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Anaplastic Ependymoma in a Child With Sickle Cell Anemia: A Case Report Highlighting Treatment Challenges for Young Children With Central Nervous System Tumors and Underlying Vasculopathy
Author(s) -
Crotty Erin E.,
Meier Emily R.,
Wells Elizabeth M.,
Hwang Eugene I.,
Packer Roger J.
Publication year - 2016
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.25809
Subject(s) - medicine , ependymoma , chemotherapy , adverse effect , anemia , radiation therapy , fetal hemoglobin , central nervous system , sickle cell anemia , oncology , pediatrics , surgery , disease , pregnancy , fetus , biology , genetics
A 3‐year‐old boy with sickle cell anemia (SCA) presented with progressive daily emesis and was found to have an anaplastic ependymoma. Radiation therapy and chemotherapy are usually employed after subtotal resections of anaplastic ependymomas, although the benefits from chemotherapy are unclear. To mitigate the risks of adjuvant treatment in this patient at risk for SCA‐associated vasculopathy, renal impairment, and other end‐organ damage, proton beam irradiation without chemotherapy was chosen. Scheduled packed red blood cell transfusions were instituted to maintain sickle hemoglobin levels less than 30%. This case highlights treatment complexities for malignant brain tumors in patients predisposed to treatment‐related adverse effects.