兒童癌症團隊

大多數癌症（99％）在成人中發展，每三個成年人中就有一個在其一生中會患上癌症，而兒童癌症發生率相對少很多，約每285名兒童中才有一個會在20歲前罹患癌症。但由於很多新療法的進步，目前兒童癌症總體存活率已超過80％！

什麼原因導致兒童癌症其實大多數未明，一小部分確知的如帶有遺傳易染體質 (唐氏症即是一例)、先前接觸輻射及有關治療導致等。

根據美國癌症中心提供的兒童癌症常見的警徴如下：

• 持續而原因不明的體重減輕
• 頭痛 (尤其當伴隨晨起嘔吐時)
• 骨骼、關節、背或腿部的腫或痛 (持續且漸增強)
• 腹部、頸部、胸部、骨盆、或腋窩摸到異常腫塊
• 紫斑、瘀青、出血皮疹
• 經常、頻繁或持續性感染
• 一個瞳孔有反光白點
• 持續噁心或嘔吐
• 經常疲倦或明顯的蒼白
• 突然出現並持續地眼睛或視力變化
• 反覆或持續性的不明原因發燒

有時，患有癌症的兒童不會顯示任何這些變化；或者，這些變化的原因可能不是癌症而來。當您擔心您的孩子有任何異常變化，請與醫師討論。

醫生會使用許多檢測來發現或診斷兒童癌症，並了解癌症是否已經傳播到身體的另一部分 (如果發生這種情況，就是所謂的轉移)。例如，影像檢測可以顯示癌症是否已經蔓延，並據此選擇治療方法。大多數類型的兒童癌症，切片檢查 (取一小塊組織樣本在實驗室中進行檢測) 是唯一可以確定身體某個部位是否有癌症的方法。如果切片檢查不可行，醫生可能會建議其他檢查，以幫助診斷。以下列出用於診斷兒童癌症的選項 (並非所有下列測試都將用於每個人)：體檢、血液測試、切片檢查、骨髓檢查、腰椎穿刺、超音波檢查、電腦斷層檢查、磁振造影檢查、正子攝影檢查（PET）或PET-CT掃描、其他掃描或放射性同位素檢測。許多這些測試可能會在治療期間和治療後重複進行，以確定治療效果如何。

出生至成人前有不同發展階段，各年齡層各有很多不同種類的好發癌症，雖然比起成人，癌症總數相對較少、但癌症種類卻非常多樣，以下大致分成15歲以下兒童及15至19歲青少年最常見的癌症類型簡略說明。

(1) 白血病Leukemia（約佔兒童癌症病例的29％）：包括急性淋巴細胞白血病（ALL）、急性髓性白血病（AML）等

(2) 腦和脊髓腫瘤Brain and spinal cord tumors（約佔26％）：包括膠質細胞瘤 Glial tumors (又細分為星形細胞瘤 Astrocytoma、寡樹突膠質細胞瘤Oligodendroglioma、室管膜瘤Ependymoma、脈絡叢癌Choroid plexus carcinoma、寡突星形細胞瘤 Oligoastrocytoma、膠質母細胞瘤Glioblastoma) 、混合神經膠質細胞瘤Mixed glial neuronal tumors (又細分為節膠質細胞瘤 Ganglioglioma、硬纖維性嬰兒節膠質細胞瘤Desmoplastic infantile ganglioglioma、多形性黃色星形細胞瘤Pleomorphioc xanthoastrocytoma、退行性節膠質細胞瘤Anaplastic ganglioglioma)、神經細胞瘤 Neural tumors (又細分為神經節細胞瘤 Gangliocytoma、神經細胞瘤 Neurocytoma) 、胚胎腫瘤 Embryonal tumors (又細分為髓母細胞瘤 Medulloblastoma、髓上皮瘤 Medulloepithelioma) 、室管膜母細胞瘤Ependymoblastoma (如非典型畸胎樣/橫紋肌樣瘤 Atypical Teratoid/Rhabdoid tumor) 、松果體腫瘤 Pineal tumors (如松果體細胞瘤Pineocytoma)

