scholarly journals National Cancer Institute–National Heart, Lung and Blood Institute/Pediatric Blood and Marrow Transplant Consortium First International Consensus Conference on Late Effects After Pediatric Hematopoietic Cell Transplantation: Long-Term Organ Damage and Dysfunction

2011 ◽  
Vol 17 (11) ◽  
pp. 1573-1584 ◽  
Author(s):  
Michael L. Nieder ◽  
George B. McDonald ◽  
Aiko Kida ◽  
Sangeeta Hingorani ◽  
Saro H. Armenian ◽  
...  
Keyword(s):  
National Cancer Institute ◽  
Hematopoietic Cell Transplantation ◽  
Organ Damage ◽  
Marrow Transplant ◽  
Consensus Conference ◽  
International Consensus ◽  
Blood Institute ◽  
Blood And Marrow Transplant ◽  
National Heart Lung

scholarly journals Subsequent neoplasms and late mortality in children undergoing allogeneic transplantation for nonmalignant diseases

2020 ◽  
Vol 4 (9) ◽  
pp. 2084-2094
Author(s):  
Justine M. Kahn ◽  
Ruta Brazauskas ◽  
Heather R. Tecca ◽  
Stephanie Bo-Subait ◽  
David Buchbinder ◽  
...  
Keyword(s):  
General Population ◽  
Hematopoietic Cell Transplantation ◽  
Allogeneic Transplantation ◽  
Marrow Transplant ◽  
Term Survival ◽  
Late Mortality ◽  
Blood And Marrow Transplant ◽  
Skin Cancers ◽  
Standardized Mortality Ratios

Abstract We examined the risk of subsequent neoplasms (SNs) and late mortality in children and adolescents undergoing allogeneic hematopoietic cell transplantation (HCT) for nonmalignant diseases (NMDs). We included 6028 patients (median age, 6 years; interquartile range, 1-11; range, <1 to 20) from the Center for International Blood and Marrow Transplant Research (1995-2012) registry. Standardized mortality ratios (SMRs) in 2-year survivors and standardized incidence ratios (SIRs) were calculated to compare mortality and SN rates with expected rates in the general population. Median follow-up of survivors was 7.8 years. Diagnoses included severe aplastic anemia (SAA; 24%), Fanconi anemia (FA; 10%), other marrow failure (6%), hemoglobinopathy (15%), immunodeficiency (23%), and metabolic/leukodystrophy syndrome (22%). Ten-year survival was 93% (95% confidence interval [95% CI], 92% to 94%; SMR, 4.2; 95% CI, 3.7-4.8). Seventy-one patients developed SNs (1.2%). Incidence was highest in FA (5.5%), SAA (1.1%), and other marrow failure syndromes (1.7%); for other NMDs, incidence was <1%. Hematologic (27%), oropharyngeal (25%), and skin cancers (13%) were most common. Leukemia risk was highest in the first 5 years posttransplantation; oropharyngeal, skin, liver, and thyroid tumors primarily occurred after 5 years. Despite a low number of SNs, patients had an 11-fold increased SN risk (SIR, 11; 95% CI, 8.9-13.9) compared with the general population. We report excellent long-term survival and low SN incidence in an international cohort of children undergoing HCT for NMDs. The risk of SN development was highest in patients with FA and marrow failure syndromes, highlighting the need for long-term posttransplantation surveillance in this population.

Concussion in sports in children and adolescents – to play or not to play?

2017 ◽  
Vol 65 (3) ◽  
Keyword(s):  
Gender Differences ◽  
Children And Adolescents ◽  
Return To Sport ◽  
Consensus Conference ◽  
Return To School ◽  
The Novel ◽  
International Consensus ◽  
Persistent Symptoms ◽  
New Findings

A lot has been published on the topic concussion in sports during the last years, conscience was sharpened, much was structured and defined more precisely, help tools were developed and rules changed. This article summarizes the fifth edition of the recently published guidelines of the “International Consensus Conference on Concussion in Sport”. In addition, new findings regarding gender differences and recovery will be presented, as well as the modified “return-to-sport” and the novel “return-to-school” protocols. Despite increased knowledge many questions remain such as the therapy of persistent symptoms or long-term sequelae of recurrent concussions.

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