Early diagnosis, care and treatment of retinoblastoma is a challengeable issue for Iranian health system. This study was designed and conducted in a referral multidisciplinary centre in the capital ...city of Iran to evaluate management, care, prognosis and survival rates of paediatric patients with retinoblastoma.
In this retrospective study, a total number of 309 patients younger than 15 years, diagnosed with retinoblastoma, who referred for diagnosis and treatment to MAHAK's Pediatric Cancer Treatment and Research Center (MPCTRC) from 2007 to 2017 were evaluated. All data were analyzed via SPSS version 22 software in regard of parametric and non-parametric data. Survival rates were analyzed using the Kaplan-Meyer method.
The mean age of patients was 20 months and the majority of patients (77%) had leukocoria as a common clinical symptom at the time of diagnosis. Primary treatment methods were systemic chemotherapy (94%), laser (35%) and primary enucleation (28%). Relapses occurred in nearly 42% of cases, and the median time from diagnosis to the first relapse was 9 months. At the time analyzing the data, 11% of patients died. Patients' 5-year OS and RFS rates were 79.6% and 41.5%, respectively.
Comparing results with other conducted studies identifies that the recurrence rate was high in our considered patients. Also, OS and RFS rates in our study were not as considerable as other reports. Screening methods, updating protocols and follow-up of patients may lead to improvements in survival rates of patients with retinoblastoma.
In this cross-sectional study, we aimed to evaluate epidemiologic data, survival, and prognosis of pediatric patients diagnosed with neuroblastoma who were referred to Mahak Pediatric Cancer ...Treatment and Research Center (MPCTRC). One-hundred thirty-seven children younger than 15 years with neuroblastoma from April 2008 to March 2020 were included in this study. Data were retrospectively extracted from their documents, and follow-up was done for alive individuals. Collected data were analyzed using SPSS software version 25 for parametric and non-parametric variables. Of all patients, 51.82% (n=71) were male (M/F ratio was 1.07:1) with a mean age of 2.48±0.26 years. According to the International Neuroblastoma Staging System (INSS), more than 70% of patients were diagnosed with stages 3, 4, and 4S. Primary tumors were located mostly in the adrenal glands (42.34%) and abdomen (29.20%), respectively. Additionally, 62% of children experienced metastasis, with the most common site being bone marrow. Moreover, patients' overall survival, progression-free survival, and event-free survival were 55.2%±5.6, 41.0%±7.9, and 30.0%±5.1, respectively. Early diagnosis and effective treatment of neuroblastoma can directly influence patients' survival, and those who are diagnosed with neuroblastoma within one month of its symptoms onset are more likely to have higher survival rates.
Background: The childhood cancer registry in Iran is a hospital-based system and there is not any unique and national registry system for pediatric malignancies in Iran. According to the limitations ...and requirements, this study was designed to clarify the aspect of childhood malignancies in Iran and promote establishing the Iranian national childhood cancer registry system.
Materials and Methods: This cross-sectional longitudinal study was implied on 1500 patients younger than 20-years old diagnosed with any malignancy and admitted at MAHAK Pediatric Cancer Treatment and Research Center (MPCTRC) from 2007 to 2014. Data collection was based on a validated questionnaire with three categories including demographic data, clinical data and type of malignancy, and outcomes. Collected data were analyzed using methods for qualitative and quantitative variables (P-Value < 0.05) by SPSS software version 22. The survival rate was calculated by the Kaplan-Meyer method.
Results: This study was implied on 1500 children with a mean age of 6.1 years old. The most common malignancy was acute leukemia (30.7%) followed by central nervous system tumors (27%). At the onset of starting treatment, the rate of conferring with relapse, metastasis, and secondary malignancies was 29%, 19.5%, and 1% respectively. In addition, 52 patients had bone marrow transplantation of whom, 14 cases died. Totally, 42% of patients died and the 3-years, 5-years, and 10-years overall survival rates were 67.7% ± 0.01, 60.3% ± 0.01, and 53.8% ± 0.01, respectively.
