Impact of ferritin serum concentration on survival in children with acute leukemia: a long-term follow-up

Introduction: Nowadays, a significant number of children with acute leukemia can be cured. Iron overload, related to blood transfusions and its long-term complications, remains a problem. Elevated ferritin concentration is often observed in this group. The aim of this study was to evaluate the prognostic value of serum ferritin on long-term outcomes in children treated for acute leukemia. Material: We studied 71 patients treated for acute lymphoblastic (ALL) or myeloblastic (AML) leukemia between 2005 and 2011. Serum ferritin concentration, serum transaminases activity, lactic dehydrogenase and C-reactive protein levels (CRP) were analysed. Serum ferritin >1,000 µg/L was considered to be a marker of iron overload. Results: Thirty-seven patients (52.1%) had iron overload. Ferritin serum concentration correlated with alanine aminotranferase activity (p =0.001) and CRP concentration (p =0.012). A total of 19 (26.76%) patients died during follow-up. Ferritin level was higher in patients with AML vs. ALL. There was a significant difference in long-term outcomes with respect to high ferritin concentrations, both in patients undergoing haematopoietic cell transplantation (HCT) and in the non-HCT group. Conclusions: In both groups, patients with higher ferritin concentrations had worse overall and event-free survivals and a higher relapse incidence. Ferritin concentration >1,000 µg/L was the strongest determinant of long-term treatment outcome. Ferritin serum concentration >1,000 µg/L is an adverse prognostic marker of survival in children with acute leukemia treated with chemotherapy with or without HCT

Rhinophyma - the end-stage of rosacea

Rhinophyma is defined as a progressive, deforming, nodular enlargement of the sebaceous glands caused by hypertrophy of the sebaceous follicles. It is assumed to be the final phase of chronic rosacea occurring mainly in Caucasian men. This disease negatively affects the quality of life of patients due to decreased self-esteem and depressive disorders. Nasal deformation by narrowing the nostrils impairs the physical performance of patients and even leads to the development of sleep apnea. Treatment is mainly based on surgery to remove pathological tissue. The literature also provides the possibility of therapy using ablative techniques and laser therapy. &nbsp

High risk of invasive fungal disease in children undergoing hematopoietic cell transplantation or complex anticancer therapy: the adverse role of post-transplant CMV replication

Introduction: We analyzed the epidemiology and outcomes of treatment of invasive fungal disease (IFD) in children during anticancer therapy (PHO, pediatric hematology and oncology) or after hematopoietic cell transplantation (HCT) over a period of eight consecutive years in a single-center study. Material and methods: Overall, a total of 254 HCTs were performed, and 415 children were newly diagnosed for malignancy. Incidence, epidemiology and outcome of IFD were analyzed. Results: The cumulative incidence of any IFD was 32.6% in allo-HCT, 22.2% in PHO, and 6.0% in auto-HCT patients. The incidence of proven +probable IFD was 12.6%, 10.4%, and 6.0%, respectively. As many as 77.0% HCT and 67.4% PHO of fungal episodes occurred in acute leukemia patients: the highest incidence of any IFD was observed for acute lymphoblastic leukemia (29.3% in HCT; 40.5% in PHO) and for acute myeloblastic leukemia (51.1% in HCT; 65.0% in PHO) patients. There were no significant differences in the incidence of fungal infections in both allo-HCT and PHO patients between the 2-year periods. Factors contributing to an increased risk of IFD in allo-HCT patients were: CMV replication, and acute and chronic graft-versus-host disease (GvHD). Survival from IFD was 91.9% in PHO, and 78.1% in HCT patients. Fungal pneumonia in HCT patients resolved in 62.9%, while in PHO patients it resolved in 93.5%. Conclusions: The risk of IFD in allo-HCT patients is much higher than in auto-HSCT and PHO patients. The outcome of IFD is better in PHO and auto-HCT than in allo-HCT settings

