Children with Down syndrome (DS) have an increased risk for acute lymphoblastic leukemia (ALL). Although previous studies have shown that DS-ALL differs clinically and genetically from non-DS-ALL, much remains to be elucidated as regards genetic and prognostic factors in DS-ALL.
To address clinical and genetic differences between DS-ALL and non-DS-ALL and to identify prognostic factors in DS-ALL, we ascertained and reviewed all 128 pediatric DS-ALL diagnosed in the Nordic countries between 1981 and 2010. Their clinical and genetic features were compared with those of the 4,647 B-cell precursor (BCP) ALL cases diagnosed during the same time period.
All 128 DS-ALL were BCP ALL, comprising 2.7% of all such cases. The 5-year event-free survival (EFS) and overall survival (OS) were significantly (P?=?0.026 and P?=?0.003, respectively) worse for DS-ALL patients with white blood cell counts =50 ? 109/l. The age distributions varied between the DS and non-DS cases, with age peaks at 2 and 3?years, respectively; none of the DS patients had infant ALL (P?=?0.029). The platelet counts were lower in the DS-ALL group (P?=?0.005). Abnormal karyotypes were more common in non-DS-ALL (P?
Cytogenetic abnormalities in childhood acute myeloid leukaemia: a Nordic series comprising all children enrolled in the NOPHO-93-AML trial between 1993 and 2001.
Between 1993 and 2001, 318 children were diagnosed with acute myeloid leukaemia (AML) in the Nordic countries. The patient group comprised 237 children 2%) were + 8 (23%) (as a sole change in 6.2%), 11q23-translocations, including cryptic MLL rearrangements (22%) [t(9;11)(p21-22;q23) in 11%], t(8;21)(q22;q22) (9.0%), inv(16)(p13q22) (6.2%), -7/7q- (5.2%), and t(15;17)(q22;q12) (3.8%). Except for +8, these abnormalities were rare in group 2; only one DS patient had a t(8;21) and none had 11q23-translocations, t(15;17) or inv(16). In the t-AML group, three cases displayed 11q23-rearrangements, all t(9;11); and there were no t(8;21), t(15;17) or inv(16). Overall, the observed frequencies of t(8;21) and t(15;17) were lower, and frequencies of trisomy 8 and 11q23-translocations higher, than in previous studies. Furthermore, seven abnormalities that were previously reported as only single AML cases were also seen, meaning that der(4)t(4;11)(q26-27;q23), der(6)t(1;6)(q24-25;q27), der(7)t(7;11)(p22;q13), inv(8)(p23q11-12), t(11;17)(p15;q21), der(16)t(10;16)(q22;p13) and der(22)t(1;22)(q21;q13) are now classified as recurrent abnormalities in AML. In addition, 37 novel aberrations were observed, 11 of which were sole anomalies.
To describe reduction as a method using van Manen's phenomenological hermeneutic research approach.
Reduction involves several levels that can be distinguished for their methodological usefulness. Researchers can use reduction in different ways and dimensions for their methodological needs.
A study of Finnish multiple-birth families in which open interviews (n=38) were conducted with public health nurses, family care workers and parents of twins.
A systematic literature and knowledge review showed there were no articles on multiple-birth families that used van Manen's method. Discussion The phenomena of the 'lifeworlds' of multiple-birth families consist of three core essential themes as told by parents: 'a state of constant vigilance', 'ensuring that they can continue to cope' and 'opportunities to share with other people'.
Reduction provides the opportunity to carry out in-depth phenomenological hermeneutic research and understand people's lives. It helps to keep research stages separate but also enables a consolidated view. Social care and healthcare professionals have to hear parents' voices better to comprehensively understand their situation; they need further tools and training to be able to empower parents of twins.
This paper adds an empirical example to the discussion of phenomenology, hermeneutic study and reduction as a method. It opens up reduction for researchers to exploit.
To describe reduction as a method in methodological and hermeneutic reduction and the hermeneutic circle using van Manen's principles, with the empirical example of the lifeworlds of multiple-birth families in Finland.
Reduction involves several levels that can be distinguished for their methodological usefulness. Researchers can use reduction in different ways and dimensions for their methodological needs.
Open interviews with public health nurses, family care workers and parents of twins.
The systematic literature and knowledge review shows there were no articles on multiple-birth families that used van Manen's method.
This paper presents reduction as a method that uses the hermeneutic circle. The lifeworlds of multiple-birth families consist of three core themes: 'A state of constant vigilance'; 'Ensuring that they can continue to cope'; and 'Opportunities to share with other people'.
Reduction allows us to perform deep phenomenological-hermeneutic research and understand people's lifeworlds. It helps to keep research stages separate but also enables a consolidated view. Social care and healthcare professionals have to hear parents' voices better to comprehensively understand their situation; they also need further tools and training to be able to empower parents of twins.
The many variations in adapting reduction mean its use can be very complex and confusing. This paper adds to the discussion of phenomenology, hermeneutic study and reduction.
