Early deaths in children after BMT. Bone Marrow Transplantation Group of the Italian Association for Pediatric Hematology and Oncology (AIEOP) and Gruppo Italiano Trapianto di Midollo Osseo (GITMO).

In order to determine the incidence and causes of death during the first 100 days after BMT (early deaths) in a pediatric population we have examined data reported in the AIEOP BMT Registry. Up to July 1990, data on 486 children who underwent allogeneic (180) or autologous (306) BMT were evaluable. The children had acute lymphoblastic leukemia (148 cases), acute non-lymphoblastic leukemia (127 cases), neuroblastoma (82 cases), chronic myelogenous leukemia (15 cases), aplastic anemia (nine cases), solid tumors, lymphoma, immunodeficiency or storage diseases.

[131I]metaiodobenzylguanidine therapy in advanced neuroblastoma.

Forty-two children with advanced neuroblastoma who either failed with first-line therapy or relapsed after achieving a complete remission, were considered for treatment with [131I]metaiodobenzylguanidine (131I-MIBG). We subdivided 42 cases into 5 groups, in accordance with the stage of disease at diagnosis, response to first-line therapy and relapse. A total of 99 courses of 131I-MIBG were administered with doses ranging from 2.

Myeloablative therapy and unpurged autologous bone marrow transplantation for poor-prognosis neuroblastoma: report of 34 cases.

From October 1984 to November 1987, 34 patients aged from 1 year 1 month to 7 years 7 months with resistant or relapsed neuroblastoma (NB) (group 1, 10 patients), unselected disseminated NB (group 2, 14 patients), or selected disseminated NB (group 3, 10 patients) received myeloablative therapy (MAT) followed by unpurged autologous bone marrow transplantation (ABMT) at the end of an intensive protocol, which included high-dose chemotherapy and surgery to the primary tumor. Median time from diagnosis to MAT and ABMT was 6 months (5 months from last relapse to MAT and ABMT in the relapsed patients). The MAT regimen included vincristine, fractionated total body irradiation (TBI), and melphalan.

Treatment of advanced neuroblastoma with I-131 meta-iodobenzylguanidine.

From February 1986 to December 1988, 31 children with advanced pretreated neuroblastoma were treated with 131-I meta-Iodobenzylguanidine (131-MIBG). Thirteen children had been resistant to first-line therapy, three had suffered a local relapse, and fourteen had suffered a disseminated relapse without over bone marrow infiltration. One child was treated initially because of resistance to first-line therapy, and subsequently for a local relapse.

Listeria monocytogenes brain abscesses in a girl with acute lymphoblastic leukaemia after late central nervous system relapse.

A case of Listeria monocytogenes bacteraemia and meningitis with intracerebral abscesses in a girl with acute lymphoblastic leukaemia in relapse is reported. The clinical features included subacute onset with fever and marked irritability followed by seizures, meningism and confusion. The pathogen was isolated from blood and cerebrospinal fluid.

Infection with Fusarium species in two children with neuroblastoma.

Two cases of Fusarium infection in children with neuroblastoma are reported. One of the patients had an overwhelming infection and the diagnosis was based on isolation of Fusarium moniliforme from blood and skin biopsy, and histological findings. The second patient developed chronic polyarthritis and Fusarium solani was cultured from synovial fluid samples taken from two different joints four months apart.

High dose peptichemio in pretreated neuroblastoma.

The aim of this study was to evaluate the antitumor effect and toxicity of a single course of Peptichemio at high dose (450 mg/sq m) given to children with neuroblastoma resistant to first line treatment or at relapse. A total of 28 children were treated. Seven children showed partial response, 4 minor response, 8 had stable disease, and in 8 the tumor progressed.

Granulocytic sarcoma presenting as an isolated mediastinal mass. A difficult diagnostic problem.

An unusual case of granulocytic sarcoma presenting in an 8-year-old boy as an isolated mediastinal mass, preceding by 7 months the development of acute myeloid leukemia, is reported. The patient was initially treated for lymphoblastic lymphoma, with poor response. We recommend that in such cases, full histocytochemical and immunological characterization of the tumor should be performed.

Role of Broviac catheters in infections in children with cancer.

In a 3-year period 157 single lumen Broviac catheters were inserted in 145 children with various neoplastic diseases. The overall duration of the catheter courses was 30,533 days (median, 171; range, 2 to 647). Sixty-five percent of the catheter courses (102 of 157) were complicated by at least 1 febrile episode, for a total of 157 episodes.

Positive direct antiglobulin test in a pediatric patient following high-dose cisplatin.

A positive direct antiglobulin test (DAT) and hemolytic anemia are uncommon side effect of cisplatin (CDDP) therapy. A 9-year-old girl treated for extraosseus Ewing's sarcoma with a multiagent regimen, including 200 mg/m2 CDDP preceded by vincristine (VCR) and cyclophosphamide (CY), developed a positive DAT, followed by hemolytic anemia. When CDDP therapy was discontinued, the DAT became negative and no signs of anemia were observed during the maintenance treatment, which included VCR and actinomycin D.

Antiblastic treatment does not affect N-myc gene amplification in neuroblastoma.

Gene amplification has been found in the genome of cells growing in vivo and/or in vitro. In cell lines with acquired multidrug resistance gene amplification has been frequently detected. Moreover, extra-copies of cellular oncogenes have been located in tumor cells in vivo; particularly N-myc gene amplification was discovered in advanced stage of neuroblastoma (NB).

[Autologous bone marrow transplantation in children. Use of parenteral nutrition].

Children undergoing ABMT, a procedure which entails massive doses of chemotherapy along with total-body irradiation, are candidate to develop severe gastrointestinal toxicity and prolonged anorexia requiring administration of Parenteral Nutrition (PN) for variable periods. We report a series of 35 consecutive children affected by malignancies who underwent 37 courses of PN after ablative therapy followed by ABMT. Age ranged from 8 months to 17 years; 16 were females, 19 males.

A short-term in vitro drug sensitivity assay in pediatric malignancies.

A short-term in vitro chemosensitivity test has been applied to 131 specimens from 109 children with various malignancies. The clinical outcome was correlated with in vitro percentage inhibition (PI) of DNA synthesis by the drug tested. In 62 correlations, PIs of responsive and of resistant patients differed significantly, with a cut-off value of 37%.

Resistant and relapsing neuroblastoma: improved response rate with a new multiagent regimen (OC-HDP) including high-dose cisplatinum.

From September 1984 to July 1985, 11 children from 6 months to 6 years of age were treated with a three-drug regimen (OC-HDP), including vincristine, cyclophosphamide, and cisplatinum 200 mg/m2 given as five dose-fractions over 5 days. Nine had resistant and two relapsed neuroblastoma. Nine children had previously been treated with cisplatinum at conventional doses; nine had not received cyclophosphamide and ten had not received vincristine.