Cardiotoxicity evaluation in pediatric patients with acute lymphoblastic leukemia - results of prospective study.

Aim: The chemotherapy protocol for acute lymphoblastic leukemia (ALL) uses low doses of anthracyclines (AC), generally associated with subclinical cardiotoxicity. The aim of our study was to evaluate the serum biomarkers and echocardiography parameters in children with ALL treated with AC in order to determine the most useful element for early detection of cardiotoxicity.

Material And Methods: In this prospective study, troponin I (TnI) and heart-type fatty acid binding protein (HFABP) were assessed five times during the first year after the onset of ALL.

The impact of additional cytogenetic abnormalities at diagnosis and during therapy with tyrosine kinase inhibitors in Chronic Myeloid Leukaemia.

Background: Chronic Myeloid Leukemia's (CML) treatment was optimized since the development of tyrosine kinase inhibitors (TKI) and an increased overall survival during TKI was noticed. During the TKI era, protocols for assessing response and resistance to treatment were developed. Additional chromosomal abnormalities (ACAs) are strongly associated with disease progression but their prognostic impact and influence on treatment response are yet to be defined.

The occurrence of chronic lymphocytic leukemia after chronic phase of chronic myeloid leukemia: case report and literature review.

The occurrence of chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL) in the same patient is a rare event. In published literature, CML diagnosis follows CLL diagnosis or both leukemias are diagnosed simultaneously or rarely, CLL diagnosis follows CML diagnosis. We report the case of one patient with renal adenocarcinoma who was diagnosed with CLL 60 months after CML diagnosis.

Medullary allotransplant in acute myeloblastic leukemia in a child.

Although acute myeloblastic leukemia (AML) is more resistant to chemotherapy than acute lymphoblastic leukemia (ALL), significant progresses have been achieved over the last 20 years with an improvement in the long-term survival up to 50-60%. This may be attributed to the intensification of chemotherapy, including the increased use of stem-cell transplantation (HSCT) in well-defined subgroups. Allo-HSCT represents an extremely effective alternative in pediatric AML treatment panel, but its efficiency is limited both by the toxic effects and by the difficulty of finding a matched HLA donor.

Up to date concepts about Von Willebrand disease and the diagnose of this hemostatic disorder.

The authors review the current data in literature regarding the recent knowledge about hemostase, coagulation and clinical and laboratory diagnostic algorithms of hemostatic disorders. They also present the pathological classification of bleeding disorders - the basis to clinical approach of these diseases.

Actual biological diagnosis of acute myeloblastic leukemia in children.

Acute myeloblastic leukemia accounts for approximately 20% of acute leukemias in children. The days the microscope represented the main tool in the diagnosis and classification of Acute Myeloblastic Leukemia seem to be very far. This review summarizes the current diagnosis of this malignancy, where the morphological, cytochemical, immunophenotyping, cytogenetic and molecular characterization represents the basement of a risk group related therapy.

Current therapy in children and adolescents with von Willebrand disease.

The article represents a review of recent data about the therapy of von Willebrand disease in children and adolescents (hereditary as well as acquired forms of the disease). The treatment of bleeding events in these patients, the indications in different subtypes, and the future lines of research are mentioned.

Fludarabine, low-dose cyclophosphamide and rabbit antithymocyte globulin allowed stable engraftment after allogeneic peripheral blood stem cell transplantation for poly-transfused dyskeratosis congenita patient: case report.

Background: Dyskeratosis congenita (DC) is characterized by the clinical triad of reticular skin pigmentation, oral leukoplakia, and nail dystrophy associated with bone marrow failure (BMF) and an high risk to develop cancer and pulmonary complications. The only curative treatment for patients with DC and BMF is stem cell transplantation. Due to the rarity of the disease, the best transplant procedure is not yet known.

Post-transplant lymphoproliferative disorders after solid organ transplantation in children.

Post-transplant lymphoproliferative disease (PTLD) is a well recognized complication of solid organ transplantation (SOT) or bone marrow transplantation (BMT) associated with therapeutic immunosuppression (IS), first reported in 1968. Risk factors, therapy, and outcomes differ between PTLD observed following BMT and SOT. PTLD is a potentially fatal complication in the clinical course of transplant recipients, representing the most common malignancy after SOT in children and the second in the adult setting.

Cytokine gene polymorphisms support diagnostic monitoring of Romanian multiple myeloma patients.

Introduction: Cytokines and their receptor genes are very polymorphic. SNPs in the promotor region of the gene may influence the rate of cytokine secretion and may affect the biological activity of the encoded cytokine. A number of cytokines and cytokine receptors have been directly linked to the development of human cancers.

Subtotal laparoscopic splenectomy and esophagogastric devascularization for the thrombocytopenia because of portal cavernoma--case report.

