26 research outputs found
Low IL-23 levels in peripheral blood and bone marrow at diagnosis of acute leukemia in children increased with the elimination of leukemic burden
IL-23 is an IL-12 cytokine family member with pleiotropic functions that
regulates tumour growth in various cancer types, exhibiting both
anti-tumorigenic and pro-tumorigenic properties. Preclinical studies
have shown a potential anti-leukemic action on childhood B-ALL cells.
The study involved 65 children with acute leukemia [59 patients with
acute lymphoblastic leukemia (ALL) and 6 patients with acute myeloid
leukemia (AML)] and 27 healthy controls. Using an enzyme-linked
immunosorbent assay, we aimed to determine the IL-23 levels in the
peripheral blood (PB) and bone marrow (BM) of patients at diagnosis and
at the end of the induction therapy (EIT). PB IL-23 levels were lower in
leukemia patients compared to the healthy controls. In all acute
leukemia patients, IL-23 levels were significantly lower at diagnosis
both in PB (P = .015) and in BM (P = .037) compared to the PB and BM
concentrations at the EIT. The same pattern was present in both
subgroups of ALL and AML patients. The high leukemic burden at diagnosis
was related with lower IL-23 levels, which were increased with the
disease remission. Considering the anti-leukemic potential of this
cytokine, the elevation of the IL-23 concentration at the disease
remission indicates a beneficial role of IL-23 in paediatric acute
leukemia
Overexpression of BCL2 and BAX following BFM induction therapy predicts ch-ALL patients’ poor response to treatment and short-term relapse
Multifocal Aeromonas Osteomyelitis in a Child with Leukemia
Aeromonas hydrophila is a Gram negative organism causing both intestinal and extraintestinal disease. The case of a 14-year-old girl with underlying immunodeficiency and leukemia who developed systemic A. hydrophila infection is described in this report. While in deep bone marrow aplasia she developed fever, severe pain in the lower extremities, and swelling of the left femur. Blood culture showed Escherichia coli and A. hydrophila whereas pus culture from the soft tissue swelling showed the presence of A. hydrophila. Imaging studies showed diffuse osteolytic lesions. Patient received 5 months of intravenous and oral antibiotics and she improved clinically whereas the radiology findings persisted
PB1748: LOW HAIR CORTISOL CONCETRANTIONS AT DIAGNOSIS OF CHILDHOOHD HEMATOLOGICAL MALIGNANCIES
Multifocal Aeromonas Osteomyelitis in a Child with Leukemia.
Aeromonas hydrophila is a Gram negative organism causing both intestinal and extraintestinal disease. The case of a 14-year-old girl with underlying immunodeficiency and leukemia who developed systemic A. hydrophila infection is described in this report. While in deep bone marrow aplasia she developed fever, severe pain in the lower extremities, and swelling of the left femur. Blood culture showed Escherichia coli and A. hydrophila whereas pus culture from the soft tissue swelling showed the presence of A. hydrophila. Imaging studies showed diffuse osteolytic lesions. Patient received 5 months of intravenous and oral antibiotics and she improved clinically whereas the radiology findings persisted
Successful Treatment in a Child with Anaplastic Large Cell Lymphoma and Coexistence of Pulmonary Tuberculosis
A 13-year-old girl was admitted to our department with a history of severe pain of her left axilla and fever. On physical examination, a block of lymph nodes in her left axilla, diffuse papular rash, and red-violet swelling of her supraclavicular and subclavian region were noted. Imaging investigations revealed left axillar and supraclavicular lymphadenopathy and a small nodular shade in the upper lobe of her left lung. A biopsy from an axillary lymph node established the diagnosis of anaplastic large cell lymphoma (ALCL), whereas DNA of Mycobacterium tuberculosis was detected by polymerase chain reaction (PCR) in the same tissue biopsy. Patient was started on chemotherapy for ALCL and achieved remission of all initially involved fields. Nevertheless, two new nodular lesions were detected in the left lower lobe. Biopsy revealed granulomas, and PCR was positive for M. tuberculosis. Our patient received treatment with the combination of isoniazid and rifampin (12 months), pyrazinamide (the first 2 months), and maintenance chemotherapy for her ALCL for one year simultaneously. Four years later, she is disease free for both mycobacterial infection and lymphoma. We are reporting this successful management of mycobacterial infection in a patient with ALCL despite intensive chemotherapy that the patient received at the same time