(3) 神經母細胞瘤 Neuroblastoma（約佔6％）：是一種未成熟神經細胞的腫瘤，最常原發於腎上腺，腎上腺位於腎臟頂部，是身體內分泌系統的一部分。

(4) 腎母細胞瘤 Wilms tumor（約佔5％）：是一種腎臟腫瘤

(5) 非何杰金氏淋巴瘤 Non-Hodgkin lymphoma（約佔5％）及何杰金氏淋巴瘤Hodgkin lymphoma（約佔3％）：是從淋巴系統原發的癌症

(6) 橫紋肌肉瘤（約佔3％）：是一種從橫紋肌原發的腫瘤，橫紋肌是人們可以控制的肌肉。另外，非橫紋肌肉瘤的其他罕見軟組織肉瘤也會發生。

(7) 視網膜母細胞瘤 Retinoblastoma（約佔2％）：是一種眼睛腫瘤

(8) 骨肉瘤 Osteosarcoma（約佔2％）和意文氏肉瘤 Ewing sarcoma（約佔1％）：通常原發於骨骼

(9) 生殖細胞腫瘤 Germ cell tumors：是罕見腫瘤，可原發於男孩睾丸或女孩卵巢，也可以原發於身體其他部位，包括大腦。

(10)    肋膜肺母細胞瘤 Pleuropulmonary blastoma：是一種罕見的肺部腫瘤

(11)    肝母細胞瘤 Hepatoblastoma和肝細胞癌 Hepatocellular carcinoma：是兩種肝腫瘤的類型

兒童到成人交界期有其特殊性，這階段有獨特的醫療，社交和情感需求，通常被歸為青少年和年輕人adolescents and young adults（AYA）族群。對於患有淋巴瘤，白血病或骨腫瘤的青少年來說，接受熟悉兒童癌症的專家治療可以提高生存率。另外，AYA族群也患有成人較常見的癌症類型，例如黑素瘤、睾丸癌、或卵巢癌，患有這些癌症的青少年可能要接受類似於成年人的治療，但他們也需要適合其年齡的社會和情感需求。15至19歲青少年中最常見的癌症類型如下：

(1) 非何杰金氏淋巴瘤 Non-Hodgkin lymphoma（15％）和何杰金氏淋巴瘤 Hodgkin lymphoma（8％）

(2) 生殖細胞腫瘤Germ cell tumors包括睾丸癌（8％）和卵巢癌（2％）等

(3) 中樞神經系統腫瘤CNS tumors (10%)

(4) 甲狀腺癌Thyroid cancer (11%)

(5) 黑色素瘤Melanoma (6%)

(6) 急性淋巴性白血病 (8%)

(7) 軟組織肉瘤Soft tissue sarcoma (7%)

(8) 骨腫瘤（7％）包括骨肉瘤 Osteosarcoma和意文氏肉瘤 Ewing sarcoma

(9) 急性骨髓性白血病 (4%)

在癌症兒童照護中，本院組成多學科團隊的醫療同仁們經常一起工作來照顧兒童病人及其家人，針對兒童及其家庭提供的額外支持服務，如兒童特別的生活輔導、營養諮詢、物理和職能治療、尋求社會資源等，此外，依需求提供特殊活動和計劃，幫助您的孩子和家庭正向面對疾病。

下面敘述兒童癌症最常見的治療方案，治療選擇和建議取決於幾個因素，如癌症的類型和分期、可能的副作用、病人的抉擇、和病人總體健康狀況等，照護計劃中治療症狀和副作用也是癌症護理的重要部分。

手術是切除腫瘤和周圍的一些健康組織的過程，許多患有腫瘤的兒童會根據階段需要接受手術治療。外科腫瘤醫師是專門用手術治療腫瘤的醫師，手術的目標是去除整個腫瘤加上安全邊緣，意即留下的周邊健康組織已沒有癌症。但大多數兒童腫瘤，手術後仍留下顯微鏡下可見的殘餘腫瘤細胞，於是醫師可能會推薦化療、放射治療、或其他治療。手術的副作用取決於腫瘤的部位和類型以及是否已轉移。

化療是使用藥物來摧毀癌細胞，通常作用機轉是抑制癌細胞的生長和分裂能力，化療計畫由兒童血液腫瘤學家提供，全身化療藥物進入血液到達整個身體的癌細胞，化療的常用方法包括靜脈注射、肌肉注射、脊髓腔注射、皮下注射，或者吞服藥丸或膠囊吸收進入靜脈。

