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Pawinska-Wasikowska K, Czogala M, Skoczen S, Surman M, Rygielska M, Ksiazek T, Pac A, Wieczorek A, Skalska-Sadowska J, Samborska M, Wachowiak J, Chaber R, Tomaszewska R, Szczepanski T, Zielezinska K, Urasinski T, Moj-Hackemer M, Kalwak K, Kozlowska M, Irga-Jaworska N, Balwierz W, Bukowska-Strakova K. Gemtuzumab ozogamicin for relapsed or primary refractory acute myeloid leukemia in children-the Polish Pediatric Leukemia and Lymphoma Study Group experience. Front Immunol 2023; 14:1268993. [PMID: 38187390 PMCID: PMC10766767 DOI: 10.3389/fimmu.2023.1268993] [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] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024] Open
Abstract
Background Gemtuzumab ozogamicin (GO), one of the first targeted drugs used in oncology, consists of an anti-cluster of differentiation 33 (CD33) monoclonal antibody bound to a derivative of cytotoxic calicheamicin. After the drug withdrawn in 2010 due to a significantly higher rate of early deaths, GO regained approval in 2017 for the treatment of newly diagnosed, refractory, or relapsed acute myeloid leukemia (AML) in adults and children over 15 years of age. The objective of the study was a retrospective analysis of clinical characteristics, treatment outcomes, and GO toxicity profile in children with primary refractory or relapsed (R/R) AML treated in Poland from 2008 to 2022. Methods Data were collected through the Polish Registry of Acute Myeloid Leukemia. From January 2008 to December 2022, 35 children with R/R AML were treated with GO in seven centers of the Polish Pediatric Leukemia and Lymphoma Study Group. Results Most of the children (30 of 35) received only one GO cycle in combination with various chemotherapy cycles (IDA-FLA, DOXO-FLA, FLA, FLAG, and others). Eighteen children (51%) achieved complete remission (CR), 14 did not respond to treatment, and three progressed. GO therapy was followed by allogeneic hematopoietic stem cell transplantation (allo-HSCT) in 18 children in CR. The 5-year overall survival (OS) after GO therapy was 37.1% ± 8.7% for the total cohort. There was a trend toward a superior outcome in patients with strong expression of CD33 expression (over 50% positive cells) compared with that in patients with lower expression of CD33 (OS, 41.2% ± 11.9% versus 27.8% ± 13.2%; p = 0.5; 5-year event-free survival, 35.4% ± 11.6% versus 25.7% ± 12.3%; p = 0.5, respectively). Children under 15 years have better outcome (OS, 34.9% ± 10.4% versus 30% ± 14.5%, p = 0.3). The most common adverse events were bone marrow aplasia, fever of unknown origin, infections, and elevated liver enzyme elevation. Sinusoidal obstruction syndrome occurred in two children. Conclusions The use of GO in severely pretreated children, including those under 15 years of age, with previous failure of AML treatment is a feasible and effective bridging therapy to allo-HSCT with an acceptable toxicity profile.
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Affiliation(s)
- Katarzyna Pawinska-Wasikowska
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, Krakow, Poland
| | - Malgorzata Czogala
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, Krakow, Poland
| | - Szymon Skoczen
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, Krakow, Poland
| | - Marta Surman
- Laboratory of Clinical Immunology, University Children’s Hospital of Krakow, Krakow, Poland
| | - Monika Rygielska
- Department of Pediatric Oncology and Hematology, Hematology Laboratory, University Children’s Hospital, Krakow, Poland
| | - Teofila Ksiazek
- Department of Medical Genetics, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
| | - Agnieszka Pac
- Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Aleksandra Wieczorek
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, Krakow, Poland
| | - Jolanta Skalska-Sadowska
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Magdalena Samborska
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznan, Poland
| | - Radoslaw Chaber
- Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszow, Rzeszow, Poland
- Department of Pediatrics, Institute of Medical Sciences, Medical College, University of Rzeszow, Rzeszow, Poland
| | - Renata Tomaszewska
- Department of Pediatric Hematology and Oncology, Zabrze, Medical University of Silesia, Katowice, Poland
| | - Tomasz Szczepanski
- Department of Pediatric Hematology and Oncology, Zabrze, Medical University of Silesia, Katowice, Poland
| | - Karolina Zielezinska
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Tomasz Urasinski
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Malgorzata Moj-Hackemer
- Clinical Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, Wroclaw, Poland
| | - Krzysztof Kalwak
- Clinical Department of Pediatric Bone Marrow Transplantation, Oncology and Hematology, Wroclaw Medical University, Wroclaw, Poland
| | - Marta Kozlowska
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Ninela Irga-Jaworska
- Department of Pediatrics, Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland
| | - Walentyna Balwierz
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
- Department of Pediatric Oncology and Hematology, University Children Hospital of Krakow, Krakow, Poland
| | - Karolina Bukowska-Strakova
- Department of Clinical Immunology, Institute of Pediatrics, Jagiellonian University Medical College, Krakow, Poland
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Troschke T, Wieczorek A, Kulinski K, Ociepa T, Zielezinska K, Lode HN, Urasinski T. Pediatric Hematology and Oncology Center Integrated by Telemedicine: Experience, Challenges and First Results of a Cross Border Network. Healthcare (Basel) 2023; 11:healthcare11101431. [PMID: 37239717 DOI: 10.3390/healthcare11101431] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/10/2023] [Accepted: 05/11/2023] [Indexed: 05/28/2023] Open
Abstract
This article reports on the development, implementation and management of a German-Polish telemedicine network in the field of pediatric oncology and hematology in the Euroregion Pomerania. The achievements and challenges of joint medical case reviews involving patients and their care givers, as well as cross-border education activities for physicians, students and nursing staff, are presented. In addition to a progress report, the results of an evaluation of the participants and teachers, likewise the measurement of knowledge growth, are given.
