Hematology, oncology in adolescence:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia
Hanley & Belfus
1999
|
| Schriftenreihe: | Adolescent medicine
10,3 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XV S., S. 359 - 469 Ill., graph. Darst. |
| ISBN: | 1560532947 |
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| 650 | 4 | |a Oncology | |
| 650 | 4 | |a Pediatric hematology | |
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Datensatz im Suchindex
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| adam_text | Contents
Preface xv
Neil J. Grossman, M.D., and Stuart S. Winter, M.D.
Anemia and Coagulation Disorders in Adolescents 359
Jeffrey D. Hord, M.D.
The transition of childhood to adulthood includes many changes to nearly all parts of
the body and that is certainly true of blood and the coagulation system. Some disor¬
ders, like iron deficiency anemia, develop as the result of rapid growth. Approximately
10% of American adolescents are anemic and the prevalence is far greater in high risk
populations, such as urban, indigent African American adolescents, in which 40 50%
of young women are anemic. Adolescents at greater than average risk for developing
iron deficiency anemia, such as athletes involved in lengthy, intense physical activities
and pregnant adolescents, should be screened for anemia. Other blood problems are
inherited but the first manifestations may not emerge until adolescence, as in the case
of an adolescent girl discovered to have von Willebrand s disease during the evaluation
of excessive menstrual bleeding. Besides iron deficiency anemia and von Willebrand s
disease, this review focuses on management of other common hematologic disorders
seen in adolescent patients, including immune thrombocytopenic purpura, hemophilia,
thrombocytosis, and hypercoagulable disorders. ADOLESC MED 10:359 367, 1999
Treatment Strategies for Adolescents with Hemophilia:
Opportunities to Enhance Development 369
Kelly Green, M.S.W., L.I.S.W.
For adolescents, negotiating developmental tasks while living with hemophilia can be
difficult. Affected adolescents must somehow negotiate tasks inherent within normal
adolescent development, along with the added complications of hemophilia. Compli¬
cations may include changes in physical appearance due to a history of bleeding
episodes and the need for adolescents to think about the consequences of neglected
treatment before they are developmentally ready. However, current strategies employed
in the treatment of hemophilia have provided adolescents, their families, and their care
givers with opportunities to minimize the impact of hemophilia on adolescent develop¬
ment. Self infusion minimizes the social impact by allowing adolescents to quietly
leave the classroom, treat themselves, and return to class without notice. Prophylactic
care maintains a factor level that allows adolescents to participate in many more activ¬
ities. A multidisciplinary treatment center model for care promotes focused care, edu¬
cation, and anticipatory guidance to minimize the impact and help families adjust to
chronic illness. Strong state and national leadership provides research advocacy and
funding support for adolescent programming. ADOLESC MED 10:369 376, 1999
Autoimmune Hemolytic and Thrombocytopenic Disease
in the Adolescent Patient 377
Russell E. Ware, M.D., Ph.D.
Immune mediated hematologic disorders are not common among adolescent patients,
but they have a distinct and sometimes dramatic clinical presentation. The two most
common forms of immune mediated disorders include idiopathic (immune) thrombo¬
cytopenic purpura (ITP) and autoimmune hemolytic anemia (AIHA). Autoimmune
ix
x Contents
platelet destruction in ITP typically manifests with mucocutaneous bleeding, which is
often insidious in onset. In contrast, autoimmune erythrocyte destruction in AIHA
leads to anemia, jaundice, and sometimes hemoglobinuria. Both disorders are charac¬
terized by the presence of autoreactive antibodies that bind to circulating blood cells
and lead to immune clearance by macrophages within the reticuloendothelial system.
A careful history and physical examination are essential in the initial evaluation of a
patient with a suspected immune mediated hematologic disorder, coupled with limited
but appropriate laboratory testing. Patients should be evaluated for the presence of an
underlying condition that causes the immune dysregulation. Therapy should be indi¬
vidualized, depending upon the clinical course and lifestyle considerations. For ado¬
lescent patients, the therapeutic benefits must be weighed against potential side effects.
ADOLESC MED 10:377 384,1999
Too Little, Too Late: Primary vs. Secondary Interventions for
Adolescents with Sickle Cell Disease 385
Kathleen L. Lemanek, Ph.D., Sandra M. Steiner, M.S.S.W., L.I.S.W.,
andNeilJ. Grossman, M.D.
The cognitive, biological, and psychological characteristics of adolescents affect their
adaptation to a chronic medical condition. This article reviews the literature on how
sickle cell disease alters the normal developmental challenges facing adolescents.
