic features. Rhabdomyosarcoma, PNET/ES, and lymphoma/leukemia are the prototypic members of this group. Another entity that may be confused with PNET is the intra-abdominal desmoplastic small round cell tumor. 

In addition, pediatric testing of anticancer agents is necessitated by childhood prevalence of fast growing cancers, such as lymphomas, leukemias, and... 

Neoplastic diseases Palliative management of leukemias and lymphomas in adults acute leukemia in childhood. 

Clinical applications include childhood acute lymphoblastic leukemia, choriocarcinoma, osteosar-com, non-Hodgkin s lymphoma and Burkitt s lymphoma. However methotrexate is also frequently used as an immunosuppressant in diseases such as psoriasis, rheumatoid arthritis and others. 

Corticosteroids suppress proliferation of lymphocytic cells, thus they are useful at combating acute lymphoblastic or undifferentiated leukemia of childhood, chronic lymphocytic leukemia, Hodgkin s lymphoma, other lymphomas. Therapy is often initiated with a steroid in combination with other agents. There is no evidence of cross resistance to unrelated agents. Mostly prednison is used however at appropriate dosages similar effects can be obtained with other glucocorticosteroids. 

Meinert R., J. Schuz, P. Kaatsch, and J. MichaeUs (2000). Leukemia and non-Hodgkin s lymphoma in childhood and exposure to pesticides Results of a register-based case-control study in Germany. American Journal of Epidemiology 7 639-646. 

Therapeutic modalities in cancer treatment may involve surgery, radiation, and/or chemotherapy. The objectives of cancer chemotherapy include (1) cure, (2) reduction in tumor size, and (3) prolongation of life. At the present time, approximately 50 percent of patients with cancer can be cured, with drug treatment estimated to contribute in 17 percent of cases. Cancer chemotherapy can be curative in testicular cancer, diffuse large cell lymphoma, Hodgkin s disease, choriocarcinoma, certain childhood tumors (acute lymphoblastic leukemia, Burkitt s lymphoma, Wilms tumor, and embryonal rhabdomyosarcoma). Certain cancers are more resistant to chemotherapy than others (e.g., lung and colon). 

In another study children aged 0-14 years with leukemia (n — 150), lymphomas (n = 46), central nervous system tumors (n — 79), a range of other solid tumours (n = 142), and a subset of acute lymphoblastic leukemia (n = 129) were compared with 111 children matched for age and sex (30). Odds ratios showed no significant positive association for leukemias (1.30 0.83, 2.03), acute lymphoblastic leukemia (1.21 0.74, 1.97), lymphomas (1.06 0.46, 2.42), central nervous system tumors (0.74 0.40, 1.34), and other solid tumors (0.59 0.37, 0.96). There was no association with acute Ijmphoblastic leukemia in children aged 1-6 years. The authors concluded that they had not confirmed the observation of an increased risk of childhood leukemia and cancer associated with intramuscular vitamin K. 

One study demonstrated that parental occupational exposures to chlorinated hydrocarbons are associated with increased risks for leukemia, lymphoma, and urinary tract cancers in offspring. Another study showed associations between maternal exposures to solvents and increased incidences of leukemia. These solvents include 1,1,1-trichloroethane, toluene, and other mononuclear aromatic hydrocarbons, mineral spirits, and alkanes. Childhood brain cancers, the second leading cause of childhood cancer, have been associated with parental occupational exposures to toxic chemicals. Industries for which such associations have been found include 10 ... 

Chen CL et al. Bioavailability and pharmacokinetic features of etoposide in childhood acute lymphoblastic leukemia patients. Leukaemia Lymphoma, 2001, 42 317-327. 

With regard to leukania, in 1976 The Lancet reported on the work of Stanislaw Garwicz of the University Hospital in Lund, Sweden. Garwicz had observed earlier that leukemia, especially childhood leukemia, correlated with the amount of protein in the diet and recommended that a low-protein diet be investigated as a treatment for leuk ia- and lymphoma-type malignancies. 

Acute myelogenous and acute lymphocytic leukemia Soft-tissue, osteogenic, and other sarcoma Hodgkin s disease non-Hodgkin s lymphoma acute leukemia breast, genitourinary, thyroid, lung, stomach cancer neuroblastoma and other childhood sarcomas... 

As of 1999,. studies of the effects of pesticide exposure on children s health were limited to those of birth defects, childhood cancer, and acute poisoning following ingestion. Some case-control studies have associated parental exposure to pesticides or pesticide use in the home with childhood brain tumors, leukemia and lymphomas, testicular cancers, and other cancers, Other studies have reported that parental exposure to pesticides or application of pesticides in the home are associated with cenain birth defects, including neural tube and other defects (Eskenazi et at., 1999). Evaluation.s iif OP and CM exposures, levels of expasures, and health impacts to children are needed. 

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