化療方案或療程表通常告訴病人在哪段時間給予特定藥物組成及給多少循環數，病人可能每次接受一種藥物或同時給予不同藥物的組合。

化療的副作用取決於個人體質和使用的藥物及劑量，可能包括疲勞、感染風險、噁心和嘔吐、脫髮、食慾不振和腹瀉。治療結束後，這些副作用通常會消失。

放射治療是利用高能X光或其他粒子如光子來摧毀癌細胞，但對於年幼的兒童其成長中的健康器官和組織特別容易面臨輻射損傷和二次癌症的風險，醫師會盡可能避免使用放射治療。

最常見的放射治療方式稱為外束放射治療，它是從身體外部的機器發出的放射線。另外，使用植入輻射物進入身體進行放射治療時，則被稱為內部放射治療或近距離放射治療。

放射治療方案或療程表則說明在一段時間內給予的特定數量的治療組成。

放射治療的副作用可能包括疲勞、輕度皮膚反應、胃部不適和排便不暢。治療結束後，大多數副作用很快消失。

免疫療法，也被稱為生物療法，旨在提高身體的天然防禦能力，以對抗癌症。它使用由源於人體或實驗室製備而成的材料，來改善、瞄準、或恢復免疫系統功能。免疫療法的實例包括免疫細胞治療、檢查點抑制劑、癌症疫苗、單株抗體和干擾素等，不同類型的免疫治療可能導致不同的副作用。

幹細胞移植是以可以發展造血及免疫功能的健康造血幹細胞來置換包含癌症的骨髓的一種醫學過程。今天，這個過程通常被稱為幹細胞移植，而不是骨髓移植，因為目前多數被移植的是採用驅趕出來的血液中的幹細胞。

在推薦移植前，醫師會與病人和家屬討論這種治療的風險，並考慮其他幾個因素，如癌症類型、以前的治療結果、病人的年齡和一般健康狀況。

幹細胞移植依替代血液幹細胞的來源大致分成主要兩種類型：異體移植和自體移植。異體移植使用別人捐贈的幹細胞，而自體移植使用病人自己的幹細胞。在這兩種類型中，目標都是使用高劑量的化學療法和/或放射療法來破壞骨髓，血液和身體其他部位的所有癌細胞，然後允許置換血液幹細胞來創造健康的骨髓。副作用取決於移植的類型、您的一般健康狀況、和其他因素。

癌症及其治療經常引起副作用，除了減緩、停止或消除癌症的治療，癌症照護很重要一部分是緩解一個人的症狀和副作用，稱為緩和或支持性照護，這包括支持病人的身體、情感和社會需求。

緩和照護是包含減輕症狀、提高生活品質、支持病人及其家屬的任何治療。任何人，無論年齡、癌症的類型和期別，都可以得到緩和照護。在癌症治療過程中儘早開始緩和照護，效果最佳。接受癌症治療和緩和照護，可同時緩解副作用。事實上，接受這兩種治療的病人往往症狀較輕，生活品質較好，並且報告他們對治療更滿意。

緩和照護種類很多，通常包括藥物治療、營養改變、放鬆技巧、情緒支持和其他治療。您也可能接受類似於消除癌症的緩和療法，如化療、手術或放射療法。

在開始治療之前，請諮詢您的孩子的健康照護團隊，了解特定治療計劃和緩和治療方案的可能副作用。治療期間和之後，請務必告訴您的孩子的醫師或其他醫療保健團隊成員，以了解您的孩子是否遇到問題，以便盡快解決問題。