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Affiliation(s)
- Tabea Troschke
- Department of Pediatric Hematology and Oncology, University Medicine of Greifswald, Ferdinand-Sauerbruch-Strasse, 17475 Greifswald, Germany
| | - Aleksandra Wieczorek
- Department of Pediatric Oncology and Hematology, Jagiellonian University Medical College, 265 Wielicka Str., 30-663 Krakow, Poland
| | - Konrad Kulinski
- Department of Pediatric Oncology and Hematology, Jagiellonian University Medical College, 265 Wielicka Str., 30-663 Krakow, Poland
| | - Tomasz Ociepa
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University, Ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Karolina Zielezinska
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University, Ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland
| | - Holger N Lode
- Department of Pediatric Hematology and Oncology, University Medicine of Greifswald, Ferdinand-Sauerbruch-Strasse, 17475 Greifswald, Germany
| | - Tomasz Urasinski
- Department of Pediatrics, Hemato-Oncology and Gastroenterology, Pomeranian Medical University, Ul. Unii Lubelskiej 1, 71-252 Szczecin, Poland
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3
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Maciak K, Adamowicz-Salach A, Siwicka A, Poznanski J, Urasinski T, Plochocka D, Gora M, Burzynska B. Hereditary xerocytosis - spectrum and clinical manifestations of variants in the PIEZO1 gene, including co-occurrence with a novel β-globin mutation. Blood Cells Mol Dis 2020; 80:102378. [DOI: 10.1016/j.bcmd.2019.102378] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 10/21/2019] [Accepted: 10/21/2019] [Indexed: 11/25/2022]
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4
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Ksiazek T, Czogala M, Kaczowka P, Sadowska B, Pawinska-Wasikowska K, Bik-Multanowski M, Sikorska-Fic B, Matysiak M, Skalska-Sadowska J, Wachowiak J, Rodziewicz-Konarska A, Chybicka A, Muszynska-Rosłan K, Krawczuk-Rybak M, Grabowski D, Kowalczyk J, Maciejka-Kemblowska L, Adamkiewicz-Drozynska E, Mlynarski W, Tomaszewska R, Szczepanski T, Pohorecka J, Karolczyk G, Mizia-Malarz A, Mycko K, Badowska W, Zielezinska K, Urasinski T, Karpinska-Derda I, Woszczyk M, Ciebiera M, Lejman M, Skoczen S, Balwierz W. High Frequency of Fusion Gene Transcript Resulting From t(10;11)(p12;q23) Translocation in Pediatric Acute Myeloid Leukemia in Poland. Front Pediatr 2020; 8:278. [PMID: 32754558 PMCID: PMC7366384 DOI: 10.3389/fped.2020.00278] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/04/2020] [Indexed: 11/17/2022] Open
Abstract
11q23/MLL rearrangements are frequently detected in pediatric acute myeloid leukemia. The analysis of their clinical significance is difficult because of the multitude of translocation fusion partners and their low frequency. The presence of t(10;11)(p12;q23) translocation was previously identified in pediatric acute myelogenous leukemia (AML). It is considered as the second most common translocation detected in pediatric 11q23/MLL-rearranged (present KMT2A) AML, after t(9;11)(p22;q23). The presence of the above translocation was previously identified as an unfavorable prognostic factor. Since June 2015, the Polish Pediatric Leukemia/Lymphoma Study Group has applied the therapeutic protocol requiring extensive diagnostics of genetic changes in pediatric AML. Until November 2019, molecular genetic studies were performed in 195 children with diagnosed AML to identify carriers of fusion gene transcripts for 28 most common chromosomal translocations in acute leukemia. The fusion gene transcript for translocation t(10;11)(p12;q23) involving MLL gene was detected with unexpectedly high frequency (8.9%) in our research. It was the highest frequency of all detected MLL rearrangements, as well as other detected fusion gene transcripts from chromosomal aberrations characteristic for AML. It seems that chromosomal aberration between chromosomes 10 and 11 can be relatively frequent in some populations. Paying attention to this fact and ensuring proper genetic diagnosis seem to be important for appropriate allocation of patients to risk groups of pediatric AML treatment protocols.
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Affiliation(s)
- Teofila Ksiazek
- Department of Medical Genetics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.,Department of Pediatric Oncology and Hematology, Cytogenetics and Molecular Genetics Laboratory, University Children's Hospital, Kraków, Poland
| | - Malgorzata Czogala
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.,University Children's Hospital, Kraków, Poland
| | - Przemyslaw Kaczowka
- Department of Pediatric Oncology and Hematology, Cytogenetics and Molecular Genetics Laboratory, University Children's Hospital, Kraków, Poland.,Department of Pediatric Oncology and Hematology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Beata Sadowska
- Department of Pediatric Oncology and Hematology, Cytogenetics and Molecular Genetics Laboratory, University Children's Hospital, Kraków, Poland
| | - Katarzyna Pawinska-Wasikowska
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.,University Children's Hospital, Kraków, Poland
| | - Mirosław Bik-Multanowski
- Department of Medical Genetics, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
| | - Barbara Sikorska-Fic
- Department of Pediatrics, Hematology and Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Michał Matysiak
- Department of Pediatrics, Hematology and Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Jolanta Skalska-Sadowska
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
| | - Anna Rodziewicz-Konarska
- Department of Bone Marrow Transplantation, Pediatric Oncology and Hematology, Medical University of Wroclaw, Wrocław, Poland
| | - Alicja Chybicka
- Department of Bone Marrow Transplantation, Pediatric Oncology and Hematology, Medical University of Wroclaw, Wrocław, Poland
| | | | - Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland
| | - Dominik Grabowski
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland
| | - Jerzy Kowalczyk
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland
| | | | | | - Wojciech Mlynarski
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Łódź, Poland
| | - Renata Tomaszewska
- Department of Pediatrics Hematology and Oncology, Medical University of Silesia, Zabrze, Poland
| | - Tomasz Szczepanski
- Department of Pediatrics Hematology and Oncology, Medical University of Silesia, Zabrze, Poland
| | - Joanna Pohorecka
- Pediatric Department of Hematology and Oncology, Regional Polyclinic Hospital in Kielce, Kielce, Poland
| | - Grazyna Karolczyk
- Pediatric Department of Hematology and Oncology, Regional Polyclinic Hospital in Kielce, Kielce, Poland
| | - Agnieszka Mizia-Malarz
- Department of Oncology, Hematology and Chemotherapy, John Paul II Upper Silesian Child Heath Centre, The Independent Public Clinical Hospital No. 6 of the Medical University of Silesia in Katowice, Katowice, Poland
| | - Katarzyna Mycko
- Department of Pediatrics and Hematology and Oncology, Province Children's Hospital, Olsztyn, Poland
| | - Wanda Badowska
- Department of Pediatrics and Hematology and Oncology, Province Children's Hospital, Olsztyn, Poland