Acute non-hematological toxicity of intensive chemotherapy of acute lymphoblastic leukemia in children

IntroductionLeukemia belong to 31% of all childhood malignancies. Acute lymphoblastic leukemia (ALL) is the most frequent type of pediatric leukemia accounting for 80–85% of all cases. Progress in diagnostics and therapy of leukemia is dependent on international cooperation. The objective of the study was the analysis of non-hematological toxicity during intensive chemotherapy according to two consecutive intercontinental protocols. Patients and methodsA total number of 210 children diagnosed for ALL who were treated in single center between 2002 and 2018 were divided in two groups defined by therapeutic protocol: ALL IC-BFM 2002 (group 1) and ALL IC-BFM 2009 (group 2). Data were entered prospectively from 2002 into international ALL IC-BFM 2002 and ALL IC-BFM 2009 registry. Non-hematological toxicity was analyzed according to the criteria followed in protocols, compatible with CTCAE criteria. ResultsThe most frequent toxicities included hepatic toxicity with transaminitis and hyperbilirubinemia, infections, oral mucositis and gut toxicity with vomiting, and/or diarrhea. Non-hematological toxicity episodes calculated as a ratio per patient were comparably often observed in both the groups; however, the distribution was different. There were more grade III and less grade II toxicities. This was mainly related to significant increase in the rates of infections and transaminitis. However, there was a significant decrease in vomiting and central and peripheral neurotoxicity. ConclusionsIntensive treatment of ALL is burdened with frequent severe toxic and infectious complications. Further progress in therapy of pediatric ALL is dependent on sophisticated supportive therapy and very well experienced and knowledgeable therapeutic team

Relapsed childhood acute myeloid leukemia: prognostic factors and outcomes: experience from a single oncology center

Introduction: Over recent decades, significant progress in the treatment of childhood acute myeloid leukemia (AML) has been made. However, the relapsed disease remains a challenge. The aim of this study was to analyze therapy results in pediatric patients treated for relapsed AML in a single oncology center, with a particular focus on prognostic factors. Materials and methods: Data from patients younger than 19 years with AML diagnosed between January 1994 and December 2020 treated in the Department of Pediatric Hematology and Oncology in Bydgoszcz, Poland was analyzed, with detailed analysis of patients with relapsed disease. Results: A total of 77 children were diagnosed with AML in the analyzed period and 21 had a relapsed disease (27.3%). Bone marrow relapse was the most common. The risk factors of relapse included white blood cells >100 G/L at initial diagnosis and classification to the high risk group. Late relapse was related to poorer outcomes. The 5-year probability of overall survival for the entire group was 28.6%, and this was significantly higher in patients who achieved second remission compared to those who did not (44.9% vs. 0.0%, p <0.001). The main reason for death was progression of disease, which occurred in 10 patients. Conclusions: Outcomes in relapsed AML in children are still dismal. Lack of second remission suggests the need for experimental therapy

Changing risk factors in childhood acute lymphoblastic leukemia: experience from Kujawsko-Pomorski region 1976–2018

Introduction: Acute lymphoblastic leukemia (ALL) is the most common malignancy in children. Risk factors in childhood ALL have changed during recent decades, mostly due to treatment personalization. The aim of this study was to analyze therapy results and prognostic factors in childhood ALL in the Kujawsko-Pomorski region of Poland between 1976 and 2018. Material and methods: Data from 495 patients (0–18 years old) diagnosed with ALL from the Kujawsko-Pomorski region between 1976 and 2018 was analyzed. Prognostic factors were analyzed separately in specific therapeutic groups, which were defined by several therapy protocols. Results: Prognostic factors have changed over the course of consecutive therapeutic periods. Between 1976 and 1988 (the first and second therapeutic protocols), central nervous system involvement was the most important risk factor. During the third therapeutic period, an unsatisfactory treatment response on days 8 and 14 was related to a poor outcome. In 1995–2002, the risk factors were hepatomegaly, splenomegaly, lymph nodes involvement, and unsatisfactory therapy response on days 15 and 33. Between 2002 and 2011, immunophenotype other than ‘common’ and hemoglobin level at diagnosis were the risk factors, and a lack of BCR-ABL aberration was related to better therapy results. During the final analyzed period (2011–2018), failure to achieve remission on day 33 was a risk factor, and patients classified as non-high risk group and those aged <6 years had better outcomes. Conclusions: The changing profile of risk factors in ALL has reflected progress in ALL therapy, with the gradual elimination of factors related to poor outcomes, mostly due to modifications in treatment and the development of diagnostic methods as well as therapy monitoring