2012-2017較常見種類累積個案

1. 新診斷急性淋巴性白血病全部達成緩解，而唯一死亡案例乃因拒絕繼續治療一年多後家中死亡
2. 四例復發急性淋巴性白血病轉來移植，皆採用非親屬周邊血幹細胞移植，且皆長期血癌治癒存活，另一例等待移植中
3. 兩例臍帶血移植、一例親屬周邊血幹細胞移植復發再以臍帶血移植解救、一例半套相合移植
4. 五例 (包含三例急性骨髓性白血病、一例續發性血癌、一例慢性骨髓性白血病)目前皆血癌治癒存活，僅一例急性骨髓性白血病移植後復發死亡
5. 一例臍帶血移植，一例非親屬周邊血幹細胞移植
6. 四例目前皆無疾病存活，兩例死於組織球性疾病惡化
7. 一例自體周邊血幹細胞移植、一例親屬周邊血幹細胞移植、一例雙胞胎周邊血幹細胞移植復發再以非親屬周邊血幹細胞移植、一例半套相合移植
8. 12例惡性淋巴瘤目前皆無疾病存活，一例死於惡性淋巴瘤惡化、一例死於移植毒性
9. 一例親屬周邊血幹細胞移植、一例非親屬周邊血幹細胞移植、一例半套相合移植
10. 八例再生不良性貧血目前皆不須輸血且為無疾病存活者
11. 六例皆自體三重連續幹細胞移植
12. 10例惡性生殖細胞瘤傳統治療即達成無疾病存活，而六例傳統治療無法緩解或復發者，接受三重連續幹細胞移植，救回三例，另三例死於惡性生殖細胞瘤惡化
13. 六例皆自體三重連續幹細胞移植、一例雙胞胎周邊血幹細胞移植
14. 兩例中高風險神經母細胞瘤者，不須幹細胞移植，目前皆無疾病存活；九例高風險神經母細胞瘤者，藉由含高劑量自體移植療程，救回七例，但兩例死於神經母細胞瘤惡化，另一例無腫瘤狀態死於車禍意外
15. 一例自體周邊血幹細胞移植、一例親屬周邊血幹細胞移植
16. 各式惡性肉瘤目前包括橫紋肌肉瘤 (2)、滑液囊肉瘤 (2)、周邊原始神經外胚層細胞瘤 (2)、脂肪肉瘤、骨肉瘤、血管樣纖維組織瘤皆存活，其他四例惡性肉瘤死於疾病惡化
17. 三例臍帶血移植，一例非親屬周邊血幹細胞移植
18. 戴布氏貧血及先天角質異常骨髓衰竭症狀皆痊癒，第二型神經纖維瘤及裴馬氏疾病神經功能皆大幅進步，進行性纖維骨化症骨化減緩，有兩例罕病死於遺傳疾病相關併發症

Chen WT, Fang LH, Chen RL. Long-term cancer-free survival after infusion of autologous cord blood cells for rejection unrelated cord blood graft after myeloablative conditioning for t-MDS: A case report. Medicine 2015 February; 94 (5): e438

Li JF, Huang Y, Chen RL, Lee HJ. Induction of apoptosis by gene transfer of human TRAIL mediated by arginine-rich intracellular delivery peptides. Anticancer Res 2010; 30: 2193-2202.

Wang TF, Wen SH, Chen RL, Lu CJ, Zheng YJ, Yang SH, Chu SC, Kao RH, Chen SH. Factors associated with peripheral blood stem cell yield in volunteer donors mobilized with granulocyte colony-stimulating factors: the impact of donor characteristics and procedural settings. Biol Blood Marrow Transplant. 2008 Nov;14(11):1305-11.

Chen RL, Ro YC, Yeh SY, Lin DY, Hsu WL. Experience of peripheral blood stem cells collection from radial artery for unrelated donor transplantation. Biol Blood Marrow Transplant 2005; 11(2):S67

Chen RL. Current status of Buddhist Tzu Chi Stem Cells Center. 5th International Donor Registry Conference Book 2004 May S3-2 (      Special Contribution Award by Bone Marrow Transplant Care Association, Taiwan, R.O.C.)

Chen RL, Wang H, Hong CM, Buckley J, Seeger RC. Oligonucleotide array expression profiling of 30 Cancer/Testis genes in metastatic neuroblastomas demonstrates heterogeneous expression and correlation with gender and MYCN gene status. Proc.Amer.Assoc.Cancer Res. 2002; 43: 280 (A1390)

Chen RL, Reynolds CP, Seeger RC. Neutrophils are cytotoxic and growth inhibitory for neuroblastoma cells with anti-GD2 antibody but can be growth stimulating if target cell interaction is ineffective. Cancer Immunol Immunotherapy 2000; 48(11): 603-12.

