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Pena-Burgos EM, Díez-Corral MC, Ortiz-Cruz EJ, Bernabéu D, Tapia-Viñe M, Redondo A, Pérez-Martínez A, Peláez A, Venegas Mascaró C, Escudero López A, Pozo-Kreilinger JJ. Periosteal Ewing Sarcoma with Distant Metastases: Report of Two Patients and Review of the Literature. Int J Surg Pathol 2024:10668969241246473. [PMID: 38706146 DOI: 10.1177/10668969241246473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Abstract
Periosteal Ewing sarcoma (ES) is an exceedingly rare topographic subtype of the ES. To our knowledge, only 60 patients have been reported in the medical English language literature. It predominantly affects men in the second decade of life and arises in the long tubular bone diaphysis. PES rarely develops distant metastases. We report two patients of this rare ES location that were found on the distal tibial shaft and proximal femoral diaphysis of a 21-year-old man and an 8-year-old boy, respectively. Both patients were treated with neoadjuvant chemotherapy, wide resection, and adjuvant chemotherapy. One of our patients had lung metastases at the time of diagnosis and died 5 years later. The other patient presented intramedullary humeral bone metastasis 19 years after diagnosis. There has been no evidence of disease in the 26 years of follow-up. Close follow-up of periosteal ES is recommended because distant metastases may exceptionally occur, even several years after diagnosis.
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Affiliation(s)
- Eva M Pena-Burgos
- Pathology Department, Príncipe de Asturias University Hospital, Alcalá de Henares, Spain
| | - María C Díez-Corral
- Pathology Department, Príncipe de Asturias University Hospital, Alcalá de Henares, Spain
| | - Eduardo J Ortiz-Cruz
- Orthopaedics and Traumatology Department, La Paz University Hospital, Madrid, Spain
| | - Daniel Bernabéu
- Radiology Department, La Paz University Hospital, Madrid, Spain
| | - Mar Tapia-Viñe
- Radiology Department, La Paz University Hospital, Madrid, Spain
| | - Andrés Redondo
- Oncology Department, La Paz University Hospital, Madrid, Spain
| | | | - Alberto Peláez
- Molecular Pathology and Therapeutic Targets Group, La Paz University Hospital (IdiPAZ), Madrid, Spain
| | - Clara Venegas Mascaró
- Institute of Medical and Molecular Genetics (INGEMM), Hospital La Paz Institute for Health Research - IdiPAZ, Madrid, Spain
- Translational Research in Pediatric Oncology Hematopoietic Transplantation & Cell Therapy, Hospital La Paz Institute for Health Research - IdiPAZ, Madrid, Spain
| | - Adela Escudero López
- Institute of Medical and Molecular Genetics (INGEMM), Hospital La Paz Institute for Health Research - IdiPAZ, Madrid, Spain
- Translational Research in Pediatric Oncology Hematopoietic Transplantation & Cell Therapy, Hospital La Paz Institute for Health Research - IdiPAZ, Madrid, Spain
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Muñoz Builes M, Vela Cuenca M, Fuster Soler JL, Astigarraga I, Pascual Martínez A, Vagace Valero JM, Tong HY, Valentín Quiroga J, Fernández Casanova L, Escudero López A, Sisinni L, Blanquer M, Mirones Aguilar I, González Martínez B, Borobia AM, Pérez-Martínez A. Study protocol for a phase II, multicentre, prospective, non-randomised clinical trial to assess the safety and efficacy of infusing allogeneic activated and expanded natural killer cells as consolidation therapy for paediatric acute myeloblastic leukaemia. BMJ Open 2020; 10:e029642. [PMID: 31919123 PMCID: PMC6955478 DOI: 10.1136/bmjopen-2019-029642] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Acute myeloblastic leukaemia (AML) constitutes the second most common haematological malignancy in the paediatric population. Current treatment regimens are based on the administration of polychemotherapy, combining high doses of cytarabine with anthracyclines and topoisomerase inhibitors. Allogeneic haematopoietic stem cell transplantation (HSCT) is an option for high-risk patients with AML (and for intermediate-risk patients if a sibling donor is available). With this strategy, AML survival has increased substantially; however, it has remained stagnant at approximately 60%, with relapse being the principal culprit. The predominant role of the immune system and natural killer (NK) cells in controlling paediatric AML has gained importance within the context of HSCT. In this protocol, we propose incorporating this cell therapy as an adjuvant treatment through the infusion of activated and expanded haploidentical NK (NKAE) cells in paediatric patients with AML who are in cytological remission after completing consolidation therapy, and with no indication for HSCT. METHODS AND ANALYSIS Patients up to 30 years of age, diagnosed with AML, in their first cytological remission, who have completed both the induction and the consolidation phases of chemotherapy and do not meet the criteria for allogeneic HSCT are eligible. The patients will receive two doses of NKAE cells once a week, using a GMP K562-mbIL15-41BBL stimulus from a haploidentical donor and interleukin 2 subcutaneously. The patients will then be followed up for 36 months to assess the primary endpoint, which is the probability of relapse after NK cell infusion. ETHICS AND DISSEMINATION This clinical trial was approved by the Clinical Research Ethics Committee of La Paz University Hospital and The Spanish Agency of Medicines and Medical Devices. Findings will be disseminated through peer-reviewed publications, conference presentations and community reporting. TRIAL REGISTRATION NUMBER EudraCT code: 2015-001901-15, ClinicalTrials.gov Identifier: NCT02763475.
