• Asian Pacific Journal of Cancer Prevention
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• v.14 no.8
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• pp.4733-4737
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• 2013

Purpose: Numerous observational epidemiological studies have evaluated associations between breastfeeding and the risk of childhood Hodgkin lymphoma; however, the existing results are inconsistent. We therefore conducted a systematic review and meta-analysis. Methods: Medical literature was searched in the Pubmed and Embase databases to identify all English-language relevant studies up to April 10, 2013. Reference lists were thereafter hand-searched for additional articles. Studies that reported relative risk ratios (RRs) or odds ratios (ORs) with 95% confidence intervals (CIs) were included. This meta-analysis was conducted in accordance with the guidelines for the meta-analysis of observational studies in epidemiology. Results: We finally included 10 case-control studies in our meta-analysis, involving 1,618 childhood Hodgkin lymphoma cases and 8,181 controls. Overall, we did found a borderline significant association between breastfeeding and reduced risk of childhood Hodgkin lymphoma comparing ever breastfed children to never breastfed children (pooled OR =0.79; 95%CI, 0.58-1.08; P=0.13), with limited evidence for between-study heterogeneity (P =0.12, $I^2$ = 35.70%). Conclusion: There is limited evidence for an inverse association between breastfeeding and risk of childhood Hodgkin lymphoma.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.4
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• pp.1585-1588
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• 2014

Background: Data regarding childhood and adolescent non Hodgkin lymphomas in Iran are limited. The aim of this study was to assess the epidemiological and histomorphological features and survival of affected patients in our center. Materials and Methods: The clinicopathologic features and outcome of 44 children and adolescents with non Hodgkin lymphoma diagnosed during 2004-2012, were investigated retrospectively. The influence of potential prognostic parameters in overall survival was investigated by log-rank test and Cox regression analysis. Results: The mean age at presentation was $13.8{\pm}6.16$ years with a male predilection (M: F=3:1). Malignant lymphoma, not otherwise specified, diffuse large cell lymphoma and Burkitt lymphoma were the three most common histological types observed. The tumors were 36.4% intermediate grade, 27.3% high grade and 34.1% belonged to the malignant lymphoma not otherwise specified group. Immunohistochemistry findings were available in 39 cases. Out of these cases 33 (84.6%) had B cell lineage, 4 (10.25%) T cell lineage and 2 (5.12%) of the cases belonged to miscellaneous group. 3 year and 5 year survivals were 48% and 30% respectively and median survival was 36 months (95%CI=21.7-50.3 months). Overall survival in patients with high grade tumors was 19.5 months, in the intermediate group,79 months, and for malignant lymphomas not otherwise specified it was 33.6 months (p value=0.000). Conclusions: The survival rate for children and adolescents with non Hodgkin lymphomas at our center during 2004-2012 was at a low level.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.7
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• pp.3515-3519
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• 2016

Background: In Thailand, a national treatment protocol for childhood leukemia and lymphoma (LL) was implemented in 2006. Access to treatment has also improved with the National Health Security system. Since these innovations, survival of childhood LL has not been fully described. Materials and Methods: Trends and survival of children under 15 with childhood cancers diagnosed between 1993 and 2012 were investigated using the hospital-based data from the Khon Kaen Cancer Registry, Srinagarind Hospital, Faculty of Medicine, Khon Kaen University, Thailand. Childhood cancers were classified into 12 diagnostic groups, according to the ICCC based on the histology of the cancer. Survival rates were described by period, depending on the treatment protocol. For leukemias and lymphomas, survival was assessed for 3 periods (1993-99, 2000-5, 2006-12) while for solid tumors it was for 2 periods (before and after 2000). The impacts of sex, age, use of the national protocol, and catchment area on leukemia and lymphoma were evaluated. Overall survival was calculated using the Kaplan-Meier method while the Cox proportional hazard model was used for multivariate analysis. Trends were calculated using the R program. Results: A total of 2,343 childhood cancer cases were included. Survival for acute lymphoblastic leukemia (ALL) from 1993-9, 2000-5, and 2006-12 improved significantly (43.7%, 64.6%, and 69.9%). This was to a lesser extent true for acute non-lymphoblastic leukemia (ANLL) (28.1%, 42.0%, and 42.2%). Survival of non-Hodgkin lymphoma (NHL) also improved significantly (44%, 65.5%, and 86.8%) but not for Hodgkin disease (HD) (30.1%, 66.1%, and 70.6%). According to multivariate analysis, significant risk factors associated with poor survival in the ALL group were age under 1 and over 10 years, while not using the national protocol had hazard ratios (HR) of 1.6, 1.3, and 2.3 respectively. In NHL, only non-use of national protocols was a risk factor (HR 3.9). In ANLL and HD, none of the factors influenced survival. Survival of solid tumors (liver tumors, retinoblastomas) were significantly increased compared to after and before 2000 while survival for CNS tumors, neuroblastoma and bone tumors was not changed. Conclusions: The survival of childhood cancer in Thailand has markedly improved. Since implementation of national protocols, this is particularly the case for ALL and NHL. These results may be generalizable for the whole country.