Unlabelled: An 8-year-old girl presented with a history of pain in the right hypocondrium, multiple petechiae in the skin, and ecchimoses at sites of minor trauma. Laboratory investigations showed severe thrombocytopenia. Doppler ultrasonography and magnetic resonance imaging showed portal and splenic vein cavernomatous transformation and splenomegaly.

Total body irradiation prior to bone marrow transplantation--the experience of the Institute of Oncology Prof. Dr. Al. Trestioreanu Bucharest.

Purpose: To present the technique of total body irradiation (TBI), applied for the first time in Romania, at the Institute of Oncology Bucharest, as part of stem cell transplantation for hematological malignancies.

Patients And Methods: The total dose administered was 12 Gy at the reference point, 2 Gy/fraction, one fraction per day, 6 consecutive days, with a total dose of 8 - 11.4 Gy delivered to the lung, using Mevatron Primus linear accelerator (6 MV & 15 MV, 200-300 cGy/min in isocenter), in vivo dosimetry detectors and equipment for the reference dosimetry, personalized blocks for lung shielding sustained by polymethylmethaacrylate (PPMA) plate, Simulix HP simulator, and computer tomographic (CT) scans.

Laparoscopic subtotal splenectomy in hereditary spherocytosis : to preserve the upper or the lower pole of the spleen?

Background: Clinical manifestations of hereditary spherocytosis can be controlled by splenectomy. The use of this procedure has been restricted due to concerns regarding exposure of patients to a lifelong risk of overwhelming infections. Subtotal splenectomy, which removes 85-90% of the enlarged spleen, is a logical alternative.

[Laparoscopic subtotal splenectomy in the treatment of hereditary spherocytosis].

Clinical manifestations of hereditary spherocytosis, the most common red blood cell membrane disorder, can be controlled by splenectomy. However, concerns regarding exposure of patients to a life long risk for overwhelming infections have restricted its use, especially în children. Subtotal splenectomy, as long as 80% to 90% of the enlarged spleen is removed, is a logical alternative.

[Neonatal convulsions: the current concepts and classification].

The authors presented a new classification of the neonatal convulsions, based on prolonged EEG registrations related to concomitant clinical or videorecording of fits. They focussed on the atypical neonatal convulsions and on the differential diagnosis between epileptic and nonepileptic seizures. Finally, they discussed the therapeutical consequences of these new conceptions about the conclusions in the neonate.

[The characteristics of the anti-infectious defenses in newborn infants].

The authors reviewed the up to date conceptions concerning the temporary alterations of the host defense mechanisms in the neonatal period (natural barriers, macrophages, complement system, cell-mediated and humoral immunity). They try to establish correlations between this temporary alterations and the high infectious risk and the severity of most of the infections in the newborn. A special attention is paid to the peculiar situation of the premature, and also to the modifications needed in the therapeutic schedules for serious neonatal infections.

[Pathogenetic mechanisms in neonatal infections].

The authors reviewed the pathogenetic mechanisms of ante-, intra- and postnatal infections of the newborn. They also discussed the results of the antenatal infections on embryo and foetus, and the clinical variants of intra- and postnatal infections. The attention is focused on the relationship between pathogenetic mechanisms and the relevant clinical and paraclinical alterations for the diagnosis of the most frequent encountered infections of the newborn.

[The diagnostic algorithm in neonatal infections].

Authors review the principles of diagnosis in neonatal bacterial infections (local and systemic), in congenital, peri- and postnatal viral infections and also in Candida spp. and other mycotic infections of the neonatal period. They try to delineate the clinical and epidemiological criteria of suspicion and modalities of confirmation of the neonatal infections by specific paraclinical methods.

[Antiviral chemotherapy in pediatrics--its present and prospects].

Authors discuss the general aspects of viral infections and the principles of antiviral chemotherapy. First section deals with the stages, the types of viral infections and the basic principles for action of antiviral drugs. Authors review also the up-to-date situation of antiviral therapy in pediatrics, the problem of resistant strains and formulate the expected progress in the field of antiviral chemotherapy.

[Infantile spasms (infantile myoclonic encephalopathy with hypsarrhythmia)].

The paper reports on a very important aspect in a pediatric practice, referring to one of the most severe forms of epilepsy of the infant, known in the modern specialty literature as infantile spasms. The paper reviews the etiologic data of the disease in its secondary form, with emphasis on the form of the disease better studied in the last years, i.e.

[The diagnosis of conjugated bilirubin jaundice in children].

The paper reports on the development of the diagnosis algorithm in jaundices with conjugated bilirubinemia in children. The clinical hepatobiliary semeiology, the data of the objective clinical examination and the laboratory and paraclinical examinations of hepatic exploration are analyzed. The paper also presents the diagnosis phases in the main clinical biological syndromes met in the child with jaundice and conjugated bilirubinemia: acute hepatic syndrome, chronic hepatic syndrome and cholestatic syndrome.