| | - Karolina Zielezinska
- Department of Pediatrics, Hematology and Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Urasinski
- Department of Pediatrics, Hematology and Oncology, Pomeranian Medical University, Szczecin, Poland
| | | | - Mariola Woszczyk
- Department of Pediatrics, Hematology and Oncology, City Hospital, Chorzow, Poland
| | - Małgorzata Ciebiera
- Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszów, Rzeszow, Poland
| | - Monika Lejman
- Department of Genetic Diagnostics, II Department Pediatrics, Medical University of Lublin, Lublin, Poland
| | - Szymon Skoczen
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.,University Children's Hospital, Kraków, Poland
| | - Walentyna Balwierz
- Department of Pediatric Oncology and Hematology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland.,University Children's Hospital, Kraków, Poland
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5
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Czogala M, Pawinska-Wasikowska K, Ksiazek T, Sikorska-Fic B, Matysiak M, Skalska-Sadowska J, Wachowiak J, Rodziewicz-Konarska A, Chybicka A, Myszynska-Roslan K, Krawczuk-Rybak M, Grabowski D, Kowalczyk J, Maciejka-Kemblowska L, Adamkiewicz-Drozynska E, Bobeff K, Mlynarski W, Tomaszewska R, Szczepanski T, Pohorecka J, Chodala-Grzywacz A, Karolczyk G, Mizia-Malarz A, Mycko K, Badowska W, Zielezinska K, Urasinski T, Nykiel M, Woszczyk M, Ciebiera M, Chaber R, Skoczen S, Balwierz W. Retrospective Analysis of the Treatment Outcome in Myeloid Leukemia of Down Syndrome in Polish Pediatric Leukemia and Lymphoma Study Group From 2005 to 2019. Front Pediatr 2020; 8:277. [PMID: 32637384 PMCID: PMC7317010 DOI: 10.3389/fped.2020.00277] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2020] [Accepted: 05/04/2020] [Indexed: 12/04/2022] Open
Abstract
Background: Children with Down syndrome (DS) have increased risk of myeloid leukemia (ML), but specific treatment protocols ensure excellent outcome. This study was a retrospective analysis of the treatment results and genetic characteristics of ML of DS (ML-DS) in Poland from 2005 to 2019. Methods: All 54 patients with ML-DS registered in the Polish Pediatric Leukemia and Lymphoma Study Group in analyzed period were enrolled to the study. There were 34 children treated with Acute Myeloid Leukemia-Berlin-Frankfurt-Munster 2004 Interim Protocol (group I) and 20 patients treated with ML-DS 2006 Protocol (group II). In the first protocol, there was reduction of the antracyclines doses and intrathecal treatment for ML-DS compared to non-DS patients. In the second protocol, further reduction of the treatment was introduced (omission of etoposide in the last cycle, no maintenance therapy). Results: Probabilities of 5-year overall survival (OS), event-free survival (EFS), and relapse-free survival in the whole analyzed group were 0.85 ± 0.05, 0.83 ± 0.05, and 0.97 ± 0.03, respectively. No significant differences were found between two protocols in the terms of OS and EFS (0.79 ± 0.07 vs. 0.95 ± 0.05, p = 0.14, and 0.76 ± 0.07 vs. 0.95 ± 0.05, p = 0.12, respectively). All deaths were caused by the treatment-related toxicities. Reduction of the treatment-related mortality was noticed (20% in group I and 5% in group II). The only one relapse in the whole cohort occurred in the patient from group I, older than 4 years, without GATA1 gene mutation. He was treated successfully with IdaFLA cycle followed by hematopoietic stem cell transplantation from matched sibling donor. No significant prognostic factor was found in the study group probably due to low number of patients in the subgroups. Conclusions: The study confirms that the reduced intensity protocols are very effective in ML-DS patients. The only cause of deaths was toxicities; however, systematic decrease of the treatment-related mortality was noticed.
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Affiliation(s)
- Malgorzata Czogala
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.,Department of Pediatric Oncology and Hematology, University Children Hospital, Kraków, Poland
| | - Katarzyna Pawinska-Wasikowska
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.,Department of Pediatric Oncology and Hematology, University Children Hospital, Kraków, Poland
| | - Teofila Ksiazek
- Department of Pediatric Oncology and Hematology, University Children Hospital, Kraków, Poland.,Department of Medical Genetics, Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
| | - Barbara Sikorska-Fic
- Department of Pediatrics, Hematology and Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Michal Matysiak
- Department of Pediatrics, Hematology and Oncology, Medical University of Warsaw, Warsaw, Poland
| | - Jolanta Skalska-Sadowska
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
| | - Jacek Wachowiak
- Department of Pediatric Oncology, Hematology and Transplantology, Poznan University of Medical Sciences, Poznań, Poland
| | - Anna Rodziewicz-Konarska
- Department of Bone Marrow Transplantation, Pediatric Oncology and Hematology, Medical University of Wroclaw, Wrocław, Poland
| | - Alicja Chybicka
- Department of Bone Marrow Transplantation, Pediatric Oncology and Hematology, Medical University of Wroclaw, Wrocław, Poland
| | | | - Maryna Krawczuk-Rybak
- Department of Pediatric Oncology and Hematology, Medical University of Bialystok, Bialystok, Poland
| | - Dominik Grabowski
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland
| | - Jerzy Kowalczyk
- Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland
| | | | | | - Katarzyna Bobeff
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Łódź, Poland
| | - Wojciech Mlynarski
- Department of Pediatrics, Oncology, Hematology and Diabetology, Medical University of Lodz, Łódź, Poland
| | - Renata Tomaszewska
- Department of Pediatrics Hematology and Oncology, Medical University of Silesia, Zabrze, Poland
| | - Tomasz Szczepanski
- Department of Pediatrics Hematology and Oncology, Medical University of Silesia, Zabrze, Poland
| | - Joanna Pohorecka
- Paediatric Department of Hematology and Oncology, Regional Polyclinic Hospital in Kielce, Kielce, Poland
| | - Agnieszka Chodala-Grzywacz
- Paediatric Department of Hematology and Oncology, Regional Polyclinic Hospital in Kielce, Kielce, Poland
| | - Grazyna Karolczyk
- Paediatric Department of Hematology and Oncology, Regional Polyclinic Hospital in Kielce, Kielce, Poland
| | - Agnieszka Mizia-Malarz
- Department of Oncology, Hematology and Chemotherapy, John Paul II Upper Silesian Child Heath Centre, The Independent Public Clinical Hospital No. 6 of the Medical University of Silesia in Katowice, Katowice, Poland
| | - Katarzyna Mycko
- Department of Pediatrics and Hematology and Oncology, Province Children's Hospital, Olsztyn, Poland
| | - Wanda Badowska
- Department of Pediatrics and Hematology and Oncology, Province Children's Hospital, Olsztyn, Poland
| | - Karolina Zielezinska
- Department of Pediatrics, Hematology and Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Urasinski
- Department of Pediatrics, Hematology and Oncology, Pomeranian Medical University, Szczecin, Poland
| | - Magdalena Nykiel
- Department of Pediatrics, Hematology and Oncology, City Hospital, Chorzów, Poland