Wen S, Wang H, Wu HW, Chen RL, Reynolds CP, Seeger RC. Improved detection of rare neuroblastoma cells in bone marrow and blood by RT-PCR analysis of PGP 9.5 and tyrosine hydroxylase expression. Proc.Amer.Assoc.Cancer Res. 1999; 40: 709 (A4689)

Chen RL, Reynolds CP, Kesheleva N, Handgrettinger R, Metelitsa L, Gillies S, Seeger RC. Neutrophils and mononuclear cells (MNC) are cytotoxic for chemotherapy-sensitive and -resistant neuroblastoma cell lines with an anti-GD2/GM-CSF fusion protein. Proc.Amer.Assoc.Cancer Res. 1999; 40: 355 (A2352) (Career Development Fellowship Award, Childrens Hospital Los Angeles, USA)

Chen RL, Yang YJ, Peters J, Reynolds CP, Seeger RC. Enhancement of antigen presentation/processing and MAGE/BAGE gene expression by interferon gamma (IFN-g) and 5-aza-2’-deoxycytidine (5-Az-dC) in neuroblastomas (NBL). Proc.Amer.Assoc.Cancer Res. 1997; 38: 118. (AACR Young Investigator Award)

Chen RL, Hong CM, Peters J, Matthay KK, Seeger RC. Frequent expression of MAGE and BAGE genes by neuroblastomas. Proc.Amer.Assoc.Cancer Res. 1996; 37: 463-4. (AACR Travel Award)

Butturini A, Chen RL, Tang SQ, Hong CM, Peters J, Matthay KK, Reynolds CP, Seeger RC. Detection of bone marrow (BM) metastasis in neuroblastoma (NBL) by RT-PCR for neural and tumor associated genes. Proc Amer Assoc. Clin Oncol. 1996; 15: 468. (A1476)

Chen RL, Lin HT, Chen LY. Chemotherapy for extracranial germ cell tumours in paediatric, adolescent, and young adult patients. Eur Med J Oncol. 2017 Oct; 51:93-102

Fang LH, Shih LS, Lee PI, Chen WT, Chen RL. Mediastinal germ cell tumor-associated histiocytic proliferations treated with thalidomide plus chemotherapy followed by alemtuzumab-containing reduced intensity allogeneic peripheral blood stem cell transplantation: A case report. Medicine 2016 January; 95 (2): e2515

Chou HC, Chen RL, Tsou Yau KI, Huang SF, Ni YH, Tang JR. Infantile choriocarcinoma with idiopathic massive fetomaternal hemorrhage. Med Pediatr Oncol 2002 Mar; 38(3): 203-4.

Jin Y, Chen RL, Wang PJ, Hsu YH, Chen HT, Chang PY. Sacrococcygeal germ cell tumor and spinal deformity in association with Sotos syndrome. Med Pediatr Oncol 2002 Feb; 38(2): 133-4.

Chen RL, Chang PY, Hsu YH, Chang YH, Peng HC. Recurrent life-threatening hemothorax in an infant with pleurocutaneous Kaposiform hemangioendothelioma. J Pediatr Hematol/Oncol 2006; 28(9): 630-632.

Chen RL. Epidemiology of childhood cancer in east Taiwan. Acta Paediatr Tw 2006; 47 (suppl): 38-42.

Sun TB, Chen RL, Hsu YH. The effect of hyperbaric oxygen on human oral cancer cells. Undersea and Hyperbaric Medicine 2004; 31(2): 251-60.

Lin MT, et al. Unstratified chemotherapy for non-metastatic osteosarcoma of the extremities in children. J Formos Med Assoc. 2003 Jun; 102(6): 387-93.

Chiu HH, Chen RL, Lin KH, Lin DT, Lin KS. Recombinant -interferon treatment of intracranial hemangioma and Kasabach-Merritt syndrome in an infant with cytomegalovirus. J Formosa Med Assoc 1995; 94: 261-6.

Chen RL. Immuno-Chemo-Target Therapy for Histiocytic Proliferative Disorders. World Cancer Congress 2017

Chen RL, Hsu YH, Ueda I, Imashuku S, Takeuchi K, Tu BP, Chuang SS. Cytophagic histiocytic panniculitis with fatal haemophagocytic lymphohistiocytosis in a paediatric patient with perforin gene mutation.  J Clin Pathol 2007 (Oct. 1); 60: 1168-1169.