Conclusion: Establishing a population-based pediatric cancer registry in Iran is necessary and will be useful for improving the survival rate of mentioned patients.
The pediatric hematology and oncology (PHO) services in Iran have steadily improved during the past 10 years. Today, we have specialized PHO services in almost all major cities throughout the ...country, where 43 board-certified or eligible pediatric hematologist-oncologists are currently giving care to children suffering from cancer or hematological disorders. In this paper, the state of Pediatric hematology-oncology in Iran will be presented.
The pediatric hematology and oncology (PHO) services in Iran have steadily improved during the past 10 years. Today, we have specialized PHO services in almost all major cities throughout the ...country, where 43 board-certified or eligible pediatric hematologist-oncologists are currently giving care to children suffering from cancer or hematological disorders. In this paper, the state of Pediatric hematology-oncology in Iran will be presented. Keywords: Pediatric- hematology-oncology- Mahak- Iran
Acute Myeloblastic Leukemia is one of the important malignancies in children. For better managing the prognosis of this disease, there should be enough information about common features of this ...malignancy. The aim of this study was to evaluate these common features in children with Acute Myeloblastic Leukemia. A total of 104 eligible children less than 15-year-old have been referred from 2007-2011 to two referral centers for childhood malignancies. Basic epidemiological information recorded in checklists for each individual. Analyzes have been done by SPSS version 22. Out of patients, 57 cases were males (54.8%). The male/female ratio was 1.2. The mean age of patients was 6.5 ± 4.3 years. The majority subtypes of patients were M3, M4, non-M3, and M2, respectively. The common molecular abnormalities were t (15;17) and inv (16). Of patients, 19.2% had an early relapse. The mean age of relapse in patients was 6.7 ± 3.9 years. Sixty patients (57.7%) were alive, and 44 cases (42.3%) died during or after therapy. The three years overall survival rate of patients was 42% in this study. According to our data, AML has the same frequency as compared with data from developing countries. But different epidemiological characteristic was a lower rate of three years overall survival in patients. These data may serve the health authorities for more effective environmental and preventive measurements, purposeful allocation of resources for facilitating up-to-date diagnostic and treatment modalities, psychological support programs for respective family members and educational purposes.
Objectives: In this study, we aimed to assess the incidence rate of adverse drug reactions (ADR) to chemotherapeutic agents and related problems in hospitalized pediatric patients diagnosed with ...cancer who referred to Mahak hospital in Tehran. Methods: All information about 125 children younger than 18-years-old who experienced ADR during their chemotherapy period (from March 2008 to March 2020) in Mahak Pediatric Cancer Treatment and Research Center (MPCTR) was collected and analyzed in SPSS-25. Results: Most of patients (approximately 65%, n=81) were male and the mean age of both genders was approximately 6.6 years of old. In addition, leukemia was the most common cancer type followed by Central Nervous System tumor. In terms of adverse events, skin and subcutaneous disorders occurred in 74 cases of 125, whereas nervous system, Immune system disorders and musculoskeletal related disorders were the least common events each occurring only in four cases. According to Naranjo’s Probability Scale, most ADRs were evaluated as probable in relation with administrated drug (61.60%) and 56.80% of reactions were determined as mild. Furthermore, the commonest ADRcausative drugs were L-asparaginase followed by carboplatin (together more than 56% of all cases. Conclusion: The overall incidence of ADR amongst children diagnosed with cancer in our retrospective study was 3.68 %. Additionally, leukemia treatment regimen including L-asparaginase seems to be significantly vulnerable to induce ADRs in pediatric ward. Finally, there is a crucial need for monitoring pediatric patients during treatment process in order to reduce the risk of ADR occurrence.