| | - Mariola Woszczyk
- Department of Pediatrics, Hematology and Oncology, City Hospital, Chorzów, Poland
| | - Malgorzata Ciebiera
- Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszów, Rzeszow, Poland
| | - Radosław Chaber
- Department of Pediatric Oncohematology, Clinical Province Hospital of Rzeszów, Rzeszow, Poland
| | - Szymon Skoczen
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.,Department of Pediatric Oncology and Hematology, University Children Hospital, Kraków, Poland
| | - Walentyna Balwierz
- Department of Pediatric Oncology and Hematology, Institute of Pediatrics, Jagiellonian University Medical College, Kraków, Poland.,Department of Pediatric Oncology and Hematology, University Children Hospital, Kraków, Poland
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6
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Styczynski J, Czyzewski K, Wysocki M, Zajac-Spychala O, Wachowiak J, Ociepa T, Urasinski T, Gryniewicz-Kwiatkowska O, Kolodziejczyk-Gietka A, Dembowska-Baginska B, Perek D, Salamonowicz M, Hutnik L, Matysiak M, Siewiera K, Frackiewicz J, Kalwak K, Badowska W, Malas Z, Gozdzik J, Urbanek-Dadela A, Karolczyk G, Stolpa W, Sobol G, Gamrot Z, Woszczyk M, Gil L. Micafungin in invasive fungal infections in children with acute leukemia or undergoing stem cell transplantation. Leuk Lymphoma 2016; 57:2456-9. [PMID: 26880109 DOI: 10.3109/10428194.2016.1143937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Jan Styczynski
- a Department of Pediatric Hematology and Oncology, Collegium Medicum , Nicolaus Copernicus University Torun , Bydgoszcz , Poland
| | - Krzysztof Czyzewski
- a Department of Pediatric Hematology and Oncology, Collegium Medicum , Nicolaus Copernicus University Torun , Bydgoszcz , Poland
| | - Mariusz Wysocki
- a Department of Pediatric Hematology and Oncology, Collegium Medicum , Nicolaus Copernicus University Torun , Bydgoszcz , Poland
| | - Olga Zajac-Spychala
- b Department of Pediatric Oncology , Hematology and Transplantology, University of Medical Sciences , Poznan , Poland
| | - Jacek Wachowiak
- b Department of Pediatric Oncology , Hematology and Transplantology, University of Medical Sciences , Poznan , Poland
| | - Tomasz Ociepa
- c Department of Pediatric Hematology and Oncology , Pomeranian Medical University , Szczecin , Poland
| | - Tomasz Urasinski
- c Department of Pediatric Hematology and Oncology , Pomeranian Medical University , Szczecin , Poland
| | | | | | | | - Danuta Perek
- d Department of Oncology , Children's Memorial Health Institute , Warszawa , Poland
| | | | - Lukasz Hutnik
- e Department of Pediatric Hematology and Oncology , Medical University , Warszawa , Poland
| | - Michal Matysiak
- e Department of Pediatric Hematology and Oncology , Medical University , Warszawa , Poland
| | - Karolina Siewiera
- f Department of Pediatric Stem Cell Transplantation, Hematology and Oncology , Medical University , Wroclaw , Poland
| | - Jowita Frackiewicz
- f Department of Pediatric Stem Cell Transplantation, Hematology and Oncology , Medical University , Wroclaw , Poland
| | - Krzysztof Kalwak
- f Department of Pediatric Stem Cell Transplantation, Hematology and Oncology , Medical University , Wroclaw , Poland
| | - Wanda Badowska
- g Division of Pediatric Hematology and Oncology , Children Hospital , Olsztyn , Poland
| | - Zofia Malas
- g Division of Pediatric Hematology and Oncology , Children Hospital , Olsztyn , Poland
| | - Jolanta Gozdzik
- h Department of Clinical Immunology and Transplantology, Stem Cell Transplant Center , University Children's Hospital, Jagiellonian University Collegium Medicum , Krakow , Poland
| | | | - Grażyna Karolczyk
- i Division of Pediatric Hematology and Oncology , Children Hospital , Kielce , Poland
| | - Weronika Stolpa
- j Department of Pediatric, Division of Pediatric Oncology, Hematology and Chemotherapy , Silesian Medical University , Katowice , Poland
| | - Grazyna Sobol
- j Department of Pediatric, Division of Pediatric Oncology, Hematology and Chemotherapy , Silesian Medical University , Katowice , Poland
| | - Zuzanna Gamrot
- k Division of Paediatric Haematology and Oncology , Chorzow Paediatric and Oncology Center , Chorzow , Poland
| | - Mariola Woszczyk
- k Division of Paediatric Haematology and Oncology , Chorzow Paediatric and Oncology Center , Chorzow , Poland
| | - Lidia Gil
- l Department of Hematology , University of Medical Sciences , Poznan , Poland
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7
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Styczynski J, Czyzewski K, Wysocki M, Gryniewicz-Kwiatkowska O, Kolodziejczyk-Gietka A, Salamonowicz M, Hutnik L, Zajac-Spychala O, Zaucha-Prazmo A, Chelmecka-Wiktorczyk L, Siewiera K, Fraczkiewicz J, Malas Z, Tomaszewska R, Irga-Jaworska N, Plonowski M, Ociepa T, Pierlejewski F, Gamrot Z, Urbanek-Dadela A, Gozdzik J, Stolpa W, Dembowska-Baginska B, Perek D, Matysiak M, Wachowiak J, Kowalczyk J, Balwierz W, Kalwak K, Chybicka A, Badowska W, Szczepanski T, Drozynska E, Krawczuk-Rybak M, Urasinski T, Mlynarski W, Woszczyk M, Karolczyk G, Sobol-Milejska G, Gil L. Increased risk of infections and infection-related mortality in children undergoing haematopoietic stem cell transplantation compared to conventional anticancer therapy: a multicentre nationwide study. Clin Microbiol Infect 2015; 22:179.e1-179.e10. [PMID: 26493843 DOI: 10.1016/j.cmi.2015.10.017] [Citation(s) in RCA: 59] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 10/06/2015] [Accepted: 10/11/2015] [Indexed: 10/22/2022]
Abstract
This nationwide multicentre study analysed the epidemiology of bacterial, viral and fungal infections in paediatric haematopoietic stem cell transplantation (HSCT) and paediatric haematology and oncology (PHO) patients over a period of 24 consecutive months, including incidence, hazard risk and outcome of infections as well as occurrence of multidrug-resistant bacteria. During this period, 308 HSCTs were performed and 1768 children were newly diagnosed for malignancy. Compared to PHO, the risk in HSCT patients was significantly higher for all infections (hazard ratio (HR) 2.7), bacterial (HR 1.4), fungal (HR 3.5) and viral (HR 15.7) infections. The risk was higher in allo- than auto-HSCT for bacterial (HR 1.4), fungal (HR 3.2) and viral (HR 17.7) infections. The incidence of resistant bacteria was higher in HSCT than in PHO patients for both G-negative (72.5% vs. 59.2%) and G-positive (41.4% vs. 20.5%) strains. Cumulative incidence of bacterial, fungal and viral infections in HSCT patients was 33.9, 22.8 and 38.3%, respectively. Cumulative incidence of viral infections in allo-HSCT was 28.0% for cytomegalovirus, 18.5% for BK virus, 15.5% for Epstein-Barr virus, 9.5% for adenovirus, 2.6% for varicella zoster virus, 0.9% for influenza, 0.9% for human herpesvirus 6 and 0.3% for hepatitis B virus. Survival rates from infections were lower in HSCT than in PHO patients in bacterial (96.0 vs. 98.2%), fungal (75.5 vs. 94.6%) and most viral infections. In conclusion, the risk of any infections and the occurrence of resistant bacterial strains in allo-HSCT patients were higher than in auto-HSCT and PHO patients, while the outcome of infections was better in the PHO setting.
