RESUMO
Nine children with neuroblastoma and five with Ewing sarcoma were found at diagnosis to have epidural extension of tumor. Five children underwent laminectomy prior to referral, with good neurologic recovery in only one. Management in the other nine children did not include laminectomy. All 14 patients were given chemotherapy without radiotherapy. Rapid regression of tumor with neurologic recovery occurred in response to chemotherapy in all patients with neurologic deficits. The responses observed in these children indicate that for chemotherapy-sensitive tumors, effective chemotherapy is a feasible alternative to laminectomy and radiation therapy in the management of epidural disease.
Assuntos
Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Laminectomia , Neuroblastoma/tratamento farmacológico , Sarcoma de Ewing/tratamento farmacológico , Neoplasias da Medula Espinal/tratamento farmacológico , Adolescente , Neoplasias Ósseas , Criança , Pré-Escolar , Terapia Combinada , Espaço Epidural , Humanos , Lactente , Neoplasias do Mediastino , Neuroblastoma/radioterapia , Neuroblastoma/secundário , Neuroblastoma/cirurgia , Sarcoma de Ewing/radioterapia , Sarcoma de Ewing/secundário , Sarcoma de Ewing/cirurgia , Neoplasias da Medula Espinal/radioterapia , Neoplasias da Medula Espinal/secundário , Neoplasias da Medula Espinal/cirurgiaAssuntos
Cisplatino/efeitos adversos , Perda Auditiva de Alta Frequência/induzido quimicamente , Perda Auditiva/induzido quimicamente , Adolescente , Limiar Auditivo , Pré-Escolar , Cisplatino/uso terapêutico , Perda Auditiva de Alta Frequência/diagnóstico , Humanos , Neoplasias/tratamento farmacológicoRESUMO
During investigation of splenomegaly in a boy with chronic renal failure and osteodystrophy, bone marrow aspirates resulted in "dry taps," whereas biopsied material provided evidence that the marrow had been replaced by fibrous tissue. In a study of six other children with chronic renal failure, similar changes were observed. These findings suggest that the anemia of chronic renal failure may in part be a result of myelofibrosis, and the resulting reduction of functional bone marrow may limit the tolerance to immunosuppressive agents in patients who undergo renal transplantation.