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Kleopatra VII Wielka to jedna z najciekawszych postaci historii starożytnej. Jej samobójcza śmierć zamknęła historię dynastii Ptolemeuszów, a jednocześnie zaczęła trwającą już niemal 2000 lat historię "królowej królów" - symbolu kobiecości i kobiecej siły. W niniejszej pracy rozpatrzona zostanie kwestia długiego i złożonego „życia pozagrobowego” Kleopatry w kulturze popularnej, a co za tym idzie pojawi się pytanie o źródło fenomenu Kleopatry. Pod wpływem europejskich stereotypów na temat Egiptu, w dzisiejszych czasach niemal każde przedstawienie Kleopatry koncentruje się na jej seksualności, jako kluczowej metodzie sprawowania przez nią władzy. Jednak Kleopatra nie była jedynie "starożytną femme fatale", lecz zręczną królową, mającą realistyczne i potencjalnie osiągalne cele.

Scandinavian social responsibility of transnational corporations on the example of : IKEA network and Nokia.

In my work I try to explain the relationship between the Nordic culture, religion and welfare state model and the process of forming a corporation, its objectives and strategy for implementation of ethical principles of social responsibility in the host countries. In this work I also focus on presenting the aims of SOP fulfilled by the Finnish company Nokia and the Swedish IKEA corporation. However, I do not mention about the allegations and controversy aroused by these two operators. The main purpose of my study is to present the implementation of the Scandinavian idea of corporate social responsibility. The first chapter of my studies is devoted to theoretical and historical issues related to the roots and evolution of corporate social responsibility objectives in Europe. In the next section I present some principles of the SOP. This section also provides information connected with organizations operating in this field. The last part of this work is devoted to the analysis of social responsibility of Nordic corporations.W pracy będę starała się wyjaśnić, jaki jest związek między kulturą nordycką, religią i modelem welfare state a procesem kształtowania się korporacji, jej założeniami etycznymi i strategią realizacji zasad społecznej odpowiedzialności w krajach przyjmujących. W swojej analizie skupię się na przedstawieniu założeń SOP realizowanych przez fiński koncern Nokia i szwedzką korporację IKEA. W analizie nie odniosę się do zarzutów i kontrowersji, jakie budzą te podmioty gospodarcze. Głównym celem mojego opracowania jest przedstawienie skandynawskiego pomysłu na realizację idei społecznej odpowiedzialności. Pierwszy rozdział mojego opracowania został poświęcony zagadnieniom teoretycznym i historycznym, które są związane z narodzinami i kształtowaniem się założeń społecznej odpowiedzialności w Europie. W kolejnym rozdziale przedstawiam uregulowania dotyczące zasad SOP, zawarte tu są także informacje na temat organizacji działających w tej sferze. Natomiast ostatnia część pracy została poświęcona analizie społecznej odpowiedzialności nordyckich korporacji

Bilateral cooperation between Poland and Japan on the political, economic and cultural level on the basis of cultural differences and soft power theory