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Affiliation(s)
- J Styczynski
- Department of Paediatric Haematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland.
| | - K Czyzewski
- Department of Paediatric Haematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | - M Wysocki
- Department of Paediatric Haematology and Oncology, Collegium Medicum, Nicolaus Copernicus University Torun, Bydgoszcz, Poland
| | | | | | - M Salamonowicz
- Department of Paediatric Haematology and Oncology, Medical University, Warszawa, Poland
| | - L Hutnik
- Department of Paediatric Haematology and Oncology, Medical University, Warszawa, Poland
| | - O Zajac-Spychala
- Department of Paediatric Oncology, Haematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - A Zaucha-Prazmo
- Department of Paediatric Haematology, Oncology and Stem Cell Transplantation, Medical University, Lublin, Poland
| | - L Chelmecka-Wiktorczyk
- Department of Paediatric Oncology and Haematology, University Children's Hospital, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - K Siewiera
- Department of Paediatric Stem Cell Transplantation, Haematology and Oncology, Medical University, Wroclaw, Poland
| | - J Fraczkiewicz
- Department of Paediatric Stem Cell Transplantation, Haematology and Oncology, Medical University, Wroclaw, Poland
| | - Z Malas
- Division of Paediatric Haematology and Oncology, Children Hospital, Olsztyn, Poland
| | - R Tomaszewska
- Department of Paediatric Haematology and Oncology, Silesian Medical University, Zabrze, Poland
| | - N Irga-Jaworska
- Department of Paediatrics, Haematology and Oncology, Medical University, Gdansk, Poland
| | - M Plonowski
- Department of Paediatric Oncology and Haematology, Medical University, Bialystok, Poland
| | - T Ociepa
- Department of Paediatric Haematology and Oncology, Pomeranian Medical University, Szczecin, Poland
| | - F Pierlejewski
- Department of Paediatric Oncology, Haematology and Diabetology, Medical University, Lodz, Poland
| | - Z Gamrot
- Division of Paediatric Haematology and Oncology, Chorzow Paediatric and Oncology Center, Chorzow, Poland
| | - A Urbanek-Dadela
- Division of Paediatric Haematology and Oncology, Children Hospital, Kielce, Poland
| | - J Gozdzik
- Stem Cell Transplant Center, University Children's Hospital, Department of Clinical Immunology and Transplantology, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - W Stolpa
- Division of Paediatric Oncology, Haematology and Chemotherapy, Department of Paediatric, Silesian Medical University, Katowice, Poland
| | | | - D Perek
- Department of Oncology, Children's Memorial Health Institute, Warszawa, Poland
| | - M Matysiak
- Department of Paediatric Haematology and Oncology, Medical University, Warszawa, Poland
| | - J Wachowiak
- Department of Paediatric Oncology, Haematology and Transplantology, University of Medical Sciences, Poznan, Poland
| | - J Kowalczyk
- Department of Paediatric Haematology, Oncology and Stem Cell Transplantation, Medical University, Lublin, Poland
| | - W Balwierz
- Department of Paediatric Oncology and Haematology, University Children's Hospital, Jagiellonian University Collegium Medicum, Krakow, Poland
| | - K Kalwak
- Department of Paediatric Stem Cell Transplantation, Haematology and Oncology, Medical University, Wroclaw, Poland
| | - A Chybicka
- Department of Paediatric Stem Cell Transplantation, Haematology and Oncology, Medical University, Wroclaw, Poland
| | - W Badowska
- Division of Paediatric Haematology and Oncology, Children Hospital, Olsztyn, Poland
| | - T Szczepanski
- Department of Paediatric Haematology and Oncology, Silesian Medical University, Zabrze, Poland
| | - E Drozynska
- Department of Paediatrics, Haematology and Oncology, Medical University, Gdansk, Poland
| | - M Krawczuk-Rybak
- Department of Paediatric Oncology and Haematology, Medical University, Bialystok, Poland
| | - T Urasinski
- Department of Paediatric Haematology and Oncology, Pomeranian Medical University, Szczecin, Poland
| | - W Mlynarski
- Department of Paediatric Oncology, Haematology and Diabetology, Medical University, Lodz, Poland
| | - M Woszczyk
- Division of Paediatric Haematology and Oncology, Chorzow Paediatric and Oncology Center, Chorzow, Poland
| | - G Karolczyk
- Division of Paediatric Haematology and Oncology, Children Hospital, Kielce, Poland
| | - G Sobol-Milejska
- Division of Paediatric Oncology, Haematology and Chemotherapy, Department of Paediatric, Silesian Medical University, Katowice, Poland
| | - L Gil
- Department of Haematology, University of Medical Sciences, Poznan, Poland
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8
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Trautmann A, Bodria M, Ozaltin F, Gheisari A, Melk A, Azocar M, Anarat A, Caliskan S, Emma F, Gellermann J, Oh J, Baskin E, Ksiazek J, Remuzzi G, Erdogan O, Akman S, Dusek J, Davitaia T, Özkaya O, Papachristou F, Firszt-Adamczyk A, Urasinski T, Testa S, Krmar RT, Hyla-Klekot L, Pasini A, Özcakar ZB, Sallay P, Cakar N, Galanti M, Terzic J, Aoun B, Caldas Afonso A, Szymanik-Grzelak H, Lipska BS, Schnaidt S, Schaefer F. Spectrum of steroid-resistant and congenital nephrotic syndrome in children: the PodoNet registry cohort. Clin J Am Soc Nephrol 2015; 10:592-600. [PMID: 25635037 PMCID: PMC4386250 DOI: 10.2215/cjn.06260614] [Citation(s) in RCA: 166] [Impact Index Per Article: 18.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2014] [Accepted: 12/22/2014] [Indexed: 02/05/2023]
Abstract
BACKGROUND AND OBJECTIVES Steroid-resistant nephrotic syndrome is a rare kidney disease involving either immune-mediated or genetic alterations of podocyte structure and function. The rare nature, heterogeneity, and slow evolution of the disorder are major obstacles to systematic genotype-phenotype, intervention, and outcome studies, hampering the development of evidence-based diagnostic and therapeutic concepts. To overcome these limitations, the PodoNet Consortium has created an international registry for congenital nephrotic syndrome and childhood-onset steroid-resistant nephrotic syndrome. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Since August of 2009, clinical, biochemical, genetic, and histopathologic information was collected both retrospectively and prospectively from 1655 patients with childhood-onset steroid-resistant nephrotic syndrome, congenital nephrotic syndrome, or persistent subnephrotic proteinuria of likely genetic origin at 67 centers in 21 countries through an online portal. RESULTS Steroid-resistant nephrotic syndrome manifested in the first 5 years of life in 64% of the patients. Congenital nephrotic syndrome accounted for 6% of all patients. Extrarenal abnormalities were reported in 17% of patients. The most common histopathologic diagnoses were FSGS (56%), minimal change nephropathy (21%), and mesangioproliferative GN (12%). Mutation screening was performed in 1174 patients, and a genetic disease cause was identified in 23.6% of the screened patients. Among 14 genes with reported mutations, abnormalities in NPHS2 (n=138), WT1 (n=48), and NPHS1 (n=41) were most commonly identified. The proportion of patients with a genetic disease cause decreased with increasing manifestation age: from 66% in congenital nephrotic syndrome to 15%-16% in schoolchildren and adolescents. Among various intensified immunosuppressive therapy protocols, calcineurin inhibitors and rituximab yielded consistently high response rates, with 40%-45% of patients achieving complete remission. Confirmation of a genetic diagnosis but not the histopathologic disease type was strongly predictive of intensified immunosuppressive therapy responsiveness. Post-transplant disease recurrence was noted in 25.8% of patients without compared with 4.5% (n=4) of patients with a genetic diagnosis. CONCLUSIONS The PodoNet cohort may serve as a source of reference for future clinical and genetic research in this rare but significant kidney disease.
