Lymphography in bone and soft tissue sarcomas. Experiences from three institutions.

Journal and index pages often block iframe embedding. This reader keeps the evidence details in Orthonotes and leaves the source page one click away.

Abstract

[Indexed for MEDLINE] 18. Pediatr Hematol Oncol. 2023 May;40(4):422-428. doi: 10.1080/08880018.2022.2124006. Epub 2022 Sep 20. Dual enzyme therapy improves adherence to chemotherapy in a patient with gaucher disease and Ewing sarcoma. Lucari B(1), Tallis E(2), Sutton VR(3), Porea T(4). Author information: (1)Department of Pediatrics at Baylor College of Medicine, Texas Children's Hospital, Houston, Texas, USA. (2)Department of Molecular and Human Genetics at Baylor College of Medicine, Houston, Texas, USA. (3)Department of Molecular and Human Genetics, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA. (4)Department of Pediatrics Division of Hematology Oncology, Baylor College of Medicine and Texas Children's Hospital, Houston, Texas, USA. This case reports concomitant use of enzyme and substrate reduction therapy to improve chemotherapy adherence in a pediatric patient diagnosed with Ewing sarcoma (ES) and type 1 Gaucher disease (GD). The 17-year-old female presented with 5 months of right knee pain with associated mass on exam. She was diagnosed with ES with pulmonary metastasis. The patient was treated with 17 alternating cycles of vincristine-doxorubicin-cyclophosphamide and ifosfamide and etoposide chemotherapy followed by tumor resection and radiation per standard protocol. As part of her staging work-up, bone marrow biopsy was performed, significant for Gaucher cells. After the second cycle of chemotherapy the patient began to experience severe delays averaging 30 days between cycles compared to 17.29 days observed in Children's Oncology Group data. Given her bone marrow biopsy findings and chemotherapy delays GD screening was obtained and the patient was diagnosed with GD following genetic confirmation. Due to delays in chemotherapy decreasing chance of remission, the patient was referred to Genetics for aggressive management with imiglucerase and eliglustat. After initiation of therapy the period between chemotherapy cycles decreased to 23 days on average, with a 21% increase in platelet count during therapy. The patient was able to complete ES therapy achieving remission. GD is associated with an increased risk of malignancy, as seen in our patient with ES. GD patients experience prolonged hematologic cytopenia during cancer treatment. Combining Enzyme and Substrate Reduction Therapies should be investigated as an option to improve chemotherapy adherence in GD patients. DOI: 10.1080/08880018.2022.2124006