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Leukaemia Leukaemia
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Epidemiology Epidemiology
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Incidence/100,000 under 16 Incidence/100,000 under 16
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Aetiology Aetiology
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Genetic predisposition Genetic predisposition
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Chromosome fragility Chromosome fragility
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Trisomy 21 Trisomy 21
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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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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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Lymphoma 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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Investigation Investigation
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Classification Classification
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Immunohistochemistry Immunohistochemistry
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Cytogenetics Cytogenetics
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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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Mature B-cell lymphoma Mature B-cell lymphoma
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Lymphoblastic lymphoma Lymphoblastic lymphoma
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Further reading Further reading
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Paediatric central nervous system tumours Paediatric central nervous system tumours
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Introduction Introduction
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Incidence Incidence
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Current survival rates Current survival rates
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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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Supratentorial PNET Supratentorial PNET
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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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Paediatric solid tumours and kidney tumours Paediatric solid tumours and kidney tumours
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Introduction Introduction
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Kidney tumours Kidney tumours
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Introduction Introduction
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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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Further reading Further reading
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Sarcomas 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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Further reading Further reading
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Neuroblastoma 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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Further reading Further reading
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Other paediatric tumours and Langerhans cell histiocytosis Other paediatric tumours and Langerhans cell histiocytosis
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Hodgkin lymphoma Hodgkin lymphoma
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Germ cell tumours 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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Further reading Further reading
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Internet resources Internet resources
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Cite
Extract
Leukaemia
Leukaemia is the commonest cancer (accounting for >40% of cases) in children. It is a clonal proliferation of stem cells which leads to bone marrow failure and tissue infiltration.
Epidemiology
Incidence/100,000 under 16
...
Peak incidence of ALL is 2–5 years. T cell-ALL is commoner in adolescence. AML, CML, MDS occur at all ages.
Aetiology
Genetic predisposition
Chromosome fragility
Increased incidence in children with Fanconi's (10–15% will develop AML), Bloom's syndrome (ALL), and ataxia telangiectasia (ALL). DNA repair defects including Li–Fraumeni syndrome, BRCA, and MSH2 mutations are associated with increased familial risk of leukaemias and solid tumours; the child may be index case.
Trisomy 21
(Down's syndrome) predisposes to ALL (15 times risk) and AML. Transient abnormal myelopoeisis (TAM) a myeloproliferative disorder with circulating megakaryoblasts, variable cytopenia, and organomegaly occurs in at least 10% of children with Down's syndrome. The majority of cases resolve spontaneously within 3 months although progressive hepatic or respiratory impairment may require therapy. Trisomy 21 results in disturbed foetal haemopoiesis in the liver and acquisition of GATA1 mutations which are present in blast cells of TAM and in the blasts of myeloid leukaemia of Down's syndrome (ML-DS), which may develop in up to 20% of children, post TAM.
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