Browsing by Author "Hendricks, Marc"

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    Evaluation of children with haemophagocytic lymphohistiocytosis (HLH) at Red Cross War Memorial Children's Hospital 1991-2010
    (2011) Switala, Juli; Hendricks, Marc
    Haemophagocytic Lymphohistiocytosis (HLH) is a rare haematological disorder in children. However, this is probably an underestimation due to the difficulty in diagnosing the disease. HLH is characterized clinically by persistent fevers, organomegaly, cytopaenias and typical biochemical derangements viz. hypertriglyceridaemia, hyperferritinaemia and hypofibrinogenaemia. Other associated findings include decreased natural killer cell (NKC) function and raised soluble CD 25. The exact pathophysiology of HLH is not completely understood but involves a trigger (often an infection) which sets off an uncontrolled inflammatory cascade, characterized by an increase in hyperactivated macrophages and T lymphocytes which leads to increased production of cytokines, alongside reduced cellular cytotoxicity as a result of reduced or absent NKC function.
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    Haemophagocytic lymphohistiocytosis following culture-proven pneumococcal infective endocarditis of the tricuspid valve
    (Health and Medical Publishing Group, 2012) Hendricks, Marc; Van Eyssen, Ann Louise
    We report a case of a 2-year-old boy presenting with persistent fever and splenomegaly who fulfilled the diagnostic criteria for haemophagocytic lymphohistiocytosis (HLH) according to the Histiocyte Society (2004). The persistence of a cardiac murmur despite multiple transfusions, and therapy which rendered him afebrile, led us to do an echocardiogram as part of surveillance for sepsis. This revealed tricuspid vegetation and a small ventricular septal defect. Blood culture and postoperative histology of the anterior leaflet of the tricuspid valve confirmed Streptococcus pneumoniae infection. The patient was successfully treated with intravenous antibiotic therapy for 6 weeks and dexamethasone for 8 weeks and remains well and in remission (from HLH) a year later with residual tricuspid regurgitation awaiting tricuspid valve replacement.
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    Medicine and the Arts Week 2 - In dialogue about children's voices
    (2015-01-21) Levine, Susan; Callaghan, Nina; Abney, Kate; Hendricks, Marc
    In this video, Associate Professor Susan Levine pose questions to Dr. Hendricks, Dr. Kate Abney, as well as Nina Callaghan in an attempt to unlock some of the synergies that brings their various perspectives into focus. Marc Hendricks is asked how doctors take care of themselves in dealing with the deaths, illness and victories of their patients’ stories. Kate talks about how she has used art as part of her research methodology and discusses how the issue of time surfaced in her work at the TB hospital. Nina provides an example of a child she had worked with. This is the fifth video in Week 2 of the Medicine and the Arts Massive Open Online Course.
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    Medicine and the Arts Week 2 - My song for the living
    (2015-01-21) Hendricks, Marc
    In this video, paediatric oncologist Mark Hendricks discusses the intersections between music and healing in the context of caring for children with cancer in middle-income settings. He discusses the importance of listening to and understanding the individual needs of children, and he emphasizes the importance of family-centered care, with the need to consider the social and cultural context when caring for children with cancer. This is the second video in Week 2 of the Medicine and the Arts Massive Open Online Course.
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    Prevalence, Risk Factors and Predictors of Adverse Outcomes of Febrile Neutropenia in Oncology Patients on Chemotherapy at the Red Cross War Memorial Children's Hospital: A Three Year Retrospective Study
    (2022) Adekunle, Motunrayo; Hendricks, Marc; Davidson, Alan
    Background: Febrile neutropenia (FN) is the commonest fatal acute complication of cancer treatment in children. The need for regional clinical decision rules allowing for home-based care in those at low risk for adverse outcomes has been identified. Aims: To evaluate the prevalence and potential risk factors for FN, identify adverse outcomes and validate a tool to identify risk for adverse outcomes in a cohort of children treated for cancer at the Red Cross War Memorial Children's Hospital, Cape-Town, South Africa. Methodology: A retrospective cohort study from 1st January 2017 to 31st December 2019. Results: In all, 179 patients had chemotherapy and 267 FN episodes occurred. Independent predictors of FN were AML (p = 0.039), ALL (p = 0.020) and intensive chemotherapy (p = < 0.001). Mucositis (p = 0.001), CVAD (p = 0.004, haematologic malignancies (p = 0.040), blood transfusion during FN episode (p = 0.001) and severe neutropenia (white cell counts< 0.3 x 109 cells/L) (p = < 0.001) were risk factors for adverse outcomes. The mortality rate from FN was 3.57%. Independent predictors of adverse outcomes were AML (p = 0.001), CVAD in-situ (p = 0.019) and severe neutropenia (p = 0.005). Validation of risk stratification for adverse outcomes using the Swiss Paediatric Oncology Group (SPOG) index with a cut-off value of nine demonstrated a sensitivity and specificity of 52.3% and 62.0%, respectively. Positive and negative predictive values were 56.3% and 58.2%, respectively, with an overall accuracy of 57.4%. In our cohort, coordinates of the curve are best able to predict adverse outcomes with a cut-off value of 7.5. Conclusion: Adverse outcomes from treatment are likely in children with AML, severe neutropenia and those with CVADs in-situ. A lower cut-off of 7.5 using the SPOG FN risk index best predicted adverse outcomes in our cohort.
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    The evolving management of Burkitt's lymphoma at Red CrossChildren's Hospital
    (2006) Davidson, Alan; Desai, Farieda; Hendricks, Marc; Hartley, Patricia; Millar, Alastair; Numanoglu, Alp; Rode, Heinz
    Background. Treatment for Burkitt’s lymphoma at Red Cross Children’s Hospital has evolved from the use of aggressive surgery and less intensive chemotherapy to a conservative surgical approach with more intensive chemotherapy. Methods. The study was a retrospective folder review of patients diagnosed with Burkitt’s lymphoma at RCCH between 1984 and 2004. Results. Ninety-two children were treated for Burkitt’s lymphoma at RCCH between 1984 and 2004. There were 10 patients with group A or fully resected disease, 52 with group B or extensive localised disease, and 30 with dissemination to the bone marrow and/or central nervous system or group C disease. Protocol 1 (less intensive chemotherapy based on the COMP regimen) was used from 1984, with protocol 2 (more intensive chemotherapy based on the LMB regimen) introduced in 1988 for group C disease, 1991 for group B disease and 1996 for group A disease. Overall 5-year survival increased from 20% with protocol 1 to 66% with protocol 2 for group C disease, and from 76.5% with protocol 1 to 88.2% with protocol 2 for group B disease. There were more admissions for neutropenic fever in patients on protocol 2 and more episodes of mucositis, and these patients required more red cell and platelet transfusions. With a more conservative surgical approach, biopsy largely replaced attempts to partially resect the tumour at primary surgery, and there was a consequent decline in surgical complications. Conclusions. Intensive chemotherapy with protocol 2 has resulted in improved survival for group C and group B patients, but with more morbidity. Protocol 1, which is less intensive with less morbidity, remains a viable strategy for group A and group B disease in resource-poor settings.