miR-125b predicts childhood acute lymphoblastic leukaemia poor response to BFM chemotherapy treatment
Overexpression of the GR Riborepressor LncRNA GAS5 Results in Poor Treatment Response and Early Relapse in Childhood B-ALL
Simple Summary Although childhood acute lymphoblastic leukemia (chALL)
management is considered as one of the success stories in modern
clinical oncology, the increased incidence of relapse in high-risk
patients and the severe toxicity/long-term health effects due to
chemotherapy intensity highlight the need for further improvements in
patients’ risk stratification and personalized management. Synthetic
glucocorticoids (GCs) are the core agents in chALL chemotherapy,
exerting their role through the nuclear glucocorticoid receptor (GR),
while GAS5 lncRNA suppresses the GCs-GR axis through binding to GR’s DNA
binding domain. The objective of the study was the evaluation of GAS5
prognostic utility in chALL. GAS5 overexpression was strongly associated
with a higher risk for short-term relapse and poor treatment outcome,
independently of patients’ clinicopathological data. Moreover,
“GAS5-including” multivariate models resulted in superior risk
stratification and clinical benefit for disease prognosis, supporting
precision medicine decisions in chALL. Glucocorticoids (GCs) remain the
cornerstone of childhood acute lymphoblastic leukemia (chALL) therapy,
exerting their cytotoxic effects through binding and activating of the
glucocorticoid receptor (GR). GAS5 lncRNA acts as a potent riborepressor
of GR transcriptional activity, and thus targeting GAS5 in GC-treated
chALL could provide further insights into GC resistance and support
personalized treatment decisions. Herein, to study the clinical utility
of GAS5 in chALL prognosis and chemotherapy response, GAS5 expression
was quantified by RT-qPCR in bone marrow samples of chB-ALL patients at
diagnosis (n = 164) and at end-of-induction (n = 109), treated with
ALL-BFM protocol. Patients’ relapse and death were used as clinical
end-points for survival analysis. Bootstrap analysis was performed for
internal validation, and decision curve analysis assessed the clinical
net benefit for chALL prognosis. Our findings demonstrated the elevated
GAS5 levels in blasts of chALL patients compared to controls and the
significantly higher risk for short-term relapse and poor treatment
outcome of patients overexpressing GAS5, independently of their
clinicopathological data. The unfavorable prognostic value of GAS5
overexpression was strongly validated in the high-risk/stem-cell
transplantation subgroup. Finally, multivariate models incorporating
GAS5 levels resulted in superior risk stratification and clinical
benefit for chALL prognostication, supporting personalized prognosis and
precision medicine decisions in chALL
Clinical utility of miR-143/miR-182 levels in prognosis and risk stratification specificity of BFM-treated childhood acute lymphoblastic leukemia
Implications of the Incidental Finding of a MYCN Amplified Adrenal Tumor: A Case Report and Update of a Pediatric Disease Diagnosed in Adults
MYCN is a well-known oncogene overexpressed in different human malignancies including neuroblastoma, rhabdomyosarcoma, medulloblastoma, astrocytoma, Wilms’ tumor, and small cell lung cancer. While neuroblastoma is one of the most common childhood malignancies, in adults it is extremely rare and its treatment is based on pediatric protocols that take into consideration stage and genotypic features, such as MYCN amplification. Although neuroblastoma therapy has evolved, identification of early stage patients who need chemotherapy continues to pose a therapeutic challenge. The emerging prognostic role of MYCN phenotype of this disease is currently under investigation as it may redefine MYCN amplified subgroups. We describe an unusual case of adult neuroblastoma with MYCN amplification diagnosed incidentally and discuss possible therapeutic dilemmas