Refining risk prediction in pediatric acute lymphoblastic leukemia through DNA methylation profiling.

Acute lymphoblastic leukemia (ALL) is the most prevalent cancer in children, and despite considerable progress in treatment outcomes, relapses still pose significant risks of mortality and long-term complications. To address this challenge, we employed a supervised machine learning technique, specifically random survival forests, to predict the risk of relapse and mortality using array-based DNA methylation data from a cohort of 763 pediatric ALL patients treated in Nordic countries. The relapse risk predictor (RRP) was constructed based on 16 CpG sites, demonstrating c-indexes of 0.

[Clinical case: Refractory hypercalcemia associated to B-cell lymphoma, an oncological emergency].

Hypercalcemia as a paraneoplastic syndrome is rare in children. Therapeutic management is aimed at promoting calciuresis with various pharmacological methods, even with extrarenal purification techniques. The aim of presenting this case is to highlight the importance of early etiologic treatment through chemotherapy as an urgent treatment in a refractory and severe hypercalcemia case, in order to avoid possible secondary complications due to this electrolyte disturbance.

Terlipressin for catecholamine-resistant septic shock in children.

Objective: To report the effects of terlipressin treatment in four paediatric patients with catecholamine-resistant hypotensive septic shock.

Design And Setting: Case report in the pediatric intensive care unit of a university hospital.

Patients: Four children with severe septic shock and hypotension resistant to high doses of norepinephrine and other cathecolamines.