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Biomedical subjects

A Balcerska

Publications and source records attributed to A Balcerska.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Implementation of a psychological support program for children with cancer in Poland. Preliminary report].

Intensive chemotherapy programme in children with cancer may result in psychological mal adjustment. Treatment facilities as well as psychological support are of great importance to minimize these side effects. In 1998 the programme of psychological support was introduced in 7 Polish paediatric haematology / oncology centres. Psychological adjustment of patients treated in each centre was examined 5 yrs after the termination of therapy. At the same time children with new diagnosis of cancer were monitored psychologically along with the psychological support programme. Psychological status of each patient was examined with the following tests: Cattell's questionnaires (CPQ, HSPQ), Manifest Anxiety Scale, Spielberger's inventories (STAI, STAIC), Wechsler Intelligence Scale. The programme of psychological support was based on guidelines of SIOP Psychosocial Committee and included such elements as informing about diagnosis and treatment, explaining any doubt, maintaining an open communication, educational care in the periods of treatment, encouraging to activity even during periods of discomfort. The analysis showed that most of the participating centres could only provide some elements of the support programme. The main problem was to convince medical staff to inform children on diagnosis and treatment plans. Preliminary results of the study indicate that full psychological support for children with cancer and their families from the beginning of therapy can result in improvement in psychological adjustment. During the ensuing period, patients and their parents appreciate the possibilities to contact a psychologist.

Adaptation, Psychological↗
PubMed1998

[Thrombus of the right ventricle simulating a cardiac tumor--case report].

A nine day infant with Down syndrome and congenital heart disease is presented in whom the course of neonatal sepsis was complicated by the presence of difficult to diagnose pathological masses in the right ventricle. The etiology of pathological masses was difficult to establish in survival investigations. Histopathological examinations revealed the presence of thrombus in the right heart and foci of granulation on a muscle of right ventricle outflow, probably after a septic embolus.

Abnormalities, Multiple↗
PubMed1998

[The efficacy of BFM-90 program in the treatment of acute lymphoblastic leukemia in children in the studies of Polish pediatric leukemia/lymphoma group].

Between years 1993 and 1998, 113 children aged from 6 months to 18 years (41 girls and 72 boys) with first relapse of acute lymphoblastic leukaemia (ALL) were included in the study. All children were treated according to BFM-90 relapse protocol. Thirty-two cases were classified as very early relapses, 56 as early and 25 as late relapses. Sixty-one children had isolated bone marrow relapse, in 30 children extramedullary relapse occurred (in 21 children in central nervous system and in 16 children in testes). There were 23 combined relapses. Remission was achieved in 12 children with very early relapse (78.12%), 32 children with early relapse (85.71) and 19 children with late relapse (96%). Event-free survival in 30 months of follow-up was 29.2%, 59.0% and 73.2% for very early, early and late relapses, respectively. Sixteen children with relapsed ALL after chemotherapy according to BFM-90 relapse protocol underwent high-dose therapy with hematopoietic stem cell transplantation (in 3 cases autologous and in 13 cases allogeneic). In 6 children isolated bone marrow relapse occurred after transplantation, all of them died during subsequent chemotherapy. Ten children is alive and well from 2 to 43 months after transplantation. The results obtained with BFM-90 chemotherapy in children with first early relapses are not acceptable. Such patients require high-dose chemotherapy and transplantation of hematopoietic progenitor cells.

Adolescent↗
PubMed1998

[The analysis of failures in the treatment of children with chronic myelocytic leukemia in the studies of Polish pediatric leukemia/ lymphoma group].

94 children with chronic myelocytic leukaemia--CML treated in period 1975-1998 were included in the study. Twenty seven of 60 children were treated with hydroxyurea or busulfan with 6 MP. In 33 children aged 1, 5-17 years IFN (Interferon alfa) was applied at the dose of 3 millions units every second day subcutaneously. Our data showed that IFN alfa could be applied as an alternative treatment in children with CML, who have not a donor for allogenic BMT (bone marrow transplantation).

Adolescent↗
PubMed1998

[The efficacy of G-CSF and GM-CSF in the adjunctive treatment of infections complicating chemotherapy of solid tumors in children. Report of Polish Pediatric Leukemia/Lymphoma Treatment Group].

Total number of 306 cycles of GM-CSF-Leucomax Sandoz (5 mg/kg/day s.c.) and/or G-CSF Filgrastim Hoffmann-La Roche (5-10 mg/kg/day s.c.) was applied in 146 children aged from 0.5-18 years during neutropenia associated with chemotherapy of solid tumours. Seventeen children with malignancies served as a historical control group. Our study have demonstrated after both G- and GM-CSF therapy shorter period of neutropenia, reduction of the number of febrile days and a decreased frequency of infectious complications and infection's duration.

Adjuvants, Immunologic↗
PubMed1998

[The effectiveness of G-CSF and GM-CSF in the adjunctive treatment of infections complicating chemotherapy of non-Hodgkin's lymphoma in children. Report of Polish Pediatric Leukemia/Lymphoma Treatment Group].