Examples of these challenges include delayed maturation, neurologic complications,
sequelae of pain episodes, and prolonged financial and family dependence. These chal¬
lenges are also discussed within the context of family and peer relationships, as well as
cultural norms. Using the principles of anticipatory guidance, interventions into the
psychological development may help to preserve normal functioning. These interven¬
tions need to be provided in a manner acceptable to the adolescent within the commu¬
nity context. The education, counseling, and medical services provided by the
multidisciplinary team in the Comprehensive Sickle Cell Program at Children s
Hospital in Columbus, Ohio are used to highlight these intervention strategies. ADO¬
LESC MED 10:385^100,1999
Myelodysplastic Syndromes in the Adolescent 401
StuartS. Winter, M.D., Prasad Mathew, M.D.,
Rebecca L. Vaughan, R.N., B.S.N., and Kathryn Foucar, M.D.
Myelodysplastic syndromes (MDS) are a group of acquired blood diseases that are the
result of abnormal bone marrow function. The ineffective production of red cells,
platelets, and white blood cells can lead to symptomatic anemia, bruising, infections,
and the likelihood of evolution into acute myelogenous leukemia. While MDS is un¬
common in the adolescent patient, a surprising number of affected individuals are also
affected with a predisposing constitutional syndrome. The treatment of MDS in the
adolescent patient is in part determined by symptoms and also by the historical out¬
comes associated with each of five morphologic categories of presentation. Improved
supportive care has allowed for increasingly more children with MDS to survive into
the second decade of life. The management of MDS in affected adolescents presents a
number of interesting and worthwhile challenges to health care professionals. ADO¬
LESC MED 10:401^106,1999
Acute Lymphocytic Leukemia in the Adolescent:
Diagnosis, Treatment, and Outcomes 407
Kimberly P. Dunsmore, M.D.
Leukemia remains the most common cancer in childhood, and while great strides have
been made in increasing event free survival in the past 20 years, patients with high risk
features still pose a challenge for successful disease free survival. Older children and
adolescents are included in that high risk group. Approximately 80 85% of cases of
leukemia in the pediatric population are of the lymphocytic subtype. Overall disease
free survival rates for acute lymphocytic leukemia have increased to 80% for those
with standard or low risk disease and 65 70% for those with high risk disease. This is
a product of both a better understanding of the molecular pathophysiology of ALL and
the development of better treatment strategies based on risk. In acute myelogenous
leukemia, we have not achieved such success, and disease free survival rates are in the
30 40% range. This article discusses the diagnosis of leukemia in the adolescent pop¬
ulation with attention to pathogenesis, prognostic risk factors, therapy, outcome, and
late effects of acute lymphocytic leukemia. ADOLESC MED 10:407 417,1999
Lymphomas and Bone Tumors: Clinical Presentation, Management,
and Potential Late Effects of Current Treatment Strategies 419
E. Clifton Russell, M.D., Nancy L Dunn, M.D., and Gita V. Massey, M.D.
While many pediatric malignancies are seen predominantly in pre school children,
many cases of childhood non Hodgkin s lymphoma and most cases of Hodgkin s dis¬
ease and bone tumors are seen in the older child and adolescent. This review focuses
on current knowledge concerning the epidemiology, histopathology, molecular biol¬
ogy, clinical presentation, diagnosis, staging, treatment, and prognosis for older chil¬
dren and adolescents diagnosed with lymphoma or either of the two commonly seen
childhood bone tumors, namely osteosarcoma and Ewing s sarcoma. Survival figures
for all of these childhood malignancies have increased markedly in the past two
decades. We now have the relatively new experience of having an increasingly large
population of childhood cancer survivors to study and, unfortunately, are beginning to
see the long term consequences of these more successful treatments. This review con¬
cludes with an overview of the potential late effects of cancer therapy, effects that may
first be detected by the primary care physician caring for the adolescent who is a
cancer survivor. ADOLESC MED 10:419 435,1999
Adolescents, Cancer, and Hospice 437
Kathryn J. Klopfenstein, M.D.
The transition from childhood to adulthood represents a time of great physiologic and
psychologic change. The adolescence period can be divided into early, middle, and late
adolescence. The diagnosis of cancer and impending death during adolescence can add
more stress and demands during this difficult period. The normal tasks of adolescence
include separation from parents, development of abstract thinking, sexual awareness,
and future orientation with goals for career and marriage. These tasks must be accom¬
plished even in the face of severe illness. The physical changes brought about by
cancer and its treatment may be the major concern for the adolescent patient. The
prospect of death is met with denial and anger. Independence and therefore refusal of
help is maintained until the younger adolescent can no longer care for himself. The
older adolescent is more confident and may allow family closeness as death ap¬
proaches. The uniqueness of the adolescent requires the knowledge and patience of
health care providers. Hospice professionals who are trained to understand adolescents
may be able to allow them to die with independence and dignity. ADOLESC MED
10:437 443,1999
Bone Marrow Transplantation in Adolescents 445
Amanda M. Rauck, M.D., and Alfred C. Grovas, M.D.