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MESH Headings
- Adolescent
- Age Distribution
- Age of Onset
- Biopsy
- Child
- Child, Preschool
- DNA Mutational Analysis
- Europe/epidemiology
- Female
- Genetic Markers
- Genetic Predisposition to Disease
- Glomerulonephritis, Membranoproliferative/diagnosis
- Glomerulonephritis, Membranoproliferative/epidemiology
- Glomerulonephritis, Membranoproliferative/genetics
- Glomerulonephritis, Membranoproliferative/therapy
- Glomerulosclerosis, Focal Segmental/diagnosis
- Glomerulosclerosis, Focal Segmental/epidemiology
- Glomerulosclerosis, Focal Segmental/genetics
- Glomerulosclerosis, Focal Segmental/therapy
- Humans
- Immunosuppressive Agents/therapeutic use
- Infant
- Infant, Newborn
- Kidney Transplantation
- Latin America/epidemiology
- Male
- Middle East/epidemiology
- Mutation
- Nephrosis, Lipoid/diagnosis
- Nephrosis, Lipoid/epidemiology
- Nephrosis, Lipoid/genetics
- Nephrosis, Lipoid/therapy
- Nephrotic Syndrome/congenital
- Nephrotic Syndrome/diagnosis
- Nephrotic Syndrome/epidemiology
- Nephrotic Syndrome/genetics
- Nephrotic Syndrome/therapy
- Phenotype
- Prospective Studies
- Recurrence
- Registries
- Remission Induction
- Retrospective Studies
- Risk Factors
- Treatment Outcome
- Young Adult
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Affiliation(s)
- Agnes Trautmann
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Monica Bodria
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Fatih Ozaltin
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Alaleh Gheisari
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Anette Melk
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Marta Azocar
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Ali Anarat
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Salim Caliskan
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Francesco Emma
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Jutta Gellermann
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Jun Oh
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Esra Baskin
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Joanna Ksiazek
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Giuseppe Remuzzi
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Ozlem Erdogan
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Sema Akman
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Jiri Dusek
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Tinatin Davitaia
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Ozan Özkaya
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Fotios Papachristou
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Agnieszka Firszt-Adamczyk
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Tomasz Urasinski
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Sara Testa
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Rafael T Krmar
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Lidia Hyla-Klekot
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Andrea Pasini
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Z Birsin Özcakar
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Peter Sallay
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Nilgun Cakar
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Monica Galanti
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Joelle Terzic
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Bilal Aoun
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Alberto Caldas Afonso
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Hanna Szymanik-Grzelak
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Beata S Lipska
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Sven Schnaidt
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material
| | - Franz Schaefer
- Due to the number of contributing authors, the affiliations are provided in the Supplemental Material.
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9
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Urasinski T, Stasyshyn O, Andreeva T, Rusen L, Perina FG, Oh MS, Chapman M, Pavlova BG, Valenta-Singer B, Abbuehl BE. Recombinant factor IX (BAX326) in previously treated paediatric patients with haemophilia B: a prospective clinical trial. Haemophilia 2014; 21:196-203. [PMID: 25495591 DOI: 10.1111/hae.12548] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/13/2014] [Indexed: 11/26/2022]
Abstract
A newly developed recombinant factor IX (BAX326(1) ) was investigated for prophylactic use in paediatric patients aged <12 years with severe (FIX level <1%) or moderately severe (FIX level 1-2%) haemophilia B. The aim of this prospective clinical trial was to assess the safety, haemostatic efficacy and pharmacokinetic profile of BAX326 in previously treated paediatric patients. BAX326 was administered as prophylaxis twice a week for a period of 6 months, and on demand for treatment of bleeds. Safety was assessed by the occurrence of related AEs, thrombotic events and immunologic assessments. Efficacy was evaluated by annualized bleeding rate (ABR), and by treatment response rating (excellent, good, fair, none). PK was assessed over 72 h. None of the 23 treated paediatric subjects had treatment-related SAEs or AEs. There were no thrombotic events, inhibitory or specific binding antibodies against FIX, rFurin or CHO protein. Twenty-six bleeds (19 non-joint vs. 7 joint bleeds) occurred (mean ABR 2.7 ± 3.14, median 2.0), of which 23 were injury-related. Twenty subjects (87%) did not experience any bleeds of spontaneous aetiology. Haemostatic efficacy of BAX326 was excellent or good for >96% of bleeds (100% of minor, 88.9% of moderate and 100% of major bleeds); the majority (88.5%) resolved after 1-2 infusions. Longer T1/2 and lower IR were observed in younger children (<6 years) compared to those aged 6 to 12 years. BAX326 administered as prophylactic treatment as well as for controlling bleeds is efficacious and safe in paediatric patients aged <12 years with haemophilia B.
