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Pediatric Hematology/Oncology

Pediatric Hematology/Oncology

Clinical discussions on pediatric blood disorders, childhood cancers, and specialized treatment protocols.

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What is the preferred treatment for a patient with an EBV+ monomorphic PTLD (DLBCL) not currently on immunosuppressive therapy?

1 Answers

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Medical Oncology · University of Maryland Cancer Center

For patients who are candidates for an anthracycline-based regimen, R-CHOP is usually given if CD20+ PTLD. Patients whose tumors do not express CD20 are treated with CHOP chemotherapy alone. R-CHOP can lead to ~ 65% of CR (Trappe et al., PMID 22173060).

How do you interpret a low VWF activity/antigen ratio, when both activity and antigen levels are above 50%?

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1 Answers

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Hematology · University of Washington School of Medicine

This discrepancy is most likely caused by heterozygosity for a VWF variant that either causes VWD type 2M, with defective binding to GPIbalpha, or interferes with the binding of ristocetin, assuming that the activity represents ristocetin cofactor activity. The presence of a bleeding history suggest...

How would you manage a young patient with HL who develops HF (EF < 30%) after 4 cycles of A+AVD who obtained a PET2 CR?

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2 Answers

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Hematology · The Robert Larner, M.D. College of Medicine at The University of Vermont

This is a tough case, and the management would depend on the extent of disease. Assuming that this is advanced stage HL, given the use of BV+AVD, I would be in favor of completing 6 cycles of therapy with a non-anthracycline-based regimen. You can consider consolidative radiation, but this would nee...