Total number of 252 cycles of GM-CSF-Leucomax Sandoz (5 mg/kg/day s.c.) and/or G-CSF Filgrastim Hoffmann-La Roche (5-10 mg/kg/day s.c.) was applied in 124 children aged from 0.5-20 years during neutropenia associated with chemotherapy of non-Hodgkin's lymphoma (NHL). Twenty four children with NHL treated according to the same chemotherapy protocol but without G-CSF and GM-CSF served as a control group. Our study have demonstrated the good efficacy of both G-CSF and GM-CSF therapy. They shortened the period of neutropenia, reduced the number of febrile days, infection's duration and decreased the frequency of infectious complications.

Adjuvants, Immunologic↗
PubMed1998

[The role of local surgical and radiological control in the treatment of soft tissue sarcoma sensitive to chemotherapy in children. Report of Polish Pediatric Solid Tumors Treatment Group].

In this paper the role local surgical and radiological control in the treatment of soft tissue sarcomas in children was analyzed. All children were treated according to CWS-91 and SIOP-IV protocols. Eighty three children with RMS A + E, EES/PNET, SS, UDS were included in the analysis. The primary surgery consisted of R0 (5%), R1 (18%) or R2 (16%) resection. In majority of cases (61%) primary surgical intervention was limited to diagnostic biopsy. Conventional or hyperfractionated radiotherapy was performed in 42.8%, 73.8% and 75% of children with disease stage II, III and IV, respectively. Delayed surgery was performed in 20 out of 53 (37.7%) children with stage III of the disease. In 5 patients without primary focus (urinary bladder in 3 and prostate in 2 cases) removed, progression of the disease occurred. In 5 children (stage IV) with progression of the disease no secondary surgery was performed. In 4 of them the primary tumor exceeded 10 cm in diameter. No delayed surgery was performed in 69% of relapsed children with stage III of the disease. Planned radiation therapy was not performed in 15.9% of cases. Primary local surgical control of primary tumor is of great importance for remission duration. In children who underwent delayed surgery the estimated EFS was of 0.7, in comparison with 0.5 EFS of those without secondary surgical treatment.

Adolescent↗
PubMed1998

[Clinical manifestation of toxic pancreas lesion in children with hematopoietic malignancies].

From January 1994 until May 1997, 54 children with leukemia and non Hodgkin lymphoma were analyzed. The enzymatic function and ultrasound examination of pancreas were estimated. In 17 of 54 patients the clinical symptoms suggesting pancreatitis or toxic lesion of pancreas were observed. In 13 cases L-asparaginase was administered. The main symptom of the pancreas disease was severe abdominal pain with vomiting. The typical ultrasound view of pancreatitis was observed in 4 cases, pancreas oedema was seen in 6 patients. The most serious course of pancreatitis was diagnosed in 3 children. Diabetes mellitus coexisted in two cases, in the third case osteoporosis was seen. Because of the toxic pancreas lesion in one patient the administration of L-asparaginase and cortical hormones was discontinued, in the remaining 2 children the therapeutic scheme was modified. In all 17 cases this side effect was completely reversible, as well as in 3 children with the most serious clinical course of pancreas lesions.

Abdominal Pain↗
PubMed1998

[Recanalization of the ductus arteriosus in a child with non-Hodgkin's lymphoma].

Dissertation describes the case of 7.5-year-old boy with recanalization of the ductus arteriosus. In this patient treated because of the non-Hodgkin lymphoma during the chemotherapy the respiratory failure occurred and mechanical ventilation was required. After the respiratorotherapy in the controlled echocardiography examination the patency of previously closed ductus arteriosus, was described. There was no description of the similar case in available references.

Child↗
PubMed1998

[The closure of persistent ductus arteriosus using coils in a child with Wilm's tumor].

In Pediatric Institute of Medical University of Gdańsk in all children with neoplasmatic diseases the echo examination is performed, due to exclude coexisting abnormalities of cardiovascular system. During this kind of procedure in 4.5-year-old girl with Wilms tumour the persistent ductus arteriosus was described. Because of the chemotherapy design and its potential cardiotoxicity the closure of PDA using coils was performed immediately. The successful closure of PDA gave the chance to apply the whole therapeutic protocol.

Child, Preschool↗
PubMed1998

[Acute leukemia in children with Down syndrome: analysis of cases].

An analysis of clinical and laboratory parameters and the results of treatment of 14 children with Down Syndrome and acute leukaemia was performed. The children were treated between 1986-1997. Their age ranged from 1 day to 13 years (average 5.5). There were 9 girls and 5 boys. Four of them had congenital heart disease. ALL was observed in 10, AML in 3 and TAM (Transient Abnormal Myelopoesis) in 1. Half of the children with ALL was classified as L1 according to FAB with the majority of common phenotypes and M6 in ANLL group. Remission was achieved in all ALL patients, six of them are still free of symptoms, the remaining four died of brain haemorrhage as a consequence of myelosuppression. Only 1 of 3 children with ANLL achieved remission. The child died of cardiac arrest after induction phase of BFM 95 programme (ADE). The 2 remaining children with ANLL also died of circulation failure before initiation of chemotherapy. The children had complicated cyanotic heart disease. The neonate with TAM is in clinical and hematological remission. In conclusion all children with ALL achieved hematological remission but tolerance of treatment was a problem. The majority of patients had diminished bone marrow reserve. Mortality was frequently related to circulatory failure in children with associated heart defects. It seems necessary to discuss the modification of accepted programmes for leukemia for the treatment of children with Down Syndrome.