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Affiliation(s)
- T Urasinski
- Department of Paediatrics, Paediatric Haematology and Oncology, Pomeranian Medical University in Szczecin, Szczecin, Poland
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10
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Solano Trujillo MH, Stasyshyn O, Rusen L, Serban M, Lamas JL, Perina FG, Urasinski T, Oh M, Knowlton WB, Valenta-Singer B, Pavlova BG, Abbuehl B. Safe switching from a pdFIX (Immunine®) to a rFIX (Bax326). Haemophilia 2014; 20:674-81. [DOI: 10.1111/hae.12444] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2014] [Accepted: 03/19/2014] [Indexed: 11/27/2022]
Affiliation(s)
| | - O. Stasyshyn
- Institute of Blood Pathology and Transfusion Medicine of Academy of Medical Sciences of Ukraine; Lviv Ukraine
| | - L. Rusen
- S.C. Sanador SRL; Bucharest Romania
| | - M. Serban
- Louis Turcanu Emergency Clinical Children′s Hospital; Timisoara Romania
| | | | - F. G. Perina
- Regional Clinical Hospital Ekaterinburg; Ekaterinburg Russia
| | - T. Urasinski
- Department of Paediatrics, Paediatric Hematology and Oncology; Pomeranian Medical University; Szczecin Poland
| | - M. Oh
- Baxter Healthcare Corporation; Westlake Village CA USA
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11
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Balwierz W, Klekawka T, Moryl-Bujakowska A, Matysiak M, Malinowska I, Chybicka A, Chaber R, Szczepanski T, Janik-Moszant A, Wachowiak J, Wziatek A, Kowalczyk J, Mitura-Lesiuk M, Adamkiewicz-Drozynska E, Stachowicz-Stencel T, Wysocki M, Koltan A, Krawczuk-Rybak M, Muszynska-Roslan K, Mlynarski W, Stolarska M, Sobol G, Wieczorek M, Piatek T, Karolczyk G, Dadela-Urbanek A, Urasinski T, Kamienska E, Dzikowska K. Influence of Age on Treatment Results in Children and Adolescence with Hodgkin's Lymphoma Polish Experience. Klin Padiatr 2014. [DOI: 10.1055/s-0034-1371114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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12
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Klukowska A, Urasinski T, Janik-Moszant A, Bobrowska H, Balwierz W, Woznica-Karczmarz I, Dobaczewski G, Wlazlowski M, Koltan A, Badowska W, Dakowicz L, Karolczyk G, Kostrzewska M, Korczowski B, Wasinski D, Pietrys D, Laguna P, Wysocka M. Prophylaxis in children with haemophilia - the Polish experience. Haemophilia 2014; 20:e108-e110. [PMID: 24251651 DOI: 10.1111/hae.12327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2013] [Indexed: 06/02/2023]
Affiliation(s)
- A Klukowska
- Department of Pediatrics, Haematology and Oncology, Warsaw Medical University, Warsaw, Poland
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13
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Pawelec K, Salamonowicz M, Panasiuk A, Demkow U, Kowalczyk J, Balwierz W, Zaleska-Czepko E, Chybicka A, Szmyd K, Szczepanski T, Bubala H, Wysocki M, Kurylak A, Wachowiak J, Szpecht D, Młynarski W, Bulas M, Krawczuk-Rybak M, Leszczynska E, Urasinski T, Peregud-Pogorzelski J, Balcerska A, Kaczorowska-Hac B, Matysiak M. First-line immunosuppressive treatment in children with aplastic anemia: rabbit antithymocyte globulin. Adv Exp Med Biol 2014; 836:55-62. [PMID: 25310948 DOI: 10.1007/5584_2014_38] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Immunosuppressive therapy is the treatment of choice in children with acquired severe aplastic anemia (AA) and no HLA-matched family donor. The paper presents results of a multicenter study of 63 children with AA treated with rabbit antithymocyte globulin (r-ATG) and cyclosporine A as the first line treatment in the years 1996-2012. Therapeutic effects were evaluated at Days 112, 180, and 360. At Day 112, remission was achieved in 28 out of the 63 patients (44.4 %), complete remission in 10 patients (15.9 %), and partial remission in 18 (28.5 %). At Day 180, 31 patients (49.2 %) were in remission including 15 cases in complete (23.8 %), and 16 cases in partial remission (25.4 %). One year after therapy onset, 34 patients (64.9 %) were in remission including 24 patients (38.0 %) in complete and 10 (15.9 %) in partial remission. Relapse occurred in 4 patients, from 8 months up to 2 years and 2 months after remission. One child, 5 years after remission, was diagnosed with paroxysmal nocturnal hemoglobinuria. The estimated 10-year overall survival rate and 10-year event-free survival rate were 67 % and 57 %, respectively.
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Affiliation(s)
- K Pawelec
- Department of Pediatric, Hematology and Oncology, Medical University of Warsaw, 24 Marszalkowska St., Warsaw, 00-576, Poland,
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14
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Urasinski T, Kamienska E, Gawlikowska-Sroka A, Ociepa T, Maloney E, Chosia K, Walecka A. Pediatric pulmonary Hodgkin lymphoma: analysis of 10 years data from a single center. Eur J Med Res 2011; 15 Suppl 2:206-10. [PMID: 21147653 PMCID: PMC4360309 DOI: 10.1186/2047-783x-15-s2-206] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Several reports indicate that lungs are the extralymphatic site most commonly affected in patients with Hodgkin lymphoma; however, the data in children are rather limited. This retrospective study aimed to assess the frequency, clinical picture, and the impact on prognosis in children with pulmonary Hodgkin lymphoma, who were diagnosed and treated in a single center during a 10-year period. Pulmonary lesions related to HL: nodules and parenchymal infiltrates with cavitations were found in 3 of 32 (9.4%) patients; in 2 cases these were found as the concomitant manifestation whereas in 1 case as the solitary form (Primary Pulmonary Hodgkin Lymphoma). B-DOPA and MVPP chemotherapy combined with mediastinal and pulmonary irradiation resulted in sustained remissions in all 3 patients, lasting 3, 7, and 64 months, respectively. Lung involvement occurs in up to 10% of children with Hodgkin lymphoma. Primary pulmonary Hodgkin lymphoma is a rare and atypical form of Hodgkin lymphoma; thus is associated with delayed diagnosis which does not seem to affect prognosis. It should be suspected in a child with non-resolving pneumonia and pulmonary parenchymal infiltrates with cavitations.
