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Review Article
Oncology
Prognostic factors and treatment of pediatric acute lymphoblastic leukemia
Jae Wook Lee, Bin Cho
Clin Exp Pediatr. 2017;60(5):129-137.   Published online May 31, 2017

The event-free survival (EFS) for pediatric acute lymphoblastic leukemia (ALL) has shown remarkable improvement in the past several decades. In Korea also, a recent study showed 10-year EFS of 78.5%. Much of the improved outcome for pediatric ALL stems from the accurate identification of prognostic factors, the designation of risk group based on these factors, and treatment of appropriate duration...

Original Article
Vascular endothelial dysfunction after anthracyclines treatment in children with acute lymphoblastic leukemia
Woo Jung Jang, Duk Yong Choi, In-Sang Jeon
Clin Exp Pediatr. 2013;56(3):130-134.   Published online March 18, 2013
Purpose

Anthracyclines have been utilized in the treatment of children with acute lymphoblastic leukemia (ALL). Recent studies have shown that anthracyclines may induce toxicity in the vascular endothelium. This study was performed using brachial artery reactivity (BAR) to evaluate vascular endothelial function in ALL patients who were treated with anthracycline chemotherapy.

Methods

We included 21 children with ALL who received anthracycline chemotherapy and...

Evaluation of changes in random blood glucose and body mass index during and after completion of chemotherapy in children with acute lymphoblastic leukemia
Kyong-Won Bang, Soo Young Seo, Jae Wook Lee, Pil-Sang Jang, Min Ho Jung, Nack-Gyun Chung, Bin Cho, Dae-Chul Jeong, Byung Kyu Suh, Hack-Ki Kim
Clin Exp Pediatr. 2012;55(4):121-127.   Published online April 30, 2012
Purpose

Improved survival of patients with childhood acute lymphoblastic leukemia (ALL) has drawn attention to the potential for late consequences of previous treatments among survivors, including metabolic syndrome. In this study, we evaluated changes in 3 parameters, namely, random blood glucose, body mass index (BMI), and Z score for BMI (Z-BMI), in children with ALL during chemotherapy and after completion of...

Outcome of allogeneic hematopoietic stem cell transplantation for childhood acute lymphoblastic leukemia in second complete remission: a single institution study
Eun-Jung Lee, Ji Yoon Han, Jae Wook Lee, Pil-Sang Jang, Nack-Gyun Chung, Dae-Chul Jeong, Bin Cho, Hack-Ki Kim
Clin Exp Pediatr. 2012;55(3):100-106.   Published online March 16, 2012
Purpose

The survival rate for childhood acute lymphoblastic leukemia (ALL) has improved significantly. However, overall prognosis for the 20 to 25% of patients who relapse is poor, and allogeneic hematopoietic stem cell transplantation (HSCT) offers the best chance for cure. In this study, we identified significant prognostic variables by analyzing the outcomes of allogeneic HSCT in ALL patients in second complete...

Review Article
Philadelphia chromosome-positive acute lymphoblastic leukemia in childhood
Hong Hoe Koo
Clin Exp Pediatr. 2011;54(3):106-110.   Published online March 31, 2011

In pediatric patients with acute lymphoblastic leukemia (ALL), the Philadelphia chromosome translocation is uncommon, with a frequency of less than 5%. However, it is classified as a high or very high risk, and only 20-30% of Philadelphia chromosome-positive (Ph+) children with ALL are cured with chemotherapy alone. Allogeneic hematopoietic stem cell transplantation from a closely matched donor cures 60% of...

Original Article
Prognostic significance of minimal residual disease detected by a simplified flow cytometric assay during remission induction chemotherapy in children with acute lymphoblastic leukemia
Kyung Nam Koh, Meerim Park, Bo Eun Kim, Ho Joon Im, Chan-Jeoung Park, Seongsoo Jang, Hyun Sook Chi, Jong Jin Seo
Clin Exp Pediatr. 2010;53(11):957-964.   Published online November 30, 2010
Purpose

Our study attempted to determine the prognostic significance of minimal residual disease (MRD) detected by a simplified flow cytometric assay during induction chemotherapy in children with B-cell acute lymphoblastic leukemia (B-ALL).

Methods

A total of 98 patients were newly diagnosed with precursor B-ALL from June 2004 to December 2008 at the Asan Medical Center (Seoul, Korea). Of those, 37 were eligible for...