Background: Childhood cancer is the second leading cause of death in children. Approximately, 40% of children with cancer need to be admitted to the intensive care unit (ICU), which plays a key role ...in their treatment procedure and overall survival. Objectives: In this study, we aimed at evaluating the impact of ICU admission on pediatric patients’ survival and prognosis at Mahak Pediatric Cancer Treatment and Research Center (MPCTRC), Tehran, Iran. Methods: Amongst a total number of 2693 hospitalized patients who were referred to our center from March 2014 to September 2019, 674 patients younger than 14 years of age who were at least admitted once to the ICU were included in this study. All the collected data were analyzed using IBM-SPSS software version 22. Results: Totally, 48.96% of patients were female and 51.03% of them were male. The most frequent types of cancer were central nervous system tumors (33.23%) and Leukemia (18.99%). Additionally, 43.62% of admitted patients were in the 1 - 4 age group, with the mean age of 1.5 ± 0.30. The mortality rate in ICU was 40.20% and the overall survival (OS) rate was 29.5% ± 2.6. Moreover, the OS in children with solid tumors and non-solid tumors were 27.1% ± 5.5 and 32.6% ± 3.1, respectively. Conclusions: The results of this conducted study provide a complete report on the status of children admitted to the ICU ward in Mahak Hospital. Because of this fact that the most frequent type of cancer was CNS tumors and children with CNS tumors are usually admitted to the ICU in the late stages of their disease, the overall survival rate in our study was 29.80%, which is lower than other studies.
The scarcity of information on pediatric ependymoma in Iran motivated this study. Our main objectives were to determine outcomes, identify clinical management challenges at a nongovernment hospital ...in Iran, and devise guidelines for improving care.
A retrospective chart review was performed for pediatric patients with ependymoma who were younger than 15 years and treated at MPCTRC between 2007 and 2015. Records included patient demographics, treatment regimens used, duration of follow-up, and outcomes. Clinical outcomes ie, 3-year overall survival (OS) and progression-free survival (PFS) were determined based on the age at diagnosis (younger or older than 3 years) by using the Kaplan-Meier method.
In total, 73 eligible patients were enrolled; 20 patients were in the younger group, and 53 were in the older group. The majority (91.8%, n = 67) of patients underwent initial gross-total or partial surgical resection, and 6 (8.2%) had a biopsy. Twenty-one patients experienced ependymoma recurrence. The median time to relapse was 1 year. The median duration of follow-up and PFS were 25 and 17 months, respectively. The 3-year OS and PFS were 61% and 59.5%, respectively. At the time of this project, 27 patients had died, and 35 were alive with no evidence of disease.
Our study demonstrated inferior outcomes of Iranian children with ependymoma. To improve our care for these children, a paradigm shift must occur that includes radiation therapy as standard of care, second-look surgery, a multidisciplinary team approach, and potentially twinning initiatives.
Celotno besedilo
Dostopno za:
DOBA, IJS, IZUM, KILJ, NUK, PILJ, PNG, SAZU, UILJ, UKNU, UL, UM, UPUK
Purpose
As central nervous system (CNS) tumors account for second most common childhood malignancies and the first cause of mortality in children with cancer, improving treatment modalities can lead ...to increase the health care of patients. In this study, we examined the prevalence of childhood brain tumors in patients who referred to MAHAK’s Pediatric Cancer Treatment and Research Center (MPCTRC) for treatment.
Methods
A retrospective review of all children less than 15 years old with a CNS histologically proven tumor, who presented to MPCTRC from April 2007 to April 2010, was performed. Data was analyzed by SPSS version 19 with Kolmogorov–Smirnov and Chi-square tests.
Results
There were 198 (124 boys) children eligible for the study. The majority of the tumors were infratentorial (
n
= 134), and the rest were supratentorial (
n
= 60) and spinal (
n
= 4) cases. The median age was 6.11 ± 3.65 years old. Medulloblastoma (
n
= 66), low-grade glioma (
n
= 52), and high-grade glioma (
n
= 40) were the most common tumors. The mean duration of follow-up was 21 months. At the time of this analysis, there were 105 (53 %) children alive, 82 (41.4 %) deaths, and 11 (5.6 %) lost for follow-up. The survival rate was 51.68 ± 5.22 %.
Conclusions
In contrast of high rate of death in this study, other general characteristics can serve as benchmark for improving our care for children with brain tumors in Iran.
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