• Childhood Kidney Diseases
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• v.21 no.1
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• pp.31-34
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• 2017

Tumor lysis syndrome is a serious complication of malignancy, resulting from the massive and rapid release of cellular components into the blood. Generally, it occurs after initiation of chemotherapy. The onset of spontaneous tumor lysis syndrome (STLS) before anti-cancer treatment is rare and occurs mostly in Burkitt lymphoma and non-Hodgkin's lymphoma. There are only a few case reports in children. Here, we report a case of STLS secondary to T-cell acute lymphoblastic leukemia (ALL), which presented with urinary stone and subsequent acute kidney injury with severe hyperuricemia. Occult malignancy should be considered in case of unexplained acute kidney injury with extreme hyperuricemia.

• Radiation Oncology Journal
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• v.13 no.3
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• pp.267-275
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• 1995

Radiotherapy and chemotherapy can effectively control cancer but can also cause new second cancers to develop as long-term complications especially in childhood cancer. We experienced two patients with second malignant solid neoplasm who had been treated with radiation and chemotherapy for childhood cancers One female patient with rhabdomyosarcoma of the right popliteal fossa was treated with radiotherapy at total dose of 54Gy Three years and seven months later, osteosarcoma developed in the field of radiation therapy The other male patient with non-Hodgkin's lymphoma of the small bowel was treated with radiotherapy and leiomyosarcoma developed in the field of radiotherapy 18 years later. We reviewed the literature of the second malignant neoplasm in children in respect of risk factors. The risk for a second primary cancer following radiotherapy or chemotherapy emphasizes the need for life long follow-up of patients receiving such treatments, particularly patients treated for childhood cancers.

• Journal of Environmental Health Sciences
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• v.45 no.3
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• pp.203-212
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• 2019

Objective: A total of five students at same middle school were reported to be diagnosed with pediatric leukemia (n=2), non-Hodgkin's lymphoma (NHL, n=1) and aplastic anemia (n=2) between 2016 and 2017. The aims of this study are to assess exposure to environmental hazardous agents known to be associated with the risk of leukemia and to examine whether the environment of school is associated with the risk leukemia. Method: A total of 11 environmental agents causing childhood leukemia were monitored using international certified method in schools where patients had ever attended. Radon & Thoron detector was used to monitor real-time airborne radon and thoron level ($Bq/m^3$). Clinician interviewed two among nine patients who agreed to participate in this study in order to examine the association of demographic and genetic factors by individually. Leukemia, NHL, and aplastic anemia were grouped into lymphohematopoietic disorder (LHP). Results: Except for airborne radon level, no environmental agents in school and household where patients may be exposed were found to higher than recommended airborne level. Clinical investigation found no individual factors that may be associated with the risk of LHP. Higher airborne radon level than Korea EPA's airborne radon criteria ($148Bq/m^3$) was monitored at most of several after-class room of one elementary school, where two leukemia patients graduated. Significant radon level was not monitored at class-room. Significant exposure to radon of patients was not estimated based on time-activity pattern. Conclusions: Our results have concluded that there have been no environmental factors in school and household environment that may be associated the risk of LHP.