Adolescent↗
PubMed1998

[Late effects of chemo- and radiotherapy in two children treated for acute lymphoblastic leukemia].

UNLABELLED: The endocrinological disorders are known sequelae of cancer therapy. The aim of our study was to evaluate the effects of chemo- and radiotherapy on growth and auxiological parameters in children treated for acute lymphoblastic leukaemia (ALL) since 1984 to 1996. We studied growth, pubertal development and endocrine functions in 32 patients who were treated for ALL. Two of them had endocrine abnormalities. Both took a different course of disease and treatment because of local relapse in uterus (the girl) and in testis (the boy). All patients received cranial preventive radiotherapy but two of them also received: abdominal irradiation (the girl) and direct testicular irradiation (the boy) with total doses 24 Gy. The girl had clinical and biochemical symptoms of primary thyroid failure, growth hormone deficiency and hypergonadotropic hypogonadism recognized after 8 years following the completion of therapy. The boy had biochemical symptoms of hypogonadism with low serum testosterone concentration responses to stimulation with human gonadotropin after 4 years of remission. CONCLUSION: We suggest that clinical and biochemical assessment of endocrinological functions including growth, pubertal development, thyroid function should be performed at regular intervals following chemotherapy and radiotherapy in patients with acute lymphoblastic leukaemia and another carcinomas.

Adolescent↗
PubMed1998

[Triton's tumor in children: a report of two cases].

Triton's tumor is a rare neoplasm, consisting of both neurogenic and rhabdomyoblastic components. Triton's tumor does not respond well to chemo- or radiotherapy, resulting in its poor therapy effects. This paper reports on two cases of this malignancy diagnosed in our department. The first one was treated with CWS chemotherapy followed by radical tumor resection, which resulted in 4.5 year complete remission. The other patient was treated with chemotherapy according to CWS protocol, achieving partial regression of the tumor. We suggest that this response may be connected with the sensitivity of the RMS embryonal component of the tumor to chemotherapy. This partial remission may create a possibility of radical tumor resection.

Child, Preschool↗
PubMed1998

[The role of chemotherapy in treatment of nephroblastoma in children. Report of the Polish Pediatric Group re. treatments of solid tumors].

Retrospective analysis of chemotherapy results of children with nephroblastoma was performed in 220 patients aged from 1 yr to 14 yrs of live in 12 centers. Stage I nephroblastoma was documented in 24.5% but stage II--in 55.3%. Histologically 74.6% cases were diagnosed as medium malignant and 12.7%--high malignant. Therapy results were similar to observed in other centers.

Adolescent↗
PubMed1995

[Clinical course and risk of fungal infections development in children with treated with chemo- and radiotherapy for solid tumors].

The authors estimated the incidence of mycotic infections among children patients with histological diagnosis of solid tumors during the period of neutropenia. Superficial mycoses including mucoses were observed in 35.3% of analysed patients, while a disseminated mycotic infections of a severe clinical course were seen in 2.9% neutropenic patients. Prophylactic administration of Diflucan (1-2 mg/kg/24h)(fluconazole) in neutropenic patients proved efficient in great majority of children, preventing the occurrence of severe mycotic complications.

Antifungal Agents↗
PubMed1993

Evaluation of the efficacy of natural human interferon alpha lozenges on the clinical course of childhood neoplasia and in chronic hepatitis B virus infection in patients who were successfully treated for pediatric malignancies.

The immunostimulating and anti-cancer action of interferons (IFNs) has been known for many years. However, IFNs have not been introduced widely into the schemes of oncological treatment because of serious side effects potentiating untoward effects of chemotherapy. In addition using high doses of IFNs by parental routes the cost of such therapy is prohibitively high. Natural human interferon alpha lozenges produced from lymphoblastoid cell line by the Hayashibara Biochemical Lab. Okayama Japan (nHuIFN-alpha, HBL) is used in small doses delivered on oral mucosa. Thus, it might be expected not to cause severe side effects, and is less expensive. Children given antineoplastic and immunostimulatory treatment for cancer were also given nHuIFN-alpha--HBL lozenges containing 50-200 units of IFN per lozenge. Children treated age varied from 3-14 years. The average time of observation was 188 days. In 6 patients nHuIFN-alpha therapy was introduced at the time of the intensive oncological treatment during break periods. Those children had advanced malignant solid tumors. For the other children the IFN therapy was used after the successfully completed oncological treatment. The reason of using nHuIFN-alpha in this group was a long lasting hepatitis B virus antigenemia. The drug was well tolerated by children from both groups and a positive immunostimulating effect was observed. One prominent effect of the nHuIFN-alpha--HBL in children was a reduction of frequency of infections, improvement of appetite and psychological feeling of well being. It seems to us that IFN oral therapy may improve the tolerance of chemotherapy and radiotherapy.

Administration, Oral↗