Tematem niniejszej pracy są relacje bilateralne Polski i Japonii na płaszczyźnie polityczno-gospodarczej i kulturowej. Celem niniejszej pracy jest jest ustalenie który z krajów jest bardziej zaangażowany w tworzenie relacji i czy współpraca przebiega równolegle. Pierwszy rozdział poświęcony jest różnicom kulturowym oraz charakterystyce japończyków i polaków w ujęciu Richarda R. Gestelanda oraz Geerta Hofstede. W drugim rozdziale przedstawiona została teoria soft power oraz jej użycie w Polsce i w Japonii. Trzeci rozdział to analiza współpracy polityczno-gospodarczej pomiędzy Polską a Japonią. W czwartym rozdziale zostały porównane dwa kierunki studiów: filologia japońska na Uniwersytecie Jagiellońskim oraz filologia polska na Tokijskim Uniwersytecie Studiów Międzynarodowych pod kątem nauki o Polsce w Japonii i nauki o Japonii w Polsce. Piąty rozdział poświęcony jest wzajemnej wymianie kulturowej w kategoriach takich jak komiks, film, literatura, teatr i taniec, muzyka oraz sztuki plastyczne. Na koniec tego rozdziału zostanie przedstawiona historia oraz rola Muzeum Sztuki i Techniki Japońskiej „Manggha” w promowaniu japońskiej kultury w Polsce. Ostatni rozdział poświęcony jest wydarzeniom organizowanym w ramach obchodów setnej rocznicy relacji polsko-japońskich zarówno w Polsce jak i w Japonii celem ukazania, który z krajów był w tej kwestii bardziej zaangażowany.The subject of this study is bilateral cooperation between Poland and Japan on the political, economic and cultural level on the basis of cultural differences and soft power theory. The aim of this work is to determine which of those countries is more involved in building relationship and is the relationship run in parallel. The first chapter is dedicated to cultural differences and Japanese and Poles charateristic in Richard R. Gesteland's and Geert Hofstede's view. The second chapter presents soft power theory and its use in Poland and Japan. The third chapter analyzes cooperation between Poland and Japan on the political and economic level. In the fourth chapter were compared two degree courses: Japanese philology on Jagiellonian University and Polish philology on Tokyo University of Foreign Studies paying special attention to learning about Poland in Japan and learning about Japan in Poland. The fifth chapter is dedicaded to bilateral cultural exchange in categories such as comics, film, literature, theatre and dance, music and fine arts. At the end of this chapter were also presented history and role of “Manggha” Museum of Japanese Art and Technology in promoting japanese culture in Poland. The last chapter is dedicated to events related to celebrations of the 100th anniversary of establishing diplomatic relations between Japan and Poland to show which of those countries was more involved in this matter

Unbalance in Iron Metabolism in Childhood Leukemia Converges with Treatment Intensity: Biochemical and Clinical Analysis

Objective: The aim of this study was to evaluate non-transferrin-bound iron (NTBI) and labile plasma iron (LPI) levels and other parameters of iron metabolism in children undergoing therapy for acute leukemia or after hematopoietic cell transplantation (HCT), in the context of iron overload. Patients: A total number of 85 children were prospectively included into four groups: controls, acute leukemia de novo, acute leukemia after intensive treatment, and after HCT. Methods: The following iron metabolism parameters were analyzed: (1) parameters measuring functional and storage iron pools: NTBI, LPI, iron, transferrin, total iron-binding capacity, ferritin, ferritin heavy and light chains; (2) proteins regulating iron absorption and its release from tissue stores: hepcidin, soluble hemojuvelin, soluble ferroportin-1; (3) proteins regulating the erythropoietic activity of bone marrow: erythroferrone, erythropoietin, soluble transferrin receptor. Results: Intensive treatment of leukemia in children was associated with the presence of serum NTBI and LPI, which was the highest in the HCT group followed by the acute leukemia after treatment and de novo groups. In patients after HCT, the most significant changes were found in NTBI, LPI, iron, ferritin, hepcidin, and ferroportin-1 levels. Conclusions: The occurrence of NTBI and LPI in the circulation and the intensification of disturbances in iron metabolism were associated with the intensity of the anti-leukemic treatment