
Contents
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14.1 Leukaemia 14.1 Leukaemia
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Introduction Introduction
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Epidemiology Epidemiology
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Aetiology Aetiology
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Genetic predisposition Genetic predisposition
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Therapy-related Therapy-related
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Sporadic Sporadic
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Clinical features Clinical features
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History and symptoms History and symptoms
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Examination Examination
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Diagnosis Diagnosis
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Management Management
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Supportive care Supportive care
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Treatment of infection Treatment of infection
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Treatment of bleeding Treatment of bleeding
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Treatment of anaemia Treatment of anaemia
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Prevention of tumour lysis Prevention of tumour lysis
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Treatment of hyperviscosity Treatment of hyperviscosity
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Curative therapy: risk-directed protocols Curative therapy: risk-directed protocols
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Treatment of acute lymphoblastic leukaemia Treatment of acute lymphoblastic leukaemia
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Subgroup-specific therapy Subgroup-specific therapy
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Infant ALL Infant ALL
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Philadelphia-positive ALL Philadelphia-positive ALL
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Relapse Relapse
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Treatment of acute myeloid leukaemia Treatment of acute myeloid leukaemia
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Subgroup-specific therapy Subgroup-specific therapy
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Down’s syndrome Down’s syndrome
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AML M3 AML M3
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Relapse Relapse
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Treatment of chronic myeloid leukaemia Treatment of chronic myeloid leukaemia
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Myelodysplasia/myeloproliferative disorders Myelodysplasia/myeloproliferative disorders
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Further reading Further reading
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14.2 Lymphoma 14.2 Lymphoma
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Introduction Introduction
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Non–Hodgkin lymphoma Non–Hodgkin lymphoma
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Aetiology Aetiology
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Genetic predisposition Genetic predisposition
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Clinical features Clinical features
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History and symptoms History and symptoms
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Examination Examination
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Investigations, classification, and staging Investigations, classification, and staging
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Investigations Investigations
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Classification Classification
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Immunohistochemistry Immunohistochemistry
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Cytogenetics Cytogenetics
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Staging Staging
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Management Management
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Supportive care Supportive care
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Curative therapy: risk directed protocols Curative therapy: risk directed protocols
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Hodgkin lymphoma Hodgkin lymphoma
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Aetiology Aetiology
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Clinical features Clinical features
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Investigations, staging, and risk groups Investigations, staging, and risk groups
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Management Management
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Classical HL Classical HL
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Nodular lymphocyte-predominant HL (nLPHL) Nodular lymphocyte-predominant HL (nLPHL)
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Further reading Further reading
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14.3 Paediatric central nervous system tumours 14.3 Paediatric central nervous system tumours
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Introduction Introduction
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Classification/types of tumours Classification/types of tumours
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Aetiology and biology Aetiology and biology
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Clinical presentation Clinical presentation
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General principles of management General principles of management
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Imaging Imaging
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Surgery Surgery
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Radiotherapy Radiotherapy
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Chemotherapy Chemotherapy
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Individual tumour types Individual tumour types
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Low-grade gliomas Low-grade gliomas
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Clinical presentation Clinical presentation
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Treatment Treatment
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Supratentorial high-grade gliomas Supratentorial high-grade gliomas
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Clinical presentation Clinical presentation
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Management Management
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Brainstem gliomas Brainstem gliomas
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Clinical presentation Clinical presentation
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Treatment Treatment
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Medulloblastoma Medulloblastoma
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Clinical presentation Clinical presentation
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Treatment Treatment
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Atypical teratoid rhabdoid tumour Atypical teratoid rhabdoid tumour
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Treatment and prognosis Treatment and prognosis
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Other embryonal tumours Other embryonal tumours
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Clinical presentation Clinical presentation
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Treatment Treatment
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Ependymoma Ependymoma
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Clinical presentation Clinical presentation
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Treatment Treatment
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Germ cell tumours Germ cell tumours
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Clinical presentation Clinical presentation
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Treatment Treatment
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Craniopharyngioma Craniopharyngioma
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Clinical presentation Clinical presentation
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Treatment Treatment
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Intramedullary spinal tumours Intramedullary spinal tumours
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Clinical presentation Clinical presentation
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Treatment Treatment
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Infant tumours Infant tumours
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Clinical presentation Clinical presentation
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Management Management
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Late effects Late effects
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Further reading Further reading
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14.4 Paediatric solid tumours and kidney tumours 14.4 Paediatric solid tumours and kidney tumours
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Solid tumours Solid tumours
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Kidney tumours Kidney tumours
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Diagnosis and staging Diagnosis and staging
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Investigations Investigations
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Biopsy Biopsy
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Histopathology, cytogenetics, and molecular biology Histopathology, cytogenetics, and molecular biology
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Treatment Treatment
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Non-metastatic unilateral disease Non-metastatic unilateral disease
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Bilateral Wilms’ tumour Bilateral Wilms’ tumour
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Metastatic Wilms’ tumour Metastatic Wilms’ tumour
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Follow-up Follow-up
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Prognostic factors and survival Prognostic factors and survival
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14.5 Sarcomas 14.5 Sarcomas
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Introduction Introduction
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Diagnosis and staging Diagnosis and staging
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Presentation Presentation
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Investigations Investigations
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Biopsy Biopsy
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Histopathology and molecular biology Histopathology and molecular biology
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Prognostic factors and survival Prognostic factors and survival
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Treatment Treatment
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14.6 Neuroblastoma 14.6 Neuroblastoma
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Introduction Introduction
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Diagnosis and staging Diagnosis and staging
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Biopsy Biopsy
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Treatment Treatment
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Follow-up Follow-up
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14.7 Other paediatric tumours and Langerhans cell histiocytosis 14.7 Other paediatric tumours and Langerhans cell histiocytosis
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Extracranial germ cell tumours Extracranial germ cell tumours
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Liver tumours Liver tumours
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Langerhans cell histiocytosis Langerhans cell histiocytosis
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14.8 Internet resources 14.8 Internet resources
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Cite
Abstract
This chapter covers all the most common types of cancer in children which include leukaemias, lymphomas, paediatric central nervous system tumours, paediatric solid tumours and kidney tumours, sarcomas, neuroblastoma, Langerhans cell histiocytosis, and other rarer entities. Leukaemia is the commonest malignant disease in children, accounting for >40% of cases. Lymphomas account for 8–10% of all childhood cancers. Non-Hodgkin lymphoma in children is aggressive and often leads to symptoms from tissue infiltration or compression of vital structures. Tumours of the central nervous system are the most common group of solid tumours in children and comprise 20–25% of all childhood neoplasms (about 400 cases per year in the UK). Whereas the majority of childhood solid tumours are embryonal in nature and carcinomas are extremely rare, sarcomas do occur at all ages and in most parts of the body. The most common sarcoma occurring in children is rhabdomyosarcoma which accounts for 25% sarcomas. Tumours of many types in children are more chemosensitive than most adult tumours. High cure rates and the risk of long-term side effects developing in survivors drive attempts to maintain or improve cure rates while minimizing sequelae and for this reason radiotherapy has a lesser role than systemic treatments in most situations.
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