Effect of p16 on glucocorticoid response in a B-cell lymphoblast cell line
Sun-Young Kim, Kyung-Yil Lee, Dae-Chul Jeong, Hak-Ki Kim
Clin Exp Pediatr. 2010;53(7):753-758.   Published online July 31, 2010
Purpose

It has been suggested that p16 has a role in glucocorticoid (GC)-related apoptosis in leukemic cells, but the exact mechanisms have yet to be clarified. We evaluated the relationship between the GC response and p16 expression in a lymphoma cell line.

Methods

We used p16 siRNA transfection to construct p16-inactivated cells by using the B-cell lymphoblast cell line NC-37. We compared glucocorticoid...

Case Report
A case of atypical hemolytic uremic syndrome as an early manifestation of acute lymphoblastic leukemia
Dong Kyun Han, Hee Jo Baek, Young Kuk Cho, Chan Jong Kim, Myung Geun Shin, Hoon Kook, Tai Ju Hwang
Clin Exp Pediatr. 2010;53(2):253-257.   Published online February 15, 2010
Hemolytic uremic syndrome (HUS) is the most common cause of acute renal failure in children younger than 4 years and is characterized by microangiopathic hemolytic anemia, acute renal failure, and thrombocytopenia. HUS associated with diarrheal prodrome is usually caused by Shiga toxin-producing Escherichia coli O157:H7 or by Shigella dysenteriae, which generally has a better outcome. However, atypical cases show a...
Original Article
The effects of shortened dexamethasone administration on remission rate and potential complications during remission induction treatment for pediatric acute lymphoblastic leukemia
Jae Wook Lee, Kwang Hee Lee, Young Joo Kwon, Dae Hyoung Lee, Nak Gyun Chung, Dae Chul Jeong, Bin Cho, Hack Ki Kim
Clin Exp Pediatr. 2007;50(12):1217-1224.   Published online December 15, 2007
Purpose : Due to its high potency against leukemic blasts, our institution has opted for the use of dexamethasone during acute lymphoblastic leukemia (ALL) remission induction, but in our most recent treatment protocol, CMCPL-2005, we shortened the length of steroid treatment from 4 to 3 weeks. We compared both the rates of remission induction and significant complications observed during induction...
Serum ghrelin and leptin concentrations in children with cancer : comparisons with normal children
So Hyun Park, Min Ho Jung, Nac Gyun Chung, Byung-Kyu Suh, Byung Churl Lee
Clin Exp Pediatr. 2007;50(9):905-911.   Published online September 15, 2007
Purpose : Ghrelin, being secreted from the stomach, stimulates growth hormone secretion and controls energy homeostasis by increasing appetite. Leptin, being secreted from the adipocytes, controls weight and energy homeostasis by decreasing appetite. Leptin concentration is reported to increase after childhood cancer therapy. This study was aimed to compare ghrelin and leptin concentrations in normal children and children who received...
Review Article
Acute lymphoblastic leukemia in children: past, present and future
Hyoung Jin Kang, Hee Young Shin, Hyo Seop Ahn
Clin Exp Pediatr. 2007;50(7):601-605.   Published online July 15, 2007
The cure rate of acute lymphoblastic leukemia (ALL) in children dramatically improved over past 5 decades from zero to about 80%. The main cause of improvement is owing to the development of chemotherapy by multicenter clinical trial of large study groups with the understanding of leukemia biology. Recently, pediatric ALL protocols were applied to the treatment of adolescent and even...
Original Article
Platelet count change by vincristine in maintenance phase of acute lymphoblastic leukemia chemotherapy
Sung Moon Lee, Soon Shik Ham, In-sang Jeon
Clin Exp Pediatr. 2006;49(2):181-186.   Published online February 15, 2006
Purpose : The hematologic change during the treatment of acute lymphoblastic leukemia(ALL) is critical as a prognostic determinant and a variable to determine the dose of chemotherapeutic agents. It is known that the dose of vincristine used in the maintenance phase of ALL is small enough to increase the count of platelet. To investigate the change of platelet count according...
Effect of Delayed Intensification on Survival of Childhood Acute Lymphoblastic Leukemia
Jie Yeon Lee, Sue Youn, Byoung Chul Kwon, Chuhl Joo Lyu, Hwang Min Kim
Clin Exp Pediatr. 2003;46(12):1260-1265.   Published online December 15, 2003
Purpose : In 1970, the Berlin-Frankfurt-Munster(BFM) group introduced an intensification therapy after remission induction to reduce relapse of acute lymphoblastic leukemia(ALL) in childhood. Delayed intensification(DI) phase has been included for treatment of ALL in our hospital since the mid-1990s. The purpose of this study is to evaluate the outcome with vs. without DI phase and the outcome with two vs....
