After allogeneic peripheral blood stem cell transplantation (PBSCT), children are at high risk of hepatitis B virus (HBV) infection because of the potential loss of HBV immunity. The factors which can affect it are not fully understand. This study aimed to assess the probability of hepatitis B surface antibody (HBsAb) disappearance after PBSCT and to evaluate the impact of donor and recipient immunity on HBsAb disappearance. A total of 110 patients who underwent PBSCT between January 2016 and December 2018 and their paired donors were retrospectively enrolled in this study. Before transplantation, 87 (79.1%) patients were HBsAb seropositive, and 23 (20.9%) were HBsAb seronegative. Fifty-five (63.2%) patients with protective HBsAb titers before PBSCT lost their HBV immunity within one year after transplantation. Univariate analysis showed that the low recipient pretransplant HBsAb titer, antithymocyte globulin (ATG) administration, corticosteroid administration and graft-versus-host disease (GVHD) were significant risk factors for HBsAb disappearance (P<0.05). Multivariate analysis showed that only recipient pretransplant HBsAb titers lower than 207.5 IU/L (P=0.022, hazard ratio (HR): 1.925, 95% confidence interval (CI): 1.101-3.367) and the presence of GVHD (P=0.033, HR=1.921, 95% CI: 1.056-3.495) were risk factors for HBsAb disappearance one year after HSCT. In conclusion, most recipients lost previously acquired immunity to HBV after PBSCT. A high titer of HBsAb in the recipient before transplantation had a protective effect against posttransplant HBsAb disappearance, but the presence of donor immunity did not significantly influence the maintenance of recipient immunity to HBV.

Abstract Children aged 2-12 years scheduled to receive moderately or highly emetogenic chemotherapy were randomly assigned to arm-A (fosaprepitant) or arm-B (aprepitant). Children recruited to arm-A received intravenous ondansetron plus dexamethasone followed by fosaprepitant infusion. Children recruited to arm-B received the same drugs as those given to children in arm-A, except that fosaprepitant was substituted with aprepitant. The primary end point of the study was to determine the proportion of patients who achieved a CR, defined as no vomiting, no retching, and no use of rescue medication, the proportion of patients who achieved a CR during the acute phase (0-24 hours) after administration of the last dose of chemotherapy. Secondary end points were the proportion of patients who achieved a CR during the 24-120 hours (delayed phase) and overall after administration of the last dose of chemotherapy. Results: One hundred and eight patients were analyzed (55 in the fosaprepitant arm and 53 in the aprepitant arm). CR rates were higher in the fosaprepitant arm compared with the aprepitant arm during the acute phase (95 % vs 79 %, P =0.01< 0.05), delayed phase (71 % vs 66 %, P =0.89 ), and overall phase (69 % vs 57 %, P =0.18). Furthermore, the demand of rescue anti-emetics observed in fosaprepitant arm (7 %) has no difference with aprepitant arm (11 %). Conclusion: Addition of fosaprepitant to ondansetron and dexamethasone is more effective than aprepitant for the prevention of acute vomiting.

Objective This study aimed to assess the development and current state of management and outcome for neuroblastoma (NB) in Shanghai China. Methods The clinical characteristics and survival rates of a large cohort of 717 NB cases in the recent 10 years from two children’s medical institutions in Shanghai China were retrospectively analyzed. Results The 8y-EFS and OS of the whole cohort in the 10 years were 67.6±2.2% and 81.2±2.1%. Our risk stratification system was updated twice during the 10 years, forming three periods. The percentage of very low risk (VLR) cohort who accepting only surgery without chemotherapy was increased in 2016-2018 period than the 2010-2015 period and 2008-2009 period. While the 3y-EFS of the three periods were similar (P=0.961). The outcome in VLR and low risk (LR) patients were excellent with 8y-EFS around 92% (VLR=93.0±2.8%, LR= 92.1±1.8%). The outcome in high risk (HR) patients was significantly poorer with 8y-EFS only as 16.6±4.1% even than intermediate risk (IR) patients with 8y-EFS as 69.6±4.4% (P<0.001). Conclusions The revision of our risk stratification system was effective, making an increasing percentage of patients without chemotherapy while with similar EFS rates. The VLR and LR cohort had excellent outcomes, however the HR cohort with most of the mortality remains one of the greatest challenges. Enriching the transplant resources, importing melphalan to make ASCT more available and effective, and importing advanced novel therapies like anti-GD2 antibody and 131I-mIBG are our objectives to improve the survival of the HR patients.

Approximately 20–40% of pediatric patients with anaplastic large-cell lymphoma (ALCL) develop recurrent disease. Here, we report a pilot experience using single-drug weekly vinorelbine (25 mg/m2/wk) as a salvage re-induction regimen in 4 consecutive pediatric patients with relapsed ALCL. All 4 patients achieved complete remission after 2 cycles of weekly vinorelbine and were disease-free alive at last evaluation. The main toxicity was hematologic. Only one week of vinorelbine administration was withheld for a grade 4 neutropenia in one patient. The results suggest that weekly vinorelbine has good efficacy and safety in the treatment of relapsed pediatric ALCL.