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Affiliation(s)
- T Urasinski
- Department of General and Clinical Anatomy, Pomeranian Medical University, Szczecin, Poland
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15
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Abstract
Diffuse alveolar hemorrhage (DAH) is a rare and life-threatening condition characterized by hemoptysis, dyspnoea, alveolar infiltrates on chest radiograph and various degrees of anemia. It may occur either as a primary disease of the lungs or a secondary condition due to cardiac, systemic vascular, collagen or renal diseases. Idiopathic pulmonary hemosiderosis (IPH) is a separate form of DAH of unknown origin, associated in some cases with celiac disease. The estimated incidence of IPH in children is 0.24-1.23 cases per million, with a mortality rate as high as 50%. Only about 500 cases of this disease have been described in medical literature. We present a case of a 9-year-old girl diagnosed with IPH, which was confirmed by the presence of many hemosiderin-laden macrophages in bronchoalveolar lavage obtained by bronchofiberoscopy. Therapy with glucocorticoids was initiated with a partial and transient response. Azathioprine and a gluten-free diet were subsequently introduced. However, the girl still suffers from recurrent episodes of hemoptysis, dyspnea and anemia.
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Affiliation(s)
- E Kamienska
- Department of Normal and Clinical Anatomy, Pomeranian Medical University, Szczecin, Poland.
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Wühl E, Trivelli A, Picca S, Litwin M, Peco-Antic A, Zurowska A, Testa S, Jankauskiene A, Emre S, Caldas-Afonso A, Anarat A, Niaudet P, Mir S, Bakkaloglu A, Enke B, Montini G, Wingen AM, Sallay P, Jeck N, Berg U, Caliskan S, Wygoda S, Hohbach-Hohenfellner K, Dusek J, Urasinski T, Arbeiter K, Neuhaus T, Gellermann J, Drozdz D, Fischbach M, Möller K, Wigger M, Peruzzi L, Mehls O, Schaefer F. Strict blood-pressure control and progression of renal failure in children. N Engl J Med 2009; 361:1639-50. [PMID: 19846849 DOI: 10.1056/nejmoa0902066] [Citation(s) in RCA: 514] [Impact Index Per Article: 34.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Although inhibition of the renin-angiotensin system delays the progression of renal failure in adults with chronic kidney disease, the blood-pressure target for optimal renal protection is controversial. We assessed the long-term renoprotective effect of intensified blood-pressure control among children who were receiving a fixed high dose of an angiotensin-converting-enzyme (ACE) inhibitor. METHODS After a 6-month run-in period, 385 children, 3 to 18 years of age, with chronic kidney disease (glomerular filtration rate of 15 to 80 ml per minute per 1.73 m(2) of body-surface area) received ramipril at a dose of 6 mg per square meter of body-surface area per day. Patients were randomly assigned to intensified blood-pressure control (with a target 24-hour mean arterial pressure below the 50th percentile) or conventional blood-pressure control (mean arterial pressure in the 50th to 95th percentile), achieved by the addition of antihypertensive therapy that does not target the renin-angiotensin system; patients were followed for 5 years. The primary end point was the time to a decline of 50% in the glomerular filtration rate or progression to end-stage renal disease. Secondary end points included changes in blood pressure, glomerular filtration rate, and urinary protein excretion. RESULTS A total of 29.9% of the patients in the group that received intensified blood-pressure control reached the primary end point, as assessed by means of a Kaplan-Meier analysis, as compared with 41.7% in the group that received conventional blood-pressure control (hazard ratio, 0.65; confidence interval, 0.44 to 0.94; P=0.02). The two groups did not differ significantly with respect to the type or incidence of adverse events or the cumulative rates of withdrawal from the study (28.0% vs. 26.5%). Proteinuria gradually rebounded during ongoing ACE inhibition after an initial 50% decrease, despite persistently good blood-pressure control. Achievement of blood-pressure targets and a decrease in proteinuria were significant independent predictors of delayed progression of renal disease. CONCLUSIONS Intensified blood-pressure control, with target 24-hour blood-pressure levels in the low range of normal, confers a substantial benefit with respect to renal function among children with chronic kidney disease. Reappearance of proteinuria after initial successful pharmacologic blood-pressure control is common among children who are receiving long-term ACE inhibition. (ClinicalTrials.gov number, NCT00221845.)
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17
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Styczynski J, Gil L, Derwich K, Wachowiak J, Balwierz W, Badowska W, Krawczuk-Rybak M, Matysiak M, Wieczorek M, Balcerska A, Sonta-Jakimczyk D, Stefaniak J, Kowalczyk J, Urasinski T, Sobol G, Komarnicki M, Wysocki M. Comparison of clofarabine activity in childhood and adult acute leukemia: individual tumor response study. Anticancer Res 2009; 29:1643-1650. [PMID: 19443380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Clofarabine is a second-generation nucleoside analogue. The aim of the study was the analysis of ex vivo activity of clofarabine and 14 other anticancer drugs in pediatric and adult acute lymphoblastic (ALL) and myeloid (AML) leukemia. PATIENTS AND METHODS The ex vivo drug resistance profile was analyzed in 282 patients, including 201 children with ALL de novo, 24 children with relapsed ALL, 25 children with AML de novo and 32 adults with AML. Cellular ex vivo drug resistance was tested by means of the MTT assay. RESULTS Clofarabine had comparable ex vivo activity against lymphoblasts and myeloblasts, both on initial diagnosis and at relapse, both in children and in adults. Its activity in acute myeloid leukemia was independent of patient age. No significant differences in drug resistance to clofarabine between pediatric age-based subgroups of ALL were detected, while it was observed for most of other drugs. An activity of clofarabine in relapsed pediatric ALL patients was as good as in newly-diagnosed ones. CONCLUSION In comparison to childhood acute lymphoblastic leukemia, lack of differences in ex vivo activity gives rationale for use of clofarabine in refractory and relapsed pediatric and adult patients with acute myeloid leukemia.
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Affiliation(s)
- Jan Styczynski
- Department of Pediatric Hematology and Oncology, Collegium Medicum, Nicolaus Copernicus University, ul. Curie-Sklodowskiej 9, 85-094 Bydgoszcz, Poland.
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