Some forms of cancer are confined to children: - Nephroblastoma - Neuroblastoma - Retinoblastoma
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Transcript of Some forms of cancer are confined to children: - Nephroblastoma - Neuroblastoma - Retinoblastoma
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Pediatric oncologyPediatric oncology- The Majority are sporadic.- The Majority are sporadic.
-2 -2ndnd cause of death in the… cause of death in the…while the 5while the 5thth in the….countries in the….countries
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Some forms of cancer are Some forms of cancer are confined to children:confined to children:
- Nephroblastoma- Nephroblastoma- Neuroblastoma- Neuroblastoma- Retinoblastoma- Retinoblastoma
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Incidence of Incidence of malignancies:malignancies:1 in 600 of< 151 in 600 of< 15Leukemias; 35%Leukemias; 35%C.N.S; 25%C.N.S; 25%Lymphomas; 10%Lymphomas; 10%All other forms; 30%All other forms; 30%
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AetiologyAetiology::Mainly unknown and sporadic but Mainly unknown and sporadic but may be associated with;may be associated with;- Fameleal tendency.- Fameleal tendency.- Genetic disorders.- Genetic disorders.- Immunodefeciency disorders.- Immunodefeciency disorders.- Chromosomal disorders.- Chromosomal disorders.- Viral infections.- Viral infections.- Enviromental factors.- Enviromental factors.
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Presenting featuresPresenting features::1)Prol.fever1)Prol.fever2)Masses:2)Masses: Abdominal Abdominal Mediastinal Mediastinal Trunk & extremities Trunk & extremities3)Bone pain3)Bone pain4) Lymphadenopathy4) Lymphadenopathy5)↑ I.C.P.5)↑ I.C.P.6)Bruising,petechiae,& pallor6)Bruising,petechiae,& pallor7)Leukorcia7)Leukorcia8)Hypertention.8)Hypertention.
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Leukemia:Leukemia:Most common pediatric Most common pediatric malignancy.malignancy.85% are of ALL85% are of ALLpeak at 2-6yrpeak at 2-6yrALL classification:ALL classification:1)Morphologicaly to 1)Morphologicaly to L1,L2,&L3L1,L2,&L32)Immunophenotypicaly to T-2)Immunophenotypicaly to T-cell , B-cell, & pre B-cell.cell , B-cell, & pre B-cell.
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Clinical picture:Clinical picture:PallorPallor
BleedingBleedingHepatosplenomegally and Hepatosplenomegally and
LAPLAPFeverFever
Bone painBone painTesticular painTesticular pain
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DIAGNOSISDIAGNOSIS C.B.C. may rarely be C.B.C. may rarely be
normalnormal B.M examination ; B.M examination ;without which without which
diagnosisdiagnosis should never be made.should never be made.
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Prognosis:Prognosis:Favorable in:Favorable in:
1-9 years1-9 yearsfemalesfemales
White raceWhite race<50,000 W.B.C.<50,000 W.B.C.
Ploidy(>53 chromosomes within Ploidy(>53 chromosomes within lymphoblasts)lymphoblasts)
No organomegaly.No organomegaly.No Chromosomal translocationNo Chromosomal translocation
Late relapasersLate relapasers
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TreatmentTreatment::1)Induction.;1)Induction.; 98% of ALL go to 98% of ALL go to remission by a 4 weeks course of:remission by a 4 weeks course of:VincristineVincristineSteroidSteroidL.asparaginaseL.asparaginaseC.S.F. treatment by MTH, cytarabine C.S.F. treatment by MTH, cytarabine &H.C.&H.C.2)Consolidation:2)Consolidation:Cyclical MTH, L-asparaginase, Cyclical MTH, L-asparaginase, doxorubicin, cytarabine, doxorubicin, cytarabine, vincristine,cyclophosphamide & vincristine,cyclophosphamide & cranial radiation ( in over 5 years ).cranial radiation ( in over 5 years ).
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3)Maintenance:3)Maintenance:Daily; 6-mercaptopurine; Weekly; Daily; 6-mercaptopurine; Weekly; Methotrexate and Monthly; Vincristine Methotrexate and Monthly; Vincristine and steroids for 2-3 years.and steroids for 2-3 years.B.M transplantation for high risk cases B.M transplantation for high risk cases & frequent relapsers.& frequent relapsers.
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