Chen RL, Wu PL, Hsu YH, Kuo PL. Evans syndrome after unrelated cord blood transplantation for disseminated Langerhans cell histiocytosis in a child. J Pediatr Hematol/Oncol 2007; 29(5): 348-350.

Chen RL. Familial and viral-associated hemophagocytic lymphohistiocytosis. Formosan J Med 2005; 9 (6): 760-767.

Chen RL, Lin JC, Wang PJ, Lee CP, Hsu YH. Human herpesvirus-8-related childhood mononucleosis syndrome: A series of three cases. Pediatr Infect Dis J 2004; 23(7): 671-4

Chen RL, et al. Childhood Langerhans cell histiocytosis increased during El Nino 1997-98: A report from Taiwan Pediatric Oncology Group. Acta Paediatr Tw 2003; 44: 14-20. (Pharmacia Award in Pediatric Research by Pediatric Society of Taiwan, R.O.C.)

Chen RL. Infection-associated childhood lymphohistiocytosis. Acta Paediatr Tw 2002; 43 (suppl): 25-8.

Chen JS, Lin KH, Lin DT, Chen RL, Jou ST, Su IJ. Longitudinal observation of non-familial childhood haemophagocytic syndrome receiving etoposide-containing regimans. Br J Haematol 1998; 103: 756-762.

Chen RL, Lin KH, Lin DT, Su IJ, Huang LM, Lee PI, Hsieh KH, Lin KS, Lee CY. Immunomodulation treatment for childhood virus-associated haemophagocytic lymphohistiocytosis. Br J Haematol 1995; 89: 282-90. (Research Award by Medical Development Foundation, Taiwan, R.O.C.)

Teng RJ, Chen RL, Lin DT, Lin KH, Lee CY. Cytomegalovirus-Induced Persistent Mononucleosis in An Infant. Acta Paed Sin 1994; 35: 221-4.

Su IJ, Chen RL, Lin DT, Lin KS, Chen CC. Epstein-Barr Virus (EBV) Infects T Lymphocytes in Childhood EBV-Associated Hemophagocytic Syndrome in Taiwan. Am J Pathol 1994; 144: 1219-25.

Chen RL, Su IJ, Lin KH, Lee SH, Lin DT, Chuu WM, Lin KS, Huang LM, Lee CY. Fulminant childhood hemophagocytic syndrome mimicking histiocytic medullary reticulosis in Taiwan: an atypical form of Epstein-Barr virus infection. Am J Clin Pathol 1991; 96:171-6. (Nestle Award in Pediatric Research by Pediatric Society of Taiwan, R.O.C.)

Su IJ, Lin DT, Hsieh HC, Lee SH, Chen JL, Chen RL, Lee CY, Chen JY. Fatal primary Epstein-Barr virus infection masquerading as histiocytic medullary reticulosis in young children in Taiwan. Hematol Pathol 1990; 4(4): 189-95.

Huang LM, Lee CY, Lin KH, Chuu WM, Lee PI, Chen RL, Chen JM, Lin DT. Human herpesvirus-6 associated with fatal haemophagocytic syndrome. Lancet 1990; ii:60-1.

Teng RJ, Chen RL, Wu TJ, Lin KH. Clover-leaf nucleus of atypical lymphocytes in CMV-mononucleosis syndrome: Report of one case. Acta Paediatr Sin 1990; 31:379-82.

Yen HJ, et al. Pediatric acute lymphoblastic leukemia with t(1;19)/TCF3-PBX1 in Taiwan. Pediatr Blood Cancer. 2017 Oct;64(2):234-241.

Li MJ, et al. Treatment of childhood acute lymphoblastic leukemia in Taiwan: Taiwan Pediatric Oncology Group ALL-2002 study emphasizing optimal reinduction therapy and central nervous system preventive therapy without cranial radiation. Pediatr Blood Cancer. 2017 Feb;64(2):234-241.