This paper reviews bone marrow transplantation in adolescents. The primary indica¬
tions for bone marrow transplantation are malignancies, usually relapsed lymphomas
xii Contents
or acute/chronic leukemias. Autologous bone marrow transplantation is used as a high
dose consolidation therapy in some solid tumor patients with varied success.
Peripheral blood stem cells are a feasible source of autologous stem cells in adoles¬
cents. The process of stem cell transplantation and the complications are the same in
adolescents as in younger children and adults. Adolescents face the same biologic bar¬
riers to allogeneic transplant (minimal residual disease, availability of donor), but may
also face more problems with their insurance status. The psychological and social as¬
pects of bone marrow transplantation during adolescence are unique to their develop¬
mental stage. With appropriate medical, nursing, and psychosocial support, bone
marrow transplantation offers cure for the adolescent with high risk disease. ADO
LESC MED 10:445^*49,1999
The Success of Limb Salvage Surgery in the Adolescent Patient
with Osteogenic Sarcoma 451
Lawrence D. Weis, M.D.
Malignant bone tumors in the adolescent population are rare but serious problems that
are both life and limb threatening. Most of these tumors originate in the extremities,
hip girdle, or pelvic girdle and require complete surgical resection for adequate ther¬
apy. The greatest majority of these tumors are diagnosed as osteogenic sarcomas. In
the past, limb ablation was the only effective therapeutic option available to surgical
oncologists in adolescent osteosarcoma patients. However, today, after two decades of
advances in chemotherapy protocols and reconstructive surgical techniques, limb sal¬
vage surgery has become an accepted treatment standard. Because skeletal immaturity
and future bone growth is generally not a major reconstructive consideration in adoles¬
cents, 90% of the patients in this age group are today treated with limb sparing
surgery. The most significant question regarding the successful use of limb salvage
surgery is whether it adversely affects long term outcome compared with standard am¬
putations. The principal studies, both single and multi institutional, that compared the
risk of local tumor recurrence and overall disease free survival rate of the two types of
procedures, demonstrated no significant difference in disease free survival rates be¬
tween the two groups. Similarly, multivariant analyses have shown no survival benefit
for choice of surgical procedure in osteosarcoma patients. As a result, limb sparing
surgery for osteosarcoma patients has now been firmly established as a safe, effective,
and successful oncology procedure compared with limb ablation. ADOLESC MED
10:451^158,1999
Index 459
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| spelling | Hematology, oncology in adolescence guest ed.: Neil J. Grossman ... Philadelphia Hanley & Belfus 1999 XV S., S. 359 - 469 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Adolescent medicine 10,3 Kind Blood Diseases Diagnosis Children Diseases Diagnosis Hematology Oncology Pediatric hematology Tumors in children Jugend (DE-588)4028859-6 gnd rswk-swf Blutkrankheit (DE-588)4007281-2 gnd rswk-swf Krebs Medizin (DE-588)4073781-0 gnd rswk-swf (DE-588)4143413-4 Aufsatzsammlung gnd-content Krebs Medizin (DE-588)4073781-0 s Jugend (DE-588)4028859-6 s DE-604 Blutkrankheit (DE-588)4007281-2 s Grossman, Neil J. Sonstige oth Adolescent medicine 10,3 (DE-604)BV002648764 10,3 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=008784646&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | Hematology, oncology in adolescence Adolescent medicine Kind Blood Diseases Diagnosis Children Diseases Diagnosis Hematology Oncology Pediatric hematology Tumors in children Jugend (DE-588)4028859-6 gnd Blutkrankheit (DE-588)4007281-2 gnd Krebs Medizin (DE-588)4073781-0 gnd |
| subject_GND | (DE-588)4028859-6 (DE-588)4007281-2 (DE-588)4073781-0 (DE-588)4143413-4 |
| title | Hematology, oncology in adolescence |
| title_auth | Hematology, oncology in adolescence |
| title_exact_search | Hematology, oncology in adolescence |
| title_full | Hematology, oncology in adolescence guest ed.: Neil J. Grossman ... |
| title_fullStr | Hematology, oncology in adolescence guest ed.: Neil J. Grossman ... |
| title_full_unstemmed | Hematology, oncology in adolescence guest ed.: Neil J. Grossman ... |
| title_short | Hematology, oncology in adolescence |
| title_sort | hematology oncology in adolescence |
| topic | Kind Blood Diseases Diagnosis Children Diseases Diagnosis Hematology Oncology Pediatric hematology Tumors in children Jugend (DE-588)4028859-6 gnd Blutkrankheit (DE-588)4007281-2 gnd Krebs Medizin (DE-588)4073781-0 gnd |
| topic_facet | Kind Blood Diseases Diagnosis Children Diseases Diagnosis Hematology Oncology Pediatric hematology Tumors in children Jugend Blutkrankheit Krebs Medizin Aufsatzsammlung |
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