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Affiliation(s)
- Mario Muñoz Builes
- La Paz Central Research and Clinical Trials Unit, Hospital Universitario La Paz, Madrid, Spain
| | - María Vela Cuenca
- Translational Research Unit in Paediatric Haemato-Oncology, Hematopoietic Stem Cell Transplantation and Cell Therapy, Hospital Universitario La Paz, Madrid, Spain
| | - Jose L Fuster Soler
- Paediatric Haematology-Oncology Unit, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain
| | - Itziar Astigarraga
- Department of Paediatrics, Hospital Universitario Cruces, Barakaldo, Spain
| | - Antonia Pascual Martínez
- Paediatric Haematology Unit, Maternal and Children Hospital, Hospital Regional Universitario de Málaga, Málaga, Spain
| | - Jose M Vagace Valero
- Paediatric Haematology Department, Maternal and Children Hospital, Complejo Hospitalario Universitario de Badajoz, Badajoz, Spain
| | - Hoi Y Tong
- La Paz Central Research and Clinical Trials Unit, Hospital Universitario La Paz, Madrid, Spain
| | - Jaime Valentín Quiroga
- Translational Research Unit in Paediatric Haemato-Oncology, Hematopoietic Stem Cell Transplantation and Cell Therapy, Hospital Universitario La Paz, Madrid, Spain
| | - Lucía Fernández Casanova
- Haematological Malignancies Clinical Research Unit, Centro Nacional de Investigaciones Oncológicas (CNIO), Madrid, Spain
| | - Adela Escudero López
- Translational Research Unit in Paediatric Hemato-Oncology, Haematopoietic Stem Cell Transplantation and Cell Therapy, Institute of Medical and Molecular Genetics (INGEMM), Hospital Universitario La Paz, Madrid, Spain
| | - Luisa Sisinni
- Paediatric Haemato-Oncology Deparment, Hospital Universitario La Paz, Madrid, Spain
| | - Miguel Blanquer
- Paediatric Haematology-Oncology Unit, Hospital Clínico Universitario Virgen de la Arrixaca, El Palmar, Spain
| | - Isabel Mirones Aguilar
- Translational Research Unit in Paediatric Haemato-Oncology, Hematopoietic Stem Cell Transplantation and Cell Therapy, Hospital Universitario La Paz, Madrid, Spain
| | - Berta González Martínez
- Translational Research Unit in Paediatric Haemato-Oncology, Hematopoietic Stem Cell Transplantation and Cell Therapy, Hospital Universitario La Paz, Madrid, Spain
- Paediatric Haemato-Oncology Deparment, Hospital Universitario La Paz, Madrid, Spain
| | - Alberto M Borobia
- Clinical Pharmacology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Antonio Pérez-Martínez
- Translational Research Unit in Paediatric Haemato-Oncology, Hematopoietic Stem Cell Transplantation and Cell Therapy, Hospital Universitario La Paz, Madrid, Spain
- Paediatric Haemato-Oncology Deparment, Hospital Universitario La Paz, Madrid, Spain
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