Liu WH, Chen WT, Fang LH, Chen RL. Idiopathic pneumonia syndrome and thrombotic microangiopathy following nonmyeloablative haploidentical peripheral blood stem cell transplantation and post-transplant cyclophosphamide: A case report. Medicine 2015 July; 94 (29): e1200

Yang SF, Chuang WY, Chang ST, Liu H, Chen RL, Chuang SS. Pediatric follicular lymphoma: a report of the first 3 cases from Taiwan and literature review. Pediatr Hematol/Oncol 2011; 28: 661-668.

Chen RL, Chuang SS, Lu YH. Treatment of progression during reductive prophase for paediatric primary mediastinal B-cell lymphoma using dose-adjusted EPOCH chemotherapy. Pediatr Blood Cancer 2011; 56: 1149-50

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Liang DC, et al. Long-term results of Taiwan Pediatric Oncology Group studies 1997 and 2002 for childhood acute lymphoblastic leukemia. Leukemia. 2010 Feb;24(2):397-405.

Chen RL, Chuang SS. Transient spontaneous remission after tumor lysis syndrome triggered by severe pulmonary infection in an adolescent boy with acute lymphoblastic leukemia. J Pediatr Hematol/Oncol 2009 Jan; 31(1):78-80.

Chien JH, Tang JL, Chen RL, Li CC, Lee CP. Detection of BCR-ABL gene mutations in Philadelphia chromosome positive leukemia patients resistant to STI-571 cancer therapy. Leukemia Res 2008; 32: 1724-1734.

Liang DC, et al. Improved treatment results for childhood acute myeloid leukemia in Taiwan. Leukemia 2006; 20: 136-141.

Ru HY, Chen RL, Lu WC, Chen JH. HBUB1 defectsin leukemia and lymphoma cells. Oncogene 2002 Jul; 21: 4673-9.

Yang CP, et al. Treatment results of the TPOG-NHL92 protocols for childhood non-Hodgkin’s lymphomas in Taiwan: A report from the Taiwan Pediatric Oncology Group (TPOG). Acta Paediatr Tw 2000; 41: 193-204.

Lee WT, Lin KH, Chen RL, Lin DT, Chieh CH, Tien HF, Yau Tsou KI, Lin KS. Congenital monoblastic leukemia in a newborn with a rare t(10;11)(p13;q21) translocation: regression after low-dose cytosine arabinoside and steroids. Int J Pediatr Hematol Oncol 1995; 2: 341-4.

Su IJ, Wang CH, Cheng AL, Chen RL. Hemophagocytic syndrome in Epstein-Barr virus-associated T-lymphoproliferative disorders: disease spectrum, pathogenesis and management. Leukemia & Lymphoma 1995; 19: 401-6.

Yu CH, Lin KH, Lin DT, Chen RL, Horng YC, Chang MH. L-asparaginase-related pancreatic pseudocyst: report of a case. J Formosa Med Assoc 1994; 93: 441-4.

Lin KH, Jou ST, Chen RL, Lin DT, Lin KS. Bone marrow transplantation for childhood acute myelogenous leukemia. Acta Paed Sin 1994; 35: 415-422.

Lin KH, Jou ST, Chen RL, Lin DT, Lin KS. Bone marrow transplantation for children with acute lymphoblastic leukemia in second remission or relapse. Acta Paed Sin 1994; 35: 487-94.

Lin KH, Su IJ, Chen RL, Lin DT, Tien HF, Chen BW, Lin KS. Peripheral T-cell lymphoma in childhood: a report of five cases in Taiwan. Med Pediatr Oncol 1994; 23: 26-35.

Tsai CF, Chen RL, Su IJ, Jee SH, Tien HF. Epstein-Barr virus-associated lymphoproliferative disorders of granular lymphocytes presenting initially as cutaneous vasculitis.  J Am Acad Dermatol 1994; 30: 339-344.

Tien HF, Su IJ, Chuang SM, Lee FY, Liu MC, Tsai TF, Lin KH, Chen RL. Cytogenetic characterization of Epstein-Barr virus-associated T-cell malignancies. Cancer Genet Cytogenet 1993; 69: 25-30.

Chen RL, Lin KS. Recent Advances in Diagnosis and Management of Pediatric Acute Leukemia. Acta Paed Sin 1993; 34: 1-7.

Hwu WL, Chen RL, Lin KH, Wang TR. DNA fingerprinting in the Chinese with an oligonucleotide probe (GTG)5. J Formosa Med Assoc 1992; 91: 839-43.

