Publications by authors named "Andrea Hraskova"
Pediatric central nervous system (CNS) tumors represent 20-25% of childhood malignancies, with 35-40 new cases annually in Slovakia. Despite treatment advances, high mortality and poor quality of life in a lot of cases persist. This study assesses the clinical features, treatment modalities, and survival rates of pediatric CNS tumor patients in the single largest center in Slovakia.
View Article and Find Full Text PDFImportance: The current standard-of-care salvage therapy in relapsed/refractory classic Hodgkin lymphoma (cHL) includes consolidation high-dose chemotherapy (HDCT)/autologous stem cell transplant (aSCT).
Objective: To investigate whether presalvage risk factors and fludeoxyglucose-18 (FDG) positron emission tomography (PET) response to reinduction chemotherapy can guide escalation or de-escalation between HDCT/aSCT or transplant-free consolidation with radiotherapy to minimize toxic effects while maintaining high cure rates.
Design, Setting, And Participants: EuroNet-PHL-R1 was a nonrandomized clinical trial that enrolled patients younger than 18 years with first relapsed/refractory cHL across 68 sites in 13 countries in Europe between January 2007 and January 2013.
Article Synopsis
- Hypodense volumes (HDV) in mediastinal masses were identified in 29.7% of Hodgkin lymphoma patients analyzed from a study involving 1178 staging CT scans.
- These HDVs were predominantly found in larger tumor volumes and exhibited various patterns, including single lesions in 69.4% of cases and well delineated lesions in 70.1% of cases.
- Patients with HDV displayed more severe symptoms and had a lower 5-year progression-free survival rate (79.6% for HDV > 40 ml) compared to those with lower HDV levels, indicating a potential connection between HDV presence and poorer prognosis in Hodgkin lymphoma.
Article Synopsis
- New lung lesions were identified in 9.2% of pediatric Hodgkin lymphoma patients after two chemotherapy cycles, indicating that these may not be related to cancer progression.
- The study utilized interim CT scans to differentiate between true lung metastases and benign lung lesions, using guidelines from the Fleischner glossary for classification.
- Most newly detected pulmonary nodules were small (under 10 mm) and often regressed by the time of later evaluations, suggesting they were likely not harmful manifestations associated with the original lymphoma.
Background: Rebound thymic hyperplasia (RTH) is a common phenomenon caused by stress factors such as chemotherapy (CTX) or radiotherapy, with an incidence between 44% and 67.7% in pediatric lymphoma. Misinterpretation of RTH and thymic lymphoma relapse (LR) may lead to unnecessary diagnostic procedures including invasive biopsies or treatment intensification.
View Article and Find Full Text PDFResponse-adapted omission of radiotherapy in children and adolescents with early-stage classical Hodgkin lymphoma and an adequate response to vincristine, etoposide, prednisone, and doxorubicin (EuroNet-PHL-C1): a titration study.
Lancet Oncol
March 2023
Article Synopsis
- The study investigates the feasibility of omitting radiotherapy for children and adolescents with early-stage classical Hodgkin lymphoma who respond adequately to OEPA chemotherapy, aiming to improve survival and quality of life.
- Conducted across 186 hospitals in 16 European countries, the EuroNet-PHL-C1 trial enrolled over 2100 patients, focusing on maintaining a 5-year event-free survival rate of 90% without the use of radiotherapy.
- The trial results, based on a median follow-up time of about 63 months, include data from 714 patients in the experimental treatment group, assessing the effectiveness and outcomes of the chemotherapy regimen.
Article Synopsis
- The study analyzed the prevalence and impact of anemia in children diagnosed with chronic myeloid leukemia (CML), highlighting that 81% of 430 patients had anemia at diagnosis, with many experiencing moderate to severe cases.
- Moderate and severe anemia were linked to younger age, symptoms like fatigue, and higher blood cell counts, leading to delays in effective treatment response with imatinib.
- Although anemia was common and influenced treatment outcomes, it did not significantly affect overall survival rates in pediatric CML patients.
Despite therapeutic advances, high-risk neuroblastoma is still associated with a poor long-term prognosis. Immunotherapy with the anti-GD2 antibody dinutuximab beta has recently been added to the standard of care for patients with high-risk neuroblastoma in our center in Bratislava, and our initial experience with dinutuximab beta has been reported previously. Here we provide a follow-up on the outcomes of 7 patients who were treated with dinutuximab beta under clinical practice conditions at our center.
View Article and Find Full Text PDFResponse-adapted omission of radiotherapy and comparison of consolidation chemotherapy in children and adolescents with intermediate-stage and advanced-stage classical Hodgkin lymphoma (EuroNet-PHL-C1): a titration study with an open-label, embedded, multinational, non-inferiority, randomised controlled trial.
Lancet Oncol
January 2022
Article Synopsis
- * Conducted at 186 hospitals across 16 European countries, this randomized controlled trial compares two and four cycles of a chemotherapy protocol (COPP) aimed at reducing long-term side effects, particularly gonadotoxicity.
- * The research excludes early-stage patients and includes a detailed regimen of medications, including vincristine, etoposide, prednisone, doxorubicin, cyclophosphamide, and procarbazine, to evaluate their impact on survival and quality of life.
Background: In the EuroNet Pediatric Hodgkin Lymphoma (EuroNet-PHL) trials, decision on Waldeyer's ring (WR) involvement is usually based on clinical assessment, that is, physical examination and/or nasopharyngoscopy. However, clinical assessment only evaluates mucosal surface and is prone to interobserver variability. Modern cross-sectional imaging technology may provide valuable information beyond mucosal surface, which may lead to a more accurate WR staging.
View Article and Find Full Text PDFBackground: Neuroblastoma is the most common extracranial solid tumour of childhood with extremely heterogeneous bio-logical and clinical behaviour. Despite advances in its treatment, the long-term prognosis of patients with a high-risk and relapsed neuroblastoma remains poor. The implementation of immunotherapy into the treatment protocols has the potential to improve it.
View Article and Find Full Text PDFBackground: Invasive fungal infections are a life-threatening complication of cancer treatments, especially in hemato-oncological patients. Mucormycosis is the third leading cause of invasive fungal infections after Aspergillus and Candida infections. The first clinical symptoms are usually non-specific, which can lead to a late diagnosis and delayed therapy.
View Article and Find Full Text PDFTo determine whether the current F-FDG PET response criterion for skeletal involvement in Hodgkin lymphoma (HL) is suitable, we performed a systematic evaluation of the different types of skeletal involvement and their response on PET after 2 cycles of chemotherapy (PET-2). A secondary objective was to observe the influence of the initial uptake intensity (measured as qPET) and initial metabolic tumor volume (MTV) of skeletal lesions on the PET-2 response. The initial PET scans of 1,068 pediatric HL patients from the EuroNet-PHL-C1 trial were evaluated for skeletal involvement by central review.
View Article and Find Full Text PDFBackground: Interim FDG-PET is used for treatment tailoring in lymphoma. Deauville response criteria consist of five ordinal categories based on visual comparison of residual tumor uptake to physiological reference uptakes. However, PET-response is a continuum and visual assessments can be distorted by optical illusions.
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