Treatment Outcomes in Children with High-Risk Acute Lymphoblastic Leukemia
Kyu Chang Park, Ho Joon Im, Sang Yun Ahn, Hahng Lee
Clin Exp Pediatr. 1999;42(3):383-389.   Published online March 15, 1999
Purpose : The survival rate of those with acute lymphoblastic leukemia(ALL) has been affected by several prognostic factors and previous reports show that a 4-year event-free survival(EFS) for high-risk(HR) group(Age≥10 years and/or WBC≥50,000/mm3 at diagnosis) was approximately 64%. We analyzed treatment outcomes and risk factors in HR-ALL. Methods : Medical records of 27 patients with HR-ALL diagnosed between May, 1985 and...
Case Report
A Case of Granular Acute Lymphoblastic Leukemia with t(5p;5p) Arising in Down Syndrome Infant
Soon Ja Lee, Young Ho An, Hai Lee Chung
Clin Exp Pediatr. 1997;40(3):417-422.   Published online March 15, 1997
Granular lymphoblast which is characterized by the presence of clearly defined azurophilic cytoplasmic granules are a relatively uncommon finding and indicate a negative impact on prognosis of childhood ALL. Granular ALL is more common in FAB L2 cases but there is no significant difference by immunophenotype and no specific cytogenetic abnormality correlated with clinical significance of granular ALL has been reported. We present a case...
A Case of Congenital T Cell Lymphoblastic Lymphoma
Eun Sun Yoo, Young Mi Hong, Kyung Hee Kim, Hae Soo Gyu, Eun Chul Chung
Clin Exp Pediatr. 1994;37(9):1296-1304.   Published online September 15, 1994
T cell lymphoblastic lymphoma is characterized by immature lymphoid cells that are indistinguishable from the lymphoblasts and prolymphocytes of acute lymphoblastic leukemia. Several characteristic clinical features of lymphoblastic lymphoma, with include a high male-to-female ratio, a relatively high incidence in older children and young adults, the frequent presence of mediastinal involvement at the time of diagnosis. Also, this disease is...
Original Article
The Effect of Cranial Irradiation on Growth of Children with Lymphatic Origin Tumors
Jin Seoup Jung, Yon Sook Rho, Sang Woo Kim
Clin Exp Pediatr. 1994;37(5):666-671.   Published online May 15, 1994
A retrospective study was conducted to investigate the effects of CNS prophylaxis with 1,800cGy cranial irradiation on standing height growth of children with acute lymphoblastic leukemia(ALL). Seventeen longterm survivors (DFS over 5 years) of ALL and Non-Hodgkins Lymphoma who had been admitted at pediatric department of Inje University Seoul Paik Hospital from January 1982 to September 1988 were studied. The long term...
Immune response induced by live attenuated varicella vaccine(Biken@) in children with acute lymphoblastic leukemia.
Hyo Seop Ahn, Joong Gon Kim
Clin Exp Pediatr. 1991;34(9):1255-1260.   Published online September 30, 1991
To determine the safety and efficacy of varicella vaccine, we studied 10 healthy children and 12 children in remission from acute lymphoblastic leukemia. They were immunized with the Oka strain of live attenuated varicella vaccine (Biken®). All the healthy children and 6 children with leukemia received the vaccine of 1,000 plaque-forming units (PFU), and 6 leukemic children received the vaccine of 500 PFU. The...
A case of bone marrow necrosis in acute lymphoblastic leukemia.
Mee Ran Kim, Hye Lim Jung, Hong Hoe Koo, Hee Young Shin, Hyo Seop Ahn
Clin Exp Pediatr. 1991;34(8):1163-1168.   Published online August 31, 1991
Bone marrow necrosis is a rare complication most commonly encountered in patients with leuke- mia, metastatic tumor in marrow, sickle cell disease, DIC and severe infections. Recently it is regarded as a more common finding frequently overlooked and carrying not so poor prognosis. We reported here a boy with ALL who showed marrow necrosis on biopsy at the time of diagnosis and achieved complete...
A case of acute lymphoblastic leukemia complicating neuroblastoma in remission.
Dong Woo Son, Bum Soo Park, Jun Jae Kim, Hong Hoe Koo, Hee Young Shin, Hyo Seop Ahn
Clin Exp Pediatr. 1991;34(5):720-729.   Published online May 31, 1991
As childhood cancer survivors are now increasing in number owing to the improvements in diagnosis, staging, and treatment, concerns have been raised regarding the quality of survival of these patients. One of the limitation to quality and length of survival has been the development of second malignant neoplasm (SMN). In Korea, only one case of SMN has been reported. However, one can expect that...