Lee SH, Su IJ, Chen RL, Lin KH, Lin DT, Chuu WM, Lin KS. A pathologic study of childhood lymphoma in Taiwan with special reference to peripheral T-cell lymphoma and the association with Epstein-Barr virus infection. Cancer 1991; 68:1954-62.

Young JH, Liu HC, Hsueh EJ, Huang ML, Peng CT, Chen RL, Maas-Enriquez M, Achilles K. Efficacy and safety evaluation of sucrose-formulated recombinant factor VIII for Taiwanese patients with haemophilia A. Haemophilia. 2009 Jul;15(4):968-70.

Chen RL, Chuang SS. Silent idiopathic pulmonary hemosiderosis with iron-deficiency anemia but normal serum ferritin. J Pediatr Hematol/Oncol 2007; 29(7): 509-511.

Chen RL, Hou JW, Chang PY, Tsai FJ, Wang PJ. Matched unrelated BMT without splenectomy for a child with Gaucher disease caused by homozygosity of the L444P mutation, who also suffered from schizencephaly. J Pediatr Hematol/Oncol 2007; 29(1): 57-59.

Lee MC, Wang PJ, Chen RL. Lumbosacral agenesis in a premature infant of a diabetic mother: Report of one case. Acta Paediatr Tw 2003; 44: 375-8

Chen RL, Wang PJ, Hsu YH, Chang PY, Fang JS. Severe lung fibrosis after chemotherapy in a child with ataxia-telangiectasia. J Pediatr Hematol/Oncol 2002 Jan; 24(1): 77-9.

Wang PJ, Chen RL, Shen YZ. Etiologies and etiological factors of childhood complex partial seizures of temporal lobe origin. Tzu Chi Med J 2000; 12: 209-216.

Hsu YS, Hwu WL, Huang SF, Lu MY, Chen RL, Lin DT, SSF Peng, Lin KH. Niemann-Pick disease type C (a cellular cholesterol lipidosis) treated by bone marrow transplantation. Bone Marrow Transplantation 1999; 24: 103-7.

Chuu WM, Lin DT, Lin KH, Chen BW, Chen RL, Lin KS. Can severe neonatal jaundice be prevented by neonatal screening for glucose-6-phosphate dehydrogenase deficiency?–a review of evidence. Acta Pediatr Tw 1996; 37: 333-41.

Lin HC, Chen RL, Wang PJ. Paroxysmal nocturnal hemoblobulinuria presenting as moyamoya syndrome. Brain & Development 1996; 18: 157-9.

Chen RL, Hsieh KH, Su IJ. Omenn phenotype with feature of angioimmunoblastic lymphadenopathy in identical twins. Int J Pediatr Hematol/Oncol 1994; 1: 271-274.

Lin KH, Chen RL, Lin DT, Lui LT, Lin KS. Bone marrow transplantation for pediatric patients with severe aplastic anemia in Taiwan. Transplant Proc 1993; 25 (suppl 3): 61-4.

Horng YC, Chou YH, Chen RL, Tsou KIY, Lin KH. Congenital factor VII deficiency complicated with hemoperitoneum and intracranial hemorrhage: Report of a case. J Formosa Med Assoc 1993; 92: 85-7.

Chen RL, Lin KH, Chen BW, Su S, Lin DT, Chuu WM, Lin KS, Huang LM, Lee CY. Long-term observation of Pediatric aplastic anemia. J Formosa Med Assoc 1992; 91:390-5.

Young C, Lin KH, Chen RL, Chuu WM, Lin DT, Su IJ. Infantile osteopetrosis: Report of two cases. J Formosa Med Assoc 1992; 91:85-9.

Chou YH, Chen RL, Lin KH, Lin DT, Huang PH. Hemorrhagic pericardial effusion in beta-thalassemia major: Report of a case. J Formosa Med Assoc 1991; 90:867-70.

Chen RL, Chang MH, Chen CL. Congenital intractable diarrhea with possible defective crypt regeneration: Report of a case. J Formosan Med Assoc 1991; 90:1194-9.

Wang PJ, Chen RL, Shen YZ. Hypotonia, congenital nystagmus, and abnormal auditary brain stem response. Pediatr Neurol 1989; 5:381-3.